Counterimmunoelectrophoresis (immunoelectroosmosis) and serum electrophoretic pattern in serologic diagnosis of canine blastomycosis

Counterimmunoelectrophoresis (CIEP) with blastomyces and histoplasma antigens was used in a serologic study of 181 dogs clinically suspected of having blastomycosis and of 8 dogs with confirmed blastomycosis or histoplasmosis. Thirteen of the 181 dogs, positive by CIEP, were euthanatized, and the diagnosis was confirmed by cultivation and/or microscopic detection of Blastomyces dermatitidis. Additional CIEP-positive dogs were confirmed by staining of aspirates collected in vivo. Radiographic support for the diagnosis was reported in 4 other dogs in which histoplasmosis was excluded by a negative CIEP with histoplasma antigen. The precipitating antibody may disappear during the course of the disease, as it did in 1 dog treated with amphotericin B, but not cured. This dog reverted from CIEP-positive to CIEP-negative within 17 months of treatment (with a weak reaction after 10 months of treatment). The CIEP-detectable antibody was present only in 1 dog without a confirmation by histopathologic findings or cultivation among 24 well-documented cases and 181 total tested sera. The CIEP was more sensitive and specific than was the gel-diffusion precipitin test, eliminated the problems of anticomplementarity that often affected the results of complement-fixation tests with canine sera, and served well in detecting dogs with blastomycosis. Electrophoretic pattern of sera from CIEP-positive dogs with blastomycosis showed a decrease in albumin and an increase in alpha 2- and often in beta- and gamma-globulins, with a substantial decrease of the albumin/globulin ratio.     

Disseminated histoplasmosis in dogs: 12 cases (1981-1986)

Diarrhea, intestinal blood loss, anemia, and lethargy were predominant clinical findings in 12 dogs with disseminated histoplasmosis. Young dogs were affected most commonly, with 6 dogs being 1 to 3 years old. A diagnosis of disseminated histoplasmosis was established on the basis of histologic or cytologic detection of Histoplasma organisms in intestinal or rectal mucosa in 7 dogs, in circulating leukocytes in 5 dogs, in bone marrow in 3 dogs, and in multiple tissues at necropsy in 1 dog (4 dogs had Histoplasma organisms detected in greater than 1 site). Anemia was detected in 10 dogs (PCV less than 20% in 3 dogs), and the anemia was inadequately regenerative or nonregenerative in 7. Hypoalbuminemia was detected in 9 dogs, and serum albumin concentrations were low (less than 1.0 g/dl) in 4 of the 9 dogs. Of 5 dogs treated with ketoconazole, 2 were in remission for greater than or equal to 1 year. Corticosteroid therapy may have exacerbated the disease in 4 dogs. Histoplasma infection of multiple organs was detected in 5 necropsied dogs.     

Calcinosis cutis associated with systemic blastomycosis in three dogs.

Three dogs treated for systemic blastomycosis with intravenous amphotericin B (one case) or amphotericin B lipid complex (two cases) developed mild to severe calcinosis cutis two to six weeks after the initiation of treatment. Abnormalities in serum calcium and phosphorus during treatment for blastomycosis or at the time of diagnosis of calcinosis cutis were slight or absent. The calcification was not associated with lesions of cutaneous blastomycosis. Calcification was limited to the skin in two cases and may have also involved the kidneys in one. The calcinosis cutis resolved completely in all three dogs with no (two cases) or only palliative (one case) therapy.     

Cytologic analysis of tracheal wash specimens and bronchoalveolar lavage fluid in the diagnosis of mycotic infections in dogs

Tracheal wash and bronchoalveolar lavage fluid analyses were performed in 9 dogs that had mycotic infections with pulmonary involvement. Characteristic organisms were identified in tracheal wash fluid in 3 of 7 dogs with blastomycosis. Organisms were identified in bronchoalveolar lavage fluid in 5 of 7 dogs with blastomycosis and in one dog with histoplasmosis. Organisms were not found in either fluid in one dog with coccidioidomycosis. These procedures should be considered for dogs with suspected mycotic infections that involve the lungs and that cannot be diagnosed by less invasive means.     

