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Blastomycosis – Fungal infection August

Blastomycosis – A Potentially Lethal Fungal Infection in Our Pets

Christopher G. Byers, DVM, DACVECC, DACVIM (SAIM), CVJ

When most folks think of infection, they think of bacteria. Yet not all infections are caused by bacteria. Many infections are caused by other infectious organisms, including fungi. If you live in certain parts of the United States, fungal infections are actually quite common. One of the more common fungal infections is called blastomycosis. This week, I’ve dedicated some time to disseminating some helpful information about this infection. Happy reading!

blastomycosis

Blastomycosis – What is it?

Blastomycosis is a fungal infection caused by a fungus called Blastomyces dermatitidis. This fungus is predominantly found in North America while occurring only sporadically in Central America, Africa, India, and Europe. Within the terrestrial borders of North America, certain regions have a preponderance of the fungus, particularly the Mississippi, Ohio, Missouri, Tennessee, and St. Lawrence river valleys.

blastomycosis

Blastomyces dermatitidis is found in two distinct forms – as yeast and mycelia. Mycelia are found in the environment; as they grow, mycelia form segments called conidia (also known as spores) that are ultimately inhaled by our pets. At body temperature, conidia transform and grow as yeast in the lungs, specifically terminal airways. After establishing an infection in the lungs, the fungus disseminates to other areas through blood and lymph vessels, particularly to the following regions/organs:

  • Skin
  • Eyes
  • Bone
  • Subcutaneous tissues
  • Lymph nodes
  • Nostrils (called nares)
  • Brain
  • Testicles

Blastomycosis – What does it look like?

Both dogs and cats may become infected with blastomycosis after 5-12 weeks of incubation.. In dogs, large breeds are more commonly affected than small breeds. Sporting breeds are over-represented, likely due to the fact they are brought to high-risk areas to hunt and work more frequently. Males are more frequently affected than females. In cats, there is no age, breed, or sex predilection.

Common clinical signs in dogs include:

  • Reduced (or loss of) appetite
  • Weight loss
  • Cough
  • Labored breathing
  • Lameness
  • Skin lesions
  • Nasal discharge
  • Eye changes
  • Depression

Clinical signs are similar in cats. Breathing changes, skin lesions, vision changes, and weight loss are most commonly reported.

blastomycosis

Blastomycosis – How is it diagnosed?

After gathering a complete medical history and performing a thorough physical examination, a veterinarian will recommend testing to confirm their clinical suspicion of blastomycosis. Testing may include:

  • Complete blood count / biochemical profile / urinalysis
  • Evaluation of cells from skin lesions (cytology and/or biopsy)
  • Urine antigen testing
  • Antibody screening
  • Chest radiographs (x-rays)
  • Abdominal sonography
  • Airway sampling

Pet parents may find it helpful to partner with a board-certified veterinary internal medicine specialist to develop a cost-effective and logical treatment plan.

Blastomycosis – How is it treated?

Blastomycosis should be treated with an antifungal medication. Common drugs that may be prescribed include:

  • Itraconazole
  • Fluconazole
  • Amphotericin B

Treatment is prolonged, often more than two months’ duration. In general, the prognosis for patients who are promptly and effectively treated is good. Dogs with central nervous system involvement typically die but treatment is occasionally successfully. Dogs with marked lung involvement carry a more guarded prognosis with 50% of dog succumbing to infection within the first week of treatment. Approximately 25% of dogs will experience a relapse after treatment. The relapse typically occurs within six months.

The take-away message about blastomycosis in dogs & cats…

Blastomycosis is a meaningful fungal infection in many parts of North America. Clinical signs reflect the organ(s) affected by infection, and may including coughing, appetite changes, skin lesions, and eye changes. With prompt identification and treatment, prognosis is good.

To find a board-certified veterinary internal medicine specialist, please visit the American College of Veterinary Internal Medicine.

