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[Fred]

Hi everyone - I found this site just today. My 30lbs (now 26 ) black terrier mix was diagnosed with blasto on Wednesday. I added her info to the case database under her name (Emma). Symptoms started very suddenly on Tuesday, I took her in Wednesday, and that day she started a fluconazole treatment. From what I've read on this site, it sounds like I'm lucky she was diagnosed so fast. She already seems a little better, she definitely eats some, but not her regular food. Any general thoughts from you guys about fluconazole vs. other treatments? It seems like costs are lower with that drug.
She probably got infected in the Three Lakes area in northern Wisconsin - has anyone heard of cases from the lakes in Oneida or Forest counties? I had heard of risks associated with river banks and beaver ponds, but never lake shores.
I'm not sure how much I should encourage her to walk around the yard or on the sidewalk. On one hand walks may keep her healthier and less prone to depression, but maybe it would tax her lungs?
I worked in the woods for many years, with the joys of having Emma at my sides as the perfect field companion - but unfortunately it meant Lyme disease and blasto for her!
Thanks for any tips
Fred

[gunner]

Hi Fred,

I am sorry that a wicked twist of fate has suffered you to find this forum, but for information and support, you couldn't have come to a better place.  Welcome. 

As far as Fluconazole vs Itraconazole, there are many topics on this forum that discuss it at lenght.  It will be to your best advantage anyway, to read as many posts on here as you can.  The more information you can gather from everyone who has experienced this devistating disease will be of benefit to you and Emma.  But in a nut shell, Fluconazole is a good drug.  Itraconazole is considered to be the best drug, but you have to look at your pocket book, and research it and discuss it with your vet and make an informed decision about what way you want to go.  I wouldn't have any problems using Fluconazole, especially if she is already responding to it. 

While she is beginning treatment, her excersize should be kept to a minnimum.  She needs all her strength to fight the disease and survive the beginning stages of the treatment.  She will let YOU know when she is ready to go for a walk, but don't push her and it is really important not to let her over do it.  You will find that topic as well if you can take the time to read further on the board. 

Do everything you can to keep her callories up.  Keep her drinking water and do all you can to keep her encouraged to fight for her life.  Yes, Fred, you live your life and you take your chances, you could have spent all Emma's life cooped up in the livingroom, but neither of you would have wonderful memories and you certainly wouldn't have had the joys you've had.  Some times the bad comes along, but would we have ever traded the good?  I don't think I would. 
Hang in there,
Joyce

[Wilson3]

Hello fred and emma
i am so glad you have found this site lots and lots of great info and support for peopel that have lived through blasto
if you have time read as many of the posts/topics as possible
we live in cudahy (milwaukee) wisconsin is very bad for blasto all long lake  michigan ( we are only a few blocks away) any lake or river can have blasto it is here today and gone tomorrow and back a month or even yrs later you never know when you will come across it
it is truely wonderful that the vets are looking for blasto more now ( maybe all our emails and newsletter are working??)
the meds your emma are on normally is given to dogs that have eye involment
if you are looking to spend more to what is in your budget their are many compounding pharmecys that work great
we used pet health pharmacy in arizona wilsons meds where $175 a month but through this place we spent $80.40 for 2 months on pills a big savings
please do keep us posted and always stay positive emma will need you most right now lots of food and liquids a must!!!anything she will eat please any questions do ask lots of people here would love to help in any way
wilson3

[Fred]

Thank you guys, I appreciate your informative posts and good vibes. Today is already a better day than yesterday, she seems hungrier and ate a hardboiled egg and some cheese. I'm looking forward to meeting my local vet next week to re-assess the treatment and get some questions answered (she was diagnosed in n. WI, and now we're back home in southern WI).
I'll keep you posted.
Have a good weekend,
Fred

Edit: Oh, and Joyce, I just saw your post about Gunner - so sorry to hear that - best of luck, and I'm sending positive vibes right back around.