Causes of anaemia other than acute blood loss and their clinical significance in dogs

Objectives : To identify the causes of anaemia, other than acute blood loss, in dogs and to determine whether severity of anaemia provides clues to the diagnosis. Methods : The veterinary medical database of the Veterinary Campus Hospital, Lyon was searched. Dogs with anaemia (packed cell volume <37%) were included and assigned to different disease groups. Dogs with acute blood loss were excluded. The case records were examined for weakness at presentation, the severity and regeneration of anaemia and the final diagnosis including tumour type if applicable. Results : The case records of 456 dogs with low packed cell volume were included. Cancer‐related anaemia and anaemia of inflammatory disease accounted for 33·1 and 28·5% of cases, respectively. Most dogs with cancer‐related anaemia had solid tumours (73%). The prevalence of immune‐mediated anaemia increased with severity of anaemia (5·3, 15·5, 41·2 and 56·2% for mild, moderate, severe and very severe anaemia, respectively), whereas the prevalence of anaemia of inflammatory disease decreased (36·7, 22·5, 2·9 and 0% for mild, moderate, severe and very severe anaemia, respectively). Clinical Significance : Anaemia of inflammatory disease and cancer‐related anaemia were the most frequently identified causes of anaemia in dogs. The percentage of dogs with immune‐mediated anaemia increased with anaemia severity, whereas the percentage of dogs with anaemia of inflammatory disease decreased with anaemia severity. Thus, severity of anaemia may provide clues to the diagnosis.     

Changes in the serum urea: creatinine ratio in dogs with babesiosis, haemolytic anaemia, and experimental haemoglobinaemia

The purpose of this study was to determine serum urea and creatinine concentrations, the derived urea : creatinine (UC) ratios, haemoglobin concentrations and glomerular filtration rates (GFR) in dogs with haemolytic anaemia and those with experimentally induced anaemia and/or haemoglobinaemia. There were 25 dogs with babesiosis (group 1), 13 control animals (group 2), six dogs with induced haemoglobinaemia and anaemia (group 3), six with induced haemoglobinaemia (group 4), and 14 with immune-mediated haemolytic anaemia (IMHA) (group 5). The median serum urea concentration was 11.18 mmol/L (group 1), 4.3 mmol/L (group 2), 4.3 mmol/L (group 3), 4.35 mmol/L (group 4), and 8.5 mmol/L (group 5). Median serum creatinine was 67 μmol/L (group 1), 75 μmol/L (group 2), 78.5 μmol/L (group 3), 84 μmol/L (group 4), and 82 μmol/L (group 5). Median serum haemoglobin was 1.3g/L (group 1), 0.8 g/L (group 2), 9 g/L (group 3), 3g/L (group 4), and 1.3g/L (group 5). The median UC ratio was 41.35 (group 1), 15.36 (group 2), 14.18 (group 3), 13.6 (group 4), and 14.15 (group 5). GFR was normal in all five groups. Serum urea concentration and the UC ratio were significantly greater in dogs with babesiosis than in those with IMHA, experimentally induced anaemia and/or haemoglobinaemia.     

Disseminated histoplasmosis in cats: 12 cases (1981-1986)

Anemia, weight loss, lethargy, fever, anorexia, and interstitial lung disease were the predominant clinical findings in 12 cats with disseminated histoplasmosis. Some cats were examined because of dysfunction or lesions of bone, eyes, or skin. In most cases, the clinical signs were observed by the owner for 4 weeks or less before seeking veterinary care. Young cats were most commonly affected, with 7 of the 12 cats less than or equal to 1 year old. Identification of Histoplasma organisms in bone marrow aspirates was used to confirm the diagnosis of histoplasmosis in 11 of the 12 cats. Histoplasma infection of multiple organs was found at necropsy. In this study, disseminated histoplasmosis had a higher prevalence in cats than in dogs at the same veterinary medical teaching hospital. Feline disseminated histoplasmosis was not associated with FeLV infection. Treatment was attempted in 7 of the 12 cats.     

