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(Autoimmune Disease )Tj
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(Presentation at BCCC Specialty, August, 1999 )Tj
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(Linda Aronson, D.V.M.)Tj
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( )Tj
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(What is an autoimmune disease? )Tj
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(When a body encounters something foreign in its )Tj
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(environment it needs to be able to mount an immune )Tj
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(response against that substance to protect itself from )Tj
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(potential harm. In order to do this effectively it must be )Tj
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(able to recognize what is self in order to respond to non-)Tj
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(self or foreign. In autoimmune diseases there is a failure to )Tj
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(recognize some part of self. Such autoimmunity may be )Tj
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(restricted to a single organ, a localized region, or the )Tj
T*
(whole animal. The consequences may vary from minimal )Tj
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(to catastrophic, depending on the extent to which the body )Tj
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(is affected. In autoimmune disease pathologic signs are )Tj
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(seen as a result of the autoimmune response. Frequently )Tj
T*
(more than one autoimmune disease will be seen in the )Tj
T*
(same animal, as well as an increased susceptibility to )Tj
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(bacterial infection. There are four basic mechanisms )Tj
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(underlying autoimmune disease:)Tj
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(1. Antibody mediated diseases: a specific antibody exists )Tj
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(targeted against a particular antigen \(protein\) which leads )Tj
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(to its destruction and signs of the disease. Examples are: )Tj
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(auto-immune mediated hemolytic anemia, where the )Tj
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(target is on the surface of the red blood cell; myasthenia )Tj
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(gravis where the target is the acetylcholine receptor in the )Tj
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(neuromuscular junction; hypoadrenocorticism \(Addison's\) )Tj
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(where the targets are the cells of the adrenal gland. )Tj
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(2. Immune-complex-mediated diseases: antibodies are )Tj
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(produced against proteins in the body, these combine into )Tj
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(large molecules which circulate around the body. In )Tj
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(systemic lupus erythematosus \(SLE\) antibodies are )Tj
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(formed against several components in the cell's nucleus )Tj
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(\(hence the anti-nuclear antibody test \(ANA\) for SLE\). Most )Tj
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(notably antibodies are made against the body's double )Tj
T*
(stranded DNA, and form circulating soluble complexes of )Tj
0 -1.2 TD
(DNA and antibody, which break down in skin causing an )Tj
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(increased sensitivity to ultraviolet light and a variety of )Tj
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(signs. As the blood is filtered through the kidneys the )Tj
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(complexes are trapped in the glomeruli and blood vessels, )Tj
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(causing the kidney to leak protein - glomerulonephritis. )Tj
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(They also cause leakage in other blood vessels, and there )Tj
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(may be hemorrhaging, as well as accumulating in synovial )Tj
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(fluid and causing signs of arthritis and joint pain. )Tj
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(Rheumatoid arthritis results from immune complexes \(IgM )Tj
