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[Ella]

Has anyone noticed an increase in steroid levels since your dog has had blasto?  Is it possible that the meds can increase steroid levels?  Any suggestions?  Initial MiraVista results in Nov were 25 (on itraconozole).  Switched to fluconozole and reading has now decreased to 19.  Noticed she was shaking and has mild incontinence.  Has anyone used terbinafine for blasto?

[Harleys Mom]

Hi Ella,

I don't know much about terbinafine except that it's the same as Lamasil & it's used primarily for nail and other skin fungi. Whether it would kill blasto too, I don't know. Could be it only kills certain types of fungi or is harmful to dogs - that would be a question for your vet.

Hope your dog's feeling better. I recently switched my dog from Itra to Flucon and he seems to be OK except he's developed a taste for frozen dead minnows. A bunch of dead ones from my husband's minnow bucket were on the mulch pile & Harley ignored them for days. Now it's gotten cold & frozen, he's become obsessive about eating those little fish-cicles. I don't think it's the medication, I think he's just being a dog & sometimes they do things that are GROSS!!

Keep us posted as to what you find out about this. I'll ask the vet too at our next follow-up visit.

[Ella]

Dead minnows eh?  How about canned cat food!! Her appetite is elevated for sure.  I suspect it's the fluconozole since it didn't happen on itraconozole.  Not sure right now if the terbinafine is easier on the system or not.  Right now the big concern is the elevated steroid level. Thanks for the reply.

[Wilson3]

anything is possible i never heard of that being a side effect but...
you never know
are you using anything for pain or swellowing? that could also cause it
dont know
if you find out anything please lets us know
wilson3

[Wilson3]

how long has your dog had blasto?
how long on treatment? dogs name???
did your vet diagnose right away?
wilson3

[Ella]

Ella is her name.  She was diagnosed with Blasto after we noticed she having trouble breathing in late June.  We took her in right away for a lung xray and found it there.  After a biopsy confirmed blasto, she was put on itraconozole in early July.  She made incredible progress and about 2 months later, x-rays showed her lungs to be clear.  However, in October we noticed a swollen rear toe that was very sensitive to the touch.  Also, she developed a few more skin lesions.  She was put on fluconozole in late October, and in early November we had her urine sent to MiraVista Labs at the results came back at 25.  In early December, we noticed she was drinking much more water and her appetite was stronger.  She also had a couple of spells of shaking and quick breathing.  We took her back and had another urine sample sent to MiraVista and it came back at 19. Feeling that the fluconozole may be the cause of the shaking and quick breathing spells, she was switched over to terbinafine.  As a follow-up to the shaking/water/appetite, a urine test was done at the vets office this week (to test for cushings disease) and it came back with the steroid reading very high.  The next step (since cushings has not been ruled out) is to do an LDDS test which is done in the vets office.  Samples are taken at 4 hours and 8 hours.  That pretty much covers it.

[Jen]

Hi -
   I did a quick search re  the use of terbanifine, and found several results that indicated its use in the treatment of Paracoccidioidomycosis, or South American Blastomycosis, but the results are from back in 1999, and it seems to have been utilized due to the lower cost.  In ideal conditions, they'd most likely use the newer, more effective antifungal group. 
   It does seem to be most useful in the treatment of cutaneous skin/nail conditions. 
The thing about South American Blastomycosis (which is not the same as Blastomycosis Dermatitides) is that most of the time the patients affected develop lesions in their mouths and noses first. 
   Usually it's because they've been picking their teeth with splinters of wood or tree bark, which harbors these types of fungi.  (Thanks to Dr. Friedlander: pathguy.com)

  Couldn't comment on testing for steroid levels.  Some dogs do have seizure/shaking spells while being treated.   
 
   I did see that someone mentioned a mulch pile?  If you search back, you'll see that many of us have the common factor of landscaping and mulch in our animals' disease history.  For myself and 2 other families that I did some landscaping work for, 2 tons of mulch equalled 4 dead dogs and 1 that survived.  Enough evidence for me.
Since then we've developed a fear of it and have eradicated it from our property.
   
     
Here's more on the use of terbanifine vs. the newer azoles:   

http://emedicine.medscape.com/article/1092860-treatment

Excerpt:
"Historically, the sulfonamides have been the most widely used medications for the treatment of P braziliensis; their advantage is their low cost. However, relapses are more common with the sulfonamides than with other mediations, and longer courses of therapy are required. The percentage of patients who have a relapse after receiving sulfonamides is 20-30%, whereas with itraconazole it is 3.5-10%, and with ketoconazole it is 7-11%. Further, 3-5 years of sulfonamide therapy may be required, whereas 6-10 months and 6-12 months are recommended with itraconazole and ketoconazole, respectively."

[Ella]

Hi everyone;
Thanks for your excellent responses (Harley's Mom, Wilson3 and Jen).  I'm a newbie, so it might take a while to get onto this message board thing.  Has anyone else seen the shaking and quick breathing in their dogs, and is this common?
I had also noted that the terbinafine seemed to be an 'older' type of medication and seemed to be more for skin issues.  I haven't seen Ella chewing on trees...thankfully.  Thanks for the link to medscape.
We did a lot of landscaping at our home this spring and early summer, and brought in mulch for the gardens.  We also have swampy areas around our home.  Not sure which one was the problem, but possibly both (mulch and swamp).  We can't do anything about the swampy areas, but the mulch might have to go.  It's too bad there isn't a test that you can do to confirm what it is...maybe in this area it's everywhere.
After Ella got blasto, we spoke to two other people who's dogs had had blasto.  One dog lived and one died.  We notified the vets in the area to be on the lookout for the blasto symptoms.
Has anyone changed their dog's food ie: go to a lower protein diet or higher protein diet?  Any differences? I'm thinking that a lower protein might be better, but not all that sure. We're feeding twice daily and giving meds after meals.
Thanks;
Ella