Epidemiologic study of canine blastomycosis in Wisconsin

An epidemiologic study was designed to investigate the increasing number of cases of canine blastomycosis being reported in Wisconsin. From January 1980 through July 1982, 200 cases of canine blastomycosis from 39 Wisconsin counties were examined to assess epidemiologic and environmental aspects of this disease. Based on a survey of 176 dog owners, principal disease characteristics for canine blastomycosis were anorexia, lethargy, shortness of breath, chronic cough, and weight loss. The greatest number of cases of canine blastomycosis was in the northwest, north central, northeast, central, and southeast regions of Wisconsin. The northeast and central regions were determined to be new enzootic areas. Sporting breeds accounted for the largest percentage of cases among the various breeds of dogs in Wisconsin. Most of the affected dogs were 3 years old or younger and there was no apparent sexual predilection. Canine blastomycosis was diagnosed more frequently from late spring through late fall. Enzootic areas, except for the southeast region of Wisconsin, were located where the soil was sandy and acid. The results of this study suggested a possible association of enzootic areas with waterways, especially impoundments.     

Evaluation of risk factors for blastomycosis in dogs: 857 cases (1980-1990)

An epidemiologic study was conducted by use of the Veterinary Medical Data Base to investigate risk factors for blastomycosis in dogs. From January 1980 through June 1990, 971 cases of blastomycosis in dogs from 22 North American veterinary teaching hospitals were identified. Of these cases, 114 (11.7%) were excluded from the study because of incomplete information regarding age, body weight, sex, and neuter status. A control group of 417,079 dogs was selected that included all other dogs with medical conditions unrelated to blastomycosis for which records were submitted to the data base during the same period. The prevalence of blastomycosis in dogs was 205/100,000 admissions during the study period. When veterinary teaching hospitals were grouped on the basis of their general geographic location, dogs in the East South central, East North central, West South central, and South Atlantic regions had a significantly (P < 0.05) increased risk of acquiring blastomycosis, compared with that of dogs in the Mountain/Pacific region. When teaching hospitals from all geographic regions were considered, dogs had a significantly (P < 0.05) increased risk of acquiring blastomycosis in autumn, compared with that in spring. Sporting dogs and hounds, as defined by the American Kennel Club, were at increased risk for blastomycosis. At highest risk were Bluetick Coonhounds, Treeing-walker Coonhounds, Pointers, and Weimaraners, compared with mixed-breed dogs. Ages of dogs with blastomycosis tended to be normally distributed. Generally, the highest-risk group was composed of sexually intact male dogs, 2 to 4 years old, weighing 22.7 to 34.1 kg. This same pattern was observed for sporting dogs and hounds.(ABSTRACT TRUNCATED AT 250 WORDS)     

Visual outcome in a group of dogs with ocular blastomycosis treated with systemic antifungals and systemic corticosteroids

