Ischemic Dermatopathy / Cutaneous vasculitis

A little known and often misdiagnosed reaction to the rabies vaccine in
dogs, this problem may develop near or over the vaccine administration
site and around the vaccine material that was injected, or as a more
widespread reaction. Symptoms include ulcers, scabs, darkening of the
skin, lumps at the vaccine site, and scarring with loss of hair. In
addition to the vaccination site, lesions most often develop on the ear
flaps (pinnae), on the elbows and hocks, in the center of the footpads
and on the face. Scarring may be permanent. Dogs do not usually seem
ill, but may develop fever. Symptoms may show up within weeks of
vaccination, or may take months to develop noticeably.

Dogs with active lesion development and / or widespread disease may be
treated with pentoxyfylline, a drug that is useful in small vessel
vasculitis, or tacrolimus, an ointment that will help suppress the
inflammation in the affected areas.

Owners and veterinarians of dogs who have developed this type of
reaction should review the vaccination protocol critically and try to
reduce future vaccinations to the extent medically and legally possible.
At the very least, vaccines from the same manufacturer should be
avoided. It is also recommended that the location in which future
vaccinations are administered should be changed to the rear leg, as far
down on the leg as possible and should be given in the muscle rather
than under the skin.

http://en.wikipedia.org/wiki/Vaccination_of_dogs
--------------------------------------------------------------------------------

A retrospective study of canine and feline cutaneous vasculitis
Patrick R. Nichols**Animal Allergy and Dermatology Center of Central
Texas, 4434 Frontier Trail, Austin, Texas 78745, USA
Daniel O. Morris††Department of Clinical Studies, Veterinary Hospital,
University of Pennsylvania, 3850 Spruce St., Philadelphia, Pennsylvania
19104, USA and
Karin M. Beale‡‡Gulf Coast Veterinary Dermatology and Allergy, 1111 West
Loop South, Suite 120, Houston, Texas 77027, USA
*Animal Allergy and Dermatology Center of Central Texas, 4434 Frontier
Trail, Austin, Texas 78745, USA †Department of Clinical Studies,
Veterinary Hospital, University of Pennsylvania, 3850 Spruce St.,
Philadelphia, Pennsylvania 19104, USA ‡Gulf Coast Veterinary Dermatology
and Allergy, 1111 West Loop South, Suite 120, Houston, Texas 77027, USA
Correspondence: Daniel O. Morris, Department of Clinical Studies,
Veterinary Hospital, University of Pennsylvania, 3850 Spruce St.,
Philadelphia, PA 19104, USA.
Abstract

Twenty-one cases of cutaneous vasculitis in small animals (dogs and
cats) were reviewed, and cases were divided by clinical signs into five
groups. An attempt was made to correlate clinical types of vasculitis
with histological inflammatory patterns, response to therapeutic drugs
and prognosis. Greater than 50% of the cases were idiopathic, whereas
five were induced by rabies vaccine, two were associated with
hypersensitivity to beef, one was associated with lymphosarcoma and two
were associated with the administration of oral drugs (ivermectin and
itraconazole). Only the cases of rabies vaccine-induced vasculitis in
dogs had a consistent histological inflammatory pattern
(mononuclear/nonleukocytoclastic) and were responsive to combination
therapy with prednisone and pentoxifylline, or to prednisone alone. Most
cases with neutrophilic or neutrophilic/eosinophilic inflammatory
patterns histologically did not respond to pentoxifylline, but responded
to sulfone/sulfonamide drugs, prednisone, or a combination of the two.

http://www.blackwell-synergy.com/doi...3.2001.00268.x
--------------------------------------------------------------------------------
Vitale, Gross, Magro (1999)
Vaccine-induced ischemic dermatopathy in the dog
Veterinary Dermatology 10 (2), 131–142.
doi:10.1046/j.1365-3164.1999.00131.x

