Print

[sheila]

I am wondering if anyone can tell me about diagnosing blastomycosis.  I am nearly certain that my dog has it and he has been on treatment (itraconzole) since 1/11/07.  He got worse for several days after treatment began and then started to improve each day.  However, the bloodwork I had run (a fungal serology panel (AGID)) on 2/7/07 was negative.  I know that an immune compromised dog might test negative and that some dogs test negative even if they have it.  I am hoping that someone can give me more info on diagnosing the disease.  Are there other blood tests I can have run? 

We started him on itraconazole because the lab found aspergillis in his joint taps.  Since then, it looks like that was due to contamination in the lab.  But, since he started improving on the itraconazole, we kept him on it and I started researching other illnesses that might respond to itraconazole.  Blasto fits very well. 

Any advice or information would be greatly appreciated.

Best,
Sheila

[Lucky]

Hi Shelia!  My dog Lucky was also negative on bloodwork.  They (internal medicine specialists) had wanted to do a trach wash but I did not have the money to do it.  That test can also diagnose it along with x-rays and of course a bone biopsy if the bone/leg is swollen like my dog was.  Is your dog's lumph nodes enlarged and does your dog have a cough/gag daily??  It took us  1 1/2 years between regular vet and specialists until she was diagnosed.  My vet had never seen a case and her symptoms matched so many different diseases, plus she was positive for a tick disease.  It wasn't until her foot/leg swelled with a hard lump and a bone biopsy was done til we really knew what she had.  She is doing ok now and will be on meds for the next 6 months.  I am supposed to have her foot/leg re-xrayed to see if the bone is better.  I hope that you have much better luck than I did.  Good Luck to you and your dog!!  Also good luck to everyone else out there too !!  Terri, Lucky and all my other critters

[Lisa]

If I remember correctly, the pathologist who tested samples from Surf said they need a fresher sample. Our vet had made slides of the stuff Surf was coughing and gagging up but they said it could have been in her throat too long so the sample wasn't able to show blastomycosis.  They too wanted to do a lung wash but by then it must have been in her nervous system because she couldn't walk so I didn't do it.  The fully involved lungs on a x-ray are a really good clue though.  Surf's lungs were completely full of the fungus.

[sheila]

Thanks for your replies, Terri and Lisa.  I am still not sure that Vince has blasto, but as I said, it fits many of his symptoms and would explain why he is getting better on the itraconazole. 

As for testing and symptoms: We took Vince to Cornell on December 31, 2006 after seeing our local vet several times and then rushing him to the emergency vet.  He has been under Cornell's care since then and they have done extensive testing on him.  They've done x-rays, biopsies, joint taps and cultures (but I don't know that the cultures ever sat long enough for blasto to grow), ultrasounds, and blood tests.  They were not looking for blasto but they came across aspergillus in his joint fluid.  As I said in my earlier post, that now seems to have been more than likely due to contamination.  I spoke with a vet in WI who sees a good number of blasto cases and he said that unless they went looking for it, even extensive testing may not show blasto.  I am very reluctant to put him through any additional testing.  Since he has to have regular blood work done to determine if he is tolerating the meds, I was happy to have the antibody test run.  As I said earlier, he tested negative for antibodies to everything on the fungal panel, including aspergillums and blastomycosis. 

We aren't quite sure how long he was ill.  We adopted him in September and now wonder if he may have already been suffering some.  He had a strange thickness to the tips of his ears that developed into sores over the course of three months.  He had a mild limp and we had him into the vet a couple times about that.  He was always somewhat exercise intolerant, and the limp progressed to the point of polyarthritis.  He was unable to walk down steps normally and so on.  He developed many sores once the testing began and ran a fever the whole time.  We don't know how long he had the fever.  He developed a sore near his eye the night that we took him to the emergency vet and while there we noticed that his lips (or gums or both) were bleeding.  His joints were extremely swollen and tender.  He never did seem to have any lung involvement, except that he has always panted hard for no apparent reason.  The panting has not gotten any better and may have gotten worse; it seems to be more intense at night.  I know that the fact that his lung x-ray was normal (1/2/07) speaks against blasto, but the vet in WI said that the lungs aren't always involved and the research I have been able to do on the internet confirms this.   

I have been trying to find a better blood test that can be run on him.  The test that I had run seems to be fairly insensitive and it only took 1 week.  In the meantime, we will continue to treat him with the itraconazole.  His "official" diagnosis at Cornell is open; suspected immune-mediated polyarthritis either primary or secondary to aspergillus infection.  His prognosis is guarded since we really don't know what is wrong with him.  He is being treated with itraconazole, had a three-week course of doxycycline while we waited for the tick titers, and is on immune-suppressive medication.  Of course, I am extremely worried about him being on the immune-suppressive med if he has blasto.  He does, however, seem to be improving.     

By the way, we have been using the compounded form of itraconazole for about 3 of the total 6 weeks he has been on the drug so far.  It seems that it is working on him, although we did start with "real" stuff, so maybe that is still in his system?  I will continue to watch him very carefully.

Thanks again for your replies and for any feedback anyone else can send me. 

--Sheila

[Lucky]

Good Luck with your dog Shelia.   FYI: The compounded formula did not work at all for my dog but that also may be do to her having the disease for so long.  She has lung, eye, and bone involvement.  She still is on oral meds and has to stay on pred 5mg daily in order to keep her breathing ok, while still fighting this disease.  She has been on lots of meds but if I were you I would read all of the posts on this sight and you will see that there are different ways to treat this disease.  Have a great day!  Terri & Lucky