Blastomycosis: a danger lurking in soil
Monday, April 2, 2012 at 2:48PM 
Diego and his family went through an extremely serious health crisis ending in blindness because of blasto.
Diego is your typical bouncy standard poodle. He normally has a sensitive tummy. However, last September things became chronic. He was vomiting bile, refusing to eat, getting terrible stomach cramps with audible stomach gurgling, diarrhea, frequent gas, and loosing weight. His people and veterinarian tried different medications and diets. None worked. He became lethargic, stopped drinking water, his eyes sunk, and while awake his third eyelid remained visible. In October the Saskatoon Veterinary College diagnosed him with Blastomycosis - blasto for short. This horribly aggressive fungi invaded poor little Diego's body and eyes.
Your dog loves to sniff soil, and that's where blasto spores live - infecting the lungs, then traveling throughout your dog's body causing all kinds of problems. If the spores move into your dog's eyeball, it's really difficult to diagnose, and also difficult to treat because medication doesn't easily move from the bloodstream into the eye itself.
The spores live in moist, sandy, acidic soil that is rich in organic matter - Regina, Swift Current, Qu'Appelle valley and surrounding areas are "hotspots". You'll find it near construction sites, gardens, camping sites, hiking trails - any place with rich soil.
After months of painful stops and starts, expensive treatments, and surgery to remove his eyes, today Diego is a healthy, happy, albeit blind dog. He even runs at the off-leash park with his buddy Cooper who wears a bell so Diego can find him. Dogs are so resilient. We can learn a lot about life from them.
If you're planning to hike, camp and be around soil, understand your risks. If you notice similar symptoms, help your veterinarian make the right and timely diagnosis by letting them know where you've been and what you've been doing.
Other Blastomycosis Resources
- Dr. Jennifer Coates veterinary blog
- A memorial site dedicated to Surf who died of blastomycosis
More About Diego's experience
Diego was a 4.5 year old purebred standard poodle at the time of becoming ill. Diego was always a picky eater and prone to vomiting bile and getting stomach cramps if he did not eat at least every 12 hours. We noticed these symptoms worsened in September 2011. The vet recommended heartburn medication. He continued to worsen such that he was ill more often than not. When returned to the vet a hypoallergenic diet was recommended with the assumption that he may have suddenly developed an allergy to food he had eaten for several years. This change in diet did not result in any improvement and Diego, already of slight build, lost even more weight. He was regularly vomiting bile, refusing to eat, getting terrible stomach cramps with audible stomach gurgling, diarrhea, and frequent gas.
In October, Diego became completely lethargic, which is completely out of character for him, and stopped drinking water. His eyes became sunken and his third eyelid remained visible even during waking hours. We knew something was terribly wrong when he didn’t greet us at the door upon returning from a Thanksgiving family gathering. We took him to emergency where they agreed that he required IV fluids. Days of hospitalization and testing revealed sludge in his gallbladder for which they began treatment. Finally, after nearly a week of hospitalization we were greeted with the news that he was eating and drinking and could return home.
Upon picking Diego up at the clinic, we noticed that his third eyelid remained protracted, but they assured us it was only an infection for which they prescribed medication. Only when he completely misjudged the stairs leading to our house did we realize something bigger was going on. Once into the house, Diego was bumping into furniture and needed to walk around with his nose to the ground. My great fear that he was blind was realized. We rushed him back to the vet who confirmed complete blindness, but could not identify the underlying cause.
The next day, we made our first of many trips to Saskatoon to access the veterinary college. They rapidly confirmed their initial suspicion of Blastomycosis. We were informed that “Blasto” was a rare fungal infection. As it turns out, Regina, Swift Current and surrounding areas are “hotspots” for this fungus whereas areas such as Saskatoon remain devoid of it. Diagnosis was initially made by viewing nodules on the lungs, followed by aspiration to sample the lungs, and finally a urine test sent to Mississippi. We were informed that the blindness would be permanent. The fungus had attacked and destroyed Diego’s eyes. In all likelihood, Diego’s eyes would need to be removed due the complication of painful glaucoma that cannot be well treated in Dogs. We returned home with a prescription for very expensive antifungal medication and the challenge of figuring out life with a blind dog.
Our belief that we were now on the right path was quickly disrupted by Diego suffering a Grand Mal seizure during his first night on the new medication. Once again, we were sent back to Saskatoon where the vet determined that Diego should remain hospitalized and begin treatment with an even more aggressive antifungal IV medication while being monitored for seizures. Fortunately, no further seizures occurred and he tolerated the treatment like a champion. While hospitalized, but his eyes developed the inevitable glaucoma and the decision was made to remove both eyes.
