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[lawgirlmmz]

My 2.5 year old lab/chow mix has been to the vet three times with no definitive diagnosis yet.  I am concerned about Blasto, but the vet suspects cancer.
He has two skin lesions that have not healed over several weeks and a swollen muzzle.  I first took him in two weeks ago Tuesday because he wasn't eating like he should, was lethargic and depressed.  The first vet said the muzzle was an allergic reaction and the lesions were staph.  Gave a cortizone shot and Keflex.
Lesions were no better by Saturday.  Took him to a new vet, who said the muzzle was normal, but found a swollen lymph node on his leg.  Said to discontinue the Keflex, gave Benadryl instead.
By Friday, no improvement, and the lesions seemed worse.  He's tired, depressed, no energy, and now his neck has a swollen lymph node.  I took him to the vet a third time, who took fine needle aspirates of both lymph nodes in the back legs and in the neck.  He said it looked like lymphoma to him, but he'd send it off to cytology at the university to be sure.

Here's my question: with all these symptoms, specifically the lesions, I'm worried about Blasto.  We live in an endemic state, near water and recently planted a garden with foreign soil and mulch.  My fear is that if it is Blasto, it won't show up in the lymph node cytology.  Does anyone know anything about that?  Is there anything else I should be looking for?  I'm so concerned that the symptoms for lymphoma and for Blasto are so similar that I don't want the vet to miss it.  He was already misdiagnosed twice, and I don't want to waste time in either circumstance. 

Does anyone have any ideas on what I can do?  Thank you so much.  I love my dog, and I want to do anything I can to save him.

[mhitesman]

If it were my dog, knowing what I know now about blasto and other diseases, I would order the vet to run a blasto antigen (urine) test because the disease is so deadly and time is so important, and it would be relief just to rule it out if nothing else.  I would pay to have the results overnighted as time is of the essence with that disease, and it sounds like your dog is getting rapidly more ill.  However, the symptoms you describe do not sound like a typical case of blasto -- if there is such a thing.  I know, though, that there were symptoms that my Comet had that were dismissed by earlier vets as nothing, and I did not learn of the relevance until fairly recently (like the small lump on the scruff of his neck that shrunk every time he would be on antibiotics for ear infections but came back as soon as they stopped), heavy grass eating, a little coughing and even more swallowing hard...)  -- so it is possible there are subtle symptoms that you are missing.  I would also insist on a blood panel.  My dog was tested for a bunch of things in addition to blasto, but time is all important.  Your dog sounds very young for cancer unless there has been a history in the family supporting this, but it does happen, I guess.

You have to be worried and scared to death; I can feel it in your words, and it makes me cry because I remember how it felt.  Good luck.  Please keep us posted.

[lawgirlmmz]

He's also been running a low-grade fever and has been favoring his back legs.  I keep forgetting all of his symptoms since we've been told so many things.

[sequinnw]

Much of this sounds like what we went through last May/June with Daisy.  She was two at the time, and also too young for cancer.  We are in Michigan, and I had no idea about blastomycosis.  As a result, we lost several weeks and spent so much money on every test under the sun when it turned out to be blasto.  If it were me and since you live in an endemic area, I would ask to begin Itraconazole as a precaution, while you wait for lab results. 

Daisy had huge, swollen lymph nodes behind her knees and one beginning to swell under her jaw.  We, too, suspected lymphoma.  When the vet tested the lymph node aspirate, it did not reveal blasto because they weren't testing for it.  She eventually underwent surgery and had a node removed and biopsied to specifically test for blasto.  We started her on medication while we awaited test results.  She also had sores that would not heal, coughing and wheezing, swollen joints and began limping.  Eventually she ran a fever and became listless and depressed, stopped running and playing.  She was treated for 6 months, but had no follow up testing (I just discovered this site last month and my vet admits to never having seen a case of it).  In May this year, her same joint began swelling and she began limping, just like last year.  It freaked me out because it was so much like last year but she was treated for a sprain.  Weeks went by with no improvement so I asked that she begin itra again.  She improved almost immediately and we will undergo another round of medication.  However, with all my newfound knowledge, I will ask for the Miravista testing to monitor her progress and keep a close eye on what's going on inside her body. 

It can't hurt to begin medication while you await test results.

[mhitesman]

I would get some generic Itraconozole and start him on it today (with the news that he is favoring back legs).  I mean, what is the down side -- it's not going to make "cancer" worse.  You should have a good idea if you are on the right track in a couple days -- when the antigen urine test comes back.  You must get a script for the itra, but any drug store can fill a week's supply.  IF you get a blasto diagnosis, you can make a decision whether to go Sporonox, generic Itra, or compounded (mail order for the most part) later. 

