Facing three irritating maladies at once, Berkley the German shepherd finds comfort in veterinary dermatologist’s treatment

Berkley the German shepherd was suffering from not one, or two, but three allergies and autoimmune disorders at once.

“We would go to vet after vet who would say, ‘I don't know. We've never seen this before,’“ recalled Caitlin Bramhall, the owner of  almost 10-year-old Berkley. “She would get put on steroids and an antibiotic, and it would kind of slightly go away, and then maybe two to four weeks later, it would flare back up.”

Suffering from recurring infections around parts of her face and near her crotch and rear as Bramhall’s work took her to multiple states, Berkley was brought to the veterinary hospital at Virginia Tech in August 2024.

Berkley was diagnosed with a form of lupus known as mucocutaneous lupus erythematosus, in addition to known problems with perianal fistulas, a form of autoimmune irritation affecting the anus; and canine atopic dermatitis, a skin-irritating allergy. 

German shepherds are known to be predisposed to allergies and autoimmune diseases, Veterinary Teaching Hospital dermatology clinician Ivan Ravera noted, but it is unusual to have three at once.

“Allergies are not autoimmune, but the immune system is involved, because we are talking about an immune system that overreacts to normal stuff,” said Ravera, a clinical assistant professor for veterinary dermatology at the Virginia-Maryland College of Veterinary Medicine. “So the uniqueness of this case is: How can you manage three chronic diseases in a big dog? Big dogs are more expensive in terms of drug administration and doses.”

Ravera’s choice for treatment was cyclosporine, an immunosuppressive agent commonly used in human medicine at greater doses following organ transplants.

“We need to suppress the immune system to avoid more damage,” Ravera said. “We call it mucocutaneous lupus because the immune system will target the joints between the skin and the mucosa,” he said, referring to the soft tissue lining in the body’s respiratory, digestive, and reproductive systems. “That's where this disease is going to target her.”

At a July re-check of Berkley, her condition was pronounced as “great” with previous lesions healed and only mild irritation remaining.  She had improved to the point that her cyclosporine will be reduced from a capsule a day to one of every three days in September.

Best of all, Berkley feels much better.

“It was definitely a struggle all those years going back to the vet over and over, because I could tell that she was not feeling good, she was kind of cranky, a little bit snippy. It’s how I feel sometimes with seasonal allergies,” Bramhall said.

“It’s incredible, honestly, where she is today compared to where she was.”