T*
(class antibody called rheumatoid factor\) against part of the )Tj
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(animal's own immune system \(part of its IgG molecules\). )Tj
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(These form complexes which are deposited in the synovia )Tj
T*
(of the joint spaces causing an inflammatory response, joint )Tj
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(swelling and pain. The collagen and cartilage of the joint )Tj
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(breaks down and is eventually replaced by fibrin which )Tj
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(fuses the joints - ankylosis.)Tj
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(3. Antibody and T Cell-mediated diseases: T cells are one )Tj
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(of two types \(the other being B-cells\) which mediate )Tj
T*
(immune reactions. Upon exposure to a particular antigen )Tj
0 -1.2 TD
(they become programmed to search for and destroy that )Tj
0 -1.2 TD
(particular protein in future. Once an animal has been )Tj
T*
(exposed to an antigen it will be able to mount a much )Tj
T*
(faster response to it the next time it encounters it. This is )Tj
T*
(the basis of vaccination. Thyroiditis \(autoimmune )Tj
0 -1.2 TD
(hypothyroidism\) seems to be of mixed etiology. Several )Tj
T*
(target antigens have been identified, including )Tj
T*
(thyroglobulin, the major hormone made by the thyroid. )Tj
T*
(Autoantibodies to antigens in the epithelial cells of the )Tj
T*
(thyroid have also been found. The thyroid becomes )Tj
T*
(invaded by large numbers of T and B cells as well as )Tj
0 -1.2 TD
(macrophages which are cells that engulf and destroy other )Tj
0 -1.2 TD
(cell types. T cells specifically programmed for )Tj
T*
(thyroglobulin have been identified.)Tj
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(4. Diseases arising from a deficiency in complement: )Tj
0 -1.2 TD
(When an antigen and antibody react they may activate a )Tj
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(series of serum enzymes \(the complement system\) with )Tj
0 -1.2 TD
(the end result being either lysis \(breakup\) of the antigen )Tj
0 -1.2 TD
(molecule or a process which makes it easier for )Tj
T*
(phagocytic cells like the macrophages to destroy it. )Tj
T*
(Animals with deficiencies in enzymes activated early in the )Tj
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(complement system develop autoimmune diseases like )Tj
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(SLE.)Tj
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( )Tj
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(Which diseases are autoimmune? )Tj
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(Those diseases of greatest concern in the Bearded Collie )Tj
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(are: )Tj
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(1. )Tj
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(Auto-immune mediated anemia \(AIMA\) also called )Tj
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(autoimmune hemolytic anemia \(AIHA\) and immune )Tj
T*
(mediated hemolytic anemia \(IMHA\). Antibodies )Tj
0 -1.2 TD
(formed against antigens in the red blood cell )Tj
T*
(membrane cause these cells to burst open. The )Tj
T*
(resulting anemia compromises the dog's ability to )Tj
T*
(provide sufficient oxygen for cell function throughout )Tj
T*
(the body. )Tj
/T1_0 1 Tf
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(2. )Tj
/TT0 1 Tf
(Immune-mediated thrombocytopenia \(ITP\). This )Tj
1.25 -1.2 Td
(results in a dangerously low level of platelets - )Tj
T*
(either due to an increase in antibody and )Tj
T*
(complement-mediated phagocytosis of platelets in )Tj
T*
(the spleen, bone marrow and liver, or decreased )Tj
T*
(production due to antibody and/or complement )Tj
T*
(mediated phagocytosis of platelet stem cells )Tj
T*
(\(megakaryocytes\) in the bone marrow. The low )Tj
T*
(platelet levels lead to spontaneous bleeding, often )Tj
T*
(nose bleeds or petechiae \(bleeding just under the )Tj
T*
(skin and mucous membranes\) are seen. Blood in )Tj
T*
(the stool, urine or vomit is less common. \(Often )Tj
T*
(seen with AIHA, SLE and RA.\) )Tj
/T1_0 1 Tf
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(3. )Tj
/TT0 1 Tf
(Autoimmune thyroiditis \(hypothyroidism\) is generally )Tj
1.25 -1.2 Td
(found with the other autoimmune diseases or may )Tj
0 -1.2 TD
(occur by itself. Loss of thyroid hormones is )Tj
T*
(manifested early by behavioral changes - )Tj
T*
(aggression, hyperactivity, anxiety/fear, compulsive )Tj
T*
(behaviors, phobic behaviors; allergies and reduced )Tj
T*
