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.


METHODS
Retrospective study.


METHODS
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.


METHODS
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.
Finn
Michael J
MJ
Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA. michael.finn@okstate.edu
Stiles
Jean
J
Krohne
Sheryl G
SG
D000666:Amphotericin B / Q000627:therapeutic use; D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use*; D001759:Blastomycosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology / Q000662:veterinary*; D004283:Dog Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D004285:Dogs; D004359:Drug Therapy, Combination; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology / Q000662:veterinary*; D015725:Fluconazole / Q000627:therapeutic use; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D017964:Itraconazole / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014785:Vision, Ocular / Q000187:drug effects / Q000502:physiology
D000935:Antifungal Agents; D005938:Glucocorticoids; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole; D011241:Prednisone