Wisconsin Fatal Fungus

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dustertoo

Wisconsin Fatal Fungus

Post by dustertoo » Mon Jan 05, 2009 8:47 pm

I'm hearing a lot about an internal fungus that bird dogs are picking up in Wisconsin, that is often fatal. A littermate to my GSP is in really rough shape with it right now. Started under the skin, then spread to internal organs. Heavy duty, expensive antibiotic treatment is underway, but it looks nip and tuck.

What's the story on this? Is it contracted from nasty pond water or ground borne?

Anyone had any experience with this, or heard about it?

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Re: Wisconsin Fatal Fungus

Post by lvrgsp » Mon Jan 05, 2009 8:48 pm

Are you talking about Blastomycosis?

Chip

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Re: Wisconsin Fatal Fungus

Post by wems2371 » Mon Jan 05, 2009 9:44 pm

There's was an article I clipped on Blastomycosis from the August 2008 Gun Dog Magazine. I don't know if you can look at those on-line or not. Denise

A quick excerpt: "Sudden lameness, weeping lesions on the feet,or a hacking cough are all common symptoms of blasto. Make sure you take your dog to the veterinariam promptly if your dog develops the above symptoms............High-prevalence blasto areas are located within the watersheds of the St. Lawrence Seaway and the Mississippi and Ohio River Basins. It's also common in the southeastern states."

As and edit: In the same issue/article there was also a piece on cyanobacteria poisoning. According to the article, cyano. thrives in warm, nutrient-rich, relatively stagnant water.

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Re: Wisconsin Fatal Fungus

Post by Will » Tue Jan 13, 2009 6:50 am

Canine Blastomycosis Awareness

No Longer Rare:

Blastomycosis (Blasto) in the dog is a commonly misdiagnosed systemic fungal disease of dogs, humans and other mammals. It is a great pretender and opportunist that can be mistaken for cancer, viral infections, Lyme Disease, or other systemic fungal diseases such as Valley Fever. Many dogs die or are euthanized each year due to delay in treatment as the result of a missed or erroneous diagnosis. Involvement of the eye may cause loss of vision or necessitate the removal of the eye. Relapse is also a concern, more often reported in females.

Canine Blastomycosis is caused by Blastomyces dermatitidis. This parasitic fungus grows as a mold in moist soil or decaying vegetation and releases spores into the environment that can be inhaled by animals or humans. Young dogs that have access to the outdoors are prime candidates for blastomycosis infection, but infection has been documented in all canine breeds, cats, horses and ferrets.

Normally, blastomycosis infection will begin in the lungs after spores are inhaled and transform into large thick-walled budding yeast, which can multiply and disseminate to other areas of the body. Dissemination into organs, lymph nodes, eyes, testicles, joints, skin, as well as the central nervous system, is a grave risk.

A diagnosis of Canine Blastomycosis must be made promptly in order to begin treatment with antifungal medications. Unless Blasto is suspected, valuable time is often wasted testing and treating for viral and bacterial infections while the fungus disseminates. Without quick recognition, accurate diagnosis, and access to reasonably priced medications, many animals are unnecessarily lost to Blasto. A high index of suspicion is crucial.

Blastomycosis cannot be eradicated from the environment, however, one may attempt to avoid or remove possible sources of contamination, such as mulched areas of flower beds, paths, bedding, areas of wetlands, etc. The idea of a commercial fungicide has been discussed, but there are none currently available that are effective against Blasto.

With the advent of compounding pharmacies and generic antifungal medications, treatment is now more effective and affordable, making successful outcome for these animals more attainable than ever. Sadly enough, as the symptoms can be widely varied and non-specific, there is sometimes a reluctance to diagnose what has previously been considered a “rare” condition.

Risk Factors:

 Endemic Areas, US - Mississippi, Missouri, Ohio River valleys, Eastern Seaboard, areas adjacent to the Great Lakes. States with highest endemnicity are Wisconsin, Minnesota, Missouri, Illinois, Michigan, Kentucky, West Virginia, Arkansas, Tennessee, North Carolina, South Carolina, Louisiana, and Mississippi. Other endemic states include Indiana, Iowa, Ohio, Virginia, Georgia, and Alabama. However, cases do occur outside the endemic areas.