(resistance to bacterial, viral, fungal and protozoal )Tj
T*
(infection - often manifest as skin and respiratory )Tj
T*
(disorders. Seizure disorders are also often related )Tj
T*
(to low thyroid levels. As the disease progresses )Tj
T*
(lethargy, obesity, alopecia \(loss of hair/poor haircoat )Tj
T*
(especially on the sides\) and infertility are more )Tj
T*
(common. )Tj
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(4. )Tj
/TT0 1 Tf
(Hypoadrenocorticism \(Addison's disease\): The )Tj
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(adrenal gland produces hormones which regulate )Tj
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(the level of sodium and potassium )Tj
T*
(\(mineralocorticoids\) and mediate the body's )Tj
0 -1.2 TD
(response to physiologic and psychological stress )Tj
0 -1.2 TD
(\(corticosteroids\). The former are needed to maintain )Tj
T*
(proper cell function, their loss is seen as muscle )Tj
T*
(weakness and eventually heart failure as the heart's )Tj
T*
(muscle cells can no longer produce the nervous )Tj
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(impulses needed for the heart to contract. )Tj
T*
(Gastrointestinal function is also usually impaired, )Tj
T*
(and weight loss is frequently seen. Animals are less )Tj
T*
(able to cope with mild, everyday occurrences and )Tj
T*
(hide, refuse to eat, and show other symptoms of )Tj
T*
(stress. )Tj
/T1_0 1 Tf
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(5. )Tj
/TT0 1 Tf
(SLE: Known as the great imitator can be hard to )Tj
1.25 -1.2 Td
(diagnose as it can manifest as a disease of the skin/)Tj
T*
(mucous membranes/nails, kidney and/or joints as )Tj
T*
(has already been described. SLE can also affect the )Tj
T*
(brain producing signs of cognitive dysfunction. It is )Tj
T*
(also hard to diagnose definitively as not all dogs )Tj
T*
(with SLE have postive ANA titers. )Tj
/T1_0 1 Tf
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(6. )Tj
/TT0 1 Tf
(Pemphigus folliaceus is a skin disease in which )Tj
1.25 -1.2 Td
(pustules are formed. In Beardies they seem to be )Tj
T*
(more common on the feet, but can be restricted to )Tj
T*
(the face or appear patchily all over the dog. After )Tj
0 -1.2 TD
(the pustules burst the skin appears crusty or scaly )Tj
T*
(and loses its hair. The dog may chew on or scratch )Tj
T*
(the lesions increasing the damage and ulcers and )Tj
T*
(serious skin erosion may result. Although the )Tj
T*
(antigen has not been specifically identified, )Tj
T*
(pemphigus is a result of autoantibodies directed )Tj
T*
(against the cell membrane of epithelial cells, )Tj
T*
(causing them to become round and separate )Tj
T*
(instead of forming a solid sheet. )Tj
/T1_0 1 Tf
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(7. )Tj
/TT0 1 Tf
(Rheumatoid Arthritis \(RA\) was described above. )Tj
/T1_0 1 Tf
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(8. )Tj
/TT0 1 Tf
(Myasthenia gravis results in a loss of muscle )Tj
1.25 -1.2 Td
(function because nerve signals are no longer )Tj
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(received by the muscles. The dog loses muscle )Tj
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(mass, due to disuse, and becomes weak and )Tj
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(will be coming over on the weekend\), and has a )Tj
0 -1.2 TD
(determined need for the vaccine, go ahead. Watch the )Tj
T*
(dog for at least an hour after the shot. Try to separate )Tj
T*
(shots, especially MLV from killed, by at least 3 weeks. )Tj
T*
(Make sure your dog has regular check-ups, including base-)Tj
T*
(line blood work annually until he's 10 and then increase )Tj
T*
(the frequency to every 6 months. Even if he seems )Tj
T*
(healthy there may be something you are missing. Do not )Tj
T*
(start puppy shots before 6 weeks of age, and space them )Tj
T*
(every 3 to 4 weeks. Do not worm and vaccinate together, )Tj
T*
(preferably 2 to 3 weeks apart.)Tj
0 -2.557 TD
(Linda Aronson DVM )Tj
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(reluctant to move. Enlargement of the esophagus )Tj
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(\(megaesophagus\) may result. This is often seen as )Tj
T*
(regurgitation of food as soon as it is swallowed, and )Tj
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(frequently results in aspiration of food into the lungs. )Tj
0 -1.2 TD
(Even when treated, dogs are liable to die of )Tj
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(aspiration pneumonia due to megaesophagus. )Tj
T*
(Untreated dogs eventually lose the use of )Tj
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(swallowing and respiratory muscles. )Tj
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(9. )Tj
