Polyautoimmunity manifest as inflammatory myopathy, uveitis, and progressive cutaneous depigmentation in a mixed breed dog: a case report.

BACKGROUND: Polyautoimmunity is the expression of more than one autoimmune disease in a single patient. This report documents polyautoimmunity in a mixed breed dog with concurrent uveitis, cutaneous depigmentation, and inflammatory myopathy. CASE PRESENTATION: A 1-year-old male neutered mixed breed dog was presented for progressive generalized leukotrichia and leukoderma, bilateral panuveitis, and masticatory muscle atrophy. The latter progressed to myositis of lingual, pharyngeal, and masticatory muscles confirmed by biopsy. Temporalis muscle was completely replaced by adipose and fibrous tissue, and necrotic myofibers with extensive infiltration of mononuclear cells indicated active myositis of lingual muscle. Skin biopsies showed severe melanin clumping in epidermis, hair follicles, and hair shafts, and perifollicular pigmentary incontinence. Uveitis, depigmentation, and myositis affecting the masticatory, pharyngeal, and tongue muscles were diagnosed based on clinical, histological, and laboratory findings. CONCLUSIONS: To the authors' knowledge, this is the first report of concurrent uveitis, progressive cutaneous depigmentation, and inflammatory myopathy in a dog.

Safety profile and effects on the peripheral immune response of fecal microbiota transplantation in clinically healthy dogs.

BACKGROUND: Fecal microbiota transplantation (FMT) is increasingly used for gastrointestinal and extra-gastrointestinal diseases in veterinary medicine. However, its effects on immune responses and possible adverse events have not been systematically investigated. HYPOTHESIS/OBJECTIVES: Determine the short-term safety profile and changes in the peripheral immune system after a single FMT administration in healthy dogs. ANIMALS: Ten client-owned, clinically healthy dogs as FMT recipients, and 2 client-owned clinically healthy dogs as FMT donors. METHODS: Prospective non-randomized clinical trial. A single rectal enema of 5 g/kg was given to clinically healthy canine recipients. During the 28 days after FMT administration, owners self-reported adverse events and fecal scores. On Days 0 (baseline), 1, 4, 10, and 28 after FMT, fecal and blood samples were collected. The canine fecal dysbiosis index (DI) was calculated using qPCR. RESULTS: No significant changes were found in the following variables: CBC, serum biochemistry, C-reactive protein, serum cytokines (interleukins [IL]-2, -6, -8, tumor necrosis factor [TNF]-α), peripheral leukocytes (B cells, T cells, cluster of differentiation [CD]4+ T cells, CD8+ T cells, T regulatory cells), and the canine DI. Mild vomiting (n = 3), diarrhea (n = 4), decreased activity (n = 2), and inappetence (n = 1) were reported, and resolved without intervention. CONCLUSIONS AND CLINICAL IMPORTANCE: Fecal microbiota transplantation did not significantly alter the evaluated variables and recipients experienced minimal adverse events associated with FMT administration. Fecal microbiota transplantation was not associated with serious adverse events, changes in peripheral immunologic variables, or the canine DI in the short-term.

Impact of mandatory physician reporting on accident risk in epilepsy.

BACKGROUND: In some jurisdictions, physicians are required by law to report patients with seizures to the department of motor vehicles. We assessed the hypothesis that mandatory reporting reduces the risk of automobile accidents in people with epilepsy. METHODS: A retrospective survey of driving and accident rates was done by mailed questionnaire to two groups of subjects with epilepsy in Canada, one living in Ontario where reporting is mandatory and the other in Alberta where it is not. Responses were obtained from a control group without epilepsy for comparison. RESULTS: The epilepsy (n = 425) and control (n = 375) groups were comparable in age and sex. Seventy-three percent of the epilepsy group were or had been licensed drivers compared to 94% of the controls (rr 0.77, 95% CI 0.73-0.83, p < 0.001). Lifetime accident rate of licensed drivers was 58% in epilepsy and 60% in controls (rr 0.99, 95%CI 0.82-1.19, ns) while 9% of the epilepsy group and 9% of the controls had an accident in the previous year (rr 1.00, 95%CI 0.95-1.06, ns). All those with epilepsy in Ontario (n = 202) and Alberta (n = 223), also comparable in age and sex, had equal lifetime accident rates of 45 and 46% (rr 0.99, 95%CI 0.67-1.47, ns) and 1-year rates of 11 and 8% (rr 1.38, 95%CI 0.59-3.27, ns). In Ontario, 20% of drivers were unlicensed compared to 9% in Alberta (rr 2.39, 95%CI 1.17-4.89, p = 0.01) CONCLUSION: Although it is clearly dangerous for many people with ongoing seizures to drive, the findings provide no support for the hypothesis that mandatory reporting of patients by physicians reduces accident risk and suggest that concerns about the impact of epilepsy on driving compared to other medical and nonmedical risk factors may be excessive.