[Wilson3]

was ella still on treatment in oct? whenyou noticed the toe

i believe everyone is on treatment for at least 6 months if not longer.
 relpse seems to happen with shorter treatments. wilson was on treatment for 8 months after 6 1/2 month got the al clear and did a bit longer to make sure it was gone and nothing was mist ( i guess something still could be but chances are less)

wilson has always been on a high protein deit  low carbs he gets raw also
i did add supplements his case is in the data dase if you have time read the cases for as many as you can
and read as many posts as you can i know their are tons of them but lots of great info
somtime if they are not on a high enough "safe" dose things can also happen
wilosns was increased after 3 months he was staying at the same point with no more improvments for it was increased then he started to show improvments again but that ws wilson it seems all cases are a bit different
i high quality food is best they do say to give some fat with the compounded itraconazole but wilson never got much fat in his diet and did great dont know i gave him natural fatty foods which where very few another person i know whos dog survived blasto also was high protein low fat diet
but i beleive most on this board gave fat with treatmetn

alot more dogs are surviving blasto these days i beleive with the newer meds and the dedication of the owners andmore knowledge out their it is helping
when i first came to this board i think maybe one or two survived but now that is different it is a very hard and long battle and lots of ups and downs
i am glad you found this site it will help you a lot!!! many wonderful people on here that are all willing to help in any way possible and all have great ideas to offer their will be someone on here that will have an idea that will work with what might be the question

why did you change meds?
where are you located?
wilson3

[Ella]

Hi Wilson3;
Yes, she was on itraconozole at the time.  That's why her meds were changed over to fluconozole in early November.  The itraconozole cleared the lungs, but with the skin and toe issue, we felt that the blasto could be 'hiding' and the fluconozole would be a better option.
Certainly there were no issues with the itraconozole other than the new skin and toe problems.  The more you learn about this disease, the more you realize how little you know.  I agree with you that there are (from the postings) a much better success rate now, and this web site is certainly a big part of that increase in success.  Nobody wants to see the their loved one suffer through blasto, but the support here is extremely helpful.
As for changing from fluconozole (this week) it's only because we felt that the shaking and quick breathing was an indication of an adverse reaction to the meds.
We're prepared to stay the course.  As for which medication to use, it isn't an issue of cost, but of what is best for Ella.  We will continue to monitor her progress (through urine tests at MiraVista) and hopefully will find the meds that work the best with the least negative effects on her kidneys or other organs.
As for where we're located.....Apsley Ontario.

[Jen]

With Blasto anything is possible. Dirtbike never had seizures, but she did shake and do all sorts of odd things.  Some days she couldn't/wouldn't walk or stand, some days she'd have a thin bloody discharge from her nose or mouth, she had febrile shaking, was hypoxic from the pneumonia and fungal die-off (which could also cause shaking), she had weakness and swelling, lesions, you name it.  It wasn't easy, but it was worth it.  She was treated with compounded Itra for about 7 months.
Joyce's Gunner had actual seizures, but got better for a very long time.
Best to you-
jen

[Ella]

Hi Jen;
Ella had the shakes and the quick breathing just before we took her off fluconozole.  She was also peeing a bit while she rested.  Since she's been off the fluconozole she hasn't had the shakes or the quick breathing, and she's only peed once (in the past 2 weeks).
We're still going to have the LDDS test done tomorrow at the vet's office to see what it is that's got her steroid level so high.
Also, we'll do another urine test to MiraVista the first part of January to see if it's still dropping.
Thanks;

[luvmyjacks]

I too live in Ontario and believe my dogs Roxy (died) and Will (survived 15 months so far) contracted blasto in the Georgian Bay area.  I am curious about how you discovered the MiraVista testing and whether or not your vet warmed up to the idea or whether you pushed for the test.  I have had/seen both reactions from vets in Toronto and one head in the sand guy in Collingwood who told me there is no blasto in the area.  Yeah right, just dead dogs.

[Ella]

Hi Luvmyjacks;
I had heard that the Georgian Bay area is a "blasto hot spot".  Our pharmacist had a dog that contacted blasto in the Georgian Bay area about 6 years ago.  Fortunately his dog lived, but 6 years ago there wasn't the information available that there is now.  I suppose that the Apsley area now qualifies as well.  We recently found out about another dog in the area that died a few years ago from blasto.
I read about MiraVista on this website and checked them out.  Our vet had no problem with sending a specimen to MiraVista.  We had results back from the second test in less than 3 days.
My wife and I (as a precaution) also got tested back in the summer.  Our Dr. was reluctant to sent bloodwork away to be checked for blasto, but finally agreed at our urging.
Glad to hear that Will is doing well.  What medication was Will on.  Was Roxy on the same meds and did both dogs get blasto at the same time?
We just had an LDDS test done for Cushings Disease and cushings has now been ruled out...whew!  Also, the skakes and quick breathing have stopped, and her appetite is back to normal.  She's not peeing while she's laying down any more either.
Still has the elevated steroid levels though.  We'll keep digging.

[Judy]

OK, I'm a bit in the dark here - when you mention steroid levels being high are they measuring cortisol levels in the blood? And they ruled out Cushings? Your dog is not getting external steroids?  Something just doesn't fit here -

Also, I know this is far fetched - but could the lungs being cleared up which is awsome, could the the swelling in the joints now be the blasto moving through - i.e. from internal -worse case scenario lungs- and now resolved, to the external joints etc, with lesions forming and then helping the blasto to be released? Just a thought, but still important to have medication. For Francie once the lesions burst and drained, (after being on the medication) she progressively got better.
Judy