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(Autoimmune myositis is usually divided between )Tj
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(polymyositis and masticatory muscle myositis. In )Tj
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(the former there is often generalized weakness )Tj
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(made worse by exercise. Most frequently the )Tj
T*
(muscles over the top of the head waste away. Fever )Tj
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(and depression are common as is megaesophagus. )Tj
T*
(Concomittant SLE, RA and myasthenia gravis have )Tj
T*
(been reported. Masticatory muscle myositis, as the )Tj
T*
(name implies, is limited to the chewing muscles, )Tj
T*
(antibodies are formed to a particular type of muscle )Tj
T*
(fiber. )Tj
/T1_0 1 Tf
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(10. )Tj
/TT0 1 Tf
(Inflammatory Bowel Disease \(IBD\) is neither a )Tj
1.75 -1.2 Td
(specific disease nor is it clearly an autoimmune )Tj
T*
(disease. In general, it is a catch-all for animals with )Tj
T*
(excessive numbers of inflammatory cells in the )Tj
T*
(mucosa of the stomach, small and/or large intestine )Tj
T*
(for which no other cause can be found and which )Tj
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(result in vomiting and/or diarrhea. Although )Tj
T*
(autoantibodies have been found, it is likely that )Tj
T*
(these have been formed secondary to the initiating )Tj
T*
(factor which exposed previously hidden antigens by )Tj
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(increasing the permeability of the g/i mucosa.)Tj
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( )Tj
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(What causes autoimmune diseases?)Tj
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( )Tj
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(Genetic: )Tj
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(It has been shown in humans that particular )Tj
0 -1.227 TD
(major histocompatibility complex \(MHC\) genes are )Tj
0 -1.2 TD
(associated with the incidence of specific autoimmune )Tj
T*
(diseases. MHC genes are present in all vertebrates, and )Tj
T*
(are unusual in that they are inherited as a unit, they )Tj
T*
(encode for two major categories of molecules that form )Tj
0 -1.2 TD
(part of cell membranes and cross the entire membrane. In )Tj
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(http://www.beaconforhealth.org/Autoimmune3.htm \(5 of 14\)3/28/2006 1:47\
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(particular they have a role in selecting the antigens )Tj
0 -1.2 TD
(recognized by T-cells.)Tj
0 -2.557 TD
(An analysis of the pedigrees received of Beardies affected )Tj
0 -1.2 TD
(by hypoadrenocorticism in the last survey by the BCCA )Tj
T*
(suggests that this disease is caused by an autosomal )Tj
T*
(recessive gene with incomplete penetrance. A study, )Tj
T*
(funded in part by donations from the BCCA, is being )Tj
0 -1.2 TD
(sponsored by AKC-CHF. The researchers hope to identify )Tj
T*
(a gene or genes at one or more loci which correlate with )Tj
T*
(hypoadrenocorticism. To date they have received blood )Tj
T*
(samples and pedigrees from well over 100 Beardies who )Tj
T*
(are either affected with the disease or are closely related )Tj
T*
(to affected dogs. Other breed clubs are now becoming )Tj
0 -1.2 TD
(involved in the project. Clearly a blood test for the disease )Tj
0 -1.2 TD
(would enable us to reduce the incidence dramatically.)Tj
0 -2.557 TD
(Analysis of pedigrees from an extremely large population )Tj
0 -1.2 TD
(of Old English sheepdogs and smaller populations of other )Tj
T*
(breeds, has shown that \(almost\) all cases of autoimmune )Tj
T*
(disease occur in particular blood lines. Vaccinosis )Tj
T*
(reactions occur in the same blood lines. However, it is )Tj
T*
(equally clear that not all dogs within these groups will )Tj
T*
(develop an autoimmune disease, the majority will live )Tj
T*
(normal, healthy lives, although some may have sub-)Tj
T*
(clinical autoimmune disorders.)Tj
0 -2.557 TD
(Conclusion: It seems likely that a dog must have a genetic )Tj
0 -1.2 TD
(tendency in order to develop an autoimmune disease. )Tj
T*
(However, for overt disease to manifest itself specific )Tj
T*
(insults to the animal's immune system must also be )Tj
T*
(presented.)Tj
/TT1 1 Tf
0 -2.557 TD
(Other factors: )Tj
/TT0 1 Tf
(We are gradually piecing together some of )Tj
0 -1.227 TD
(the factors which can influence whether a dog will develop )Tj
0 -1.2 TD
(an autoimmune disease. The health of its immune system )Tj
T*
(in general seems to be a major factor. Dogs are at far )Tj
T*
(more risk when they are already stressed by disease. For )Tj
T*
(this reason it is imperative that we do not further stress a )Tj
