I have followed with some interest the newspaper stories on the invasive fungus coccidioidomycosis that causes valley fever in people up and down the Central Valley.
I learned a lot about valley fever in Arizona, if for no other reason than you won’t pass the Arizona State Boards to practice there if you don’t. Cases of valley fever are that common in Arizona.
The fungal spores picked up in the dry winds blowing off the mountains and desert settle in the lungs and bodies of two especially susceptible species: man and his best friend, the dog.
This is not your everyday little athlete’s foot fungus or swimmer’s ear kind of yeast that creates mildly aggravating rashes and inspires odd TV commercials. While most fungi like a moist environment, they have trouble getting past the body’s great defense: skin. Coccidioidomycosis is a “systemic” fungi, meaning the fungal spores invade deep inside the body’s systems and organs. I know of three different systemic fungi common to the United States, each found primarily in its own region of the country. For us in the Central Valley desert and arid parts of the West, we have to deal with valley fever.
It was July of 2011 when Mr. Cardwell brought his dog in. Tick was a nearly 11-year-old hound of mixed pedigree (a bit of a mystery, but every girl needs that). Tick had been coughing for a couple of days, just a little tickle in her throat but rather persistent. The common stuff we were looking for ran the gamut from kennel cough to heartworm disease to congestive heart failure to cancer and then some.
We noted she had a high fever. Her weight was good, even plump. We took a set of chest X-rays, and there on the images that captured the outlines of her heart and lungs we could see a fuzzy white shadow lurking low in the right lung. Hm.
Unfortunately, indistinct shadows are not enough to make a diagnosis (choices, always other possibilities!) and Tick didn’t seem so very sick to Mr. Cardwell. Reasonably enough, he asked to treat her for something like kennel cough, so we complied with a course of antibiotics and cough suppressants.
Which was all well and fine, but no one consulted Tick, and she wasn’t having any of this medicine stuff. No way, no how.
After a couple of trips back to our hospital to discuss new ways to get a pill into her, we weren’t sure if her failure to improve was because she wasn’t getting her meds or if it was time to go further in our diagnostic tests. Ten days after we’d first examined her, Tick’s fever was down, but so was her weight. She’d lost 4 pounds (she started at 28) and her lungs sounded dry and crackly.
The coughing was persistent, though still more of a wheeze. Mr. Cardwell gave the OK for a battery of general blood and urine tests, which revealed that she did not have heartworm and that most of her organs were functioning well, but she had a terrible infection driving her white cell count up over 36,000 (normal is probably around 8,000).
We sent out a blood test checking for valley fever. Tick’s tests were positive on two out of three run for coccidioidomycosis. Bingo! Definitive diagnosis!
With this information, and knowing that her other tests and body organs were normal, we could recommend a treatment plan, one where she would take a powerful anti-fungal pill for a minimum of six months, and knowing that some dogs’ immune systems never can quite fight it off and either require medication the rest of their life or, may not tolerate the strong pill necessary to save them.
Tick started her pills the next day. Five days later she had lost 11/2 more pounds and was sleeping a lot, but her owner reported the cough had slowed considerably. Within two weeks she was jumping onto the bed at home and had no cough.
Tick’s blood counts slowly normalized and she regained her weight.
One year later, she was finished with medication and deemed fully recovered, as are approximately 80 percent of treated dog cases.