[evayola]

I agree 100%. I say get some meds right away and send off for the urine test to get the right diagnosis. Marge had swollen lymph nodes everywhere possible. She too was limping on her rear leg and also her front leg. you will not make things worse by treating him if it is something else. Push for meds immediately and get that test sent out. Timing is KEY! I am not trying to scare you but I remember all too well what you are feeling and I would hate for you to wait any longer and allow the blasto to move through his body. I think that the reason Marge's eye was affected is because we waited so long to find out her diagnosis and the blasto was able to spread through her body. Keep us posted Please!
Eva

[Jen]

I agree that your dog's symptoms sound highly suspicious and would encourage you to see about Blasto testing.  
If there are lesions, the vet should be able to do a simple slide right in the office and have results immediately.  That's how Dirtbike was diagnosed.

(You might print out a copy of our Blastomycosis Newsletter - it has lots of this information.)
The urine test is a great tool if (for some reason) they can't do cytology.
I don't think that treating before definitive dx can hurt either.
The problem is usually getting the vet to accept that it could actually be blasto.  

Here is contact information for MiraVista labs:

http://72.14.205.104/search?q=cache:aDcmXJ4-rRoJ:www.miravistalabs.com/Files/pdf/BlastomycosisInfosheet.pdf+miravista+labs+blastomycosis+antigen+assay+test+request&hl=en&ct=clnk&cd=1&gl=us

Hope you get an answer soon.
I know it's very frightening, but everyone will help.
Good luck, and keep us posted-
jen

[Wilson3]

wilson was tested buy doing a blood test and they took samples of his lesions and lymph nodes all came back positve it takes time thought to get the results so we went ahaed and ordered the meds anyways

i would test for blasto it will rule it out if it isnt it but it sure sounds like it could be

good luck and keep us posted
Wilson3

[lawgirlmmz]

I just emailed MiraVista--I live in Indianapolis so I was hoping I could drop off a urine sample myself.  We've been to three different vets--the last one who drew the aspirates said that he "doesn't even look for fungus" in the slides.  He said he saw evidence of cancer, but it's the same type of thing that can also happen with inflammation.  The fact that he doesn't even look for it worries me.  And that he didn't test the lesions at all.  He said that he's diagnosed cancer before and had it turn out to be fungus--I just worry that the cytology may not test for blasto either, since he never even mentioned it. 
I just checked on Jonah at lunch.  The nodes in his legs look smaller--but the ones in his neck are still large.  I would think with cancer that they'd only grow, but what do I know?

Is there anywhere I can get Itra without a script?  I hate going back to this vet, and I'm scared that I'm wasting time. 

Thank you for all your help and your good thoughts.

[Jen]

I forgot:

Once we learned that we were dealing with a fungal infection, we stopped using antibiotic creams on DB's lesions and switched over to antifungal cream.
There are also antifungal shampoos that contain Nizoral (Ketoconazole) and Diflucan (Fluconazole) available both OTC and by prescription. There are creams, too.
It helped clear up the lesions.

Our vet pressed a slide to Dirt's largest sore, stained the exudate with New Methylene Blue, and the yeast showed right up. 
We were VERY lucky to have a vet who was on his toes and suspected blasto before anything else.
His name is Darren Dell, DVM, and I think he's in Dermatology @ IU now.
(We're near Muncie.)
Our old vet would've treated/tested for everything but blasto, I'm sure of it.
jen

[luvmyjacks]

I have to weigh in on this too..... treat with itra right now and don't lose the time you might while waiting for the urine test results to come back.  My vet said cancer or fungal and while I waited for the test results I lost a week and my sweet Roxanne died.  If I could do it all again I would say I suspect blasto and need a script for today while we await the results.  Any vet with knowledge of this terrible disease knows that it can kill very quickly.  The cost of a few pills will be worth it.  Sorry to seem pushy but endemic area, water, new soil/mulch, sores, lameness........ way too many symptoms of blasto to ignore it as a possible diagnosis!

[mhitesman]

I think you need a script to get the meds.  There may or may not be a quasi legal way to get something, but you need to be sure of what you are getting, the dosage, and you need it fast.  Get on the phone and start calling local vets or a teaching hospital if there is one close enough.  First, though, BEG your vet to give you a script to try.  Then take the script to your local pharmacy.  I think you want Itra (generic or Sporonox).  Even a ten day or so supply will buy you and your dog some time if it is, in fact, a fungal infection.

Good luck.  We are all here for support.  Please act quickly.  I think I speak for the entire group when I say that if you want to talk on the phone, you just have to ask.

[mhitesman]

Or call Jen's vet in Muncie who may be persuaded after talking to you to fax a script to your local pharmacy.

[lawgirlmmz]

Well, the lab won't take a sample from me.  I've got a call into the vet to see what we can get as far as a script tonight or if there's any word on the cytology.  Either way, cancer or blasto, I wish I knew now so I could get started on treatment.  It breaks my heart to know he's not feeling well and I can't help.

Thank you all for all your ideas and help.

Keep us in your thoughts and prayers.

Marcy and Jonah

[sequinnw]

Insist that you be heard.  Daisy was on medication for a week before we got the test results, after weeks of misdiagnoses.  If your vet doesn't respond today,  what about an emergency clinic?  Can you print off a copy of the newsletter from this site and take it with you?  I know the fear you are feeling.