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.


METHODS
Retrospective case series.


METHODS
125 dogs with pulmonary blastomycosis.


METHODS
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
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.
Crews
Laura J
LJ
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.
Feeney
Daniel A
DA
Jessen
Carl R
CR
Newman
Allison B
AB
Sharkey
Leslie C
LC
D000818:Animals; D000908:Antibodies, Fungal / Q000097:blood; D000935:Antifungal Agents / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle / Q000379:methods / Q000662:veterinary*; D001758:Blastomyces / Q000276:immunology; D001759:Blastomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D003937:Diagnosis, Differential; D004283:Dog Diseases / Q000175:diagnosis* / Q000188:drug therapy; D004285:Dogs; D005260:Female; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000662:veterinary; D012189:Retrospective Studies; D016896:Treatment Outcome
D000908:Antibodies, Fungal; D000935:Antifungal Agents