Karmel – a difficult diagnosis for the vet

My beautiful brindle galga Karmel is sick. It is just one year since I went to Spain, to Cuidad Real, to collect her from the refuge. She has brought such love and affection into our home, and now she is sick, and we don’t know the cause.

A problem has developed in the feet of my galga. My vet thinks it could be an allergy problem but, as she is one of the hundreds to come out of Spain whose history is unknown, we don’t know if she has suffered this problem before.

All her tests for filaria, leishmaniosis, ehrlichia were negative and, until 3 months ago, she was a normal galga, sleeping on her sofa, walking our meadows, stealing food from the kitchen, even though she had plenty to eat!

Suddenly one morning in April, she went very lame, hardly able to walk.

The pads of her feet were inflamed, the insides of her ears were very pink, and she had a small open sore on her tummy. My vet took scrapings for microscopic examination.

As we know nothing of Karmel’s history, it was difficult to ascertain if it was an allergy – it was that time of year – or genetic, or her immune system.

A course of vitamin B, anti-inflammatory and anti-biotics was commenced, and my beautiful galga soon improved. When the course of treatment finished, Karmel was lame again within a week.

We racked our brains as to what might be affecting her feet, and not those of our other 3 dogs, but could not come up with any solution. My vet explained that some dogs can be allergic to concrete, if they spend a lot of time in concrete runs. We don’t have any concrete, the floors are tiles, wood, dust floor in the barn where the dogs sleep at night. The only concrete floor is covered with linoleum. Our courtyard is stones.

This time, Karmel was given just anti-inflammatory, with a smaller dosage than previously. For the past month she has been fine, eager to walk the meadows again, happy to wander around the courtyard.

The course of tablets finished last Tuesday. I noticed on Wednesday evening that Karmel was not quite to happy walking about. Thursday morning saw her hardly able to walk, so off I went to the vet again. She arranged for us to go to La Rochelle for Karmel to be examined by a specialist dermatologist vet.

He was also uncertain as to the cause, either infection or immune system. Because Karmel had only finished the course of anti-inflammatory tablets 2 days before, he could not do a biopsy. So he decided to work on treatment for an infection first. Vetoquinol, 2 per day for 10 days. She is booked to go back to his surgery at La Rochelle in 10 days.

Today she cannot walk, the skin is halfway over her eyes, she is thoroughly depressed. I have spoken to my vet and am just about to go off to the surgery for anti-inflammatory treatment again. My vet will also discuss the problem with the specialist vet this afternoon, when he is back in his clinic.

Please keep your fingers crossed for my beautiful galga.

Update 18/07- my vet gave Karmel an anti-inflammatory injection, and cream for her eyes. I have 2 anti-inflammatory tablets just as stand-by for Saturday and Sunday, in case she is bad again, before the surgeries open on Monday.

I have been out this afternoon to interview Jakki Cunningham, who has organised and is leading the riding of 10 Camargue horses through France to the UK, to donate to Riding for the Disabled. Read about it here, they still need donations to fund the enterprise, which will benefit many handicapped and deprived teenagers.

On my return, Karmel was much improved, as my vet said she would be, thank goodness! She came and had her dinner (another antibiotic tablet included) and even felt up to walking across the lino to go outside to the toilet. So now I await a phone call from my vet on the results of her discussions with the specialist vet.

In the meantime, a friend has emailed me privately to tell me about this product K9 http://www.dogcancer.co.uk/immunity.html

Update 20/07 – It is now 3 days since our visit to the specialist vet, and I am a little unhappy, to say the least. For the cost of 95 euros he has given me Vetedine to paint on Karmel’s feet – it looks like iodine, of which I have a large bottle in my animal medicine kit! – and antibiotics twice a day. The day after my visit to him – 3 days after Karmel finished the last of the anti-inflammatory tablets – I had to go back to my vet as Karmel was deteriorating noticeably. She gave an anti-inflammatory injection, plus two tablets to see us through the weekend. I have had to use them, as Karmel obviously cannot now manage without them. My vet is back in her surgery tomorrow.

However, I am not pleased with the specialist vet. He said he would contact my vet on Friday (the day after he examined Karmel) and he did not. She telephoned him but he did not return her call. I telephoned his surgery on Saturday morning but he was not in, so I had to leave a message. In my book, vets should not tell a client they will discuss a case with each other, and then not do it.

The pads on Karmel’s feet now have more cracks and small holes, the outer layer of pad is coming away, and she can only manage to walk if she is dosed with anti-inflammatory tablets. But the vet cannot do a biopsy with anti-inflammatory medication in Karmel’s system! What does one do?!