 Endemic Areas, Canada - Blasto is prevalent in Kenora, Ontario. Also found in Manitoba, Ontario (Kenora, Sault Ste. Marie, Chapleau), Quebec, New Brunswick, in particular areas around the Great Lakes and in a small area a small area in New York and Canada along the St. Lawrence River. Has also been increasingly reported along the Georgian Bay coastline (including Midland and Penetang), Dryden, and in Southern Ontario at the Rockwood Conservation area.

 Environment - Research shows that exposure to wet or decaying organic material, recently disturbed soil, rotting vegetation, bird droppings, and landscaping projects is a strong indicator of disease possibility. Some research has shown a strong link to wood mulch and importation of non-local soil. Patient history will often reveal exposure to mulched areas and disturbed soil in parks, yards, walking paths, etc. By questioning an owner about the animals’ activities, it is often found that exposure may have occurred while vacationing, camping, or visiting an area where Blastomycosis is endemic.

 Breed/Age – Young, large-breed dogs with the highest rates of infection are normally Coonhounds,
Pointers, and Weimaraners. This is normally attributed to higher exposure to endemic areas due to use in hunting. Breed, size, and age, however, are not a reliable indicator of susceptibility, as all are at risk

Symptoms:

After initial spore inhalation, incubation can range from days to weeks, sometimes months, which makes pinpointing a source of infection extremely difficult. The presentation of Blasto is often non-specific, and can imitate a range of other diseases. Symptoms include:

 Lethargy
 Persistent fever of 103 degrees or more
 Anorexia
 Vomiting
 Persistent, usually non-productive cough
 Exercise intolerance
 Respiratory symptoms, fungal pneumonia
 Ocular infection, sudden blindness
 Depression
 CNS symptoms: twitches, stumbling gait, loss of coordination
 Skin ulcerations, non-healing lesions
 Lumps, nodes, swellings
 Weight loss
 Hair loss
 Lameness, fungal arthritis
 Hematuria

Diagnostic Testing:

Diagnosis is based on clinical signs, a thorough patient history, and laboratory findings. Not all findings are specific, some tests are faster and more efficient, and some cases may benefit from antifungal treatment even before definitive diagnosis.

 Cytology: New Methylene Blue stain used to identify organisms from exudates of skin abcesses/lesions/sputum/fluid aspirated from lungs appears to be the fastest, most reliable and cost-effective method. Not all cases, however, will present with accessible material, necessitating further diagnostics.
 MiraVista Diagnostics Antigen Assay: Very high sensitivity with urine (studies show 92.9% sensitivity, specificity 79.3%), slightly less sensitive with serum. 4-5 days for results, at a cost of approx. $100. Also useful in monitoring the efficacy of antifungal therapy.
 Chest X-Ray – signature “snowstorm” pattern
 Area Bone Radiograph
 Lymph node biopsy / fine needle aspiration
 Serum Antibody Titer: regarded as a fairly poor diagnostic tool for Blastomycosis
 Tracheal wash
 Ultrasound

Be Aggressive:

Excerpt: Journal of Clinical Microbiology, October 2004, p. 4873-4875, Vol. 42, No. 10
“Most patients with blastomycosis exhibit progressive illnesses that require antifungal therapy. In one study, diagnosis was delayed for more than 1 month in nearly half of the cases. Blastomycosis was correctly suspected in only 20% of patients, resulting in unnecessary surgeries and treatment delays. In two-thirds of patients who died of acute respiratory distress syndrome caused by blastomycosis, the diagnosis was either not suspected or considered only after the patient became moribund.”