T*
(sick dog by vaccinating it \(more on this in the other talk\). )Tj
T*
(The reported incidence of autoimmune disease is on the )Tj
T*
(rise, and there is some debate as to whether this is )Tj
T*
(because it is really more common or because we are )Tj
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(better at detecting it. I believe that both factors are )Tj
0 -1.2 TD
(probably involved.)Tj
0 -2.557 TD
(A couple of recent papers suggest that both an increase in )Tj
0 -1.2 TD
(pollution and an increase in sanitation could be )Tj
T*
(problematic.)Tj
0 -2.557 TD
(Study 1: Over the last 25 years or more we have received )Tj
0 -1.2 TD
(\(as have our dogs\) small daily doses of insecticides, weed )Tj
T*
(killers and artificial fertilizers in our drinking and bath )Tj
T*
(water. Levels tend to be higher in rural areas where wells )Tj
T*
(are the water source. Most commonly found are )Tj
T*
(carbamate insecticides and triazine herbicides. The )Tj
T*
(government in its wisdom has looked at the effect \(mostly )Tj
0 -1.2 TD
(looking for cancer\) of each chemical individually at low )Tj
0 -1.2 TD
(levels when given to lab rodents, and deemed the levels in )Tj
T*
(groundwater "safe". For the last five years a group in )Tj
T*
(Wisconsin have fed cocktails of these contaminants as )Tj
T*
(they are typically found in tap water to male mice via their )Tj
T*
(drinking water. They report a measurable effect on )Tj
T*
(nervous, immune and endocrine systems. Specifically they )Tj
T*
(found the mice less able to mount an antibody response to )Tj
T*
(foreign proteins, increased or reduced levels of thyroid )Tj
T*
(hormones \(depending on the mixture\) and an increase in )Tj
T*
(aggressive behavior. \(They only measured these 3 )Tj
T*
(parameters so other effects on the body were not tested )Tj
T*
(for.\) These results were found if the mice received )Tj
0 -1.2 TD
(mixtures but not individual chemicals at these low levels. A )Tj
T*
(study of 4 and 5 year old, lowland living children in Mexico )Tj
T*
(exposed to pesticides compared to a highland group living )Tj
T*
(where there is no pesticide use found increased )Tj
T*
(aggression, reduced stamina and impaired cognitive ability )Tj
T*
(in the former group - all symptoms of hypothyroidism )Tj
T*
(although thyroid levels were not measured in these )Tj
T*
(groups. How about the pesticides we put on our dogs for )Tj
T*
(fleas and ticks, or the lawn and other garden chemicals?)Tj
0 -2.557 TD
(Study 2: A recent article in New Scientist reports a small )Tj
0 -1.2 TD
(study from the University of Iowa looking at IBD. It was )Tj
T*
(noted by the group that the reported incidence of IBD )Tj
T*
(correlated with the elimination of intestinal worms. They )Tj
T*
(gave 6 people with chronic IBD a drink with eggs from )Tj
T*
(intestinal worms that don't normally affect people. Five )Tj
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(http://www.beaconforhealth.org/Autoimmune3.htm \(7 of 14\)3/28/2006 1:47\
:18 AM)Tj
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(went into complete remission. A larger study is planned. )Tj
0 -1.2 TD
(Throughout history until very recently our immune system )Tj
T*
(has been used to the presence of worms in the g/i tract, it )Tj
0 -1.2 TD
(seems their removal may have caused the immune )Tj
0 -1.2 TD
(system to go into overdrive. It also makes me wonder )Tj
T*
(about the effect of monthly worming our dogs. )Tj
0 -2.457 TD
( )Tj
0 -1.1 TD
(Drugs. A number of drugs have been associated with the )Tj
0 -1.2 TD
(onset of autoimmune disease. Please contact the author )Tj
T*
(for more information.)Tj
0 -2.557 TD
(Stress is important, whether it is environmental, )Tj
0 -1.2 TD
(psychological or physiological. Pregnancy is a stress, as is )Tj
T*
(lactation. Reproductive abnormalities may point to an )Tj
T*
(underlying autoimmune problem or prime the dog's )Tj
T*
(immune system so that it is more susceptible to other )Tj
T*
(stresses. The same is true of many diseases - viral )Tj
T*
(diseases, lymphoma and bone marrow problems as well )Tj
T*
(as failure of immunity seem to be particularly dangerous, )Tj
T*
(however. )Tj
0 -2.557 TD
(Food can also be a source of chemicals which have been )Tj
0 -1.2 TD
(implicated in the acquisition of autoimmune disease. )Tj
T*
(Processing resulting in the loss of protective agents from )Tj
T*
(the diet as well, may also be a contributing factor. )Tj
0 -2.557 TD
(Summary. Clearly we cannot protect our dogs - or )Tj
0 -1.2 TD
(ourselves - from all potential risk factors, not least )Tj
T*
(because there are still so many which have yet to be )Tj
T*
(identified. Running a complete thyroid panel every year or )Tj
T*
(two on all dogs used for breeding is at present still our )Tj
T*
