I’m writing this diary because I think it might be something people who learn their dog has this rare fungal infection might find helpful to read. Blastomycosis (aka: blasto) mimics many other ailments, and is diverse in its symptoms. Stella’s experience will be different from another dog’s. But the effect of nursing a dog with blasto remains the same for caregivers: it’s stressful. It costs a lot of time and energy, especially in the initial stages; it drains you emotionally; and there is a heavy financial burden.
Unfortunately for Stella and many other dogs in my region of Northwestern Ontario, this appears to be the world’s blasto capital. On the up side, our vets are the recognised animal specialists, so Stella is in good hands. And I’ve been here before with her, so I’m a bit more prepared this time for the wallop that’s coming.
Blasto takes a long time to treat – the better part of a year, in fact, so this page may get pretty long. If you are looking for something specific, you can hold the Ctrl + F keys down to get a search engine for just this page. That might help reduce your reading time. I’ll be writing more in the initial stages of our battle, then entries will become less regular.
I welcome your comments and stories, and your moral support!
Thursday, March 29, 2012 – Day One
Stella seems a bit down today, and when I brought her in for her breakfast, she refused to touch it. She never refuses to eat – well, the only time she ever has before now was when she had blasto in 2010. She began limping yesterday morning, so I’m thinking maybe she’s having a lot of pain. I’ve phoned the vet, and will walk her over (it’s just a block and a half from the shop) to have her examined.
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Just got back from the vets’. Dr. Celia says she thinks it’s blasto again, and has kept Stella for the day. Stella’s temperature was 39.6C, so she’s running a fever. They need to do a urine test, and there isn’t enough in her bladder to extract just now. And Stella is too much of a lady to go in front of strangers in someone else’s yard! So, they’ll wait ’til there’s a build-up and draw some from her bladder later in the afternoon. I’ll pick her up at four.
I can’t describe how devastating this news is. I just finished paying off my debt from her last bout of treatments, which ended in February 2011. The vet asked me today if there was any question of my having her treated. Stella has saved me from two very dangerous and potentially harmful situations, risking her own life to do so, and we’ve grown very close. There is no way I could euthanize her if she stands a good chance of making it through treatment. It would be like euthanizing my child. It simply isn’t an option. I’ve spent the afternoon trying to figure out what I can do to manage finances to accommodate this… I will manage because there’s no other option for me. But I feel like a ton of spider web has settled around me.
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I picked up Stella at the vets’ after work and Mom drove us home. $388.56. It’s started all ready. Dr. Celia wants to initiate treatment even though the test results wont get back ’til Tuesday or Wednesday next week. I understand her reasoning. Blastomycosis is a deadly fungal infection. It can be in the system for weeks or months before making itself known. When it erupts, though, it strikes fast and it’s debilitating. So she’s back on the itraconazole.
Itraconazole is a potent fungicide, one of two used to treat both dogs and humans with blastomycosis. It is less expensive than fluconazole and only a little less effective in some cases. Even so, one 250 mg capsule costs $7.13. Stella needs two of these per day initially, then one a day for a period of, generally, 7-8 months, depending on the tenacity of the infection. It’s important to watch her liver function as this type of drug is known to adversely affect the liver. So are the drugs Stella must take to check her epilepsy. I’m concerned about this.
Last time Stella got blasto – July of 2010 – she became extremely sick in just a few hours one Friday. She quit eating, went hangdog and got pouchy-eyed within an afternoon. I ran her into the vets’, but they thought it might be a flu bug at that point. She lost several pounds over the weekend it struck. High outdoor temperatures didn’t help (I actually thought she might have heat stroke, and I packed her in ice to bring her temperature down – we haven’t got air conditioning). It was terrifying to see my robust, active, extremely healthy puppy (she was ten months old) just cave in on herself, literally, in a matter of hours. She didn’t have much of a fever, a cough, or lesions on her skin – typical indicators of the infection – so testing was delayed for the weekend. The test results then were positive, and x-rays showed a significant lesion on one of her lungs.