Prev Article Next Article
Full Article
Vaccine-induced ischemic dermatopathy in the dog
Vitale,
Gross &
Magro
1Department of Medicine and Epidemiology, School of Veterinary Medicine,
University of California, Davis, California 95616, USA, 2IDDEX
Veterinary Services, California Dermatopathology Service, 2825 KOVR
Drive, West Sacramento, California 95605, USA, 3Department of Pathology,
Beth Israel Hospital, Harvard Medical School, Pathology Services, Inc.,
640 Memorial Drive, Cambridge, Massuchusetts 02139, USA
Correspondence to: Carlo B. Vitale
Present address: Encina Veterinary Hospital, 2803 Ygnacio Valley Road,
Walnut Creek, California 94598, USA.
Abstract
Post-rabies vaccination alopecia associated with concurrent multifocal
ischemic dermatopathy was identified in three unrelated dogs. All dogs
received subcutaneous rabies vaccine dorsally between the scapulae
several months prior to observation of the initial area of alopecia at
the vaccination site. All three dogs developed multifocal cutaneous
disease within 1–5 months after the appearance of the initial skin
lesion. Cutaneous lesions were characterized clinically by variable
alopecia, crusting, hyperpigmentation, erosions, and ulcers on the
pinnal margins, periocular areas, skin overlying boney prominences, tip
of the tail, and paw pads. Lingual erosions and ulcers were observed in
two dogs. Histopathologic examination of the skin revealed moderate to
severe follicular atrophy, hyalinization of collagen, vasculopathy, and
cell-poor interface dermatitis and mural folliculitis. Hypovascularity
was demonstrated by diminished Factor VIII staining of blood vessels.
Nodular accumulations of lymphocytes, plasma cells, and histiocytes in
the deep dermis and panniculus also were noted at the rabies vaccination
site. An atrophic, ischemic myopathy paralleling the onset of skin
disease was identified in two dogs. Histological examination of muscle
biopsy specimens demonstrated perifascicular atrophy, perimysial
fibrosis, and complement (C) 5b-9 (membrane attack complex) deposition
in the microvasculature of both dogs with myopathy. Marked improvement
of the skin disease was obtained with oral pentoxifylline and vitamin E.

http://www.blackwell-synergy.com/doi...4.1999.00131.x

--------------------------------------------------------------------------------
The Armed Forces Institute of Pathology
Department of Veterinary Pathology
WEDNESDAY SLIDE CONFERENCE
2002-2003

CONFERENCE 19
26 February 2003

Conference Moderator:
Dr. Michael Goldschmidt, MSc, BVMS, MRCVS Diplomate, ACVP
Professor, School of Veterinary Medicine
University of Pennsylvania
Philadelphia, PA 19104-6051

CASE II - 2513-02 (AFIP 2839301)

Signalment: 5-year-old, male, castrated, canine, Chihuahua
History: One by three cm lesion on the dorso-lateral neck
Gross Pathology: None
03WSC19 - 2 -
Laboratory Results: None

Contributor’s Morphologic Diagnosis: Post-rabies vaccination alopecia
with injection site granuloma and panniculitis

Contributor’s Comment: The hair follicles are markedly atretic and their
lower portions are replaced by an eosinophilic, hyaline stroma. The
deeper dermis also has a cleft or seroma pocket that is partially lined
by a thin layer of foamy macrophages and multinucleated giant cells with
more peripheral lymphoid nodules with many scattered dermal macrophages,
lymphocytes and plasma cells. Scattered melanin-laden macrophages
(positive with Fontana-Masson melanin stain and negative for hemosiderin
with a Prussian blue stain) are in the hyalinized lengths of the hair
follicles with a few beneath the epidermal basement membrane (pigmentary
incontinence).

This is post-rabies vaccination alopecia with an underlying injection
site granuloma. Post-rabies vaccination alopecia is most commonly seen
in toy or small breeds, especially Poodles, but Chihuahua cases have
been reported. The lesion usually develops three to six months after
vaccination.

Other reports describe mild to severe lymphocytic inflammation with
macrophages in the superficial or deep dermis or scattered around hair
follicle remnants. The dermis may have smudging of the collagen,
especially around the hair follicles. Rabies vaccine antigen has been
found in the hair follicle epithelium and in the walls of vessels in the
area. One report of focal alopecia developing in all twelve of twelve
inbred miniature Poodles injected with a killed rabies vaccine two
months earlier suggest that there may be a familial predisposition to
this apparently idiosyncratic, hypersensitivity reaction to the antigen.

http://www.afip.org/vetpath/WSC/wsc02/02wsc19.pdf
--------------------------------------------------------------------------------
Article entitled, ISCHEMIC SKIN DISEASE IN THE DOG by Dr. Peter J.
Ihrke, VMD, DACVD
Professor of Dermatology, Chief, Dermatology Service, VMTH, Department
of Medicine & Epidemiology, School of Veterinary Medicine, University of
California, Davis, CA, USA presented at the World Small Animal
Veterinary Association 2006 Congress (article accessible at
http://www.vin.com/proceedings/Proce...765&O=Generic).

