The exact cause of immune mediated disease isn’t known, but there are many theories in both conventional as well as holistic veterinary medicine on why the inappropriate antigen triggers the immune cascade.
There are two theories to explain how vaccination can induce immunologic reactions in dogs.
The first is known as epitope mimicry. Antigens are substances that trigger the immune response in the body; an epitope is part of an antigen that’s recognized by the immune system. In epitope mimicry, one of the antigens in a vaccine shares structural similarities with self antigens. The immune system recognizes the vaccine antigen as foreign and initiates an immune response, which may also extend to host cells with similar self antigens.
The second theory involves the autoimmune effect of adjuvants.
Various adjuvants are introduced into vaccines to intensify the body’s immune response to the vaccine antigens. Lymphocytes are a type of white blood cell produced in lymphoid tissue. Some adjuvants have been found to trigger autoaggressive lymphocytes that can damage host tissues.
There is also some research into the role of Toll-like receptors and the cytokines involved. Toll-like receptors – TLRs – are innate immune system proteins that detect pathogens and launch immune and inflammatory responses to destroy invaders. Cytokines are proteins secreted by various cell types; they regulate the immune response as well as cell-to-cell communication. These cytokines may shift, resulting in their overexpression in many immune mediated diseases such as multiple sclerosis (related to degenerative myelopathy in dogs), rheumatoid arthritis and psoriasis.
Young animals are afflicted with autoimmune diseases more than older animals because protein coding genes in younger animals are limited and may allow overexpression of certain cytokines and TLRs. The neonatal immune system responds to multiple environmental microbes, pathogens and vaccines, all of which stimulate TLRs in the body.
Based on this information, it stands to reason that the sooner we can introduce healthy intestinal flora and probiotics the better. This can be as simple as supplementing his diet with a powdered product or as extensive as giving her a homemade diet with foods like green tripe that can propagate healthy intestinal flora. Most important, you should eliminate or limit antibiotic use.
From a clinical perspective, I’ve seen an increase in the incidence of all immune mediated diseases, from skin allergies to polyarthritis. It’s easier to track vaccination triggers, especially in the case of polyarthritis when joint pain and swelling frequently occurs within six weeks of vaccinations, but rarely in dogs that have not seen the veterinarian.
However, I now feel that immune mediated diseases occur with or without vaccinations. This may be due to the homeopathic concept of miasm, which proposes that vaccinations have weakened canine genetics over several generations.
Other potential autoimmune triggers are food allergens. Typically I use NAET to diagnose food allergies, and recommend avoiding as many allergens as possible in the diet. However, sometimes this list changes over time as the immune system shifts. Changing protein sources every three to four weeks helps prevent a reaction to that potential allergen, and switching from kibble to single protein raw diets with no carbohydrates often helps prevent itching.
An article published in Veterinary Dermatology in October 2001 on canine and feline cutaneous vasculitis found several triggers. They include the rabies vaccine, hypersensitivity to beef, and the common anti-parasitic substances ivermectin and itraconazole. Regardless of the potential cause and type of immune cells causing the inflammation, conventional treatments are very limited, usually involving drugs that suppress the immune system.
A CASE STUDY
I have been treating Bonnie, a 14 year old German Shepherd, for several years for a variety of immune mediated issues including discoid lupus (a form of cutaneous vasculitis), lip-fold vasculitis, interdigital pododermatitis, inflammatory bowel disease and skin allergies.
By treating these immune mediated symptoms with acupuncture and herbs, we may have prevented the worst autoimmune disease for Shepherds: anal fistula disease. Many animals with immune mediated diseases have a variety of inflammatory symptoms. For example, many polyarthritic dogs also itch excessively when fed certain foods.
Bonnie has been treated with single source homemade raw or cooked diets, rotation of novel proteins, rotation of both Chinese and western herbs (resistance occurs with herbs too), no vaccinations except rabies titers, acupuncture and a variety of nutraceuticals such as green tea extract, bioflavonoids, omega-3, rotation of vitamins and topical treatments including bentonite clay packs, diluted tea tree oil, green tea and Epsom salt soaks.
Her human is very dedicated and committed to avoiding pharmaceuticals, especially immune suppression medications like prednisone and Atopica. Because of this reduced pharmaceutical burden on her liver and kidneys, Bonnie has made it to 14 in relatively good health. She enjoys her food and her daily walks.
Here are some simple tips for prevention/early treatment of immune mediated diseases:
Take care of the GI flora. Consider probiotics or fermented foods like sauerkraut.
Limit antibiotic use, realizing that veterinarians overuse this class of medications because we feel forced to send home medicines.
Feed raw or cooked single protein, limited carbohydrate diets. It’s not as simple as grain free. Watch those treats! Change protein sources every month to bait and switch your dog’s immune response.
Check for fleas, even if you think they are not there.
See part 1 of this topic here.