Autoimmune disease symptoms and treatment

[IamKat]

Hey all,
I started a thread a while ago called 'unknown illness?' about my hamster Soybean's strange symptoms. However I thought I'd just start a new thread regarding the outcome. It turns out Soybean has a very rare and unusual autoimmune disease, that in fact neither the vet nor the lab had ever seen presented in a hamster before (they were very surprised..). I thought I'd just post some details about Soybean's symptoms to help anybody that might experience this in the future.

It began (and was possibly triggered by) an eye infection, that was cleared up with isathal eye drops and a course of enrobactin oral antibiotics. It took a good few weeks to clear. During this time I noticed a small bald patch appear under her chin that progressively spread ventrally and then up over her flanks over the course of 5 weeks, combined with a lot of itching in the area. She tested negative for parasitic infection and ringworm, there were no pouch issues or oral abscesses, she has normal teeth and normal urine concentration. I then went to the exotic who took a skin biopsy which indicated this autoimmune disease, and she is now on a course of steroids.

Symptoms:
- Itching
- Increased scent from scent glands
- fur loss in itched areas - under chin, tummy, scent glands, legs and now around the eyes. Not symmetrical
- Sagging and very wrinkled skin
- Thinning of skin in bald areas but no lesions or cuts
- Increased rubbing behaviour
- Mouth hanging open slightly
- Some weight loss

Normal eating and drinking, normal energy levels and no apparent pain - just discomfort from itching. Soybean has become a little clingy over the last week, coming to the cage for attention and to be let out way more so than usual. This could be because the itching keeps her awake and so she is a little restless.

Soybean is now on steroids and I'll update this thread as to her progress. Steroid tablets are being crushed and mixed with baby food, she has no problem taking it in this way. I also rub a little oil into the skin when I can that seems to calm some of the itching, I'm also giving her evening primrose oil but I'm not sure if this is doing anything really. Also, her substrate was changed fairly early on from aspen to Carefresh which is softer and more gentle against her skin.

I hope this helps anyone in the future that might find these same symptoms. I never really considered autoimmune disease before and neither did the vet!

I will just say that this has been a perfect example of why it's a really good idea to save for a vet fund, the poor girl has been through the mill, and this has been really rather pricey... ! My vet fund has saved me a lot of stress and worry.

[Pebbles82]

This is amazing - how very clever of your exotic vet to diagnose this. Did they say specifically what kind of auto-immune disease? I am quite interested in this area as even with humans there is no real cause pinned down and varying views on why these diseases occur depending on which type it is. I think generally it's thought that there is a genetic predisposition that can be triggered by a virus of some kind.

An auto immune disease is where the body attacks itself. Normally the immune system develops antibodies to attach external negative things like viruses and bacteria to prevent against disease. In an auto immune disease the body produces antibodies against normal proteins and other things and the antibodies effectively attack a part of the body as if it is an invader. Examples of auto immune diseases in humans are Asthma, Rheumatoid Arthritis, Multiple Sclerosis and Myasthenia Gravis and there are others. In serious conditions like Myasthenia Gravis the muscles are affected and high doses of steroids are needed to suppress the body's immune system until other treatment is effective. Steroids are also used for asthma, eczema and RA sometimes too, amongst other things.

Usually it means due to the suppressed immune system due to steroid treatment there is more proneness to cathching illnesses or bugs as less defence against them, so extra careful measures if anyone has a cold eg.

There is also a link between allergy and auto-immune disease. I think I would also try her with a non allergenic paper bedding like Fitch. Although Carefresh is technically non allergenic there have been cases of hamsters having an allergy to it. Carefresh is wood pulp and there are a lot more chemical processes involved to make wood pulp than to make paper. It could be soybean is sensitive to some residue within the Carefresh or the dust. Allergies can have different effects - sometimes it can be a respiratory reaction - sneezing and wheezing - sometimes a skin reaction.

What a little trooper Soybean is. Did the vet rule out Cushings as that can also cause skin itching and I think it can only be diagnosed by a blood test. Just asking because there is treatment for Cushings - Coco's hamster Mocho had it.

[dreamtree1234]

What a brave little ham Soybean is! I'm so relieved that the exotic vet is able to help her recover. I will definitely keep her in my prayers and hope that she is feeling better soon. Thank you so much for sharing this with all of us. I'm sure it will help other hams in the future.

[IamKat]

Thanks so much Dreamtree and Serendipity for the wellwishes :)
This has been pretty awful and I hate seeing my girl deteriorate :( . Soybean's affectionate and bubbly personality keeps me smiling though :)

Serendipity - yeah it's really odd, but that's a very interesting theory about a possible allergy setting it off. I know these kind of diseases are thought to be genetic, but that their expression is triggered by some stress on the immune system, which is why I naturally assumed the eye infection was the culprit... but that's a great theory about the allergies.. I've immediately ordered some Fitch just in case (it certainly can't hurt :mad:).

The vet didn't give me a specific name for the disease, and I was so overwhelmed and shocked to get the news that I didn't think to ask at the time! But I am also interested to know, and will be talking to him in a week or so, so will gather a host of questions for him. Is there anything else you'd be interested to know? I'm happy to ask him.

In terms of Cushings, we ruled it out fairly early on because firstly she was drinking as normal, and her urine concentration confirmed that. Usually in Cushings the first thing people notice is excessive drinking. Secondly the hair loss usually begins at the back in a symmetrical manner, and progresses forwards. It was pretty much the opposite for Soybean. However, given that she is sable and I know with Cushings it tends to be a 'sable thing' , if the steroids don't work I may pursue this further.

