Locality: Central Michigan
Medical Diagnosis of Blastomycosis?: No
Where Caught: My backyard. I live adjacent to a river and wetlands with a wooded area between my house and the river. From what I have read, this is the perfect habitat to foster the Blastomycosis organism.
In addition I also had an atypical pneumonia that did not respond to antibiotics a few years after I moved to this property. I was ruled out for Histiocytosis, but suspect now that I had Blastomycosis which was not tested for. I recovered on my own.
Symptoms: I noticed an open sore on my Pointers rear thigh around the third week in June and thinking she had an injury sustained from playing with the other dogs, started treating her for a common abbrasion. A week later I noticed she was not feeling well and had started to limp. On closer examination I found that the muscle under what was now clearly a spreading ulcerative process was affected, along with a huge inguinal lymph node on the same side. A head to toe exam showed other lymph involvement, and we were at the Vet the next day.
My vet suspected Cutaneous T Cell Lymphoma and biopsies were sent out the first week in July. We were both positive of the Lymphoma diagnosis. There was none of the lung involvement(CXR clear) that is so typical in Blasto or Histo and the now spreading lymph node involvement seemed diagnostic.
Due to the holiday weekend the biopsy results were delayed and Abbey's disease was rapidly progressing. Her inguinal node was now huge. She had multiple lymph node involvement and new minor cutaneous lesions. In addition, she suffered what appeared to be a neurological incident that involved gait abnormalities in association with tremors (it was not a seizure); this resolved with acepromazine and did not reoccur. In addition, Abbey's neurologic exam the next day was normal.
The biopsy results came back on a Friday July 11th, and were negative for lymphoma. We were left hanging with our mouths open. Luckily I had the whole weekend to go into "google mania" and eventually decided that Blasto was the next most likely diagnosis. I called my Vet on Monday and he agreed to try antifungals. We started Abbey on Fluconozol as a trial which was readily available. I knew within 48 hours that we were right. We switched her to Itraconazole one week later. Abbey has now been on Itraconozol for close to 3 weeks and is doing well.
The time from symptoms to definitive treatment was not more then 4 weeks and I am very hopeful that we are on top of the curve. Abbey has one new cutaneous lesion which is bothersome and I will have it looked at tomorrow. There is still no pulmonary involvement and she feels well. YIPEE!!
Treatment: Tramadol for pain as needed.
Fluconozol for one week empirically (see history)
Itraconazole from here on out...
Cost of Treatment: Total around $600 right now, not including medications. This is cheap, but I decided I would not go for a definitive medical diagnosis. The fact that Abbey is responding to treatment is good enough.
Itracanozole through a compounding mail order pharmacy is going to be around $90.00 a month.
Additional Comments: I am most fortunate to have a Vet who is willing to work with me. Sometimes this whole medical care thing is about partnership, hunches, and collaboration. If I had a Vet who had not been willing to treat without a diagnosis my dog would most likely be dead or dying right now. As it is, I think (hope) she will go into long term remission.