What’s Wrong With My Pet?
Apr 04, 2013
A dog comes into the clinic with coughing, lameness, weight loss or fever. His owner reports a decrease in appetite and just not feeling well. My first thought is does this dog have Valley Fever. Valley Fever otherwise known as Coccidioidomycosis is a disease caused by the fungus Coccidiodes immitis which exists as a mold found in the soil. This disease occurs primarily in the desert areas of the southwestern United States and needs a warm arid climate with alkaline soil to survive. Animals present with one of two forms of this infectious disease.
In the primary form, the disease process is limited to the lungs and lymph nodes in the chest. These dogs usually present with coughing as their primary complaint. In the disseminated form the process has advanced and the infection has spread to other areas in the body including bones, central nervous system and almost any other organ in the body. These patients often present with lameness as a common clinical sign.
Diagnosis of Valley Fever is made with a group of tests including radiographs and blood serology. Once the diagnosis is confirmed we will immediately start treatment. Fluconazole is the most common anti fungal medication used to treat Valley Fever. Most dogs are able to tolerate this drug well. However, some dogs will exhibit liver toxicity so careful monitoring of bloodwork is a necessity.
The treatment protocol that we follow at River Road Pet Clinic is as follows:
1. Initial Exam, we will do radiographs, check a titer for confirmation of positive exposure to Valley Fever, and check baseline bloodwork to check the white blood cell count, and determine health of internal organs (especially the liver!) At this time we will often start the patient on an anti inflammatory drug to make them more comfortable.
2. Recheck exam in one month to check blood panel and ensure liver is doing well with the medication and patient is feeling better
3. Recheck exam in 3 months to recheck the titer values and to ensure liver values are not elevating. At this point, if everything is going well, we will usually recheck the patient every 6 months for a titer check and to check liver values. Once the titer is negative we will discontinue the medication and do a final recheck titer in 6 to 8 weeks.
Valley Fever is a treatable disease but owners of infected animals need to be aware it can be a long process to completely clear this disease. Fluconazole does not kill the Valley Fever organism but stops it from replicating so the pet’s immune system has to clear out the organism and this process can take time. Some of our patients are unable to discontinue the fluconazole and remain on some dose of the drug for life. On a final note, Valley Fever while more common in dogs is also seen in some of our feline patients. Their clinical signs can be more vague including ocular issues and weight loss. However, we do commonly see lameness with cats as well as dogs that have Valley Fever.
Written by Dr. Maria Miller