When to consider aspergillosis in dogs - Veterinary Medicine
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When to consider aspergillosis in dogs
Sinonasal and disseminated aspergillosis—the two classic presentations—are caused by different Aspergillus fungi. Learn how to manage these clinically distinct infections, and find out how the prognoses for affected dogs differ between the two.


VETERINARY MEDICINE


As topical administration of antifungal agents is only appropriate if the cribriform plate is intact, a CT scan is warranted before each treatment.

Systemic therapy. Although oral antifungal medications are expensive and side effects are common, systemic therapy is recommended if there is fungal invasion of extranasal structures. Several azole drugs have been used to treat dogs with sinonasal aspergillosis, but the success rates are moderate at best. One treatment protocol using ketoconazole and surgical débridement was curative in only three of seven dogs, while six of 10 dogs with fungal rhinitis due to either Aspergillus or Penicillium species responded to fluconazole.18,19 One report describes the successful treatment of a dog with sinonasal aspergillosis using itraconazole alone, while others have reported positive responses in dogs given itraconazole after surgical and topical therapy.20,21 Anorexia, vomiting, and hepatotoxicosis have been reported with long-term use of these three antifungal agents in dogs, so monitor serum alanine transaminase activity regularly.1

Prognosis

The prognosis of dogs with sinonasal aspergillosis depends on the extent of extranasal involvement and the response to initial therapy. Most dogs treated with topical antifungals do well, although a series of treatments may be necessary. In some patients with extensive turbinate damage, nasal discharge may persist, and bacterial rhinitis occurs in up to 25% of dogs after successful resolution of the primary fungal disease.1 The response to treatment is indicated by a reduction of clinical signs and is supported by repeat CT examination. The use of serology to assess response to treatment is limited, as antibody titers remain high for up to five years after successful therapy.1

In a recent report of three dogs successfully treated for frontal sinus aspergillosis, sinonasal tumors were diagnosed 13 to 30 months after standard treatment with topical clotrimazole.22 Although it was hypothesized that the infection, inflammatory response, or drug may have been carcinogenic, no causal associations were evident and no conclusions can be made from this small veterinary case series.

In general, dogs without extranasal involvement carry a good prognosis, and recurrence of aspergillosis after successful treatment is rare.


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Source: VETERINARY MEDICINE,
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