[Jen]

Hi Fred, welcome.
Hopefully you have caught it early, and if you can keep her eating, maybe it won't be so bad.
It depends on your vet's opinion, Emma's dose, and the choice of medicine, but several of us have used compounding pharmacies (some are listed in the newsletter).  I used Pet Health Pharmacy, and Dirtbike's Itraconazole (150 mg.) was about $80 for 60 doses. Our vet recommended them and had them on the phone at the time of her diagnosis. We were very happy with them.
jen

[Fred]

An update.
A week after beginning treatment with fluconazole, Emma's blood test came back negative. The local vet wanted to take her off the antifungal, and keep her on antibiotics, but the original vet I saw from northern Wisconsin suggested that the blood test had a high rate of false negatives. So along with the local vet here, we decided to send a urine sample to Miravista for an antigen test. The result came back negative also. So it turns out it may not be blasto after all? As anyone published rates of false negatives for the antigen test? All symptoms pointed to it, but the microscope exams, blood test, and urine antigen test say no. I'm glad, but I still don't know what made my dog sick. She about 90% recovered now, but starts coughing if she runs hard. Perhaps just a bad pneumonia? Back on antibiotics then I guess.

[Jen]

Huh.
The blood test is regarded as a fairly poor tool for diagnosing Blasto.
The MiraVista test is highly specific, and they've done a good job making sure that it doesn't light up with cross-reactives.  Which means it won't necessarily find a different fungus, like Aspergillus or Histo, but they still should've shown up in a culture if that was done. And Itraconazole still works on them too.
I dunno.

[Wilson3]

my guess is anything is possible
if emma was responding to the antifungal meds better then the antibiotics i would think to stay wih the antifungal meds
strange things happen and their is always the one in a million and you guys could be it
wilson3

[mhitesman]

What were her symptoms that led to a blasto diagnosis?
If there were lumps or lesions, they could be biopsied?  Sounds like coughing, you say, so maybe the xrays resulted in the diagnosis?  I guess I would personally want another blasto antigen test before considering discontinuation of meds.  Also, checks for other fungal infections (which itra also works on).

Comet was on itra rather than fluconazole even though his right eye was the chief presenting symptom and his lungs were not involved.  Fluconazole penetrates eye and brain barriers better than itra but itra treats the whole body better.  When he was diagnosed, his retina was 100% detached, vision was gone with almost no hope, his ocular pressure was off the charts, and he suffered from secondary glaucoma.  His eye was also the size of a golf ball, sore, inflamed, and raw looking.  We were treating with numerous eye drops, including steroids, to reduce inflamation, reduce pressure behind the eye, and also to reduce tear creation also to try to manage ocular pressure.  None of it worked, and his eye ruptured resulting in emergency surgery to remove his eye.  The vet would have prefered to remove the eye immediately but we needed to try to save it -- even if it was blind.  Maybe the fluconazole would have worked better on Comet.  Then again, 10 dogs presented in the two week period before Comet's diagnosis, and all but Comet died ... so I feel very lucky to have my boy.

I just hope this latest trouble is not a relapse.  The relapse rate is high -- approaching 30% and may be higher in dogs with ocular involvement or testes involvement.  I have not read statistics as to whether removal of the blind eye reduces the chances of relapse.  The one statistic that I cling to, always, is that dogs that beat it once ... beat it again.

[mhitesman]

Comet had a negative (.28 -- whatever that means) blasto test (miravista urine antigen) in early August, and I just started him back on itra because I have been observing suspicious signs for several weeks (which is why the latest blasto test) followed by sudden severe rear lameness two days ago.

Absent of proof, I don't trust any of the tests 100% any more.  His previous test, before that, was negative as well, in June (.42).  If the fluconazole or other antifungal are working, keep using it until you have medical reasons to quit.  My humble opinion.

[Fred]

Thanks for your replies. Emma's symptoms were a high fever, unwillingness to walk, eat or drink, clouding on the chest x-ray, and coughing. No sores or eye issues. Blood tests and urine tests were negative.The vet that initially saw her highly suspected blasto, and she has seen lots of cases. But she co-prescribed anti-biotics, since Emma has chronic (if rarely apparent) Lyme disease. Her Lyme symptoms typically appear after a large energy expenditure, like a full day in the field, and her recent symptoms appeared the day after a demanding 5-mile run. I am now almost convinced it was a Lyme's bout, and we're continuing the antibiotics. Emma appears completely recovered now, and we'll reappraise right away if symptoms reappear. I'll let you know if the weight of evidence balances back to blasto...
best to all of you,
Fred