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[cj_jenna]

Hi,

I have a female, almost 8 year old Golden Retriever named Jenna and I am wondering if she could have blastomycosis.
We had her at the vet yesterday because she was limping and favouring her left front leg.  As we just lost another
one of our Goldens last year to Osteosarcoma we were worried this is what Jenna had.  The results from yesterday
have left us completely baffled and we're no further ahead.  I was doing some research tonight trying to find some answers
and found information about blastomycosis, that seemed to tie in all the findings.  And then I found this forum!

We live in Kingston, Ontario however we adopted Jenna in October 2007 through a rescue organization.  Originally
she was from the Barrie area and we know that she has also travelled to northern Ontario and South Carolina.

Jenna is completely asymptomatic except for this lameness that just appeared last weekend.  The vet xrayed her
leg and it showed arthritis in her wrist joint (and this also seemed to him to be the source of the pain) but then
in her left radius and ulna there was the dreaded star burst pattern, which is highly indicative of osteosarcoma.
Because of this finding he xrayed her lungs.  Osteosarcoma usually metatastizes to the lungs first so this is a logical
next step to diagnose OSA.  What he found was multiple lesions/growths, who knows what, primarily in her upper lungs
near the bronchial tubes.  Her lower lungs aren't in great shape either but more the density is lighter than a normal lung. My
husband who saywthe xray said it almost looked like a line in her lungs above which were all these white spots and below
there were none.

For osteosarcoma one would expect to see lesions throughout the lungs.  Her heart is also enlarged, the vet said probably due
to the strain from her lungs, which is not a good finding either.

Should also mention the weird thing abour her leg xray is that the star burst pattern is in the same place in both bones,
i.e. right beside each other.  This is something that usually wouldn't happen with osteosarcoma, or so we've been told.

Other than that she appears as a completely healthy almost 8 year old dog.  She is fairly arthritic, more than I would expect
for a dog her age and she also has a huge number of skin lumps (a lot are fatty tumours which are common for the breed)
all over her, which I also found unusual.  Up until now she hasn't been on medication for her arthritis though.

Interestingly enough she is completely asymptomatic for respiratory problems.  If you listen to her heart and lungs with
a stethescope they sound completely normal and healthy.  She doesn't cough, wheeze, have shortness of breath or
trouble with exercise.

My vet has no idea what is wrong with her.  The plan at the moment is wait for 2 weeks and re-xray her leg to see if
there are changes.  Osteosarcoma is an extremely aggressive form of cancer....if she has it in her leg the tumour
will have grown considerably and she will probably be in excrutiating pain.  Not exactly the best plan of action to me
but I've never been the wait and see kind of person!

Do these results sound like it could be blastomycosis?  Once a dog has been exposed to blastomycosis how long does
it take for them to show symptoms?  Could this have been a chronic condiition that has been going on for months or even
years?  What is the definitive test for blasto?  If she is positive how soon should treatment begin?  This is all new to me and
I'm afraid I don't know anything about this.

Thank you very, very much for your help!  Any information that you can provide me with will be invaluable to us as we're
lost at this point.

Sincerely,

CJ (and Jenna)

[luvmyjacks]

The big problem here is that if it is Blastomycosis timing is critical.  Every single day's delay can be life threatening as it can take over the dog very quickly.  My Will had ONLY a slight lameness
but within 24 hours of looking at the x rays of his back (which also included his lungs) he was in the iCU and near death.  There is a urine test  which is highly effective in detecting blasto and it might be well worth the cost.  The lab phone number is listed on a recent post here on the forum.  Has your vet considered that it might be blasto?  Do you take Jenna for walks along the water's edge, into ravines etc in Kingston; places where Blasto exposure might have occurred?  Has she been exposed to any excavation, landscaping projects using mulch?  If your research seems to keep pointing you towards blasto you might consider asking your vet to start Jenna on a course of Itraconazole while awaiting the results of a urine test - and someone familiar with blasto might be able to give another opinion on the x rays.   Trying not to sound like a know it all, but I see blastomycosis in every sick dog these days.... Please keep us posted.

[cj_jenna]

Jenna could have had a lot of exposure!  Where we live is on the edge of a forest...lots of trees, little creeks, fields etc.  Plus she's been at a cottage recently so more of the same plus a lake.

