DISCOID CUTANEOUS LUPUS ERYTHEMATOSIS
(Collie Nose)

Lupus is an autoimmune disease which occurs rarely in dogs, although it probably is under-diagnosed. The symptoms of lupus vary widely and often are missed until the disease has reached an advanced stage. Two types of lupus occur in domestic dogs - discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE).

Collie nose problems may result from either one of two causes. Firstly, Discoid Lupus Erythematosus , an autoimmune disease which can eventually lead to squamous cell carcinoma  if untreated or secondly a lack of pigment at birth that can then lead to a gradual removal of the nose pad resulting eventually in ulcers which can also lead to squamous cell carcinoma.

What is Discoid Lupus Erythematosus
Discoid Lupus Erythematosus (DLE) is a skin condition of dogs that typically causes a loss of color (discoloration) on the hairless part of the nose. A black nose may fade to gray or pink. The discoloration can be accompanied by ulcers and bleeding. The surrounding skin may also be effected.

Lack of Pigment
Some dogs with less pigment on the nose area, after exposure to the sun, may experience a blistering of the nose. Collies and related breeds can get a weepy, crusty dermatitis on the nose if they spend too much time in the sun. Treatment for Collie nose involves keeping the area protected as it is difficult to keep a dog out of the sun. It is not only Border Collies that suffer from these nose problems but also Shetland Sheepdogs and Beagles.

Discoid (cutaneous) lupus erythematosus is a relatively benign variant of systemic lupus erythematosus that primarily affects facial skin. The most common site is the hairless surface of the bridge of the nose, called the nasal planum or planum nasale. Other sites are the lips, mouth, periocular area (around the eyes), pinnae (ear flaps) and, rarely, the genitalia or feet. Dogs with DLE usually are otherwise healthy. The symptoms of DLE can include one or more of the following:

  • Depigmentation (paleness) of the skin on the bridge of the nose
  • Skin redness (erythema), especially on the bridge of the nose, face and lips
  • Skin scaling and flaking, especially on the bridge of the nose, face and lips
  • Skin erosions (sores), especially on the bridge of the nose, face and lips
  • Skin ulcerations, especially on the bridge of the nose, face and lips
  • Skin crusting, especially on the bridge of the nose, face and lips
  • Scarring, especially on the bridge of the nose, face and lips
  • Pain at affected areas
  • Itchiness (pruritis), may or may not be present
  • Scratching at affected areas (variable)
  • Secondary bacterial infections (pyoderma)

In addition to losing its pigment, the hairless surface of the nasal planum in dogs with DLE typically transitions from its normal “pebbly” texture to a smoother, more shiny surface. Flaking and crusting at junctions between haired and hairless facial areas are also commonly seen. Many cases of DLE eventually go into remission.

Systemic lupus erythematosus is a much more serious condition than its cutaneous counterpart. SLE is a multi-system, immune-mediated disease characterized by the formation of antibodies against normal body cells and tissues. Basically, the dog’s body attacks itself, from the inside out. While a large number of autoimmune symptoms can be caused by SLE, the most common include one or more of the following:

  • Shifting leg lameness (the most common sign of this disease)
  • Arthritis; polyarthritis (swollen, painful joints; non-septic; non-erosive; common)
  • Stiff, stilted gait
  • Lethargy
  • Depression
  • Loss of appetite (inappetence; anorexia)
  • Anemia (hemolytic); other bleeding problems
  • Skin lesions (redness; depigmentation; sores; pustules; vesicles/blisters), especially on the muzzle and in other areas exposed to sunlight
  • Secondary bacterial infections (pyoderma; common contributor to death)
  • Pain
  • Muscle wasting (atrophy)
  • Fever of unknown origin (fluctuating)
  • Oral ulcerations
  • Pale gums and other mucous membranes
  • Hair loss (alopecia)
  • Thickened foot pads
  • Ulcerated foot pads
  • Enlarged lymph nodes (lymphadenopathy)
  • Enlarged liver (hepatomegaly)
  • Enlarged spleen (splenomegaly)
  • Increased thirst
  • Increased water intake (polydipsia)
  • Increased urination (polyuria)
  • Neurological abnormalities (highly variable)

Signs of SLE can occur anywhere, including within the musculoskeletal system, skin, kidneys, liver, heart, lungs or other organs or organ systems. The symptoms can occur suddenly or slowly and can wax and wane over time. Often, the signs of SLE follow a cyclic pattern. Owners may notice their dog limping on a front leg, then returning to normal. Weeks or even months later, the same dog might begin to limp on a back leg, or on the other front leg. This sporadic lameness is attributable to swollen, painful joints.