Treatment Options*:

 Itraconazole (Sporanox) capsules: First line preferred treatment, given with a fatty food to increase bioavailability
 Amphoterericin-B: Higher efficacy in patients with CNS involvement
 Itraconazole (Sporanox) suspension: Shorter shelf-life, but can be given without food
 Ketoconazole (Nizoral): In initial treatment w/Ampho-B, similar results as Itraconazole - slightly less expensive
 Fluconazole (Diflucan): Somewhat generally less effective than Itraconazole, but may have better effect in cases with CNS and/or eye involvement.
 Posaconazole: Higher cost, similar effects to Itraconazole, few studies
 Voriconazole: Higher cost, somewhat better efficacy in cases w/CNS involvement, few studies
 Prednisone: For treatment of inflammatory issues
*http://www.miravistalabs.com/Files/pdf/ ... gs2007.pdf.

In the past, Amphotericin-B was the only known medication useful against Blastomycosis and the other systemic fungal organisms. It was given intravenously and with care to keep the dose from harming the kidneys.

More recently, research has provided oral azoles that are highly effective in treating fungal infections. Itraconazole (Sporanox), Ketoconazole (Nizoral), and Fluconazole (Diflucan) are available as capsules and oral suspensions that may be administered for 3 to 6 months (depending on the severity of infection, treatment may be even longer).

Compounding pharmacies have made these medications much more affordable and available in custom dosages for different sized animals. Generic and brand name medications are equally effective, and given the very high cost of brand names, the generic compounded alternatives are saving lives that may have previously been lost due to the cost and length of treatment.

Treatment – It Gets Worse Before it Gets Better:

Once Blasto is diagnosed or is highly suspected, treatment can be started with the appropriate antifungal medication. In the early stages of treatment large numbers of fungi begin to die in the lungs and often elicit an inflammatory response. Prednisone is sometimes prescribed to help reduce inflammation issues.

Many of these animals are fighting a fungal pneumonia. As a result, respiratory distress is often a significant problem in the first few days following initiation of therapy. Since the severity of the infection will determine the amount of fungi inhabiting the dog’s lungs, early diagnosis and treatment is an efficient means of reducing post-treatment respiratory distress and can significantly influence a dog’s chances of survival.

The animal’s prognosis will always be guarded, and antifungal treatment is never a guarantee of recovery. Intense supportive care and a high level of commitment to recovery on the part of the owner are imperative. Round the clock care is often necessary. Removal to a medical facility for IV treatment and hydration may be helpful and sometimes unavoidable, but can be very stressful for a compromised animal. If the owners are able to provide care, the security of home and loved ones may reduce stress. The outcome will also vary with the degree of infection, whether Blasto has disseminated into other organs, CNS, bones, or in the event of secondary bacterial or viral infection.

Eye involvement may result in blindness or necessitate removal of eye(s). Recently some experimental treatments have reported some success in the nominal recovery of vision. These treatments can be fairly expensive, and are not a guarantee of sight recovery. (**See Dogs In Canada article: “Blasto What”, by Rick Hayward.)

During the first few weeks of therapy, the animal may become alarmingly ill, anorexic, and may have to be force-fed. Weight loss may continue; hydration and calories are important. During this time, the idea of eating “healthy” may need to be suspended in favor of getting any nutrition possible into the animal. Owners who have successfully treated their animals recommend the following:

 Ensure Plus: added protein with about 300 calories per can; well tolerated, may be bottle-fed
 Hill’s A/D canine "prescription" dog food: can be mixed with water and given by syringe
 Canned Tripe
 Sav-A-Calf Electrolytes Plus: very good reported results, may be bottle-fed
 Canned Dog Food
 Cooked chicken, chicken broth
 Meal Bones-Whole meals
 Stewed meats, soups
 Burger
 Peanut butter: lots of fat and calories, and they pretty much cannot avoid swallowing it
 Frozen Gatorade
 Frozen Ensure
 Frozen Pedialyte: also helpful when used in a squirt or spray bottle
 Cheese
 Ice Cream
 Margarine
 Sausage
 Eggs
 Yogurt


Medication: Sources and Cost:

Antifungal prescriptions from retail pharmacies can range from $4 to $9 per dose. As treatment must be continued for as long as 12 months, cost will be an issue that affects the owners’ decision regarding treatment vs. euthanasia.

