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Home » Pumi health

Canine eosinophilic granuloma in pumis

Submitted by on Apr 06, 2010 – 3:35 PMNo Comment
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This is a synopsis of my own article published in Puminfo (magazine of the Hungarian Pumi Club) in 2004, “Eosinophilic granuloma – should we be frightened?”

Eosin What is in the name?

  • Eosin (chem.): protein, a fluorescent

    red dye. Used for example in lipstick.

  • Eosinophil (med./vet.): a type of

    white blood cell found in vertebrate blood containing cytoplasmic granules that are easily stained by eosin. They are produced in the bone marrow and migrate to tissues throughout the body. Eosinophils are participants in immune responses but their function and functioning is not yet completely understood. They are prominent at sites of allergic reactions and with parasitic larvae infections. When a foreign substance enters the body, lymphocytes attract eosinophils which release toxic substances to kill the invader.

  • Granuloma (med./vet.): an inflammatory growth composed of granulation tissue usually associated with ulcerated infections.

So what is CEG?

Eosinophilic granuloma is one of a group of diseases commonly known as the eosinophilic granuloma complex (egc), which represents a disorder in the eosinophil function. It affects cats, dogs and horses, and also humans but is NOT a zoonotic disease, that can be transmitted from animals to men.

What does it look like?

CEG in a pumi's mouthEosinophilic granulomas are typically raised, well-circumscribed, yellowish to pink lesions, and histologically show granulomatous dermatitis with multifocal areas of collagen coated with the released substances from degranualted eosionphils. These lesions may be seen as ulcerated or vegetative masses most often in the oral cavity (on the tongue, under the tongue, on the palate, on the lips) or on the inner thighs.

In less severe cases often go unnoticed since most owners and vets are not aware of this disease and do not check for it regularly or are simply dismissed as “wounds” or symptoms of other diseases. The only way to be sure a lesion is due to CEG is by performing a biopsy. The dog on the left is SUSPECTED to have CEG, but has never been tested.

Etymology

Since the disease is very little understood, there are several theories as to how and why it develops.

I. Theories that have been refuted

1. Parasites
Because eosinophils are prominent at sites with parasitic larvae, for a long time CEG has been associated with parasites and therefore treated with anti-parasite medicine. The treatment has actually had positive effects on the patients. Today, however, we know that CEG has occurred in animals negatively diagnosed against parasites. It is believed that anti-parasite treatment is likely to have positively influenced CEG due to its immune-stimulant effect.

2. Bacterial and viral infections
The presence of bacteria and viruses in CEG lesions are not surprising considering the level of oral hygiene in dogs. However, no viruses or bacteria were successfully isolated from tissue samples. Also, tissue samples implanted on other animals often failed to provoke the symptoms. The disease was declared non-contagious.

II. Theories that still stand

1. Autoimmune origins
Since eosinophils participate in the body’s immune reaction to foreign substances, it is suspected that CEG might actually have an autoimmune origin.

Dog food with lamb meet2. Allergy
Eosinophils are prominent also at sites of allergic reactions. When dietary hypersensitivity was suspected in patients, elimination therapy and de-sensitivity treatment was successfully applied. The suggested diet consists exclusively of lamb meat for at least 6 weeks. If the therapy is effective, it should be kept up throughout the life of the dog. NOTE: This has actually worked in the first Hungarian case we know of. When the owner later decided to change back to „normal” dog food, the lesions recurred very soon.

3. Genetic predisposition
It is more than likely that the actual occurrence of symptoms requires a predisposition from the dog. The development of the lesions is attributed to traumas and stress, which, in the case of thigh lesions can be as small as a mosquito bite, or, in the case of oral CEG a foreign body in the mouth. The fact that stress can trigger the symptoms in certain dogs might suggest that CEG might affect dogs with a weaker nervous system more.

Due to the fact that certain breeds seem to be more prone to the disease than other breeds, a deeper genetic background of the disease was also suggested. The affected breeds are the Arctic Circle breeds, especially the Siberian Husky, but also breeds like the Bull Mastiff, Cavalier King Charles spaniel, Basenji, Beagle, Bouvier and German shepherd. NOTE: About 30% of the puppies born by a bitch with CEG have shown signs of CEG in one affected pumi kennel.

4. Hormonal influence
It is also known that hormonal changes in a bitch (e.g. heat) or in the environment of a dog can trigger the occurrence of the disease even in sexually not mature animals. Neutering these bitches has a benevolent influence on the symptoms, often completely solving the problem.

How serious can it get?

In most cases changing the diet, giving some vitamins and some immunostimulants will help. The real danger lies in severe cases when the lesions are so painful that the dog has difficulty eating or drinking. Medication of these already weak animals might have fatal effects.

Treatment and prevention

Treatment options
The actual symptoms are curable in most cases, but the predisposition for the illness and therefore the recurrence of the lesions will stay. Like hypersensitivity disorders in general, cases of CEG should first be investigated by allergy testing and dietary elimination trials. Hypo sensitization and dietary management should be instituted when appropriate. Antibiotic therapy can also be tried (amoxicillin, cefadroxil). Many lesions seem much more responsive to corticosteroids, such as oral prednisolone. Other methods include radiotherapy, cryosurgery, laser, surgical excisions, interferon and levamisole. Progrestational drugs have also been effective, however, they are not recommended because of their potential side effects. Spontaneous healing has also been observed.

Prevention
Draw a mental map of the pink spots in your dogs mouth and check for new spots regularly in the mouth, on the palate and the tongue. Look often, because CEG is not always in the active phase. Some researchers suggest that bad breath may also be an indication of CEG. Advice to breeders: Do not mate two dogs which are suspected to have CEG. Do not mate a dog with severe CEG at all.

CEG in pumis

The disease was first noticed in pumis in Finland and Sweden. At first it was suspected that it does not affect pumis of pure Hungarian bloodlines – this, of course, is not true. Rather, Hungarian breeders never looked into the mouth of their dogs looking for pink lesions. After the first reports of the disease in Finland, the first Hungarian case was suspected* in 2004. Currently there is no “register” for dogs with CEG (like there is for hip dysplasia), and the names of the affected dogs have not been published. The breed clubs of these countries are trying to raise awareness for the disease.
*It is important to note that none of the known CEG cases were checked with biopsy.

Summary

Little is known of the disease:
- how does it develop, when and why?
- what influences the severity of the symptoms?
- which is the most effective treatment?

Pumis seem to be an affected breed, although at present there is no way to know how much. Monitoring the pumi population would be essential to eliminate the disease.

Sources and further reading

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