Image Quiz: Fragile, hyperextensible skin in a dog

Recommend supportive care, such as environmental alterations, is correct!

This condition is incurable.3 If the dog has no signs of joint hypermobility and laxity and the owner is compliant with supportive care, including seeking veterinary care appropriately, then the dog may live an extensive life.3,8 A dog with joint involvement is deemed as more severe and the prognosis worsens. Many owners elect to euthanize dogs with this condition because of the long-term suffering experienced.8,10

Appropriate supportive care includes environmental alterations such as a padded bed and rounded furniture, gentle handling of the dog, punctual owner attention to any skin condition that may irritate the dog and cause self-mutilation or lacerations, and prompt veterinary attention for wound cleaning and apposition.3,8,10 There are sources describing the beneficial use of oral vitamin C to decrease weakened skin.3,8,10

Because cutaneous asthenia is a congenital, hereditary connective tissue disorder (it is either dominant when both parents carry the mutated gene or recessive with one parent carrying the gene10), eliminating the gene from a breeding program is imperative. Thus, the patient along with its sire and dam should be removed from breeding.3,7,10

References

1. Barrera R, Mane C, Duran E, et al. Ehlers-Danlos syndrome in a dog. Can Vet J 2004;45:355-356.

2. Bellini MH, Caldini ET, Scapinelli MP, et al. Increased elastic microfibrils and thickening of fibroblastic nuclear lamina in canine cutaneous asthenia. Vet Dermatol 2009;20:139-143.

3. Ehlers-Danlos syndrome: what is it and is there a cure? Available at: http://www.cvm.okstate.edu/index.php?option=com_content&view=article&id=219:ehlers-danlos-syndrome-what-is-it-and-is-there-a-cure&catid=27:small-animal-questions&Itemid=315. Accessed April 14, 2014.

4. Rodriguez F, Herraez P, Espinosa de los Monteros A, et al. Collagen dysplasia in a litter of Garafiano shepherd dogs. Zentralbl Veterinarmed A 1996;43:509-512.

5. Bernal LJ, Sanchez J. Fragilidad cutanea adquirida: caso clinico. Consulta Difus Vet 1998;6:1960-1961.

6. Paciello O, Lamagna F, Lamagna B, et al. Ehlers-Danlos-like syndrome in 2 dogs: clinical, histologic, and ultrastructural findings. Vet Clin Pathol 2003;32:13-18.

7. Poulsen PH, Thomsen MK, Kristensen F. Cutaneous asthenia in the dog. A report of two cases. Nord Vet Med 1985;37:291-297.

8. Scott DW, Miller WH, Griffin CE. Muller & Kirk's small animal dermatology. 6th ed. Philadelphia, Pa: W.B. Saunders Co, 2001;602-604.

9. Iglauer F, Wilmering G, Huisinga E, et al. [Cutaneous asthenia (Ehlers-Danlos syndrome) in a domestic rabbit]. Dtsch Tierarztl Wochenschr 1999;106(12):500-505.

10. Stretchy, saggy, painful skin in dogs. Available at: http://www.petmd.com/dog/conditions/skin/c_multi_cutaneous_asthenia. Accessed March 31, 2014.

Acknowledgements

Special thanks to the Aloha Veterinary Center in Hilo, Hawaii, which shared this case and permitted its publication.

Julie Ann Luiz Adrian, DVM

Department of Pharmacy Practice

The Daniel K. Inouye College of Pharmacy

University of Hawaii

Hilo, HI 96720