Changes

This is an '''uncommon metabolic skin disease of dogs''', in which a '''vacuolar hepatopathy''' is associated with an '''ulcerative necrolytic dermatitis'''.  

This is an '''uncommon metabolic skin disease of dogs''', in which a '''vacuolar hepatopathy''' is associated with an '''ulcerative necrolytic dermatitis'''.  

The aetiology is unknown, but hepatic disease, particularly vacuolar degeneration or cirrhosis, or '''pancreatic tumours''' producing glucagon (which is the syndrome seen in humans) are present. Some dogs also have '''diabetes mellitus'''. The link between systemic disease and the skin disorder is unclear but may reflect '''low plasma levels of amino acids'''. Whether the changes in the liver or pancreas are a cause or an effect of the hypoaminoacidaemia is unknown.

The aetiology is unknown, but hepatic disease, particularly vacuolar degeneration or cirrhosis, or '''pancreatic tumours''' producing glucagon (which is the syndrome seen in humans) are present. Some dogs also have [[Diabetes Mellitus|'''diabetes mellitus''']]. The link between systemic disease and the skin disorder is unclear but may reflect '''low plasma levels of amino acids'''. Whether the changes in the liver or pancreas are a cause or an effect of the hypoaminoacidaemia is unknown.

The skin disease may precede or occur at the same time as signs of internal disease.

The skin disease may precede or occur at the same time as signs of internal disease.

==Diagnosis==

==Diagnosis==

The condition is often misdiagnosed as an '''autoimmune disorder''' due to the similar clinical signs. Pemphigus foliaceus, SLE and drug eruptions should be ruled out.

The condition is often misdiagnosed as an '''autoimmune disorder''' due to the similar clinical signs. [[Pemphigus foliaceus]], [[SLE]] and drug eruptions should be ruled out.

'''Haematology and biochemistry''' may reveal: increased ALT, AST and ALP, hyperglycaemia without ketoacidosis, non-regenerative or mildly regenerative anaemia, hypoalbuminaemia, severe hypoaminoacidaemia, elevated bile acids.

'''Haematology and biochemistry''' may reveal: increased ALT, AST and ALP, hyperglycaemia without ketoacidosis, Regenerative and Non-regenerative Anaemias|non-regenerative or mildly regenerative anaemia]], hypoalbuminaemia, severe hypoaminoacidaemia, elevated [[Bile Acids|bile acids]].

'''Abdominal ultrasonography''' may reveal diffuse hepatic disease (a 'honeycomb pattern') or a pancreatic tumour and its metastases.

'''Abdominal ultrasonography''' may reveal diffuse hepatic disease (a 'honeycomb pattern') or a pancreatic tumour and its metastases.

Moriello, K. (2005) '''Self-assessment colour review of small animal dermatology''' ''Manson Publishing''

Moriello, K. (2005) '''Self-assessment colour review of small animal dermatology''' ''Manson Publishing''

[[Category:To Do - Helen]]

 

[[Category:To Do - Review]]

[[Category:Dermatological Diseases - Dog]]

[[Category:Integumentary System - Pathology]]

[[Category:Expert Review - Small Animal]]