Compounding pharmacies have made generic and custom doses much more affordable. For example, the cost of generic Itraconazole 150 mg. from Pet Health Pharmacy in Arizona is approximately $1 per dose. Overnight shipping is available at a cost of about $8-$10 extra. These medications appear to be equally effective as brand name varieties and make the option of treatment more feasible for the owner.

Contact information for a few trusted compounding pharmacies, more available at www.veterinarypartner.com/Content.plx?A=546

 Pet Health Pharmacy, Inc.: Highly recommended. 12012 N 111th Ave. Youngtown, AZ 85363
Toll Free Phone (800) 742-0516 · Toll Free Fax (866) 373-0030
 RoadRunner Pharmacy: 711 E. Carefree Highway, Suite 140 Phoenix, AZ 85085
Toll Free Phone (877) 518-4589
 Victoria Compounding Pharmacy: 1089 Fort St. Victoria, BC V8V 3K5, Canada
Telephone: (250) 388-5181
 American Health Solutions Pharmacy, Inc.: (800) 337-2844
 Wedgewood Pharmacy: (800) 331-8272, (888)-678-1967 Veterinary

To Sum It Up:

The information in this newsletter was compiled over the course of approximately one year, and is a collaborative effort undertaken by a group of people who have first-hand experience with Blastomycosis in their animals and/or loved ones during the last year.
On the web, it began at www.Blastomycosis.ca, a website by Lisa Schuyler, dedicated to her beloved Golden Retriever, Surf, who died of Blasto in 2005. The site has become a wealth of information, research, links, tips, and support from people who have had successful outcomes and/or suffered the loss of their animals or loved ones.

As discussed, Blasto is often misdiagnosed, or valuable time ticks away while treating for ailments that may be considered more common. By reading the case database at Blastomycosis.ca, it quickly becomes apparent that the key to a successful outcome is not the amount of money spent on expensive care, name brand medications or tests.

The reality is often quite the opposite: some severe cases were successfully treated at home for less than $1000, while others spent well into the thousands on hospital care and brand name treatments, only to lose their animals. The difference is in timely diagnostics, access to affordable medications, and the dedication to weeks or months of intensive care for a very sick animal.

Blasto is no longer rare, but increasingly prevalent in endemic areas as well as areas that are not considered a risk, such as Texas and Vermont. It is our hope that by circulating this resource, we can raise awareness and save the life of even one animal.

Visit Blastomycosis.ca and read the wonderful success stories of dogs like Wilson, Will, Gunner, Dirtbike, Marge, and Rocket, as well as the heart-breaking instances of dogs like Missy, Bandit, Roxy, or Chewbakka, who were tragically lost. The website is frequented by experienced owners who sometimes check in several times a day to offer their support and knowledge to frightened newcomers to Blasto. Their love and dedication extends to everyone’s animal as if it were their own. Our thanks to everyone for their time and interest.

On the Web - Resources:

There is a wealth of information available online. Informed vets and owners make for a better outcome.

 Blastomycosis.Ca: http://blastomycosis.ca/forum/index.php/board,1.0.html
 News Article: Commercial Mulch as a Potential Source of Blastomyces Dermatitides
http://www.acponline.org/about_acp/chap ... amettu.htm
 CanisMajor.com: www.canismajor.com/dog/blstomyc.html
 Blastomycosis in the Dog: www.thepetcenter.com/gen/blasto.html
 Blastomycosis Lounge: www.Blastohounds.livejournal.com
 ** “Blasto What” by Rick Hayward: www.dogsincanada.com
 Health Articles: www.dogstuff.info/blastomycosis.html
 Facebook: www.facebook.com/group.php?gid=13680105258&ref=mf

Authors grant permission to reprint, distribute, submit or copy:
Jennifer S. Wilcox, text
Lee Petterson, pdf. file & pictures
April, 2008
We never really own a dog as much as he owns us. Gene Hill

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Re: Wisconsin Fatal Fungus

Post by snips » Tue Jan 13, 2009 7:06 am

Any update on this dog? Is this the same illness your dog has?
brenda

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Re: Wisconsin Fatal Fungus

Post by lvrgsp » Tue Jan 13, 2009 4:43 pm

Very informative Will, GOOD POST!!!
I lost my 10yr.old liver male to this disease the spring of '06 and it is a devastating disease. It is absolutely crucial to catch it in time, as the article states.
The fungi spores are inhaled, into the lungs, germinate there and slowly drown or suffocate your dog with the fungus. Buster was in the IC vet for 2 weeks and just never recovered, they never could keep the lungs from filling with fluid after draining. It is very prevalent in warm moist areas. Wisconsin has a lot of cases Illinois River bottom areas, it is really becoming more known now. I do believe the University of Wisconsin has done extensive research on this as well.