I'm going to try and get some pictures of the affected areas to post here as a reference.

[SimonandSyril]

I wish your ham Soybean good luck and if you think about it him getting the rare disease is a good thing in the long run because then if other hamsters get it the world will hopefully know a little more about exactly what to do. Soybean's a hero!

[Pebbles82]

I am glad she is still bubbly and affectionate and has an owner who cares about her. Very hard for you. I hope, as it's a fairly rare case, your vet gives you a discount or some free information! Keep us posted if it all improves with the steroid treatment.

I'd be interested to know if the steroid treatment is a course that is reduced and stopped or whether it is a continuous thing - but just out of interest really. I do hope you see some improvement with her.

[IamKat]

Aw thanks guys! :D

I believe that if it works it will be an 'if symptoms flare up' sort of situation but I'll double check when I chat to him next week.

[BorisPasha]

It's very interesting to read more about it here after seeing your instagram post. I really hope that the steroids will get the autoimmune condition under control and that she remains stable without any flare ups.

[IamKat]

Thanks BorisPasha!

An update on Soybean, so she has been on the steroids for 2 weeks now, and we had a vet checkup on Tuesday. The vet is really happy with her progression, she has regrown some of the fur on the tummy. She has experienced some pigment changes on the skin but the vet says this is normal of inflammatory conditions. She is also less itchy. We are keeping her on the steroids for another month in the hope she continues to improve, and then will visit the idea of reducing her dose.

There are some side effects of the steroids, in particular her body shape has changed a little, as she has lost a little muscle. She has put weight on though even though she looks thinner (because of the body shape change), probably because the steroids make her hungry. However I'm glad about the weight gain because she had lost some prior to treatment. In general she is improving and the steroids seem to be doing good, so I'm really happy :)

Thanks for all the well wishes, I'll continue to update this thread and at some point will add some pics of what she looked like before and after treatment!

[dreamtree1234]

I'm so glad that Soybean is responding very well to the steroid treatment and she is doing much better. It must be a total relief to you that she is gaining some of her weight back and some of her hair has regrown, too. I will be keeping you both in my thoughts and hoping that she continues to improve and soon recovers completely so her treatments can be reduced in the future. Hugs to you. Please give Soybean a cuddle for me, too. :)

[SimonandSyril]

It's so promising that soybean is moving in the right direction, good luck on the future!

[IamKat]

Argh, so, Soybean was looking great for a few weeks, she grew the hair back on her tummy and pretty much completely stopped itching. She has been eating and drinking well and has had tons of energy so a lot of out of cage time. However... the last week or so has seen an odd turn where her eyes have become verryy bulgy and uncomfortable looking. The vet is unsure if this is an additional symptom of the disease that's not improved by the steroid or a symptom of the steroid itself... so we are trying her on half a tablet every other day instead of every day. She also has some drops to keep the eye moist but she hates them and that makes it difficult as i'm very loathe to restrain her considering the eyes. Has anybody had anything like this happen with steroids before? I'm really concerned about coming down one morning and finding a prolapse. Poor Soybean.. i never expected all this for her.

[Pebbles82]

So sorry about this. In humans steroids can cause eye bulging (and also something called "moon face" where the face becomes larger). But other diseases can cause it too. Difficult to know. Hope the dose reduction helps.

[BorisPasha]

Aww poor Soybean, that is such a shame when things had been going so well for her. I really hope that the reduced dose of the steroid will help and that the half dose will still keep her auto immune condition under control. Keeping my fingers crossed for her x

[dreamtree1234]

Aww, poor little Soybean. I am really sorry that she is now having this symptom after things have been looking up for her with her treatment. I really do hope that her bulging eye symptom goes away and her autoimmune disease is still controlled after you reduce her dosage. I will be wishing her and you all of the best. Hugs to you and cuddles to Soybean and the rest of your hamily. :)

[IamKat]

Thanks so much for the well wishes guys. It's impossible for me to put drops in now as it causes her so much stress and obvious discomfort - the benefits of the lubricant seem to be outweighed by the negatives. So I'm not bothering any more. It didn't seem to help much anyway.

Since dropping her dose her eyes do in general seem a bit better - she has up and down days with sometimes the eyes looking normal and sometimes super bulgy. But she has been itching again under her chin and lost a little fur again - goes to show how much the steroids were helping in that regard. So not sure where to go from here. I guess when I see the vet again in a few weeks we will re-assess.

Feeling pretty demoralised. Obviously I don't want her to suffer, but will do absolutely everything in my power to give her net happiness even if some days she feels poorly.

Thanks again all. xx

[dreamtree1234]

I am SO sorry that she is getting stressed by the steroids and now her symptoms are beginning to reemerge. I do hope that the vet will be able to give you some good suggestions as to what is best at this point. I hope there will be a good solution to help dear Soybean; bless her. Hugs to you, IamKat. I will definitely be keeping you both in my prayers and wishing the very best always. xx

[BorisPasha]

I'll be keeping everything crossed that the vet will be able to come up with an alternative for Soybean. It's a shame that she has a little fur loss again. Maybe it's been caused by the stress of the eye drops rather than the reduction in steroids, I hope so anyway xx

[IamKat]

Thanks so much guys. And that's a good point about the eye drops BP.. I guess we will see how things go over the next week or so. xx