Skin Ulcers And Kidney Disease

Skin lesions are not commonly associated with acute kidney injury (AKI) in dogs, unless the AKI has resulted from immune-mediated disease, certain neoplasms, infectious diseases or vasculopathy. Cutaneous and renal glomerular vasculopathy (CRGV) is one of the diseases reported to cause ulceration of dog's extremeties. CRGV has been reported in greyhounds and Great Danes. The disease leads to widespread formation of microthrombi and results in decrease of thrombocytes, hemolytic anemia, multiorgan failure and inflammation and damage to blood vessels. It is the only canine disease previously reported to cause a disease affecting the small vessels of the kidney and skin.

Dog breeds susceptible to skin lesions are English springer spaniel, flat-coated retriever, whippet, border collie, Jack Russell terrier, Doberman, Labrador retriever, cocker spaniel, Staffordshire bull terrier, Hungarian vizsla, Weimaraner, Dalmatian and Tibetan terrier.

Skin lesions commonly appear before signs of systemic illness (lethargy, loss of appetite, vomiting, increased body temperature). Time from development of skin lesions to diagnosis of AKI is usually four days. The lesions are most often seen on legs, paws, abdomen and oral cavity/muzzle. Many dogs have more than one lesion and lesions in multiple locations. The appearance of the skin lesions can be highly variable, ranging from superficial erosion through to full thickness ulceration, with redness, swelling and pus discharge. The skin lesions are often attributed to wounds, bites, stings or local dermatitis. Lesion size ranges from 0.5 to 5 cm in diameter. Lesions are typically painful and paw lesions often cause lameness. Oral lesions are most often erosions or ulcers.

Cutaneous and renal glomerular vasculopathy and hemolytic uremic syndrome (HUS) are diseases of unknown cause which, when abnormally high levels of nitrogen-containing compounds (azotemia) develops, currently appears to carry a grave prognosis. One dog with CRGV was reportedly ineffectively managed with immunosuppressive therapy. The efficacy of plasma therapy and monoclonal antibody therapy has yet to be evaluated in CRGV. The question remains as to whether this is an emerging disease or, one that was previously present but unrecognised.

References

  1. Cutaneous and renal glomerular vasculopathy as a cause of acute kidney injury in dogs in the UK