OBJECTIVE: To evaluate the success of the use of systemic corticosteroids and antifungal medications in the treatment of dogs with ocular lesions associated with systemic blastomycosis. DESIGN: Retrospective study. ANIMALS STUDIED: Medical records of 25 dogs diagnosed with blastomycosis, via either cytology or histopathology, at the Purdue University Veterinary Teaching Hospital between 1 January 2000 and 1 January 2005, were reviewed. PROCEDURE: Data collected from the medical records included signalment, presence and progression of ocular lesions, antifungal drugs administered, oral and topical corticosteroid administration, length of follow-up, response to treatment, and visual outcome. RESULTS: Of the 25 cases reviewed, 12 dogs (19 eyes) with follow-up information were found to have lesions consistent with ocular blastomycosis. Length of follow-up in the 12 cases ranged from 1 month to 31 months with a mean of 9 months. Antifungal therapy for all cases consisted of oral itraconazole (5 mg/kg every 24 h) initially. In seven cases, the antifungal drug administered was changed from itraconazole to oral fluconazole. Two of these also received intravenous amphotericin B, and two received additional treatment with itraconazole. All 12 dogs also received oral prednisone. The dose of oral prednisone utilized ranged from 0.2 mg/kg/day to 1.4 mg/kg/day with a mean of 0.7 mg/kg/day; the duration of oral prednisone administration ranged from 2 weeks to 8.5 months with a mean of 3 months. Topical prednisolone was a component of the treatment of 16 of the 19 eyes. Duration of topical prednisolone treatment ranged from 1 month to 30 months with a mean of 5 months. Lesions not located in the eyes exhibited a positive response to treatment in 11 (92%) of the 12 dogs. Overall, 14/19 (74%) affected eyes were visual at the time of their final recheck. All eyes with mild or moderate lesions and 5/10 (50%) severely affected eyes were visual at their last recorded recheck examination. CONCLUSIONS: The administration of systemic corticosteroids did not appear to adversely affect the survival rate and might have played a role in preservation of vision in a majority of dogs in this group with ocular blastomycosis.     

Doppler ultrasonographic changes in the canine kidney during normovolaemic anaemia

The haemodynamics of the canine left renal artery (LRA) and interlobar artery (ILA) were evaluated in eleven fasted, healthy, conscious beagles with severe acute (haematocrit [Hct] 16%), moderate chronic (Hct 26%) and mild chronic (Hct 34%) normovolaemic anaemia using Doppler ultrasound. Heart rate, peak systolic velocity (PSV), end diastolic velocity (EDV), time-averaged mean velocity (TAVmean), pulsatility index (PI) and resistive index (RI) were recorded. Doppler values in the dogs following the induction of anaemia states were compared with corresponding values in the same dogs prior to the induction of anaemia. Left renal artery mean PSV, mean PI and mean RI were significantly higher and the mean EDV was significantly lower in severe acute anaemia. No significant change was seen in mean values of the same parameters in moderate or mild chronic anaemia. There was no significant change in TAVmean of the LRA or mean PI and mean RI of the ILA in any grade of anaemia. Acute, severe normovolaemic anaemia significantly altered LRA Doppler parameters in resting dogs without influencing those of the ILA. Moderate or mild chronic anaemia had no effect on any renal Doppler parameter.     

Canine antibody response to Blastomyces dermatitidis WI-1 antigen

OBJECTIVE: To assess whether dogs with blastomycosis produce antibodies against the WI-1 and A-antigens of Blastomyces dermatitidis and whether the antibodies are useful in serodiagnosis. SAMPLE POPULATION: 359 serum samples obtained from 245 dogs. PROCEDURE: 233 samples from 122 dogs with blastomycosis, and 1 sample each from 24 dogs with suspected blastomycosis, 51 control dogs without infection, and 48 healthy dogs from an enzootic region were obtained. Antibodies against WI-1 antigen were detected by radioimmunoassay (RIA). Serum samples were tested in parallel for antibodies against the A-antigen of B dermatitidis by commercial agar-gel immunodiffusion (AGID) in a reference laboratory. RESULTS: Antibodies were detected in 92% of infected dogs by RIA and in 41 % by AGID. For 29 serum samples that were obtained 11 to 1,545 days after diagnosis, antibodies were detected in 92% of samples by RIA and 7% by AGID. For 93 serial serum samples from 29 dogs with blastomycosis, the mean anti-WI-1 titer was 1:18,761 at the time of diagnosis, and decreased to a mean of 1:1,338 by 210 days after treatment was initiated. Of 24 dogs with suspected infection, antibodies were detected in 67% by RIA and 33% by AGID. Control dogs without blastomycosis had no detectable antibodies in either assay. Thus, sensitivity was 92% for RIA and 41 % for AGID, and specificity was 100% for both tests. CONCLUSIONS AND CLINICAL RELEVANCE: Anti-WI-1 antibodies are readily detected by RIA in dogs with blastomycosis. Titers become high, decline during treatment, and persist for months. Anti-A antibodies are sometimes detected with AGID, but these decrease quickly.     

