Sjögren-like Syndrome in Dogs

Sjögren-like syndrome is a chronic, systemic autoimmune disease seen in adult dogs. Similar to the eponymous human illness, this syndrome is typically characterized by dry eyes, dry mouth, and glandular inflammation due to the infiltration of lymphocytes and plasma cells (white blood cells which produce antibodies). It is also associated with other autoimmune or immune-mediated diseases, such as rheumatoid arthritis and pemphigus.

The underlying cause of Sjögren-like syndrome is currently unknown.  However, autoantibodies which attack the glandular tissues are thought to be a factor. Dog breeds that are more prone to this syndrome include the English bulldog, West Highland white terrier, and miniature schnauzer.  (Cats do not seem to develop this Sjögren-like syndrome.)

Symptoms and Types

Typically, the onset of symptoms associated with Sjögren-like syndrome begin once the dog reaches adulthood. Such symptoms include:

• Dry eyes due to insufficient tear production (keratoconjuctivitis sicca); most prominent clinical feature
• Inflammation of the tissues around the eye (conjunctivitis)
• Inflammation of the cornea (keratitis)
• Abnormal eye twitching (blepharospasm)
• Redness of the tissue around the eyes
• Corneal lesions (opacity to ulceration)
• Inflammation of the gums (gingivitis)
• Ulcers in the mouth (stomatitis)

Causes

Because it develops concurrently with other immune-mediated and autoimmune diseases, there appears to be an immunologic factor to Sjögren-like syndrome. Some dog breeds may also be genetically predisposed to this disease.

Diagnosis

You will need to give a thorough history of your dog’s health to your veterinarian, including the onset and nature of the symptoms. He or she will then perform a complete physical examination as well as a complete blood count, biochemistry profile, and urinalysis. Your veterinarian may also employ a Schirmer tear test to determine if the tear production is at a normal rate (0 to 5 millimeters per minute).

A few common serological results seen in dogs with Sjögren-like syndrome include:

• Hypergammaglobulinemia (lots of antibodies in the blood) revealed by serum protein electrophoresis.
• Positive antinuclear antibody test
• Positive lupus erythematosus (immune-disorder causing skin disease) cell test
• Positive rheumatoid factor test (immune-disorder causing arthritis)
• Positive indirect fluorescent antibody test for autoantibodies (antibodies the animal may have against its own body)

Treatment

Often directed at managing concurrent diseases and controlling controlling keratoconjunctivitis sicca. This entails the use of topical tear preparations, immunosuppressive or anti-inflammatory drugs, and topical antibiotics for secondary bacterial infection of the cornea. Dogs that do not respond well the these methods may require surgery.

Living and Management

Your veterinarian will schedule regular follow-up appointments to examine the dog's progress and manage concurrent diseases and side effects associated with immunosuppressive drugs.