On Halloween, Diego underwent evisceration of the eyes (removal of the content of the eyes while maintaining the outer eye “covering”) and insertion of prosthetic balls. He tolerated the treatment beautifully other than having to wear a cone for three weeks. The decision to use eye prostheses was entirely selfish on our part, but we do not regret it. It is much easier to look at our little Diego and have his eyes blink back at us. He still communicates so much through his eye movements. It requires a little more work on our part (e.g., twice daily eye drops due to the nerve damage caused by glaucoma that prevents the normal production of tears and regular flushing of the eyes to minimize irritants), but it is well worth it.
Diego continues to be treated for Blasto. Once we have a negative urine test, we will treat for one more month. Blasto has the ability to hide anywhere in the system and if treatment is discontinued too early, it will return. We consider ourselves so lucky that Diego survived his ordeal with Blasto. From our research, we know that there are many who are not as lucky. Sadly, diagnosing this illness is the biggest challenge. Blasto can present in a variety of ways depending upon what tissues are affected. Typically, Blasto enters the lungs and multiplies before spreading to other areas; this first symptom is often respiratory, but in Diego’s case and the two other cases in Regina I’m familiar with, there were no respiratory symptoms despite evidence of nodules when chest radiographs were reviewed. Other symptoms that can be observed include limping or lameness if the blasto attacks bones, skin lesions, blindness, or central nervous system symptoms (e.g., seizures) if it attacks the brain. Due to the various presentations of this illness and its relative rareness, it is difficult to diagnosis and early diagnosis is the key to effective treatment. The treatment itself is exceptionally expensive as one month of antifungal medication costs approximately $500 along with the associated costs of vet visits and monthly testing to monitor the treatment efficacy.
While dealing with this life threatening illness, we were also faced with adapting to doggie blindness. Prior to illness, Diego’s greatest pleasure in life was chasing a ball in the park. My initial response to the diagnosis of blindness was sadness over this loss. However, the vet assured me that Diego wouldn’t be thinking of it in this manner and she was correct. We have had the opportunity to learn many lessons about adapting to adversity while watching Diego learn how to live as a blind dog. He remains the same outgoing, tail wagging, happy fellow he was prior to injury. His ability to navigate around the house, yard, and even off leash in our local park has been astounding. We introduced a water fountain for their water dish so he can easily find it and it serves as a reference point to orient him within the house. He has mastered ascending stairs with relative ease, descending remains a slow process. Those who meet him or see him chasing our other dog “Cooper” in the park (Cooper wears a bell giving Diego an advantage in chasing him) would never know he was blind. Consequently, Diego wears a collar when in the park or when company comes over with big writing reminding others that he is blind (to many people expected that he would move out of their way, but he couldn’t since he didn’t see them coming). He continues to find whatever toy he is seeking within the house, even chases a ball with a bell inside, and jumps up on furniture like a champ. Contrary to my initial expectation, blindness has changed his life very little.
Diego has now gained back the nearly 15lbs he lost over the course of illness and looks every bit the healthy dog he was prior to Blasto. From this experience, we have learned how resilient our four legged friends are, how much they touch our lives, and how to deal with adversity by focussing on moving forward and adapting rather than dwelling on the changes and loss.
In terms of preventing Blasto, there isn’t much we can do. Dogs contract Blasto by sniffing spores from the fungus that are on the ground. Blasto typically stays under the ground in moist areas where the soil is acidic and there is significant decay. However, if the ground is disturbed, the spores become exposed and inhalation can occur. This ground disturbance was common this past spring and summer as a result of flooding. According to the vets I have spoken to, there has been a spike in cases of Blasto in the Qu’Appelle Valley region that is likely linked to the excess water experienced in 2011. We took our dogs camping throughout the summer and took walks by the water where Diego frequently sniffed around. Our other poodle, Cooper did not contract the fungus and, it should be noted, the illness is not contagious between dogs. The affected dog must inhale the Blasto spores directly. As for diagnosis, Blasto should remain present, but as a remote possibility, in the back of your mind when encountering sudden illness in a dog. The presentation is variable (gastro-intestinal upset, respiratory symptoms, lameness, CNS disturbance, blindness), but early diagnosis is the key to successful treatment. So, if your dog lives in one of the hotspots, and may have been exposed to conditions where Blasto propagates, and is demonstrating any of these symptoms that cannot be otherwise explained, ask your vet about the possibility of Blasto.
