Is there treatment for Canine Valley Fever?

Answer 1

most cases, a dog ill enough from Valley Fever to be seen by a veterinarian will require treatment with antifungal medication. Courses of medication are usually extensive, averaging 6-12 months. Dogs with disseminated disease in bones, skin, or internal organs usually require longer courses of medication. Central nervous system (brain or spinal cord) involvement frequently requires lifetime treatment with medication to keep symptoms from recurring.

Oral antifungal medication in the form of daily pills or capsules is the usual treatment for Valley Fever. There are three common medications used to treat Valley Fever in dogs.

Ketoconazole (Nizoral) is the most commonly prescribed and the least expensive. Incidence of side effects is relatively high and the drug is usually administered twice daily with food. Absorption is an issue on an empty stomach and acidification usually improves uptake.

Itraconazole (Sporanox) is expensive with a moderate incidence of side effects. Administration is once to twice daily with food. Absorption is usually poor on an empty stomach. An oral liquid formulation with much better absorption is available and might be indicated for animals who are not eating very well but need this medication. However, expense may be an issue.

Fluconazole (Diflucan) is expensive with a low incidence of side effects compared to the other two medications. It is administered once or twice daily. Absorption is excellent even on an empty stomach and this drug is often a good choice for very sick dogs that aren’t eating well. Fluconazole is the drug of choice for dogs and cats with infection of the brain, spinal cord, or eyes as it is the only drug that crosses into those tissues.

Other treatments for Valley Fever are mainly directed at supportive care: making your dog feel better while the antifungal medication starts to heal the infection.

Cough suppressants - the cough may be so severe that your veterinarian will prescribe medicine to relieve it.
Pain and fever relief - anti-inflammatories or pain medication prescribed by your veterinarian may greatly help your dog’s attitude and appetite during the severe stages of the disease.
Nutritional support - while some dogs eat reasonably well with Valley Fever, others will shun food entirely. These patients may need measures taken to get nutrition into them.
Hospitalization - dogs that are too sick to eat and drink and are becoming dehydrated or are in severe respiratory distress may need 24-hour care, intravenous fluids, oxygen, or other medication that can only be given in the hospital environment.
Amphotericin B, is an old but very effective antifungal medication that is mainly used for extremely sick dogs in today’s veterinary practices. Amphotericin B is only available for intravenous administration and has the serious drawback of toxicity to the kidneys. Newer formulations of amphotericin B (lipid-complexed amphotericin B - brand names: Abelcet; Ambisome) with much lower kidney toxicity have recently become available. For dogs that are either very ill with Valley Fever or dogs that are not recovering on oral medication, intravenous treatment with amphotericin B, especially one of the newer lipid formulations, may be indicated. Cost is very high.

Drugs very recently introduced to the market for treatment of fungal disease in humans include:

Voriconazole (Vfend)
Caspofungin (Cancidas)
The role of these drugs in treating human Valley Fever is not yet clear. They are likely cost-prohibitive for use in animals at this time, as well as of unknown efficacy and safety, but they may have a role in the future for treating dogs.

FAQ - What is the best treatment for Valley Fever?

Treatment choices vary by the individual veterinarian and patient. Reasons for choice of medication include practitioner’s experience with the drugs, costs, side effects, efficacy, severity of illness, and convenience to the owner. If one medication is unsuccessful, another will often be tried.

For disease of the brain and spinal cord, fluconazole (Diflucan) is the drug of choice. Fluconazole is also the only drug that penetrates tissues of the eye and should be employed in ocular cases.

FAQ - What is the proper dose of Valley Fever medications?

Your veterinarian is skilled in the diagnosis and treatment of your pet’s illness. Should you feel that your dog is not responding or may have side effects to the medicine, you should first discuss your concerns with your veterinarian. If the results are not satisfactory, you can seek a second opinion.

FAQ - What are the side effects of oral Valley Fever drugs (ketoconazole, itraconazole, and fluconazole)?

Ketoconazole (Nizoral) has the highest incidence of side effects. Loss of appetite is the most common and may be severe in some dogs. Others include lightening of the haircoat (may grey in blacks), vomiting, diarrhea, elevated liver enzymes, and reduced fertility of males. Giving the drug with food may reduce gastrointestinal side effects as well as improving absorption of the medicine.
The coat color effects reverse with discontinuation of the medication (with the exception of a few black dogs this author has heard about that have remained grey).
Liver enzymes are monitored by routinely testing your dog’s blood. If your veterinarian determines that they are significantly elevated, the medication may be stopped or the dose decreased.