When we got home this evening, though, Stella went straight to the kitchen and ate the food I’d put out for her in the morning. I am so relieved. The fact that she’s eating must mean she’s feeling better, perhaps that the vet’s diagnosis is wrong and the tests will be negative!
Friday, 30 March 2012 – Day Two
Stella seems much better today. She’s eating, and enjoyed her walk this morning. She’s taking her treats and seems happy at the shop.
I phoned the vets’ to let them know how improved she was, but they told me to keep her on the itraconazole. It’s good that she’s eating, but…. I am told my concern over the drug’s side effects are something I can let go.
She’s still limping, and I noticed this evening when I put her to bed in her run that she was very stiff. We walked around the yard and up and down the road for some time before she would relieve herself, too. She seemed tired and ready to call it a night when we went into her run to settle her down for the night.
Saturday, 31 March 2012 – Day Three
Stella was rarin’ to go this morning, and had a great run after I let her off the leash at the top of our road. She ate her breakfast, but by then I noticed she’d slowed down a bit and her limp was back. She seems fine otherwise, though – much her old self.
This evening again, she was walking like an old dog when I took her out to bed. We went for a short companionable walk up to the barn and back, which she seemed to enjoy. She does seem a bit depressed in the evenings, though. I want to crawl into her dog house and hold her for a while, just to let her know she’s loved and everything is going to be fine.
Sunday, 1 April 2012 – Day Four
Stella’s much the same as yesterday. I gave her a cow’s ear as a special treat, and she trotted it into the living room to show Mom before crunching it down to nothing. It’s good to see her so enthused by a treat. I feel so positive that this isn’t blasto. It must be something else.
But tonight again, she was stiff and a bit more difficult to persuade to her chicken and bed. She didn’t really want to go into her house. I got the impression she did just to make me feel better.
Monday, 2 April 2012 – Day Five
Stella is her usual impish self. We got to work and she seemed to want to play a little. So, I tossed Benny the Hedgehog for her. She tore around the tin room shaking Benny ’til he almost rattled to death, then tossed him to me for another throw, and so on for about a quarter of an hour. At one point, I noticed she had something under her lip – looked like a big marble. I lifted her lip to check it and felt a pop. there was a mark on the inside as if she’d pinched the lining with her teeth, but there was nothing trapped there, and the bulge was gone. I told her it was time for work and she curled up beside me.
The plumber came at about noon to start on a major project in the building. Stella has always had a crush on our plumber. She spent the afternoon supervising as much as she could.
We were late getting home. Stella wasn’t particularly eager to eat, though, and wouldn’t until I stood beside her. I noticed later that she left some kibble in her bowl – not like her. I had a really difficult time persuading her to get up from her favourite place in the hall at bedtime. She took her pills, but she refused to go into her house for her treats. I felt badly leaving her. She watched me go all the way back to the house from her vantage point through the fencing beside her house.
Tuesday, 3 April 2012 – Day Six
We went for a walk this morning – half a mile. Stella took it slow, stopping to check out the scents on tufts of grass along the road. Joe and Steffi passed us on their way to take away the remains of her old dog house and run. We built the new run in a different location because Joe found what he thought was blasto fungus underneath the matting I put down in the old run. He built the ne run with raised decking to ensure air circulation below the floor and to minimize the threat of fungal infection there, too.
When we got home, Stella refused to come in. That’s not unusual beaviour; she often likes to go for a little run into the woods to do her business first, and with Joe and Steffi working outside, she could also want to keep an eye on them.
When we had finished our breakfast without her deigning to come in for hers, I decided to leave it outside for her. We had to go in early this morning to get some grocery shopping done, and I really didn’t want her to go without food! She refused it outright. Not only that, but she refused to take her pills, which I wrap in a ball of canned food. That is extraordinarily unusual. Stella has never refused her chicken or cheeseball before. I had to force her to take it.
When we were ready to leave, she obviously wasn’t excited about going for her ride. Even when her back leg was split open to the bone she was happy to hop in for the ride to the vet. I supposed it could be because we were leaving Joe and Steffi to work, but in my heart I knew that was a form of denial. Stella was having a really bad day.