Update 21/07 – It’s been awful this weekend. Karmel has just gone downhill . I’ve hardly slept all weekend, the poor dog just looks as though she wants to give up and die. It now looks as though it is breaking out around her nose, as it is on her feet, her feet are much worse and so is her tummy. I’ve no more anti-inflammatories so now I’m scared she will go even worse. I spoke to my vet this morning and she is going to find out from the lab what is the minimum number of days Karmel needs to be off anti-inflammatories, for a true diagnosis after a biopsy. I shall ask my vet if she will do the biopsy, she still hasn’t been able to get the specialist vet in La Rochelle, and he hasn’t rung her, so I really really do not want to go back there. 95 euros for what?!

Update 23/07

My vet eventually got hold of the La Rochelle vet, nothing new to come out of that. My vet is going to do the biopsy herself on Friday this week, 25th. So Karmel has had to get through this week without any medication, so we get a true diagnosis.

Karmel continues to cope without any medication, surprisingly she is brighter than she was last weekend, when on anti-inflammatories – but…………things are getting worse!

The outer covering of her feet pads seem to be drying up – they are turning light grey – as though the covering is dying, and it is peeling off as she licks it. Bare patches are now breaking up around her nose where it joins the hair-covered skin – as developed on her feet. The inner ears are bright pink, covered in minute lumps and scabs. Her head is now covered in spots, and her body is developing the same spots – as in chicken pox! She is running a bit of a temperature and drinking a lot of water.

We only have Thursday to get through and then she goes in for her biopsy on Friday morning.

Fingers crossed.

Update 24/07

Poor Karmel’s body is now covered in spots, even her feet. The insides of her ears are crusted where she has unfortunately scratched. Her skin is bright pink, and today she is quite subdued – not the depression of last weekend, but not as bright as she has been. Not surprising, when her body must itch terribly. I keep thinking I should cover her in calamine lotion to try and soothe it, but I don’t want to risk affecting the biopsy in any way!

Only today and tonight to get through, hopefully after the biopsy tomorrow, my vet will prescribed some interim medication, till the diagnosis of the whole problem is made.

I’ve forgotten what it’s like to get a decent night’s sleep!

Update 26/07

Karmel had her biopsy samples taken by the vet yesterday; one from her nose, 2 from her body and 2 from 2 different feet. The vet also took a sample of the pus from one of the hundreds of lumps now covering the whole of Karmel’s body. The samples were sent to the lab in the midday post yesterday, marked urgent. My vet will telephone the lab on Monday to speak to them about the samples, and she is hoping to have the results of the biopsy by Thursday, or even Wednesday.

In the meantime, Karmel is back on anti-inflammatory and antibiotic medication in large doses. My vet is worried that Karmel’s condition is worsening quite rapidly now and, although this medication seems to control it, long-term damage could be caused to Karmel’s organs if continued over a long period of time.

My poor galga, she does not deserve to suffer like this

Update 02/08

We visited our vet this morning to discuss the results of the biopsy. The diagnosis is Pemphigus Foliaceus, a genetic skin disease. This is a good site to read about it.http://www.dermvet.com/pemphigusfoliaceus.htm

Interestingly, research has shown that 6.3 years is the age of a dog when the disease manifests itself. Karmel is 6.

Treatment is lifelong. to help her auto immune system keep the disease in check.

Megasolone anti-inflammatory tablets are prescribed. My vet recommended doubling the dosage Karmel is now on, for 2-3 weeks, and then we will try reducing it by half, in the hope that we can get it down to perhaps a tablet every other day. Side effects are drinking lots of water, weight increase, diahorrea, and possible kidney and liver damage long term.

There is an alternative treatment to Megasolone, which is more expensive. Some research is still being carried out and my vet is going to speak to the lab to see if they will accept Karmel for some tests.

I would like to give credit to my vet. From the beginning, in April, when she first saw Karmel and the problem with her feet, she suggested either auto immune problems, or infection. Infection was eventually ruled out, as was allergy. She has been proven correct, and I continue to have the utmost faith in her.

Update – 16/08

After the diagnosis of pemphigus foliaceous (PF) a couple of weeks ago, my vet has been researching the best treatment for Karmel.

Because of the serious effects on her body, the dose of Megasolone was doubled, to knock the PF on the head! She is also having fresh chicken, yoghurt, cod liver oil and Canine Tahitian Noni to improve her condition.

She has been bathed in special shampoo, which has got rid of the loose dead hair, and her skin is now not such a bright pink.

She now has weekly visits to the vet, to monitor her condition.

Probably as a result of the 3mg per day dose of Megasolone, she has become pear-shaped (see right); her abdomen has swollen, and the weight has dropped dramatically from her hind quarters, even though she is eating as much food as normal, and trying to steal even more if she gets the chance!

Her last visit to the vet was today. The Megasolone has been reduced to one and a half tablets per day, and her next visit to the vet is August 25.

If her condition has not worsened, then my vet is considering running another treatment alongside this one, which does not have such severe side effects, but takes longer – 4-6 weeks – to show any improvement .

In herself, she is contented, still loves going for walks in the meadows, looking for cats in the garden, demanding lots of caresses.

After her visit to the vet next week, I will report on the next stage of treatment