Itraconazole (Sporanox) may also cause lack of appetite and GI signs, though with less frequency than ketoconazole. It may increase liver enzymes. Occasionally, itraconazole can cause ulcerated lesions of the skin. If this happens, a reduction in dose may clear it up, or your dog may need to be treated with a different medication. Monitoring of liver enzymes is as for ketoconazole.

Effects of itraconazole on coat color are unknown by this author but may be similar to ketoconazole in an occasional dog. Itraconazole is not known to affect fertility of males.

Fluconazole (Diflucan) has the fewest side effects. Gastrointestinal signs can occur, though are often mild, and elevations in liver enzymes are relatively uncommon. Unlike itraconazole and ketoconazole, fluconazole is mainly eliminated by the kidneys. Dose reductions may be needed in animals with poor kidney function. Liver enzymes also need to be monitored because of occasional problems with enzyme elevations. Fluconazole has minimal to no effect on male fertility.

All the oral Valley Fever drugs cause birth defects in fetuses and should be avoided in pregnant animals unless the benefit to the mother outweighs any risk to the fetuses.

FAQ - Are there vitamins, nutritional supplements, or alternative therapies for pets with Valley Fever?

Most ill dogs could receive a pet multivitamin supplement safely and possibly with benefit to overall well-being. Vitamin C is often prescribed to be administered with ketoconazole. This aids absorption of the drug by helping to acidify the stomach and may also “boost” the dog’s immune system. Use of the vitamin C should be checked with your veterinarian as high doses may cause gastrointestinal irritation.

Talk to your veterinarian about your dog’s overall nutrition status and the nutritional goals you need to meet while your pet is ill. The more ill your dog, the more important it is to discuss this issue with your vet.

For dogs that will eat nothing at all, force feeding may be an option to attempt to meet nutritional needs. For help in determining if this drastic measure should be taken and what food should be used to implement it, talk to your veterinarian. Force feeding is a big commitment and an unpleasant venture for both dog and owner, but in occasional situations it may mean the difference between recovery and loss of the dog. If the dog’s nutritional needs can’t be met any other way, surgical placement of a feeding tube may be an alternative.

Alternative therapies, such as herbs or acupuncture, have not been scientifically tested against Valley Fever. If you wish to pursue alternative treatments, this author recommends you consult a veterinarian trained in holistic medicine. These professionals are your best source of help.

For cats, it is highly recommended that no herbs or supplements be given without the guidance of a veterinarian. Cats have a much different metabolism than dogs and what might be harmless in a dog could prove very toxic to a cat. For cats that won’t eat at all while sick, surgical placement of a feeding tube may be necessary to make sure the cat does not develop fatty liver syndrome because of the lack of food intake.

Answer 2

Yes... the blood work has sto be done first to make that determination.. Then.. the treatment.....

In most cases, a dog ill enough from Valley Fever to be seen by a veterinarian will require treatment with antifungal medication.
Courses of medication are usually extensive, averaging 6-12 months. Dogs with bone disease or central nervous system (brain or spinal) involvement may require lifetime treatment with medication to keep symptoms from recurring.The most common medication prescribed is ketoconazole (brand name Nizoral) and is the least expensive of a class of very expensive drugs. Side effects of ketoconazole include inappetance (sometimes difficult to distinguish from the disease itself), vomiting, and lightening of the coat. The coat changes are temporary and will reverse once the dog is off medication. Occasionally, a dog will have an adverse reaction to the drug, affecting the liver, and it will have to stop taking it. Newer drugs related to ketoconazole are raconazole (Sporanox) and fluconazole (Diflucan). Both drugs are reported to have fewer gastrointestinal side effects and they may be more effective than ketoconazole; their big drawback is that they cost more. They are often used in animals who are not doing well on ketoconazole. For dogs that have disease known to be in their brain, fluconazole is the drug of choice.Very ill dogs may require hospitalization and intravenous antifungal therapy. Fluconazole is available for intravenous infusion. Amphotericin B, an excellent antifungal drug, is only available for intravenous use but has the serious drawback of toxicity to the kidney. Newer formulations of amphotericin B with much lower kidney toxicity have recently become available but have not been extensively tested in animals.

Answer 3

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