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Old July 22nd, 2009, 10:12 PM
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Dr Lee Dr Lee is offline
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Originally Posted by mommyof3loy2 View Post
I have a 7 year old boxer who has vally fever. ...5 years and all of those years shes been on fluconazole. She just went into the vet and her levels are incressing instead of decressing... In the past year she has started having shaking in her head... ...laila is starting to become aggresive to new animals and strange people.
I am sorry to hear about the difficulties that you are having. Do you have the weight of your pet and the fluconazole dose?

Fluconazole is fungistatic. This means that it stops the growth of valley fever but does not kill it. If the pet's immune system recognizes and is able to fight the valley fever, then the fluconazole can help the body 'cure itself'. Many times, the fungus will not ever be gotten rid of for various reasons (pet's immune system, location of fungus, concurrent disease, level of spread, etc...).

If the pet is on fluconazole, the valley fever can still spread however this is not typical. If this is the case, then I agree that increase of the amount of fluconazole might be a good idea. Also changing to itraconazole might be considered however fluconazole is typically better for intracranial spreads of valley fever.

My recommendation however would be to rule out that we do not have a second disorder unrelated to the valley fever. It sounds like she Laila has been doing well on the current dose for 5 years. As an older boxer, the possibility of another disorder might exist. General blood tests, abdominal and chest radiographs and referral to a neurologist would be my recommendation. Blood tests can look for thyroid issues, infections, etc... Abdominal radiographs can look for other problems such as spleen masses, etc... Chest radiographs can also help get an idea of how the valley fever is doing (blood titers help but are not the only test to look at valley fever. the titer looks only at the amount of antibodies against the fungus).

Referral to a neurologist will likely lead to an MRI. It can look for evidence of valley fever spread, tumors, cysts and signs of inflammation. This can help explain the underlying cause of the head shaking and aggression.

I am sorry I don't have an easy answer for you but I hope this helps.
Christopher A. Lee, D.V.M., C.V.L.S.
Promoting surgical options and pet comfort through the use of lasers.
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