Cats and lupus
Lupus is rare in cats, but is believed to be under diagnosed. As with humans there are 2 forms of lupus: discoid lupus (DLE) and systemic lupus (SLE), both can cause damage to various organs and can be fatal without treatment.
The mean age is six years, but it can occur at any age, gender does not play a role.
Some of the breeds that appear to have a predilection for SLE include Persian, Siamese, and Himalayan cat breeds.
The symptoms of SLE may be acute (appear suddenly) or chronic (they come and go).
Common symptoms of SLE include:
Fever that does not respond to antibiotics
Shifting leg lameness (the most common symptom). An owner may notice their cat limping on a front leg, then not limping at all. Weeks or months later, the same cat might start limping on a back leg, or on the other front leg.
Painful joints and muscles
Lack of appetite
Low platelet and white blood cell numbers
Skin lesions (especially on the bridge of the nose)
Increased thirst and urination
Common symptoms of DLE include:
Loss of pigmentation around lips, eyes, ears, or genitals
Change in texture of the nose (rough to smooth)
As in humans many of the symptoms of both SLE and DLE can mimic other disorders, so it is important for the vet to make a positive diagnosis before beginning treatment.
Diagnosing lupus in cats
If your cat shows any of the symptoms above you should visit your vet immediately.
SLE is typically diagnosed through an examination of physical symptoms as well as a series of lab tests, including blood work (antinuclear antibodies (ANA) test) and urinalysis. Your vet will need to look at all of the clinical signs in order to exclude other conditions that can cause similar symptoms, such as cancer or infection.
As in dogs, DLE is definitively diagnosed through a skin biopsy. In some cases, sedation or anesthesia may be required to calm an anxious cat or if the skin sample will be taken from a sensitive area.
How is lupus in cats treated?
There is no cure for lupus, and many cats will require lifelong treatment. Treatment is primarily aimed at suppressing the inappropriate immune response and reducing pain and inflammation. More specific treatments may be required if a cat’s organs have been affected by SLE.
Cats suffering from severe, acute effects of SLE may need to be hospitalized for initial management until the condition can be stabilized. Enforced rest and a protein-restricted diet are hallmarks of initial treatment.
Common treatment options for SLE include:
Anti-inflammatory/immunosuppressive drugs, including NSAIDs and corticosteroids such as Prednisoneand Dexamethasone.
Some cats may require stronger immunosuppressive drugs, such as Cyclosporine.
Antibiotics if a secondary infection is present.
Limited exposure to sunlight.
In most cases, treatment (or more accurately, management) of SLE must be continued for life, although doses of medication can be tapered if remission occurs.
Common treatment options for DLE include:
Oral steroids such as Prednisone.
Topical steroid creams, though these are often licked off by cats.
Antibiotics to treat any secondary infections.
Omega 3 Fatty Acids and vitamin E can provide relief from inflammation and swelling.
Keeping the cat out of the sun will also help to reduce future occurrences of the signs of DLE
What is the outlook/prognosis?
The prognosis for cats with lupus can vary and will depend on the severity of your cat’s condition. Some cats with SLE will survive with the help of long-term treatments to control the immune response. Other cats will not survive. In general, the prognosis for cats suffering with SLE is guarded.
Those cats that do develop DLE often go into remission, making chronic immunosuppressive therapy less commonly necessary. Moreover, cats with DLE usually feel fine, even though the condition can be disfiguring.
Cats with lupus should be kept out of the sun as much as possible as symptoms of SLE and DLE usually worsen with exposure to ultraviolet light. Owners can apply waterproof, high SPF sunscreen to affected areas as well.
As with SLE, cats with DLE should be checked by a veterinarian regularly to assess progression of the disease and to monitor the success of treatment. Affected cats should not be used for breeding.
Gobbolino belonged to Professor David D'Cruz of the Louise Coote Lupus Unit at Guys Hospital. Gobbolino had lupus of the paw, she was treated with steroids and recovered well. Gobbolino passed away in 2008. After battling lupus she developed cancer.
Felix lost the fur on his nose and had terrible nose bleeds in 2011 . He was on high dose steroids for around 3 years and then went into remission . He passed away in 2019 following a tumour in his neck.