(best defense. However, we should be careful to not stress )Tj
T*
(our dogs' immune systems. Never vaccinate sick animals - )Tj
T*
(or stress them unnecessarily. Don't worm and vaccinate at )Tj
T*
(the same time, avoid multivalent vaccines. At the same )Tj
T*
(time don't stress yourself by worrying about things over )Tj
T*
(which you have no control. It is important to remember )Tj
T*
(that Beardies are still one of the healthier breeds. In any )Tj
T*
(attempt to reduce the incidence of one problem whether it )Tj
T*
(is poor tail set, bad bites or autoimmune disease we must )Tj
T*
(avoid throwing out the baby with the bathwater, and )Tj
T*
(maintain the loveable, outgoing breed which has been )Tj
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(http://www.beaconforhealth.org/Autoimmune3.htm \(8 of 14\)3/28/2006 1:47\
:18 AM)Tj
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(entrusted to our stewardship.)Tj
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(Vaccination)Tj
/TT0 1 Tf
( )Tj
0 -1.227 TD
(Together with improved sanitation and epidemiological )Tj
0 -1.2 TD
(control vaccination has helped reduce to almost )Tj
0 -1.2 TD
(insignificant levels many of the major diseases affecting )Tj
T*
(both humans and animals. It is only because their )Tj
T*
(incidence has been so dramaticaly reduced that we are )Tj
T*
(now able to address concerns relating to vaccine efficacy )Tj
0 -1.2 TD
(and safety. While some problems have been traced to )Tj
T*
(poorly attenuated batches of vaccine that revert to )Tj
T*
(virulence after injection or to contamination, others reflect )Tj
T*
(the animals' genetic predisposition to adverse reaction. )Tj
0 -2.557 TD
(These reactions may be immediate anaphylactic )Tj
0 -1.2 TD
(hypersensitivity; or acute \(24 - 72 hours\) or chronic \(10 - )Tj
0 -1.2 TD
(30 or more days\) immunologic responses. The incidence )Tj
0 -1.2 TD
(is low. Estimates vary between a low of 1: 1to 3.5 million )Tj
T*
(to a high of 1: 50,000 to 100,000 animals. Part of the )Tj
T*
(difficulty in obtaining accurate estimates comes in the )Tj
T*
(case of delayed reactions when it is sometimes not )Tj
T*
(possible to establish whether the vaccination was causal )Tj
T*
(or coincidental. However, it is also possible that many of )Tj
T*
(these cases will be missed as the relationship to )Tj
T*
(vaccination a month or more earlier will not seem relevant. )Tj
T*
(Unfortunately, predicting which animals will be susceptible )Tj
T*
(is anywhere from difficult to impossible, and if one owns )Tj
T*
(one of those animals which does react the low odds are )Tj
T*
(unimportant.)Tj
0 -2.557 TD
(Anaphylactic collapse is dramatic and life threatening. )Tj
0 -1.2 TD
(Animals have been previously sensitized to the antigens in )Tj
T*
(the vaccine. Signs include vomiting, diarrhea, coldness, )Tj
T*
(pale/colorless mucous membranes, loss of voluntary )Tj
T*
(muscle control, rapid breathing and heart rate. It results )Tj
T*
(from the release of histamine and other amines which )Tj
T*
(cause blood vessels to dilate and blood to pool in )Tj
T*
(peripheral vessels. Death may occur before epinephine )Tj
T*
(and antihistamines can be administered.)Tj
0 -2.557 TD
(Less dramatic reactions may result in fever, stiffness, )Tj
0 -1.2 TD
(abdominal tenderness, increased susceptibility to )Tj
T*
(infection, encephalitis, neurological signs, uveitis, )Tj
ET
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:18 AM)Tj
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(autoimmune disease - most often AIHA and/or ITP - and )Tj
0 -1.2 TD
(the signs associated with them. Liver and kidney enzyme )Tj
T*
(levels may be elevated, and either organ may collapse. )Tj
0 -1.2 TD
(Bone marrow suppression may occur as well. Transient )Tj
0 -1.2 TD
(seizures are seen quite often especially in animals prone )Tj
T*
(to thyroiditis or AIHA or ITP. A postvaccination )Tj
T*
(polyneuropathy has been associated with distemper, )Tj
T*
(parvovirus and rabies vaccines among others. This may )Tj
0 -1.2 TD
(result in muscle atrophy, reduced neuronal control of )Tj
T*
(organs and tissues, muscle excitation, incoordination or )Tj
T*
(weakness and seizures. )Tj
0 -2.557 TD
(Contamination of vaccines has indicated a need for )Tj
0 -1.2 TD
(greater quality control during vaccine production. Most )Tj
T*
(notably a canine distemper vaccine was contaminated )Tj
T*
(with sheep blue-tongue virus and led to abortion and )Tj
T*
(death in pregnant bitches. Potent adjuvants are commonly )Tj
T*
(added to killed vaccines to produce a more sustained and )Tj
T*
(stronger immune response. These adjuvants have also )Tj
T*
(produced adverse effects, the worst probably resulting )Tj
T*
(from those added to a killed leptospirosis vaccine which )Tj
T*
(has since been withdrawn from the market. The presence )Tj
