Uveodermatologic Syndrome

Patty Khuly

Summary

In humans, a condition known as Vogt-Koyanagi-Harada (VKH) or uveomeningoencephalitic syndrome has been described. “Uveodermatologic syndrome” is the canine counterpart to this human disease complex characterized by eye, skin and nervous system symptoms.

Affected dogs usually suffer eye problems (including uveitis and retinal separation), a premature whitening of the hair (poliosis) and vitiligo (skin depigmentation). It’s important to understand that the worst case scenario for the skin is merely cosmetic while that for the eyes is much worse: blindness.

It’s cause is understood to be related to the immune system’s auto-destruction of melanocytes (pigment-making cells) which are concentrated in the skin and eyes. A virus may be responsible for triggering this process. Though its heritability is presupposed due to its predisposition in certain breeds, its mode of genetic transmission is unknown.

Symptoms and Identification

Most dogs initially present with symptoms related to eye discomfort. Painful, red eyes are common with the uveitis that accompanies this syndrome. Vision changes are often noted when dogs begin to bump into objects. Constricted pupils and a clouding of the eyes is typical as well.

Approximately 90% of dogs will have premature whitening of the hair associated with this condition. It usually occurs within 3 to 6 months of the eye symptoms and, along with biopsy of the affected areas of the skin, it generally serves as the determining symptom for diagnosis of the condition.

50% of affected dogs will have vitiligo. This would be most evident on the nose, lips, eyelids, footpads and scrotum. These areas should be biopsied as well to help achieve a definitive diagnosis.

Affected Breeds

Akitas, Siberian Huskies, Alaskan Malamutes and Samoyeds are most commonly affected.

Treatment

Treatment is directed at the uveitis affecting the eyes. Systemic corticosteroid treatment (as with drugs like prednisone) is typically undertaken along with topical approaches to the eye. Treatment for the eyes is typically a months- to years-long process.

In general, dogs with this condition do poorly as far as their eyes go. The eye problems tend to recur and irreversible blindness is common. Sometimes, however, aggressive therapy to prevent the body’s attack on itself can help relieve the inflammation in the eyes and reverse the skin symptoms as well.

Veterinary Cost

The cost of diagnosis is typically a $500 to $1,500 affair if a dermatologist and/or ophthalmologist is involved and multiple surgical biopsies are undertaken. Observation of symptoms and response to corticosteroid therapy, however, may suffice for diagnosis of some of our more mildly affected patients. This may amount to no more than $200 to $500 for a lucky few.

With respect to treatment, costs may escalate quickly if pain and vision changes do not respond well to initial treatments with inexpensive corticosteroids and pricey drugs must be employed. Side effects related to corticosteroids or other immunosuppressive drugs may also raise the price precipitously for those sensitive to these therapies.

Prevention

Though inheritance modalities have not yet been established it’s considered advisable to refrain from breeding affected dogs and their first degree relatives (parents and siblings).



References

Kern, Thomas J.; Walton, Donna K.; Riis, Ronald C.; Manning, Thomas O.; Laratta, Louis J. and Dziezyc, Joan Uveitis associated with poliosis and vitiligo in six dogs. Journal of the American Veterinary Medical Association 1985 (15 August);187 (4):408-414.

Brooks, Wendy C.; Vogt-Koyanagi-Harada-Like Syndrome in Dogs. VeterinaryPartner.com Pet Heath Library. 2008.