The thing is she doesn't seem to be getting worse.  The lameness started a week ago today and it isn't getting worse and she hasn't developed any other symptoms.  Just the xrays which showed her lungs were in very bad shape with a unusual (according to our vet) pattern of white spots etc.  That and the findings on the leg xray.  I'm so confused maybe I'm just grasping at straws. 

Thank you for your help!  Greatly appreciated!

[luvmyjacks]

The lungs and the lameness both point to blasto as I see it and the big damage is going on inside.  The lameness in Will stayed the same but his lungs were filling up quickly even though he wasn't having trouble breathing. I know the panic you must be feeling so weigh the risk/reward and if you aren't sure why not start the itraconazole in the meantime.  If she seems to get quite sick as soon as she's on it that's also a good indicator the meds are fighting the fungus.  I'm up in Collingwood so I could talk to you on the phone about this tomorrow morning if you want.  My e-mail info is posted on my profile so feel free to let me know a number and time and I'll give you a call.  As well, we have a version of the newsletter which whos x rays of a dog that died of blasto.  Perhaps your vet could have a look at these pics and see if there are enough similarities to help with a diagnosis?

[gunner]

I am sorry to hear about your dog, but am glad you have found this site.  We will all do our best to help however we can, whether your dog has Blasto or not.  

I agree with Jen regarding putting Jenna on an antifungal "just in case".  Your vet may be resistant to the idea, but at this point, what will a week's worth of antifungal treatment hurt anyway?  You should begin to see some sign that the medicine is working in a week and by then your blasto test, if you have one done, should be returned.  Sometimes though, the sign that it is working can be very distressing.  Blasto has a nasty reputation for getting worse before it gets better, especially when the lungs are involved.  Itraconazole can be really expensive so even a less expensive broad spectrum antifungal like Ketoconazole or Fluconazole will be better than nothing untill you can get a diffinitive answer.  

Not all dogs experience all symptoms.  Jenna's symptoms do not sound like "typical" blasto symptoms, but the only thing "typical" about blasto, is that it isn't typical.  That said, one of the most typical misdiagnosis for Blasto is some sort of cancer.   Testing for Blasto can also be a very tricky thing, there are often false negatives and occasionally false positives.  This condition could have been going on for months, but I doubt greatly that it could have gone on for years in your dog.  You didn't mention if Jenna had a low grade fever or not.  That is about the only symptom that is almost always present (but then again, not always either).   Just the combination of the lameness, strange x-ray pattern in the lungs and lumps on her body send up some big red flags to me.  Not that I'm an expert or anything.

If your vet hasn't had much experience with it, you will have to help your vet to find the answers you will need.  At this point, I believe that all of his/her text book training will be out of date.
 
The easiest and fastest way (though not the cheapest) to get your dog ACCURATELY tested for Blasto is  to do this (at least it worked well for me.  Go to the following link:
http://www.miravistalabs.com/Files/pdf/ReqForm_060308.pdf.pdf
Print it out and take it to your vet.  It is the test requesition form for MiraVista Lab.  Your vet can either draw blood or take a urine sample and send it to them for testing.  They are very fast in sending the results back and they are the most accurate test that we know of.  

I will be thinking of you and really hoping for the best.  Hang in there!
Joyce

[Jen]

Lameness, lungs, and lumps, you live in the right spot too.
I agree: get the pee test at least. The specificity is very high, and it doesn't hurt to start treating even before diagnosis.
Hopefully you won't need to continue.
Let us know-
jen
 (Actually, Joyce: doesn't CJ's post sound eerily like your first ones here?)

[gunner]

Yes Jen,

Dejavu!  Yikesies!

[luvmyjacks]

Let me know the clinic and vet you use in Kingston as I have one I hold in high regard who looked after some horse business for me.  With any luck your own vet will  be open minded and hopefully not shut you down with the message that blasto doesn't exist in Kingston because trust me, it does, and it also travels to new places all the time.  Joyce gave you a very good synopsis on this situation and most of use here are thinking you have a case of blasto on your hands.  If you start treatment please stay on the forum daily as the road will be bumpy for a while.  There is lots of fabulous info on feeding as well as what to expect. 

[cj_jenna]

Thank you everyone for your replies.  They are very helpful.

I took Jenna's temperature this morning and it was 38.84C which is 101.9F...so within a normal range.
She is still her normal self, except for favouring her left leg.  It's always worse after she's been lying
down and then gets better the more she moves around.  No new symptoms though.