The following are quotes from Dr. Ihrke's presentation:

3. Localized post-rabies vaccination panniculitis (Post-Rabies): A
localized ischemic skin disease associated with a rabies vaccination
site and temporal link with the vaccination.

4. Generalized vaccine-induced ischemic dermatopathy (GVIID): A
generalized ischemic skin disease with a temporal linkage with rabies
vaccination, but with more severe generalized post-rabies
vaccination-associated disease.

2. Post-rabies vaccination associated disease is presumed to be due to
an idiosyncratic immunologic reaction to rabies antigen that partially
targets vessels. Rabies viral antigen can be documented in the walls of
dermal blood vessels and in the epithelium of hair follicles via
immunofluorescent testing. Since this syndrome is seen predominantly in
very small dogs, it is tempting to speculate that the disease may be
partially linked to increased antigenic load in comparison to the body
size of the dog, since the same volume of rabies vaccine is given to all
dogs subcutaneously.

Initial lesions--an alopecic macule or plaque develops at the site of
prior subcutaneous rabies vaccine deposition. The time between
vaccination and noting of the lesion usually is between one and three
months.
__________________________________________________ ________________________
http://www.vin.com/proceedings/Proce...8602&O=Generic

Cutaneous Vasculitis and Vasculopathy
Verena K. Affolter
School of Veterinary Medicine, University of California, Davis
Davis, CA, USA

" Immune-mediated vasculitis is typically triggered by an adverse drug
reaction (antibiotics, nonsteroidal anti-inflammatory medications,
vaccines,...."

"Vaccine-induced vasculitis is mainly seen in small breed dogs...."

"Acute vasculitis--Legs and feet, ears, lips, tip of the tail, scrotum,
and oral mucosa are mostly affected. These areas are more vulnerable as
their blood supply has limited collateral circulation. With cutaneous
vasculitis erythema, ecchymoses, areas of necrosis, and well-demarcated,
"punched out" ulcers, and occasionally hemorrhagic bullae and/or
pustules are seen. Erythema caused by vasculitis does not blanche with
diascopy because of extravasation of the red blood cells. Subcutaneous
vasculitis presents as nodular lesions. Systemic vasculitis causes
variable clinical signs depending on the organ systems involved: phasic
pyrexia, lethargy, anorexia, myalgia, arthralgia, lymphadenopathy and
nasal discharge are seen. Wide spread systemic vasculitis may progress
into shock and disseminated intravascular coagulation.
Chronic vasculitis--Less severe or slowly progressive vasculitis results
in low-grade ischemia. Clinically these cases become evident at a
chronic stage. Patchy alopecia, scaling, erythema and hyperpigmentation
are seen. Lesions typically involve the pinnae, face, feet and tip of
the tail often occurring over pressure points."

__________________________________________________ __________________________________________________ ________________
Combination Vaccines, Multiple Shots--on Page 16 of the 2003 AAHA
Guidelines under Immunological Factors Determining Vaccine Safety, it
states that: "Although increasing the number of components in a vaccine
may be more convenient for the practitioner or owner, the likelihood for
adverse effects may increase. Also, interference can occur among the
components. Care must be taken not to administer a product containing
too many vaccines simultaneously if adverse events are to be avoided and
optimal immune responses are sought. "
--------------------------------------------------------------------------------

Duration of Immunity to Canine Vaccines: What We Know and Don't Know,
Dr. Ronald Schultz http://www.cedarbayvet.com/duration_of_immunity.htm

World Small Animal Veterinary Association 2007 Vaccine Guidelines
http://www.wsava.org/SAC.htm Scroll down to Vaccine Guidelines 2007 (PDF)

The 2003 American Animal Hospital Association's Canine Vaccine
Guidelines are accessible online at
http://www.leerburg.com/special_report.htm .

The 2006 American Animal Hospital Association's Canine Vaccine
Guidelines are downloadable in PDF format at
http://www.aahanet.org/PublicDocumen...s06Revised.pdf .