Evaluation of total and ionized calcium status in dogs with blastomycosis: 38 cases (1997-2006)

OBJECTIVE: To determine blood ionized calcium (iCa) and serum total calcium (tCa) concentrations in dogs with blastomycosis and to evaluate whether serum tCa concentration, albumin-adjusted serum calcium concentration (AdjCa-Alb), and total protein-adjusted serum calcium concentration (AdjCa-TP) accurately predict iCa status. DESIGN: Retrospective case series. ANIMALS: 38 client-owned dogs with a cytologic diagnosis of blastomycosis. PROCEDURES: Dogs were classified as hypocalcemic, normocalcemic, or hypercalcemic on the basis of blood iCa concentration, serum tCa concentration, AdjCa-Alb, and AdjCa-TP; classification on the basis of serum tCa concentration, AdjCa-Alb, and AdjCa-TP was compared with blood iCa concentration. RESULTS: Except for 2 hypercalcemic dogs, all dogs had blood iCa concentrations within the reference interval. Use of serum tCa concentration overestimated hypocalcemia in 57.9% (22/38) of dogs and underestimated hypercalcemia in 1 dog. Use of AdjCa-Alb correctly reclassified all dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, but failed to predict hypercalcemia in 1 dog. Use of AdjCa-TP correctly reclassified all but 2 dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, and failed to predict hypercalcemia in 1 dog. No correlation was found between blood iCa concentration and serum concentrations of tCa, total protein, and albumin; AdjCa-Alb; or AdjCa-TP. CONCLUSIONS AND CLINICAL RELEVANCE: High blood iCa concentration was uncommon in dogs with blastomycosis. Hypoalbuminemia contributed to a low serum tCa concentration despite a blood iCa concentration within reference limits. The use of serum tCa concentration, AdjCa-Alb, and AdjCa-TP may fail to identify a small number of dogs with high blood iCa concentrations.     

Abnormal Hemostatic Profiles and Gastric Necrosis in Canine Gastric Dilatation-Volvulus

Hemostatic profiles (prothrombin time, activated partial thromboplastin time, fibrinogen concentration, fibrin degradation product concentration, platelet count, and antithrombin III activity) were acquired prospectively in 20 dogs with a diagnosis of gastric dilatation-volvulus. Eighteen dogs had abnormal results of one or more hemostatic test, including eight dogs that had hemostatic profiles consistent with a diagnosis of disseminated intravascular coagulation. During surgery, or at necropsy, the dogs' stomachs were evaluated for gross abnormalities, and lesions were graded subjectively as mild, moderate, or severe. Eight dogs had mild gastric lesions, five had moderate lesions, and seven had severe changes indicating gastric necrosis. Seventy percent (7/10) of the dogs with two to six abnormal hemostatic test results had gastric necrosis, whereas none of the 10 dogs with no or one abnormality had gastric necrosis (p < .001). A multiple linear regression equation, based on fibrin degradation product concentration, activated partial thromboplastin time, and antithrombin III activity was derived to predict gastric necrosis. This equation correctly identified gastric necrosis with 86% sensitivity, 100% specificity, 100% positive predictive value, and 93% negative predictive value.     

