Bone Lesions can only be Controlled with Long Term Medication

Question:

After we moved to Tucson in 2002 our Keeshond developed Valley Fever which didn’t invade his lungs or spine, but led to almost complete disintegration of his bones in his front legs. He stays on fluconizole for 4 months or so, then his titer is normal, so he goes off it.  About six months later he starts going lame again, so the titer is run, he goes on the drug for 4-5 months. When he is on the drug, he acts like a young kid again, running and bounding around.  Is it right for him to keep going off and on the drug?  Will he ever be “cured” or will I have to deal with this the rest of his life?

 

Dr. Nichol:

Valley fever can invade many parts of the body including the lungs, skin, eyes, liver, brain, kidneys, and of course the bones. The infection responds well to medication but not every case is curable. Untreated pets face almost certain death.

 

The fungal organism, coccidioides immitis, that’s responsible for your Keeshond’s disease, is found in the soil of Arizona, southern New Mexico, and a handful of other southwestern states. Infection occurs by inhaling the fungal spores. Fever, lethargy, poor appetite, coughing, joint pain, stiffness, and swollen lymph nodes are common early symptoms. A dog with more advanced disease may develop paralysis, neck and back pain, weight loss, and seizures. Valley fever can cause permanent damage.

 

Fluconizole is generally effective and safe for long term use. Blood titers (tests that measure antibody levels) are important for monitoring the infection even when the drug is used long term. Lymph node aspirates are another useful yardstick.

 

Your dog’s joy of living while taking the medication speaks volumes. Many pets require at least one year of non-stop fluconizole. Your dog’s repeated relapses suggest that it may be necessary for the rest of his life.