T*
(of adjuvants calls into question the supposition that killed )Tj
T*
(vaccines are safer than modified-live vaccines. The latter )Tj
T*
(make up the majority of products available currently. They )Tj
T*
(are easier and cheaper to produce, and elicit a longer and )Tj
T*
(more complete antibody response than killed vaccines. )Tj
T*
(Mixing combinations of MLV products with killed bacterins )Tj
0 -1.2 TD
(added in the diluent \(common in some multivalent )Tj
T*
(vaccines\) appears to particularly stress susceptible )Tj
T*
(individuals. MLV vaccines continue to replicate in the host )Tj
T*
(after injection, and trigger a much stronger response, )Tj
T*
(particularly if given in combination with other vaccines. In )Tj
T*
(most cases this may produce a better immune response )Tj
T*
(but in stressed, immature or sick animals who are )Tj
T*
(genetically susceptible the results can be disasterous. )Tj
T*
(Puppies with their immature immune systems are )Tj
T*
(particularly vulnerable, and should not receive vaccines )Tj
T*
(closer than 3 weeks apart \(3 to 4 weeks seems optimal\). )Tj
T*
(There is some evidence that over vaccinating puppies )Tj
T*
(\(some vets advocate weekly vaccination\) can make them )Tj
T*
(more susceptible to chronic debilitating diseases as )Tj
T*
(adults. Dogs with atopic allergies tend to have a )Tj
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7:18 AM)Tj
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(worsening of signs after vaccination, and it is better to )Tj
0 -1.2 TD
(vaccinate them when their seasonal allergies are not )Tj
T*
(active.)Tj
0 -2.557 TD
(Overvaccination is a concern. This may manifest not only )Tj
0 -1.2 TD
(as vaccinating more frequently than is necessary, but in )Tj
T*
(giving vaccines which are ineffective or prevent infection )Tj
T*
(by agents which produce a mild disease which may not be )Tj
0 -1.2 TD
(noticed. Leptospirosis vaccines have provided short lived )Tj
T*
(\(3-6 month\) protection against serovars which dogs are )Tj
T*
(not presenting with clinically. A new vaccine was promised )Tj
T*
(to combat varieties which dogs are now getting, but I have )Tj
T*
(not heard any more about it recently, and doubt its long )Tj
T*
(term efficacy. Not only has the leptospirosis vaccine been )Tj
0 -1.2 TD
(implicated in numerous vaccinosis reactions, but both )Tj
0 -1.2 TD
(owners and veterinarians may overlook a diagnosis of the )Tj
T*
(disease in the mistaken belief the dog is immune to it as a )Tj
T*
(result of vaccination. Vaccination against Lyme disease )Tj
T*
(frequently results in positive Lyme titers if the dog is )Tj
T*
(suspected of having the disease. Most Lyme vaccines )Tj
T*
(have limited efficacy. Corona virus does not cause illness )Tj
T*
(in adult dogs and generally only mild disease in puppies. A )Tj
T*
(new vaccine against rotavirus has been introduced )Tj
T*
(although there has been no evidence that it causes )Tj
T*
(disease except perhaps in newborns. Canine hepatitis )Tj
T*
(seems to have been eradicated, yet dogs still routinely )Tj
T*
(receive the vaccine. The adminstration of each vaccine )Tj
T*
(introduces more foreign substances into the dog's body )Tj
0 -1.2 TD
(with the potential for causing adverse reactions. )Tj
T*
(Meanwhile the owners are having to pay for this. Studies )Tj
T*
(have also shown that immunity induced by giving a puppy )Tj
T*
(series of shots is generally protective for far more than a )Tj
T*
(year, sometimes being effective for life.)Tj
0 -2.557 TD
(A sick dog should never be vaccinated until it is well and )Tj
0 -1.2 TD
(recouperated. Vaccination can wait, with the possible )Tj
T*
(exception of the rabies vaccine which some states require )Tj
T*
(be given to the day to consider a dog legally vaccinated )Tj
T*
(\(for this reason it may be wise to plan to give a three year )Tj
T*
(shot a month or so early in case the dog is ill when the )Tj
T*
(shot is due\). MLV vaccines are shed in the feces for )Tj
T*
(several days after vaccination, and recently vaccinated )Tj
T*
(dogs should be exercised in separate areas from )Tj
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7:18 AM)Tj
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(immunocompromised or sick dogs, puppies and pregnant/)Tj
0 -1.2 TD
(lactating bitches. Hormonal changes can trigger )Tj
T*
(autoimmune disease, and for this reason it is wise to avoid )Tj
0 -1.2 TD
(giving vaccinations before \(30 days before expected )Tj
0 -1.2 TD
(onset\) during or immediately after a bitch's estrus \(heat\) )Tj
T*
(period. \(It has been shown that giving MLV vaccines to )Tj
T*
(heiffers in estrus induces necrotic changes in their )Tj
T*
(ovaries.\) Pregnant and lactating bitches should also not be )Tj
0 -1.2 TD