Wishing you wet-nosed kisses,

CriticalCareDVM

CriticalCareDVM

FDA Investigating Potential Connection Between Diet and Cases of Canine Heart Disease

My heart goes out to a member of our Gordon Setter community who lost her beautiful Gordon companion to canine dilated cardiomyopathy (DCM). Her heart is broken. Learning, while doctoring to save her Gordon, that the food she had so carefully chosen to ensure her Gordon’s health and longevity, cost him his life instead, added unbearable pain to an already devastating loss.

We want you to be aware that DCM caused by diet has been confirmed in our beloved breed.

Sally Gift, Mesa AZ

Link between Diet and Canine Heart Disease

July 12, 2018

The U.S. Food and Drug Administration is alerting pet owners and veterinary professionals about reports of canine dilated cardiomyopathy (DCM) in dogs eating certain pet foods containing peas, lentils, other legume seeds, or potatoes as main ingredients. These reports are unusual because DCM is occurring in breeds not typically genetically prone to the disease. The FDA’s Center for Veterinary Medicine and the Veterinary Laboratory Investigation and Response Network, a collaboration of government and veterinary diagnostic laboratories, are investigating this potential association.

Canine DCM is a disease of a dog’s heart muscle and results in an enlarged heart. As the heart and its chambers become dilated, it becomes harder for the heart to pump, and heart valves may leak, leading to a buildup of fluids in the chest and abdomen. DCM often results in congestive heart failure. Heart function may improve in cases that are not linked to genetics with appropriate veterinary treatment and dietary modification, if caught early.

The underlying cause of DCM is not truly known, but is thought to have a genetic component. Breeds that are typically more frequently affected by DCM include large and giant breed dogs, such as Great Danes, Boxers, Newfoundlands, Irish Wolfhounds, Saint Bernards and Doberman Pinschers. It is less common in small and medium breed dogs, except American and English Cocker Spaniels. However, the cases that have been reported to the FDA have included Golden and Labrador Retrievers, Whippets, a Shih Tzu, a Bulldog and Miniature Schnauzers, as well as mixed breeds.

Diets in cases reported to the FDA frequently list potatoes or multiple legumes such as peas, lentils, other “pulses” (seeds of legumes), and their protein, starch and fiber derivatives early in the ingredient list, indicating that they are main ingredients. Early reports from the veterinary cardiology community indicate that the dogs consistently ate these foods as their primary source of nutrition for time periods ranging from months to years. High levels of legumes or potatoes appear to be more common in diets labeled as “grain-free,” but it is not yet known how these ingredients are linked to cases of DCM. Changes in diet, especially for dogs with DCM, should be made in consultation with a licensed veterinarian.

In the reports the FDA has received, some of the dogs showed signs of heart disease, including decreased energy, cough, difficulty breathing and episodes of collapse. Medical records for four atypical DCM cases, three Golden Retrievers and one Labrador Retriever, show that these dogs had low whole blood levels of the amino acid taurine. Taurine deficiency is well-documented as potentially leading to DCM. The Labrador Retriever with low whole blood taurine levels is recovering with veterinary treatment, including taurine supplementation, and a diet change. Four other cases of DCM in atypical dog breeds, a Miniature Schnauzer, Shih Tzu and two Labrador Retrievers, had normal blood taurine levels. The FDA continues to work with board certified veterinary cardiologists and veterinary nutritionists to better understand the clinical presentation of these dogs. The agency has also been in contact with pet food manufacturers to discuss these reports and to help further the investigation.

The FDA encourages pet owners and veterinary professionals to report cases of DCM in dogs suspected of having a link to diet by using the electronic Safety Reporting Portal or calling their state’s FDA Consumer Complaint Coordinators. Please see the link below about “How to Report a Pet Food Complaint” for additional instructions.

Additional Information

Blastomycosis—What Every Dog Owner Needs to Know – Life with Llewellin Setters

Blastomycosis, or Blasto as it is often called, is a very serious and potentially deadly, systemic fungal disease that can affect dogs, humans, and other mammals. Blasto is caused by inhaling the spores of the fungus Blastomyces dermatitidis. B. dermatitis grows as a mold in acidic, organically rich …

Source: Blastomycosis—What Every Dog Owner Needs to Know – Life with Llewellin Setters