Locality: Florence, Alabama
Medical Diagnosis of Blastomycosis?: Yes
Where Caught: Our house is on a wooded lot and we have the Tennessee river on three sides ranging from about 1/4 mile to 3/4 mile. Plus Lola is a rabbit chaser. So I imagine she got it sticking her nose in a rabbit hole on our property somewhere.
Symptoms: Originally took her to the vet on 11/7 for excessive drooling and what seemed to be pain in her face or mouth. At the time my vet thought it was gastoritis. In the process of the exam my vet mentioned that they had had some Heartguard failures and tested her for heartworms. She was positive. They took an xray to try to stage the heartworms and found a small spot on her lung. (Heartworms were stage 1 and Heartguard Co. has agreed to cover the cost of treatment when we get to the point of treating them.) They were unsure what it could be and sent the x-ray to a radiologist at Auburn Univ.
In the meantime we treated her for the gastoritis with Prednisone, Amoxy and Pepcid.
Lola didn't respond well to the gastoritis treatments, so I took her to another vet for a second opinion. This vet diagnosed her with a ruptured cervical disc. More Prednisone, Flexarill, and Pain meds. She still didn't respond to the treatment.
Lola had two blood profiles and a urinalysis and they were all unremarkable.
Finally we got the results back from the radiologist in Auburn and he suggested that it might be an enlarged lymph node pressing on her lung and causing a shadow. The vet put her on massive doses (immune suppressing doses) of Dexamethasone for 18 days. She seemed to respond and the drooling stopped. I took her back for a follow up exam 14 days into the treatment. They took another xray and it was all over her lungs. My vet said this is either Blastomycosis or lung cancer. We did an antibody test for Blasto and he sent me home with Ketaconazole. I did some research and asked to switch to Itraconazole 2 days later.
The following Monday the antibody test came back neg. We did an antigen test that day...also came back neg. Because both of these tests were done while she was being weened from the Dexamethasone my vet was concerned that they could be skewing the results of the tests and we decided to continue with the antifungals and wait to see.
The first 7-10 days were really bad. She was struggling to breath and breathing really fast. And I had to give her Prednisone to keep her breathing. A follow up x-ray was taken 2 weeks later which didn't show any improvement or worsening. We sent that x-ray to the radiologist from Auburn. He could not distiquish if it was cancer or Blasto.
We waited until she was off all steroids for 3 weeks and did another Antigen test. This time it was positive. It took a total of 89 days from the time I first took Lola to the vet and 5 weeks of antifungal treatment before we could get a confirmed diagnosis.
It has been a rough ride but Lola is doing GREAT. We are almost 6 weeks into treatment now. Her breathing is not quite normal but hardly noticable. She had some running eyes off and on. And she had some pain and swelling in her hind legs for a short time. No lessions, CNS involvement or blindness.
I want to thank my vet DR Walters from CenterStar Vet Clinic for catching this (despite all evidence to the contrary). I cannot praise him enough.
Treatment: Two days of Ketaconazole then we switched to Itraconazole 125mg daily. My vet contacted a family who's dog didn't survive and got me the first 18 days of my Spornax for free. We tried bulk powdered Itra from a local compounder but didn't see any significant drop in her antigen values so we switched to a generic Itraconazole and then we started to see about a 3 pt a month drop.
We also gave Lola buttermilk with a turkey bastor to calm her tummy and Propectalin for the loose stools. We have been giving Plant enzymes and Probiotics for the past 9 days, which have helped to regulate her system.
Lola is currently a little over 11 months into treatment. Last month she was at a 1.37 on her antigen test. We will stop the Itra at the one year mark or 12/25/2011. AND WE ARE PRAYING FOR NO RELAPSE.
Cost of Treatment: A LOT. In excess of $2000.00 but most of this was due to trying to figure out what was wrong and mistreating. Actual cost of treatment since we have been treating for Blasto is about $500.00.
Heartworms were treated with bi-monthly HEARTGUARD AND A Doxy PULSE 10 DAYS ON AND 10 DAYS OFF, We believe we have beat the Heartworms bc she hasn't showed any symptoms but we wont test again until 3/2012.
Additional Comments: Thank you, thank you, thank you Dr. Walton.