Coccidioidomycosis in Cats

By Malcolm Weir, DVM, MSc, MPH; Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CRPP

What is coccidioidomycosis?

Another name for the disease called coccidioidomycosis is “valley fever”. This is a fungal disease caused by the soil fungus Coccidioides immitis. It is primarily found in the southwestern United States and northern Mexico, as well as parts of Central and South America. The distribution of the organism is changing, however, with cases reported as far north as Washington state.

The organism grows down several inches into the soil and can survive the high temperatures of the desert regions. During the rainy season, Coccidioides immitis can return to the surface and sporulate, allowing infective spores to be spread by the wind.

The early signs of coccidioidomycosis include fever, lethargy, lack of appetite, coughing, and joint pain. The cat may develop lameness and/or weakness, as well as back and neck pain. In severe cases, if the organism spreads throughout the body, becoming systemic, the cat may develop seizures or blindness.

Most cats who develop coccidioidomycosis are young as this is the demographic of cats who tend to be more active outdoors. Cats who dig in the dirt or spend time outdoors following a dust storm may also be at greater risk for exposure.

How can my cat get coccidioidomycosis?

Coccidioidomycosis occurs after inhalation of the fungal spores. In a susceptible cat, inhalation of fewer than 10 spores can cause illness.

How is coccidioidomycosis diagnosed?

Diagnosis of coccidioidomycosis in cats can be challenging because the symptoms are not specific for this disease. The first wave of symptoms typically includes fever, coughing, and difficulty breathing. If the disease spreads to other parts of the body, the symptoms will depend on the tissues and organs that are involved. The cat may exhibit lameness, joint swelling, or swelling in the bones. The lymph nodes may be enlarged, there may be nervous system dysfunction, and eyes can become inflamed, causing vision problems. Finally, the skin may develop draining tracts or sores that will not heal. X-rays of the chest may assist in the diagnosis.

While coccidioidomycosis can be definitively diagnosed via biopsy, the most common way it is diagnosed is by testing for antibodies to the organism.

How is coccidioidomycosis treated?

Most cats with coccidioidomycosis are treated at home rather than in hospital. This is a very serious illness requiring long-term treatment. For many cats, this means treatment for at least one year. There are several oral medications your veterinarian may choose from to treat this disease.

What sort of follow-up is required for cats who are being treated for coccidioidomycosis?

Cats being treated for coccidioidomycosis should have repeated measurements of their antibodies against this organism. Levels are typically measured every 3-4 months and treated until levels are normal. Regular monitoring of kidney and liver function may also be recommended. If needed, cough suppressants may be prescribed if severe coughing develops.

Unfortunately, disseminated (body-wide) coccidioidomycosis carries with it a guarded to grave prognosis, and while cats may improve during medical therapy, relapses are common. Overall recovery from coccidioidomycosis has been reported at between 60% and 90%. Life-long therapy may be required.

Cats with localized skin disease generally have a good prognosis.

Why don’t all outdoor cats in endemic areas have coccidioidomycosis?

Interestingly enough, despite the presence of Coccidioides immitis in the soil (and soil is everywhere), coccidioidomycosis is not very common, even in the endemic areas of the U.S. Asymptomatic infections may occur, in which cats are exposed, but develop immunity without experiencing the signs of full-blown disease.

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