Veterinarian, Dr. Robert Rogers,has an excellent presentation on
veterinary vaccines at http://www.newvaccinationprotocols.com/

In article ,
chardonnay9 wrote:
Ischemic Dermatopathy / Cutaneous vasculitis

I think the evidence is pretty compelling that you do not
know the definition of a single one of those words.
--
Melinda Shore - Software longa, hardware brevis -

Prouder than ever to be a member of the reality-based community

chardonnay9 chardonnay9
@earthlink.net spoke these words of
wisdom in
news:TdSdnYCOZdXjHdzUnZ2dnUVZ_oWdnZ2d
@earthlink.com:

I was bitten by a rabid cat about 30
years ago. The rabies series saved my
life. I had violent allergic
reactions to the series. They managed
the allergic reactions and I still
had to take the series ALLERGIC or
NOT.
It saved my life.
My horse was also bitten by another
rabid cat that day. She died. If she
had a rabies vaccine preventative,
she never would have died at all.

It would have been so simple to
prevent. But not having her
vaccinated cost her life.

I can't imagine NOT vaccinating.
It's so simple. I had no idea that
rabies was even present in our area
when this all went down.

Now, not only my dogs get rabies
vaccines, my horse does too.
As do I .

I didn't invite rabies into my life,
and I had no idea it was even
lurking.

I didn't expect it then. I know
better now. A simple shot, and it's
not even a worry. It's all so simple.

chardonnay9 wrote:

*snip*

Hey, dog abuser! Thought you might be interested in hearing this
story that was posted to one of the raw feeding email lists today:

"I just got off the phone with an acquaintance who was turned
in to Animal Control for raw feeding her dogs. Apparently one
of the animal rescue shows on Animal Planet showed a group of
dogs being seized for poor living conditions and being fed
animal carcasses - legs, organs, etc. Her neighbors turned
her in after viewing the show. She feeds raw/prey model, and
the dogs usually eat their meals outdoors on her deck or in
their back yard.

"Animal Control cited her with failure to provide a proper diet
as she had no 'dog food' in the house. She is being asked to
feed a 'dog appropriate kibble diet' and will be checked on
periodically by AC to insure she is complying or her animals
will be seized.

"They are in the process of moving to a rural area in another
state, but she's really torn up about this. The AC vet,
unfortunately, sides with AC that raw food is not a safe diet."

Ha ha ha ha ha ha ha ....

Dianne

diddy wrote:
chardonnay9 chardonnay9
@earthlink.net spoke these words of
wisdom in
news:TdSdnYCOZdXjHdzUnZ2dnUVZ_oWdnZ2d
@earthlink.com:

I was bitten by a rabid cat about 30
years ago. The rabies series saved my
life. I had violent allergic
reactions to the series. They managed
the allergic reactions and I still
had to take the series ALLERGIC or
NOT.
It saved my life.
My horse was also bitten by another
rabid cat that day. She died. If she
had a rabies vaccine preventative,
she never would have died at all.

It would have been so simple to
prevent. But not having her
vaccinated cost her life.

I can't imagine NOT vaccinating.
It's so simple. I had no idea that
rabies was even present in our area
when this all went down.

Now, not only my dogs get rabies
vaccines, my horse does too.
As do I .

I didn't invite rabies into my life,
and I had no idea it was even
lurking.

I didn't expect it then. I know
better now. A simple shot, and it's
not even a worry. It's all so simple.

Ok, so why do it over and over again when the protection doesn't wear off?

chardonnay9 spoke these words of wisdom in
m:

diddy wrote:
chardonnay9 chardonnay9
@earthlink.net spoke these words of
wisdom in
news:TdSdnYCOZdXjHdzUnZ2dnUVZ_oWdnZ2d
@earthlink.com:

I was bitten by a rabid cat about 30
years ago. The rabies series saved my
life. I had violent allergic
reactions to the series. They managed
the allergic reactions and I still
had to take the series ALLERGIC or
NOT.
It saved my life.
My horse was also bitten by another
rabid cat that day. She died. If she
had a rabies vaccine preventative,
she never would have died at all.

It would have been so simple to
prevent. But not having her
vaccinated cost her life.

I can't imagine NOT vaccinating.
It's so simple. I had no idea that
rabies was even present in our area
when this all went down.

Now, not only my dogs get rabies
vaccines, my horse does too.
As do I .

I didn't invite rabies into my life,
and I had no idea it was even
lurking.

I didn't expect it then. I know
better now. A simple shot, and it's
not even a worry. It's all so simple.

