The exact mechanism is unknown. Data regarding glucagon levels in veterinary patients is limited, and the role of glucagon in this disease in dogs is unknown. The disease is seen in older dogs. No breed predisposition has been identified. Footpad lesions are very common.
Lesions are gradually progressive.
Laboratory evaluation may be consistent with hepatic dysfunction, or may show hyperglycemia or non-regenerative anemia. ANA titer may be positive. Cytology of fluid from the vesicles is completely acellular. Skin biopsy will reveal diffuse parakeratotic hyperkeratosis and vacuolation of keratinocytes that results in a band of edema in the upper half of the epidermis. Dermal changes usually are minimal and, if present, include perivascular accumulations of lymphocytes and plasma cells.