Clinicopathological findings and clinical outcomes in 49 cases of feline pemphigus foliaceus examined in Northern California, USA (1987–2017)

Abstract

Background -Few studies have described the pathophysiology, clinical course, treatment outcomes and quality of life (QoL) of cats with pemphigus foliaceus (PF). Objective -Describe clinicopathological features, treatment outcomes and impacts on QoL in feline PF.Animals -Forty-nine client-owned cats with PF that presented to a veterinary teaching hospital between 1987 and 2017.Methods and materials -Medical records and histopathological reports were reviewed to obtain clinicopathological data and treatment outcomes. Owners were contacted and requested to complete a questionnaire to obtain long-term follow-up and evaluate the impacts of PF on QoL of cats and owners.Results -Domestic short/medium/long hair breeds were most commonly affected, with pinnae, head, haired face, nasal planum and ungual folds most frequently involved. Associated pruritus and systemic signs of illness were common. Vasculopathological changes were noted in a small proportion of cats. Corticosteroid monotherapy was sufficient to induce complete remission in the majority of cats. Pemphigus foliaceus and its management had a negative impact on QoL of both cats and owners. Receiving/administering medications, attending veterinary appointments, and financial and time commitments were cited sources of stress for affected cats and/or owners.Conclusions and clinical importance -Results illustrate that affected cats generally respond favourably to treatment but do require long-term therapy. The exact aetiology of the vasculopathological changes was unclear; it may reflect the stage or severity of disease or suggest the presence of a cutaneous adverse drug reaction. Clinicians managing cats with PF should be aware of the potential negative impact on QoL of owners and cats and adjust management accordingly. Case selection criteriaAn electronic search of the computerized medical records of the veterinary teaching hospital was performed to identify cats diagnosed

Chronic Otitis in Cats: Clinical management of primary, predisposing and perpetuating factors

“…15 Though 80-92% of cats with PF have pinnal lesions, the ear canal is less frequently affected. [61][62][63] Otitis externa has been reported in 7-30% of cats with PF. 63,64 Most cats with PF have lesions affecting multiple sites.…”

“…[61][62][63] Otitis externa has been reported in 7-30% of cats with PF. 63,64 Most cats with PF have lesions affecting multiple sites. [61][62][63] The primary lesion of PF is a subcorneal pustule, but these are prone to rupture, so crusts, erosions, alopecia and erythema are more often seen clinically.…”

Pruritus in Autoimmune and Inflammatory Dermatoses

“…Pemphigus foliaceus is another disease of this group. Here, pruritus occurs in more than half of the patients (61%) (54). The histopathological characteristic findings include intraepithelial cleavage with acantholysis beneath the stratum corneum and a dermal inflammation, predominantly with neutrophils, mast cells and plasma cells (54).…”

“…Here, pruritus occurs in more than half of the patients (61%) (54). The histopathological characteristic findings include intraepithelial cleavage with acantholysis beneath the stratum corneum and a dermal inflammation, predominantly with neutrophils, mast cells and plasma cells (54). Although there is little systematic data on pruritus in the pemphigus group, the parameter pruritus contributes to the assessment whether the disease is controlled or not (55).…”

Detection of circulating anti‐keratinocyte autoantibodies in feline pemphigus foliaceus

“…2,3 The clinical and therapeutic aspects of feline PF have been extensively reviewed and updated, yet investigations into an underlying pathogenesis remain minimal. 2,[4][5][6][7] As feline PF is phenotypically and histologically similar to the canine and human forms, an aetiology involving pathogenic autoantibodies targeting keratinocyte adhesion protein(s) can be inferred. 2 Prior direct immunofluorescence (IF) studies that successfully confirmed circulating, anti-keratinocyte autoantibodies in biopsies from PF-affected cats support this hypothesis.…”