Health Alert: Blastomycosis

I am writing about a serious and relatively rare fungal infection [blastomycosis] one of our dogs contracted. It might be a good idea to alert the neighborhood given that the fungus lives in the soil and can be contracted by people and animals. It is fatal if not treated and is difficult to diagnose.

The Bench note: Blastomycosis is a fungal infection that can be airborne, and contracted by inhalation.

Allegra, our 10.5 year old Newfoundland dog, got a tear on the pad of one of her paws at the end of Nov. The vet saw it and gave some ointment and said that it should heal within a week or so. It seemed to heal but by the end of Dec. the tear seemed to be back and was worse. We took her to the vet who determined that the tear was actually a tumor and it needed to be surgically removed (by amputating the entire toe). After running tests (foot and chest xrays, bloodwork, and a full exam), surgery was schedule for 4 days later. The day of the surgery the vet called to tell us that he could not operate because Alle's heart was acting up. Her heart rate was 300 (it should be closer to 100) and she had atrial fibrillation. Now we had another problem. We needed to treat her heart. She went on digoxin and a beta blocker. Meanwhile, the tumor was causing her great discomfort. She could barely walk, had to wear bandaging 24/7 which had to be changed every other day, and had to suffer us putting some kind of bootie on her sore paw just to go outside to do her business. We felt so helpless: the tumor shouldn't have been fatal but the heart problem prevented us from treating the tumor. Allegra was sleeping a lot but otherwise had a zest for life. She wanted to go on walks. She wanted to chase the cats. She wanted to run to the kitchen for treats. But the tumor was preventing her from movement. My gut said that the heart problem could be managed -- we couldn't know for how long -- but Alle wasn't ready to check out. I thought about it for a week or so and called the vet, insisting on a referral to the surgical hospital in Buffalo Grove . Perhaps someone there would be willing to remove the toe under a local anesthesia. We'd take the chance that we'd fix her paw but her heart would give out later. We got an appointment, Alle was examined, and the cardiologist on staff decided that her heart rate was now low enough (190) that they could risk surgery by sedating her and then giving her a twilight anesthesia that immobilized her but did not entirely knock her out. The vet ran a biopsy on the tumor at which point it was discovered that Alle has a serious fungal infection called blastomycosis. Blastomycosis (or blasto, as it is commonly referred to) is a fungal infection that is typically contracted through the soil by inhalation and is diagnosed through chest xrays showing lesions and/or under microscope by taking cells from skin lesions that often present. Alle had none of those symptoms, or other common symptoms such as coughing. Apparently blasto is difficult to diagnose because it can present as other problems such as a skin rash or weight loss. In Alle's case it's likely it would have continued to go undetected (and would have led to death) unless we forced the toe removal issue and the tumor was biopsied. We have no idea where or how Allegra contracted this and how it is that none of the other dogs did. Given the tumor on the paw pad, it's likely she stepped in it. Did she tear her paw and then get it or did she get it before and the tear was never really a tear but a blasto lesion that became a tumor? We can't know. It also can’t be known how long she has had the infection. The infection should not be contagious between Alle and other animals or us unless she develops lesions that ooze pus in which case we'll want to wear gloves when cleaning it and keep it bandaged so the other dogs don't come in contact with it. It is also remotely possible that the blasto could be causing the atrial fibrillation which would explain the sudden onset of heart problems (not there one day but present a few days later). Blasto has not been particularly common to Chicago . There is a blasto zone in WI and a few in Canada . It is also known to be present in the environment along the Ohio and Mississippi river valley areas and in some parts of IL. How is it that a dog that has not left the area in several years contracted it? Is blasto now present in Rogers Park? Or did Allegra pick it up at some other location in the metro area? Has it been introduced through soil matter brought in from other areas for landscaping and/or plant containers? Hard to know. The good news is that our vet has previously treated blasto successfully. The treatment involves heavy duty antibiotics, 100 mg. x 3 of itraconazole/day for 2 months. The drugs are very expensive. Allegra is not out of the woods but she’s not ready to quit the party quite yet either. Hopefully she will respond positively to the treatment. I share this with neighborhood residents because people can also contract blasto. If you, your children, or your pet have a weird illness, keep pushing for a diagnosis and do mention to your medic that blasto has presented in the neighborhood. If you have been in WI or near a lake or river system (the fungus likes sandy, acidic soil), tell the doctor or vet. Blasto is fatal if not treated but the recovery rate is high if caught early and treated aggressively.

Blastomycosis Blastomycosis is acquired via inhalation; Blastomycosis may coexist or mimic a bronchogenic carcinoma and tuberculosis.

Blastomycosis Blastomycosis is an uncommon, but potentially serious fungal infection.