(vaccinated. It can affect their puppies as well as the bitch )Tj
T*
(herself. When should a puppy receive its first vaccination? )Tj
T*
(In North Ameica we usually initiate puppy shots at 6 )Tj
T*
(weeks, in Britain the first shot is not given until the puppy )Tj
T*
(is 10 weeks old and in its new home. Certainly I do not )Tj
T*
(believe puppies should be vaccinated at less than 6 weeks )Tj
0 -1.2 TD
(of age, although puppies which did not receive colostrum )Tj
0 -1.2 TD
(might represent a special case. Maternal immunity )Tj
T*
(transferred to the puppy in the colostrum has a varaible )Tj
T*
(duration, but in general the puppy will respond optimally to )Tj
T*
(the vaccine only when it is 12 weeks old or more. Breed )Tj
T*
(and individual variation within breed can have a significant )Tj
T*
(effect, however. Most dogs have mature immune systems )Tj
T*
(by 22 weeks of age.)Tj
0 -2.557 TD
(In general, all dogs no matter their age or size receive the )Tj
0 -1.2 TD
(same dose of vaccine. This makes sense for MLV viruses, )Tj
T*
(but not for killed vaccines. Dose size is based on the )Tj
T*
(minimal immunizing dose for the giant breed and optimal )Tj
T*
(dose has rarely been examined. In humans, attempts to )Tj
0 -1.2 TD
(overcome maternal antibodies to measles by giving )Tj
T*
(greater vaccine titers tragically led to high levels of infant )Tj
T*
(mortality, not from measles but from other infectious )Tj
T*
(diseases. )Tj
0 -2.557 TD
(Some breeds of dogs or lines within a breed, or those with )Tj
0 -1.2 TD
(double dilute factors may be at such high risk of adverse )Tj
T*
(vaccine reactions that their owners will choose not to )Tj
T*
(vaccinate them. Studies have shown that exposure to )Tj
T*
(shedding dogs, particularly if the unvaccinated individual is )Tj
T*
(a show dog, tends to produce some level of immunity )Tj
T*
(against the illnesses for which the majority of dogs receive )Tj
T*
(vaccination. For dogs which have had previous reactions )Tj
T*
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(has adequate protection one alternative is to take titers )Tj
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(\(commonly available only for distemper and parvovirus\) )Tj
T*
(every 2 or 3 years and only vaccinate if titers drop below )Tj
0 -1.2 TD
(protective levels. They and owners of geriatric dogs ot )Tj
0 -1.2 TD
(those with chronic illness may also consider the use of )Tj
T*
(homeopathic nosodes. These are made from an isolate of )Tj
T*
(the particular disease agent. This is prepared as a tincture )Tj
T*
(which then undergoes serial dilutions \(potentiation\) and )Tj
0 -1.2 TD
(succussions \(shaking to add kinetic energy\). The nosode )Tj
T*
(retains only the energy of the starting isolate and cannot )Tj
T*
(produce infection. While illegal for protection against )Tj
T*
(rabies, nosodes are available for most of the diseases )Tj
T*
(against which there are vaccinations including Lyme )Tj
T*
(disease and kennel cough, as well as heartworm disease. )Tj
0 -1.2 TD
(Properly designed controlled studies have not been )Tj
0 -1.2 TD
(performed to compare the efficacy of nosodes against )Tj
T*
(allopathic vaccines. A preliminary clinical trial of a nosode )Tj
T*
(for parvovirus failed to protect against challenge from )Tj
T*
(naturally occurring disease. At this point they can only be )Tj
T*
(considered an experimental therapy.)Tj
0 -2.557 TD
(Vaccine manufacturers are being spurred to activity which )Tj
0 -1.2 TD
(is perhaps the best result of the vaccine controversy which )Tj
T*
(is being waged in both the veterinary and pet owning )Tj
T*
(communities. In future we can expect to have killed )Tj
T*
(vaccines in doses appropraite for different sizes, breeds )Tj
T*
(and ages of dogs. Recombinant vaccines may also be )Tj
T*
(developed although early experiments have produced )Tj
0 -1.2 TD
(unexpected and unacceptable side-effects. Safer, new )Tj
T*
(adjuvants which boost and prolong the effect of killed )Tj
T*
(vaccines can also be expected. So can more research into )Tj
T*
(the length of efficacy of vaccines. )Tj
0 -2.557 TD
(In the meantime, I would recommend asking whether the )Tj
0 -1.2 TD
(vaccine you plan to give is needed - is this a disease the )Tj
T*
(dog has any chance of being exposed to, does it cause )Tj
T*
(significant illness in dogs of this age? Is this vaccine )Tj
T*
(effective? If the answer to each is yes, then you may wish )Tj
T*
(to determine whether the dog is still effectively protected )Tj
T*
(against this disease by previous vaccinations \(i.e. have )Tj
T*
(blood titers done\). If the dog is healthy, not stressed \(I )Tj
T*
(would plan to give shots at least 2 to 3 weeks before a trip )Tj
T*
(for example, or avoid them if the whole of your local club )Tj
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