Myopathy and alterations in serum 3-methylhistidine in dogs with liver disease

Liver disease can influence the metabolism of various other organs. Regarding the influence of liver diseases on muscles, only a few studies done on people exist. The goal of our study was to investigate the influence of liver diseases on muscles in dogs. Twenty-eight dogs with different liver diseases were investigated in this study. The diagnosis of muscle alteration was based on electromyography (EMG), creatine kinase serum activity, 3-methylhistidine serum concentration and a muscle biopsy in some cases. Our results suggest that liver diseases in dogs can be accompanied with muscle alteration. 3-Methylhistidine serum concentration as a new parameter for muscle destruction in dogs was significantly increased compared to clinical healthy dogs and was comparable to those concentrations in dogs with histologically confirmed myopathy of different types. The differentiation of the liver diseases into severe hepatitis, moderate hepatitis and liver tumours showed a significant elevation of 3-methylhistidine serum concentration in cases of liver tumours (P=0.03) and a tendency in cases of severe hepatitis (P=0.07). Based on our study we can conclude that liver diseases have an influence on muscles in dogs and 3-methylhistidine could be a useful parameter for muscle destruction.     

Treatment of Blastomycosis With Itraconazole in 112 Dogs

One hundred twelve client-owned dogs with blastomycosis were treated with itraconazole, 5 or 10 mg/kg/d. The first group of 70 dogs treated in 1987 and 1988 received 10 mg/kg/d (group 1), and the second group of 42 dogs treated after October 1988 received 5 mg/kg/d (group 2). Even though the groups were treated at different times, the dogs were similar in age and gender distribution, number of sites involved, and percent and severity of pulmonary involvement. The proportion of dogs cured with a 60–day course of itraconazole was similar for both groups (53.6% versus 54.3%) and for a second historical control group treated with amphotericin B (57%); the recurrence rate was also similar, 20%, 21.4%, and 20%, respectively. Dogs treated with itraconazole had similar mortality rates (25.7% at 5 mg/kg/d; 25% at 10 mg/kg/day) to those treated with amphotericin B (23%). Seventeen of the 23 dogs that died (74%), did so during the first week of treatment; these early deaths were usually attributed to respiratory failure. The only site of infection that was significantly associated with failure (death or recurrence) was the brain. There was a marked difference in survival times between dogs without lung disease or with mild lung disease compared with dogs with moderate or severe lung disease. Serum itraconazole concentrations reached steady state by 14 days of treatment. Dogs receiving 5 mg/kg/d of itraconazole (group 2) had mean serum concentrations of 3.55 ± 2.81 mg/mL (range, 0.67 to 10.8 μg/mL), whereas dogs receiving 10 μg/kg/d (group 1) had mean concentrations of 13.46 ± 8.49 μg/mL (range, 1.8 to 28 μg/mL) (P ≤ .001). There was no association between cure and serum itraconazole concentrations. Dogs in group 1 had significantly more adverse effects than dogs in group 2 (P= .046). Anorexia was the most common adverse effect, occurring in 14.9% of dogs in group 1. Only 8% of dogs in group 2 had adverse effects. Serum concentrations of itraconazole were positively correlated with serum alkaline phosphatase and alanine aminotransferase activities. Our findings indicate that itraconazole administered at a dose of 5 mg/kg/d is the drug of choice for blastomycosis in dogs.     

Disseminated Canine Histoplasmosis: A Clinical Survey of 24 Cases in Texas

The clinical features of 24 cases of disseminated canine histoplasmosis are presented. The enteric form predominated and the age at presentation was from five months to ten years. The principal clinical findings were chronic diarrhea, weight loss, pyrexia and anemia.

A premortem diagnosis was reached in 20 cases, by demonstrating Histoplasma capsulatum organisms in peripheral blood smears, rectal scrapings or surgical biopsies. Five of seven dogs treated with amphotericin B were released in asymptomatic condition. Four of these cases relapsed six to 15 months following therapy. The overall mortality rate was 80%.