Some breeds are predisposed to developing discoid lupus erythematosus, including Collies, German Shepherds, Siberian Huskies, Shetland Sheepdogs, Brittany Spaniels, German Shorthaired Pointers, Alaskan Malamutes, Chow Chows and crosses of these breeds. There is no age or sex predilection.

The mean age of dogs with systemic lupus erythematosus is 6 years, but it can occur in dogs of any age. German Shepherds are clearly overrepresented. Other breeds that are predisposed to developing SLE include Shetland Sheepdogs, Collies, Old English Sheepdogs, Afghan Hounds, Beagles, Irish Setters and Poodles.

Discoid lupus erythematosus cannot be cured but is more manageable than the systemic form of the disease. The goals of treating DLE are to control and resolve the facial skin lesions, particularly on the hairless areas of the top of the muzzle. Treatment protocols may include oral or topical antibiotics, topical lotions or ointments, oral vitamin E, oral fatty acid supplements and oral or topical corticosteroids. Affected dogs should be kept out of the sun as much as possible, because the symptoms of DLE worsen with exposure to ultraviolet light. Owners can apply waterproof, high SPF sunscreen to their dog’s face and ears to slow the progression of the disease. Dogs with DLE should be checked by a veterinarian regularly to assess their progress and to monitor the success of treatment. These dogs should not be used for breeding.

Treatment Options – Systemic Lupus Erythematosus

Systemic lupus erythematosus is also incurable. The goals of treating SLE are to manage the symptoms of the disease, relieve the dog from pain and lameness and prevent progressive renal or other organ failure if possible. Because the effects of SLE often wax and wane, not all cases need to be treated aggressively at all times. Dogs suffering from severe, acute-onset SLE may need to be hospitalized for initial management, until their condition is stabilized. There are a number of drugs that can be used to help manage SLE, including corticosteroids to suppress the abnormal immune reaction and non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammatory response. NSAIDs and steroids normally are not given in combination, because of the increased risk of gastrointestinal ulceration. Secondary bacterial skin infections should be treated aggressively with appropriate antibiotics.

Dogs with SLE usually require chronic chemotherapeutic treatment to suppress their immune systems and manage the painful symptoms of the disease. Often, a combination of steroids and other immunosuppressant drugs is used to combat the effects of lupus. Supportive care, enforced rest and dietary restriction to reduce protein intake may also be recommended. In most cases, SLE must be managed for life, although sometimes the daily dosage of medication can be tapered if the disease goes into remission. Long-term immunosuppressive therapy can have adverse side effects that should be discussed by the veterinarian and owner when designing a treatment protocol for a dog with SLE. These can include bone marrow suppression and a dramatically increased risk of developing severe infections, such as bronchopneumonia and urinary tract infections, among other things. Weight gain is also common with steroid use. Unfortunately, lifelong immunosuppressive therapy is the only viable method for managing SLE at the present time. There is no surgical option. Regular physical examinations, urinalyses and blood tests (complete blood counts and serum biochemistry profiles) should be conducted to monitor the side effects of chronic chemotherapy. Affected animals should not be bred.

Any animals affected with Collie Nose should be fed a natural, raw fed diet, with no kibble, or anything with preservatives
from feedback, this has a 50% success rate in curing this auto immune condition.

During the summer months, you should also use an animal sunscreen like FiltaBac, which should be applied each time the dog goes outside.

Vaccinations should also be avoided as these are known to trigger symptoms.