Mom gave her a stroke down her back when we got back from the shopping expedition. Stella was lying on the seat of the car, Her whole back twitched like a horse’s skin will when a fly lands on it. Her mane moved two inches toward her spine in the process.
When I opened the door to let her hop out of the car, she just lay there. She always loves to go to work, and I usually need to get her to sit on the edge of the seat while I snap the leash on. Today, she got up slowly and stiffly at the sound of the snap, and limped into the shop. She plunked down and pretty much stayed in the same place all day. If I left for any length of time, she’d come and find me, then plunk down there. Every once-in-a-while, I’d see the twitch move down her spine. She couldn’t e bothered with greeting customers when the doorbell sounded, one of her favourite jobs at the shop!
About lunchtime I phoned the vets’ to tell them about the weird swelling on her lip yesterday and about her condition today. The twitching, the vet relayed, might be either neurological or pain. I was instructed to keep her quiet and limit exercise.
She neither ate nor drank by closing time, so Mom and I decided to take her into the vets’. Dr. Celia saw her again. She examined Stella and took her temperature: 40C. She thinks the bulge on Stella’s lip yesterday might just have been a blocked salivary gland. The blasto test results still hadn’t arrived, and thinking it was looking even more likely that Stella has blastomycosis again, Dr. Celia gave Stella a shot for pain.
She explained to us that it probably wasn’t a new infection, but rather that something had lowered her immune system’s strength, and that gave the blasto already in her body – it never leaves once it’s there, apparently – the opportunity to burst out of the casing the dog’s immune system had built around it. The spores become active wherever in the dog’s system they find they can thrive. Stella has coughed very discretely a few times today, indicating that perhaps her lungs are affected again. Her eyes seem a little bloodshot, and there’s the stiffness and limping, the depression, loss of appetite, weight-loss and fever (up to 40 degrees today). It’s all pointing toward blasto. Dr. Celia says it could be something else, but given her history, it’s really looking like blasto again.
I got Stella to have a little drink when we arrived home.
At bedtime, I found Stella in Mom’s bedroom, lying on her side with her head and neck thrust under Mom’s dresser. She wouldn’t move a muscle when I called her or patted her. Eventually I pulled her out from under the dresser, at which point she looked at me (without raising her head) as if to say, “What’d you do that for? I was enjoying my isolation booth, and now you’ve gone and spoiled it!” I left the room, calling her to come and get her chicken. She came eventually, but I had to force them again. Concerned with the fact that she’d gone the whole day with nothing more than her pill balls, I then tried plying her with her favourite treat, Haagen Daz ice cream, which I use when she has a seizure. She ate it! After four tablespoons, I decided to try her on her absolute favourite canned food – salmon and tuna. She ate a whole can!
I pulled her blanket out of her house and laid it on the decking of her run this evening, so she can use it if she likes to lie on tonight. She’s taken a skunner to her house for the time being.
I might try mixing a bit of her kibble into the canned food tomorrow. I use top grade organic canned food, a small can of which costs over $3. That’s fine if I’m using it for her pills, a tablespoon full at a time, but as meals, well, another price increase to the treatment….. Recommended serving size is 3/4 to 1.5 cans per 15 pounds body weight per day. That’s almost 4 cans a day at the minimum for a dog Stella’s size!
Wednesday, 4 April 2012 – Day Seven
My birthday, and I’m really hoping for good news, although by this point, I’m beginning to think that the vet is bang on with the blastomycosis diagnosis. I’ve taken Stella for a round along the edge of our yard, but she won’t do her business this morning.
Inside, she did take her pills. I dumped her food outside for the Whiskey Jacks or fox and washed out her bowl. I put a bit of kibble in, just 1/2 cup, then mixed some of the canned food with it, hoping she’d take that and extend the life of the cans. She wouldn’t touch anything unless I gave it to her on a spoon. I got about three dessert spoons full into her before she turned and walked away.
