Ranger is a 12 week old, chocolate Labrador Retriever. He presented to Bemidji Veterinary Hospital on Saturday August 30th, 2014. The client was concerned because Ranger was not acting like a normal, energetic Labrador puppy ever since she had gotten him. In addition to being lethargic, he had not had a very good appetite. In the past few days he had stopped eating entirely. The client had noticed his breathing was more labored and seemed louder. He had also been coughing and hacking.
It was obvious upon physical exam that something was just not right with Ranger. Usually a puppy of this age would be hard to keep still, trying to jump off the table and chew on everything in sight. Ranger just sat on the exam table and allowed the technician and veterinarian to take his temperature, listen to his heart and lungs, and do a full physical exam with no objections. His temperature was elevated at 105.1*F (normal is around 100-103*F). His respirations were increased and his lungs sounded harsh and raspy. The rest of his exam was normal.
The client consented to radiographs of his chest. Normal lungs appear black on radiograph due to the rays penetrating the air easily while tissues such as the heart and valves appear in shades of grey. Ranger’s radiographs showed noticeable abnormalities in his chest. It looked almost as though the lungs were filled with cotton balls. The abnormalities were blocking the ability to even see the outline of the heart.
The rule outs for a radiograph showing this would be pneumonia, cancer, or a fungal infection called Blastomycosis. Cancer was highly unlikely due to the young age of the patient. Blastomycosis is somewhat common in our area and became our primary suspect. Normally, to diagnose Blastomycosis, a sample of sputum needs to be obtained from far down in their trachea (airway to lungs) for microscopic examination to identify the fungal spores. This typically requires sedation and placing a tube in the trachea. Due to his respiratory distress, we were concerned about sedating him safely. We decided to attempt to obtain a sample of sputum from his throat during his coughing. The odds of finding the fungal spores in this manner were slim, but surprisingly we were able to find them.
The veterinarian discussed the diagnosis and treatment options with the client. The patient was given a guarded prognosis during initial treatment. The client consented to starting treatment and hospitalizing the patient. An IV catheter was placed in case emergency medications were needed. He was started on a regimen of oral anti-fungal medications to eliminate the fungus in his lungs. This medication would need to be given daily for approximately 4-6 months. A steroid was started to counteract the inflammation caused by the fungal spores dying. He was offered a high calorie soft food to stimulate his appetite which he ate well.
The next morning he was still quiet but seemed a little brighter than the day before. His temperature had decreased to 101.9*F. His respirations had slowed down a little. His lungs still sounded harsh and raspy. He was offered food and ate well. He continued to show a little improvement on day three. By day four he showed enough improvement to be discharged into the care of his owners. He will continue on his medications and will need to be rested for a couple weeks. We will recheck his radiographs in about 2 months to see if the lungs are clearing.
We contacted the client a few days later to check in on Ranger. The client reported that he was doing very well. He was eating better, his breathing had improved, and he wasn’t coughing or hacking. We were happy to hear such an encouraging update given the severity of his case. We will continue to track his progress and hope to bring you positive updates in the future.
We see many cases of Blastomycosis throughout the year in Bemidji and the surrounding areas. We are not sure where Ranger contracted the fungus. He and his family live in the Baudette area, and he was born near Red River Falls, MN. Blastomycosis fungi grow well in moist areas and are often found in the soil near lakes, rivers and other bodies of water.
If your pet is diagnosed with an infectious disease, communicate with your friends and neighbors and encourage them to contact their veterinarian. You may prompt them to identify the symptoms in their pets and prevent the spread or help them catch a disease in the early stages. For questions or to schedule an appointment, contact Bemidji Veterinary Hospital at 218-751-2753.