Ok, so why do it over and over again when the protection doesn't wear
off?


They are studying that. The tests need that. It's been discovered that just
because a dog has adequate titers, does not guarantee protection. (No
cite, just wom from my veterinarian) And we need to find something accurate
to measure protection with. Apparently titers are not even the gold
standard.

Been bit once, I'd rather be safe.

Melinda Shore wrote:
In article ,
chardonnay9 wrote:
Ischemic Dermatopathy / Cutaneous vasculitis

I think the evidence is pretty compelling that you do not
know the definition of a single one of those words.

The evidence is also pretty compelling that you do not have a leg to
stand on concerning what I post so you have to resort to personal
attacks and lies.

diddy wrote:
chardonnay9 spoke these words of wisdom in
m:

diddy wrote:
chardonnay9 chardonnay9
@earthlink.net spoke these words of
wisdom in
news:TdSdnYCOZdXjHdzUnZ2dnUVZ_oWdnZ2d
@earthlink.com:

I was bitten by a rabid cat about 30
years ago. The rabies series saved my
life. I had violent allergic
reactions to the series. They managed
the allergic reactions and I still
had to take the series ALLERGIC or
NOT.
It saved my life.
My horse was also bitten by another
rabid cat that day. She died. If she
had a rabies vaccine preventative,
she never would have died at all.

It would have been so simple to
prevent. But not having her
vaccinated cost her life.

I can't imagine NOT vaccinating.
It's so simple. I had no idea that
rabies was even present in our area
when this all went down.

Now, not only my dogs get rabies
vaccines, my horse does too.
As do I .

I didn't invite rabies into my life,
and I had no idea it was even
lurking.

I didn't expect it then. I know
better now. A simple shot, and it's
not even a worry. It's all so simple.
Ok, so why do it over and over again when the protection doesn't wear
off?

They are studying that. The tests need that. It's been discovered that just
because a dog has adequate titers, does not guarantee protection. (No
cite, just wom from my veterinarian) And we need to find something accurate
to measure protection with. Apparently titers are not even the gold
standard.

Been bit once, I'd rather be safe.

It's been known for a long time that the shots last at least for years
if not for life. Problem has been that there has been a lack of studies
on this because the vaccine manufacturers don't want to cut off their
nose to spite their face. This is the same reason why kibble producers
don't do studies and compare their kibble with natural feeding. Cites?
You want cites? Knowing the truth doesn't always lead to cites. It's us
against the huge corporations.

Thank goodness for Jean Dodd and friends, who, on a grass roots level,
got such a study going that will save dogs from all those horrible
vaccine reactions and illnesses.

http://www.rabieschallengefund.org/

In article ,
chardonnay9 wrote:
Cites?
You want cites? Knowing the truth doesn't always lead to cites.

Can I quote you on that?

Just because everybody thinks you're an idiot doesn't mean
you're Galileo.
--
Melinda Shore - Software longa, hardware brevis -

Prouder than ever to be a member of the reality-based community

I'm one of a fairly small minority of humans in this province who get a
rabies vaccination. I wouldn't say that the 'average' person in this
province is at risk of getting rabies. Yes its here, but most people aren't
in an environment where they are likely to be exposed. The largest reservoir
for rabies around here is undoubtedly bats.

I got a rabies vaccination because its not unlikely that at some point I
will be exposed to rabies, and there is a chance that at the time of
exposure I might not know it. (Was chatting with one of my profs, and he
told me that last time he had his titer checked, it had gone up rather than
down, he has no idea when he might have been exposed*)

I had, what in my mind amounts to a relatively mild reaction to the vaccine.
I was very tired for a several days following the vaccination and my skin
became hypersensitive for about a week (when ever I put on nitrile gloves,
I'd start to itch). I also developed a small red lump at the injection site
that eventually went away (this is considered normal for the human vaccine).

In my mind, this is a relatively minor price to pay to have protection
against something that will kill me if I get it. If the best science we've
been able to apply to the situation says that at some point I should be
revaccinated to ensure that the protection is maintained, well I'll be
revaccinated.

For my pets its a similar story. I can't control what they might encounter
when I'm not watching them. I can't get in to their heads, and be sure that
they take appropriate precautions when dealing with potentially rabid
animals, and if there is ever any question, well not vaccinating could
easily be a fatal mistake for them on my part. (Is there even a post
exposure protocol for animals? I don't think there is...)

Dale