The phone rang during breakfast. Dr. Celia with the test results. “They’ve come back negative,” she said, “but that doesn’t mean it isn’t blasto. Tests will often give negative results during the early stages of the infection.” With the negative blasto results, though, it is time to start eliminating other possibilities. Dr. Celia asked me to bring Stella in for x-rays, blood tests and urine tests, etc. I’ll leave her there for the day again.
After breakfast though, she snuck back into the kitchen and ate the rest of what I’d put in her bowl. When I saw her go back again later, I gave her another 1/4 cup of the canned food, which she ate.
A short walk before our ride into town yielded no results.
At the vets’, Stella weighed in at 111.4 pounds. We all get a kick out of her. She knows the first thing we do after greeting all the animals and people (only staff there this morning) is to go in to get weighed. She trots right onto the scale and waits as they take the reading. She’s done that from her second visit to this day. I left her in a run at the back. I’m instructed to call if I haven’t heard from them by noon.
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Just got off the phone with the vet. The x-rays aren’t showing anything but a slightly swollen liver. Her liver enzymes are up a bit which is probably a result of the phenobarbital at work. Her red blood cell count is down a bit but her white blood cell count is normal. Her temperature is still at 40C, up fractionally from last evening despite the anti-inflammatory injection. Dr. Celia says that it still looks more like blasto than anything else, so we’re going to continue treating her for the blasto, giving her a herbal concoction for her liver and waiting for the second urine test results. I’ll pick her up after work….
Dr. Celia tells me that although the fever is a concern, it is the body’s way of fighting the fungal infection, and it is better to let it run its course than to try to bring it down with anti-inflammatories. For now, it is better just to let her rest in the cool outdoor environment of her run so she’s more comfortable.
So, once again, it’s a waiting game.
I’m going to pick up some yoghourt for her tonight, and maybe some ground beef and vegetables to puree and mix for her. She loved yoghourt last time she was ill with blasto, so maybe it will entice her to eat a bit more and thus to keep her strength up. I’ll also get some kibble samples from the pet food shop to see if there is one she will like. That is also something I had to do last time. She would only eat the Orijen, the most expensive brand (mind you, she needs less of it than what I’m feeding her now, Eagle senior’s low fat, high grade food to help manage her weight while she’s on the phenobarbital/potassium bromide). LOL. Nothing but the best for my Stella…
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The vet just phoned again, this time with some urine test results. She found crystals in the urine, an elevated number of white blood cells and some bacteria, so she is sending a culture off to an eastern lab. The Manitoba labs will be closed for a long Easter weekend, but the lab down east will be open Saturday.
I picked Stella up after work. Today’s vet bill: $678.91. She could barely get into the car, and lay down on the seat all the way home. I took her for a short walk when we got home, and she urinated in short spurts. She had a good drink, ate about a half cup of food and started her Meloxicam (for pain and fever), Amoxil (for the bacterial infection) and Silybum Marianum E (for her liver).
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I looked out the window while getting her evening meds ready and noticed a bear in the yard. I don’t think I’ll put any food out for her to nibble on through the night. I was wondering about the wisdom in doing that; seems I have my answer.
About ten-thirty Stella began barking. She doesn’t bark much from her run, so I figured the bear was back. I went out and got her in case she needed to relieve herself, then brought her into the house. I thought that maybe with the adrenaline surge she was experiencing, she might eat something. And she did! She polished off the mix I made for supper and also ate some broccoli. Another half cup of food into the incredible shrinking dog. I brought some more broccoli and three tiny soft chicken treats out and left her munching them in the run. She barked quite a bit through the night, but it was more a “You just stay away from here…!” sort of a bark, not too excited.
Thursday, 5 April 2012 – Day Eight
Stella seems a little perkier this morning. She wanted to go for a longer walk – following the bear’s trail through the yard – but wasn’t difficult to coax inside. She seems to know that she’s in no shape to challenge anyone.
I mashed up a banana, some salmon/tuna canned food and chicken kibble. Yummmeeee! But she only ate about half, and that required coaxing. I did get her to take her meds without any problem, though. She’s not too keen on the Silybum, which gets squirted into her mouth through a little syringe. I gave her a salmon/tuna chaser to help it go down a bit easier, lol.