     

Serial monitoring of clinical, haematological and immunological parameters in canine autoimmune haemolytic anaemia

Clinical, haematological and immunological data are presented from 14 dogs with autoimmune haemolytic anaemia (AIHA) serially monitored for up to 945 days after initial presentation. At the time of diagnosis, all dogs had severe anaemia (mean packed cell volume [PCV] 17.6±7.1 per cent) with leucocytosis in seven cases and thrombocytopenia in four dogs. The Coombs' test was positive in all cases. Immunoglobulin G (IgG) autoantibody alone was identified in eight cases, a combination of IgG and IgM autoantibodies was recognised in three cases, and in two dogs only IgM autoantibody was recorded (complement fixing in one of these dogs). All dogs were treated with immunosuppressive doses of corticosteroids and some animals also received cyclophosphamide (four cases), azathio-prine (two cases), blood transfusion (four cases) or underwent splenectomy (two cases). Two dogs died during the initial episode of AIHA. In 12 dogs, the anaemia was resolved by an average of 36.3 ±16.0 days after initial presentation, but autoantibody titre often persisted after clinical improvement and normalisation of PCV. Four dogs had a clinical relapse 67 to 170 days after initial presentation and one of these dogs subsequently died from thromboembolic disease. One dog developed lymphocytic thyroiditis and serum antinuclear antibody at day 691 after initial presentation, and two cases developed disease consistent with autoimmune thrombocytopenia (AITP) at 365 and 618 days post initial presentation. In one of these dogs, AITP was concurrent with multicentric lymphoma. No correlation was recorded between haematological and immunological parameters at presentation and subsequent response to therapy or long-term clinical behaviour.     

CT FINDINGS OF INTRACRANIAL BLASTOMYCOSIS IN A DOG

Computed tomography (CT) findings in a dog with intracranial blastomycosis were marked periventricular contrast enhancement of the lateral ventricles, the 3rd ventricle, and the mesencephalic aqueduct. The CT appearance correlated with the histopathologic findings, where severe ependymitis was present throughout the ventricular system and there was stenosis of the mesencephalic aqueduct due to an inflammatory infiltrate. CT is therefore recommended as a screening test for intracranial blastomycosis in dogs and also as an imaging modality for follow-up evaluation after treatment. This is particularly true in dogs with systemic or ocular blastomycosis, which appear to be at higher risk of developing CNS involvement.     

Utility of diagnostic tests for and medical treatment of pulmonary blastomycosis in dogs: 125 cases (1989-2006)

OBJECTIVE: To compare results of the most common diagnostic tests for pulmonary blastomycosis in dogs, identify factors associated with outcome, and determine response to various antifungal treatment protocols. DESIGN: Retrospective case series. ANIMALS: 125 dogs with pulmonary blastomycosis. PROCEDURES: Medical records were reviewed, and information was obtained regarding diagnostic methods, results of routine laboratory testing, and radiographic response to antifungal treatment. RESULTS: 79 dogs survived, 38 died, and 8 were euthanized. Transthoracic fine-needle aspiration and transtracheal lavage were the most common diagnostic methods. Results of an agar gel immunodiffusion test for antibodies against Blastomyces dermatitidis were negative in 12 of 24 (50%) dogs. Only 3 of 94 (3.2%) dogs in which cytologic or histologic examination or bacterial culture of pulmonary samples were performed had any evidence of concurrent bacterial infection. The half-time for radiographic resolution of pulmonary infiltrates did not vary significantly with antifungal treatment, and use of a loading dosage of itraconazole was not associated with significant improvements in outcome or time to disease resolution. Dogs that died had a higher number of band neutrophils at initial examination, compared with those that survived. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the agar gel immunodiffusion test should not be used as the sole diagnostic test for pulmonary blastomycosis in dogs, that concurrent bacterial pneumonia was uncommon in dogs with pulmonary blastomycosis, and that the rate with which pulmonary infiltrates resolved did not vary significantly among antifungal treatments.