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Systemic Lupus Erythematosis (SLE) in Dogs

What is systemic lupus erythematosus, and which dogs get it?

systemic-lupus-erythematosis-in-dogsSystemic lupus erythematosus (SLE) is an immune-mediated disease in which a dog’s immune system begins to attack her own tissues. Every tissue in the body contains substances that may stimulate an immune system reaction. These substances are called “antigens.”  When the immune system reacts to antigens, it produces proteins called “antibodies” that induce an immune response. SLE involves many body systems and tissues.

Some breeds are predisposed to developing SLE. They tend to be medium to large dogs. These include:

  • German Shepherds
  • Shetland Sheepdogs
  • Collies
  • Beagles
  • Poodles

The mean age of onset is 5 years, but SLE has been reported in dogs a young as 6 months of age. Male dogs were more likely to develop systemic lupus erythematosus than female dogs in a single study.

What happens when a dog develops SLE?

Signs of SLE can occur acutely (suddenly) or chronically (slowly and subtly over time). A dog’s symptoms will depend upon where in the body the immune system is attacking the tissues, for example the skin or the joints. The signs of SLE may wax and wane over time – the dog may get better, then worse, then better again. There may be more signs as SLE progresses.

Specific signs of SLE may include any or all of the following:

  • Lethargy
  • Decreased appetite
  • Lameness that appears to move from limb to limb
  • Skin signs that may include redness, thinning, localized ulceration, loss of pigment, and thinning or loss of hair
  • Fever
  • Ulcers at mucocutaneous junctions (areas where the skin meets mucous membranes, like the lips)
  • Enlarged lymph nodes
  • Enlarged spleen
  • Enlarged liver
  • Muscle pain
  • Muscle atrophy (wasting)
  • Issues with the nervous system

What causes SLE?

A single definitive cause for SLE has never been identified.

How is SLE treated?

Most of the time, dogs with SLE are treated as outpatients, but if the dog’s immune system is attacking her red blood cells, a short hospitalization may be required. Treatment will depend upon which body systems are affected. If the joints are inflamed, then rest and restricted activity is critical. If the skin is sensitized to UV radiation, then protection from the sun will help prevent progression of skin lesions. If the kidneys are affected and compromised, then a modified, high-quality protein diet with omega-3 (n-3) fatty acid supplementation is recommended.

"There are several medications
that may be used to manage SLE."

There are several medications that may be used to manage SLE. Corticosteroids (e.g. prednisone) are used to reduce inflammation and to help suppress the abnormal immune system activity associated with SLE. There are certain chemotherapeutic agents that may be used when prednisone is inadequate alone. Another immune-system suppressing medication that may be prescribed is cyclosporine.

What are some long-term issues involved with SLE?

Patients with SLE need physical examinations frequently at first. Bloodwork will be repeated periodically to monitor for the potential side effects of the medications that are used to manage SLE.

Since there seems to be a genetic predisposition in some breeds, dogs affected by SLE should not be used for breeding.

Dogs affected by SLE may develop kidney failure. Nephrotic syndrome is also associated with SLE. In nephrotic syndrome, the dog develops protein in the urine, low levels of blood albumin, high levels of cholesterol, and fluid accumulation in the abdomen, chest, and/or under the skin as a result of inflammation of the filtration apparatus of the kidney. Some dogs with SLE will develop overwhelming infection or even sepsis (severe inflammation triggered by the body’s immune response that can cause organ failure).

What is the outlook for dogs with SLE?

Dogs with SLE have a guarded prognosis. This is a devastating disease, and one that is difficult to treat. It is progressive and unpredictable, and dogs with this diagnosis require long-term treatment to decrease the immune response. Suppressing the immune system has potentially serious side effects, making both the disease and its treatments worrisome.

This client information sheet is based on material written by: Robin Downing, DVM, DAAPM, DACVSMR, CVPP