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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 29808
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My 12 YO cat was just diagnosed w blastomycosis in s lungs,

Customer Question

my 12 YO cat was just diagnosed w blastomycosis in his lungs, liver and 3 skin lesions. vet has him in hospital. what is usual prognosis and what treatment would you recommend?
Submitted: 1 year ago via VeterinaryMedicalImages.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry to hear of this with your cat. There are so few cases described in the literature with such conflicting data that I have to be less informative for you than I'd like. Currently, treatment with itraconazole is recommended with the prognosis guarded to poor. In one study of four cats treated with itraconazole*, three died within 12 days of diagnosis. Cats with severe lung involvement have a grave prognosis. Please respond with further questions or concerns if you wish.

*Consider an oral liquid formulation (10 mg/mL) which has higher bioavailability in cats rather than the pellets from the capsules which are mixed with palatable food for ease of administration.

Customer: replied 1 year ago.
an oral formulation of itraconazole? I guess his lungs have been infiltrated for a while with no outward symptoms? the tail lesions and low RBC count is what I initially took him into vet for a month ago. Im hoping that because he's had no respiratory symptoms until just yesterday it may not be severe.....?
Expert:  Dr. Michael Salkin replied 1 year ago.

Yes, Sporanox is the trade name for the oral solution. Compounded solutions aren't necessarily bioavailable and so if one is considered, his vet needs to consult with the compounding pharmacy as to the solution's bioavailability. Yes, the diagnosis of blastomycosis can be difficult in cats particularly because there are no pathognomonic (specifically indicative) clinical manifestations. Radiographic changes may include nonspecific poorly defined soft tissue opacities with nodules or masses or alveolar lung consolidation and pleural effusion which may arise only after long-standing infection and so his not having respiratory symptoms until recently may give us false hope.

Please continue our conversation if you wish.

Customer: replied 1 year ago.
thx. they took liver & nasal & skin biopsies and all came back as blastocytosis. Involvement of the lungs is very serious, I know, and would love to find hope and be realistic at the same time. is there anything else that you could recommend to either improve his condition, or quality of life? Can this be transmitted to our other cats or myself as I have 2 diff immune disorders? is there anything else to do in addition to lots of prayers?
Expert:  Dr. Michael Salkin replied 1 year ago.

It's not considered contagious. It appears that each patient has to inhale his/her own spores of this fungus but the source of infection in cats remains unclear. Many reported cases have occurred in strictly indoor cats. I wish there were something else you could do. I wish I had some magic for these patients.