We are going to call our vet first thing tomorrow morning and talk some more with him.  If going on
anti-fungal medicine won't hurt her (if it's not blasto) then I'm game to try it and get her tested.
I think our regular vet will be back in the office tomorrow (he was on holiday last week) so I'm hoping
if he sees the xrays he might have more input.

You know this is just a fluke that this was all found.  The vet was xraying her wrist and as it happened the
way he positioned her allowed him to see the lesion in her radius and ulna.  And that led him to xray
her lungs (thinking it was OSA) and find what a mess they were.

So this could have been around for months but not years.  Since we got Jenna in October 2007 then
she would have had to pick it up where we live (or more recently at the cottage which is in the Ottawa
Valley).  Interesting.  I also have another dog (Samoyed/Setter cross) and he seems completely fine.
Should I be worried about him too?

Thank you again for your invaluable help and suggestions.  Right now I feel like I'm just twisting in the wind!

CJ and Jenna

[cj_jenna]

Hi again,

We go to the Bayridge Animal Hospital.  Usually we see Dr. Jay Black but he was away last week so
Dr. John Wilson saw Jenna.

CJ and Jenna.

[gunner]

Hi again,

I wouldn't worry too much for your other dog if he isn't showing any kind of sympotms.  There are several dog owners on here that have more than one dog, but only had one dog get blasto.

One of the topics on this site has been about how almost every dog that has come down with blasto always seems to have had "a little something" wrong with them.  Just subtle signs of one sort or another that their immune system wasn't quite 100%.  (Even just being stressed, like coming to a new home, can weaken the immune system some.) So if your other dog has always been the picture of health, I wouldn't worry too much about him. 

On the other hand however, those of us who have suffered through blasto always seem to be on red alert for any signs of this horrible disease in just about any animal we come across.  I guess the best advice is vigilance but don't loose any sleep. 
Best of luck tomorrow!
Joyce

[luvmyjacks]

We found Will's condition when x raying his back ... pretty much the same situation as you have.  He seemed symptom free except for the little limp which changed his gait but really didn't slow him down. My other dog, Roxy was already diagnosed with Blasto so Will was positioned in such a way that the lungs would show as well.  We had no indication at all that he might have blaso.   But his lungs looked awful and once the anit fungals were started he got very sick because the fungi were fighting back and dying.  I am sending you a pdf format for our newsletter and it has x rays, pics of lesions etc so you could forward it to your clinc for them to review when you get there.

[evayola]

We thought for the longest time that Marge had a bone infection and it was growing up her foot and into her leg. We ended up removing the infected toe and sent the WHOLE toe to MiraVista. The tests came back negative. That doesnt always mean anything. Marge was diagnosed shortly after. Your best bet is the urine test, and maybe start treatment in the meantime just in case. If you can get a leg up on this crazy disease, you will be in a much better position to make sure Jenna can recover. (if this is what she has) Definitely keep us posted.

Eva

[Jen]

Also remember:
Blasto is everywhere; no informed vet can say, "Well, it's not around here..."  As we've seen, Ontario is notorious for it, and we've all discovered common risk factors, like rivers, ponds, wetlands, mulch, etc.
Joyce is in Texas; imagine what she went through just trying to get Gunner tested.
If it's actually blasto and you can get a head-start, perhaps you can avoid the trauma of the fungal pneumonia and initial die-off.
It's worth trying for.
jen

[luvmyjacks]

Here's the latest on Jenna.  I spoke to Carolyn.   Her regular vet was back in town for their Monday visit and luckily he has had experience with blasto.  He looked at the x rays and said that he felt they were "old dog lungs" and not like the snowy pattern he would expect to see.  He also felt the lameness was age related.  So, they have newsletter in hand and are watching Jenna like a hawk but not treating her at the moment.  The good news is that the newsletter went to one more clinic, the first vet who said no blasto around here has been updated and Jenna enjoyed two weeks at a cottage with no apparent downward spiral in her health.  Every time a dog's symptoms point to blasto we will rejoice when it turns out not to be - especially when it gives us a chance to remind a clinic that blasto is no longer rare.  As well, each dog owner in this situation has a chance to learn about the disease and most important of all SPREAD THE WORD.  So, for now, another happy ending.