Objective—To identify factors affecting prognosis,
outcome, and complications associated with pemphigus
foliaceus in dogs.
Animals—43 dogs with pemphigus foliaceus.
Procedure—Medical records were reviewed for signalment,
age at diagnosis, duration to diagnosis, body
area affected, initial immunosuppressive regimens
and concurrent use of antimicrobials and sucralfate or
histamine receptor 2 blocking agent, adverse effects
of treatment, duration of treatment, number of visits
for follow-up care, cause of death, and credentials of
the veterinarians responsible for continued care.
Results—The case fatality rate was 60.5%. Factors
significantly correlated with survival time included
concurrent use of antimicrobials during initiation of
immunosuppressive treatment and a lower number
of adverse effects to treatment. Treatment times lasting
more than 10 months from diagnosis correlated
significantly with survival.
Conclusions and Clinical Relevance—Treatment with
or prophylactic use of antimicrobials may be warranted
during initial immunosuppressive treatment. The inverse
correlation between survival time and number of
adverse treatment effects was not unexpected because
it was reflective of the owners' decision to euthanatize
their dogs and of corticosteroid-related secondary diseases.
Survival beyond the tenth month of treatment
predicted long-term survival, which suggests that dogs
require careful management during the early months of
treatment. (J Am Vet Med Assoc 2004;224:1312–1316)
Improved understanding of the pathogenesis of atopic dermatitis in dogs has led to more effective treatment plans, including skin barrier repair and new targeted treatments for management of allergy-associated itch and inflammation. The intent of this review article is to provide an update on the etiologic rationale behind current recommendations that emphasize a multimodal approach for the management of atopic dermatitis in dogs. Increasing knowledge of this complex disease process will help direct future treatment options.