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  Blastomycosis

Blastomycosis is a caused by a fungus named Blastomyces dermatitidis and it infects human beings as well as dogs, and occasionally cats. This fungal organism is found as a mold in the soil or at room temperatures and in yeast form in tissues or at body temperatures. Blastomycosis is not generally considered as a zoonotic disease, meaning it is not potentially contagious to people. However, if you have a pet infected with blastomyces, it may signify that you may be at risk for contracting the same disease because of having a common environmental source such as contaminated soil or near a waterway like river valleys or lakes.

Blastomycosis Skin diseases
Blastomycosis


Any dog may contract blastomycosis given the right circumstances but certain populations which include the young adult hunting and sporting breeds are considered to be at greater risk. This is because their use involves exposure to soil in wet areas. For unknown reasons, male dogs are more predominantly afflicted with blastomycosis than female dogs. Nevertheless, in one study female dogs was found to have better survival rates with therapy despite being more likely to suffer relapses than the male counterpart.

Dogs acquire the fungus by inhalation of its spores from the soil into the lungs inducing a self-limiting pulmonary infection. By direct inoculation of the spores into the skin thru punctured wounds, it may also cause local cutaneous infection. So far, the most common form of blastomycosis seen by veterinarians is the generalized or disseminated form. This form spreads from the lungs then involving the eyes, brain, bone, lymph nodes, genito-urinary system, skin and subcutaneous tissues via the bloodstream or lymphatic system.

The clinical signs of blastomycosis may differ depending on the target organs involved and may include any one or all of the following: anorexia, depression, weight loss, fever, coughing, shortness of breath, exercise intolerance, enlarged lymph nodes, eye problem, or skin lesions with bloody or purulent exudates that do not respond to antibiotics.

Definitive diagnosis of blastomycosis is by detecting the yeast-like organism in specimen samples drained from the oozing skin lesions or swollen lymph node. In addition, chest x-rays and complete blood count may be requested but not considered as the gold standard in the diagnosis. Blood chemistry results are usually within normal limits. Serum fungal titers confirm the diagnosis and aid in differentiating blastomycosis from histoplasmosis, another fungal-related disease with similar signs and geographic areas of distribution.

Some pet dog owners may opt to euthanize their infected pets because aside from a rather complicated and long period of treatment with associated potential serious side-effects, it is also costly. Nevertheless, about 65% of dogs diagnosed with blastomycosis survive. Survival rate increases in dogs undergoing treatment to approximately 85 %. However, relapse may still occur in up to 25% of suffering dogs. Those dogs with brain or eye involvement, impaired liver or kidney functions have a worse prognosis. In these cases, they may not be able to tolerate the needed drugs because of poor organs involved in drug metabolism. The standard therapy for blastomycosis has been amphotericin B for several years. Amphotericin B is still the first drug of choice for acute, life-threatening illness. A marked improvement in treated dogs is noted in three to five days of therapy. Amphotericin is usually given as an intravenous injection, either as a slow IV drip or as rapid IV bolus injections. Close monitoring on the kidney function is necessary while under treatment because of the drug’s potential nephrotoxic effects. Rapid injections is likewise avoided because it increases the incidence of acute drug reactions.

An alternative drug for blastomycosis treatment is ketoconazole given orally twice daily. This drug is effective in milder cases and in a dog with impaired kidney function but it may take 10-14 days of treatment before seeing any clinical improvement. The potency of this drug is higher if given in combination with amphotericin. Ketoconazole has a lower cure rate as compared to amphotericin when given alone. Because of its synergistic effects, veterinarians tend to use lower doses of amphotericin hence; minimizing the risk of kidney failure but promoting a more rapid and complete cure. Some of the known side effects of ketoconazole are related to liver toxicity which includes loss of appetite, nausea, and vomiting. Ketoconazole is harmful to pregnant dogs and it may also affect the fertility of male dogs.

The newest medication used for blastomycosis is the itraconazole which is given orally twice a day initially, then once daily for two to three months duration. This drug has the same fast effectivity with amphotericin and also has the same cure rate as the amphotericin-ketoconazole combination. The side effects of itraconazole are also similar with ketoconazole, but in addition, skin ulcers and leg swelling occur at the higher doses.

Recent studies indicate that there is some degree of risk when a penetrating wound is exposed to sharp contaminated objects (e.g. sharp stick or a dog bite), so good safety and hygienic measures are always practiced. Those persons with weak immune systems should definitely not be handling dogs infected with blastomycosis.

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