Dustertoo is this what you are talking about? I hope all is well.

Chip

dustertoo

Re: Wisconsin Fatal Fungus

Post by dustertoo » Tue Jan 13, 2009 5:50 pm

The last I heard, which was a few days ago, she was responding to the treatment and the owner was encouraged but reserving his optimism. He knows how serious the situation is. I have not talked directly to the owner, so I can't say for sure that this is what she has, but it sure sounds like it...especially the cost of the treatment.
Last edited by dustertoo on Tue Jan 13, 2009 8:14 pm, edited 1 time in total.

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Will
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Re: Wisconsin Fatal Fungus

Post by Will » Tue Jan 13, 2009 6:49 pm

It's bad stuff. I lost my Angus to Blasto in September. He made it 2 weeks after diagnoses. Treatment with Itraconazole began on the day of diagnoses. It tore me up so bad that it seriously made me consider finding a new hobby.

I hope this dog makes it.

Please keep us updated.
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Re: Wisconsin Fatal Fungus

Post by Cocksquawk » Tue Jan 13, 2009 8:30 pm

Lots of info here … Thanks for posting it …. Sounds like early awareness is a plus

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Re: Wisconsin Fatal Fungus

Post by BirdDog1 » Wed Jan 14, 2009 12:23 pm

Well I think I am the owner that duster2 was referring to. I have a three year old femal GSP named Bailey, about 9 mths ago she had a swelling like knot on her side and took her to the vet and he took samples and sent off to the lab and nothing came back except for infection so we treated with doxycycline not sure on spelling and it would go away but come back within 2 to 3 weeks later. We were training for a NAVHDA UT test and as soon as we got through that the vet decided that he wanted to remove it by surgery so we did. About a month went by and she got a little soar that was leaking puss beside where he had taken the lump off so he took that off, the whole time we thought that she just got a briar stuck inside that got infected but did not find anything, he also sent the lump into the lab to have tested as well no sign of blasto. Well with in 8 days she really went down hill and lost alot of muscle mass and had no energy, took her back to the vet and we did a chest x-ray and seen what looked like snowflakes on her lunges at this time he thinks we are dealing with blast. We instantly get her started on Itraconazole and put her back ob doxcycline. We are on our 11th treatment tonight and she has alot of her energy back and is eating and able to keep it down. But we still have not had a diognoses of anything all test have come back neg.

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Re: Wisconsin Fatal Fungus

Post by jetto » Wed Jan 14, 2009 1:16 pm

When I read your post about her having a lump- I thought of these articles:

http://clubs.akc.org/brit/VetArticles/A ... ageDVM.htm
http://clubs.akc.org/brit/VetArticles/N ... manDVM.htm


I hope she makes a full recovery for you.....Kristi Anglen

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Re: Wisconsin Fatal Fungus

Post by snips » Wed Jan 14, 2009 2:00 pm

I have seen alot of speargrass this yr. I know of 2 dogs lost by it. I had it in my Wires neck removed successfully, it is danderous if gotten in or around a lung.. Good luck.
brenda

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Re: Wisconsin Fatal Fungus

Post by Will » Wed Jan 14, 2009 3:09 pm

Has your vet sent a urine sample to MiraVista labs for a Blastomyces Antigen Test yet?

It is my understanding this is the only way to accurately confirm the presence of blasto. The test will also tell you if the level of Itra in your dog's system is adequate and whether it is effectively treating the fungi.

Please ask if he has done this.

It is fabulous news that the dog is eating. Make sure she is drinking plenty also.
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