So many of you have followed the regular updates on the progress of Karmel's health, since we first visited the vet with her in April 2008. What killed her?
She died of a heart attack. What caused the heart attack? Most likely cause is the terrible breathing problems she developed overnight 2 weeks before she died. It is not clear what caused these breathing problems, as it was not a symptom of either of the diseases from which she suffered at the end of her life.
She had developed Pemphigus Foliaceous early in 2008 and was being treated for this disease. We had thought we had reached the minimum dose of megasolene 20mg to keep the disease under control, and we introducing a low level of Imurel, with the intention of eventually stopping the megasolene (which can affect the liver) and using solely Imurel, which has no side effects.
Unfortunately just before Christmas 2008 the pemphigus started to break out again, spots of raw lesions on her face, and redness round her anus.
When we took her into the Centre Hospitalier Veterinaire Atlantia in Nantes, which is the university veterinary teaching hospital for Western France, tests showed she was losing protein through her urine, there was the possibility of an aortic embolism - which needed further investigation - and x-rays showed problems with her lungs - one was very dark and one was very white. Tests also showed she had developed chronic ehrlichiosis. The latter surprised us as she had tested negative for leishmania, ehrlichiosis and filaria before she left Spain, and also in a blood test after she arrived in France.
In discussions with my vet and the specialist vet at Nantes, they explained that chronic ehrlichiosis is quite different from acute ehrlichiosis. The latter develops internally showing no external symptoms, whereas the former does not - in Karmel's case it was able to do this because the pemphigus foliaceous had broken down Karmel's auto immune system, leaving her susceptible to infection, and affecting her kidneys.
My French vet likened the chronic ehrlichiosis to canine lupus. French hunting dogs are susceptible to canine lupus, which shows no outward symptoms but suddenly 'explodes' when the dog is about 7 years old, usually killing it because it is too late to treat it.
In Karmel's case, there was no indication of ehrlichiosis throughout the 10 months of her regular visits to my vet.
During the 6 days of her stay at the Nantes veterinary hospital, she received the best possible care as they monitored and observed her condition. After 5 days, her condition was still stable, but overnight she deteriorated and by the morning of the 6th day, she was on oxygen for her breathing, and morphine to ease her pain. She died of a heart attack, possibly because of the strain of the respiration problems. It is still not know what caused her breathing to suddenly escalate from normal to 20 per minute.
The outlook for Karmel prior to her death was not good, had she been able to return home. The medication she would have needed to control the pemphigus foliaceous and also the chronic ehrlichiosis would have acted contra to each other, and the latter disease is usually fatal.
The vet at Nantes had warned me, when she advised me of Karmel's deterioration overnight, that if Karmel did not respond to the oxygen and morphine later in the day, they would consider stopping further treatment. The decision was taken out of all our hands, thank goodness.
Karmel spent 18 happy months in our home, after her rescue from Spain. Apart from the occasional irritation of the pemphigus where it had broken out on her face - which was treated with Dermoval cream, she led a normal life. It makes me very angry that, because of indiscriminate and uncontrolled breeding of galgos by the galguerros, my beautiful dog suffered at the end. Pemphigus Foliaceous is a genetic disease,which breaks down an animal's auto immune system, and is passed on by a bitch to her puppies. I hope Karmel has not passed it on to any puppies she had.
Karmel's ashes will be sent to us and she will be buried in a small marked grave in our garden, as we do with all our pets at the end of their days. (Well, except the horses!)
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