Tux and Valley Fever

We head back to Sequim tomorrow. While in AZ I took Tux to the vet for an annual check. After getting prices for her Fluconazole in WA (quoted $180 to $300 for a 45 day supply) it was clear we need to continue to buy the compounded version through this vet. Tux has been doing so well and maintaining her weight that I thought for sure her Valley Fever titer would come back negative. Seven months ago it was down to 1:16 (from a high of 1:256) but this test came in higher at 1:32. Disappointing to say the least. The poor dog is into her third year with this disease and it's just not getting any easier. The good news is that her lungs sound good (no sign of VF pneumonia), and other blood work came back normal so everything is functioning well.

History of meds

Initial treatment was Fluconazole but it was clearly ineffective and the dog was nearly dead after six months. Fluconazole acted synergistically with her anti inflammatory meds and caused nose bleeds so  she can no longer take them and is now limited to Tramadol for arthritis pain.

Next we treated with Itraconazole, acquired through a Canadian pharmacy for affordability. It was highly effective and there was a substantial drop in her titer immediately, but she developed sores on her leg after a few months. The sores didn't clear up with reduced dosage so we had to stop. 

So we were back to Fluconazole, now adding Terbinafine, which acts on the fungus at a different stage of its development. Now even fish oils cause explosive nose bleeds so she can take nothing at all for inflammation. The two anti fungals together seemed to be working, albeit slowly, until this latest test. If a second test confirms these drugs are no longer effective I guess we are back to Itraconazole and treating for the sores.

What a frustrating journey this has been.