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Could The Medication Cause This?


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We started anti-fungal medication on Wednesday. Yesterday I came home from one night away and Shanti's foot is swollen. It is the foot with the Valley Fever issues. And the VF did go into the metatarsals. Could this be from the medication working on it and the body fighting it off?

 

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I don't see any signs of stings or bites or anything. In the 2 years we have been battling this, her foot has never swollen up like this. The only thing new is the VF medication.

 

 

The Girls

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Guest ctgreylover

I would call the vet if the are not open, try a local pharmacy. they may have an idea of what the side effects could be.

Good luck

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Email Jean and ask. She's usually very quick to answer emails. If you don't have her email address, pm me and I'll send it to you.

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Missing my little Misty who took a huge piece of my heart with her on 5/2/09, and Ekko, on 6/28/12

 

 

:candle For the sick, the lost, and the homeless

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I just found and red the warnings for the other medication.

 

"About 7% of dogs will develop skin ulcers, inflammation of the veins, and swelling of the legs. Sometimes these effects will go away with lover doses, but sometimes may be severe enough that the drug must be stopped completely. Rarely, a serious condition called toxic epidermal necrolysis can occur that can be fatal."

 

Now it is not the exact medication, but guessing they all have similar side effects since they treat the same thing.

 

You know my girl, she likes the smaller percentiles.

The Girls

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Shanti's on fluconazole, right? I looked in the latest edition of Plumb's Veterinary Drug Handbook, and edema is not one of the side effects listed. However, he does note that there has been limited experience with fluconazole in domestic animals ("but it appears safe for use"). I did find the edema listed as a possible side effect of the itraconazole, and as you mention, they are from the same class of compounds, so it is possible. I do find it interesting that the swelling is only in the affected limb.

 

Out of curiosity, I also checked the Five Minute Veterinary Consult, and swelling of the affected limb was not mentioned as an effect of either the disease or the medicine.

 

So in short, I don't know, but I was curious enough to go looking and thought I'd post what I learned.

Deanna with galgo Willow, greyhound Finn, and DH Brian
Remembering Marcus (11/16/93 - 11/16/05), Tyler (2/3/01 - 11/6/06), Frazzle (7/2/94 - 7/23/07), Carrie (5/8/96 - 2/24/09), Blitz (3/28/97 - 6/10/11), Symbra (12/30/02 - 7/16/13), Scarlett (10/10/02 - 08/31/13), Wren (5/25/01 - 5/19/14),  Rooster (3/7/07 - 8/28/18), Q (2008 - 8/31/19), and Momma Mia (2002 - 12/9/19).

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Guest MAXNAV

Oh man. Do you guys ever get a break?

Is the area hot where it's swollen? I came home one day after being gone about an hour and Navigator's leg was swollen (and he wouldn't put it on the floor) in the same area where it looks like Shanti's is. Off to the vet. X-rays but nothing conclusive. A small puss pocket, inside, on the leg where the swelling was, but not visible to the eye. The vet determined it was some sort of infection. He put him on abs and metacam, and he was better in a few days. We never did figure out what happened.

 

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Jenny, you always manage to get me thinking... and researching.. and learning something new.

 

The short answer to your question is, YES, this might possibly be a reaction to the itraconazole. I pulled up some studies -- some of them apply more to cutaneous (skin) reactions, but they also describe an acute inflammatory response in animals (and people) put onto oral antifungals:

 

human dermatology - inflammatory flare-ups

In this report, we describe five patients, observed over a 10-year period, who presented with inflammatory exacerbations following oral antifungal therapy for dermatomycoses. We also review the literature on inflammatory reactions exacerbated by oral antifungal agents.

 

Another report (in a dog) of a reaction to itraconazole:

Plotnick AN, Boshoven EW, Rosychuk RA.Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523-1620, USA.

 

Three weeks after traveling to Arizona, a 13-month-old, female Labrador retriever developed draining tracts in the right hind limb. Primary cutaneous coccidioidomycosis was diagnosed. Initial treatment with itraconazole resulted in exacerbation of clinical signs. Histopathology was suggestive of a cutaneous drug eruption. Discontinuation of the itraconazole caused resolution of the drug eruption. Successful treatment of the fungal infection was achieved using ketoconazole.

 

PMID: 9111724 [PubMed - indexed for MEDLINE]

 

There's not much in the literature about this subject but it's definitely worth discussing with your vet ASAP before continuing with the itraconazole. I'll see if I can find anything else in the human literature.

 

 

 

 

 

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Jenny, you always manage to get me thinking... and researching.. and learning something new.

 

The short answer to your question is, YES, this might possibly be a reaction to the itraconazole. I pulled up some studies -- some of them apply more to cutaneous (skin) reactions, but they also describe an acute inflammatory response in animals (and people) put onto oral antifungals:

 

human dermatology - inflammatory flare-ups

In this report, we describe five patients, observed over a 10-year period, who presented with inflammatory exacerbations following oral antifungal therapy for dermatomycoses. We also review the literature on inflammatory reactions exacerbated by oral antifungal agents.

 

Another report (in a dog) of a reaction to itraconazole:

Plotnick AN, Boshoven EW, Rosychuk RA.Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523-1620, USA.

 

Three weeks after traveling to Arizona, a 13-month-old, female Labrador retriever developed draining tracts in the right hind limb. Primary cutaneous coccidioidomycosis was diagnosed. Initial treatment with itraconazole resulted in exacerbation of clinical signs. Histopathology was suggestive of a cutaneous drug eruption. Discontinuation of the itraconazole caused resolution of the drug eruption. Successful treatment of the fungal infection was achieved using ketoconazole.

 

PMID: 9111724 [PubMed - indexed for MEDLINE]

 

There's not much in the literature about this subject but it's definitely worth discussing with your vet ASAP before continuing with the itraconazole. I'll see if I can find anything else in the human literature.

But would this be the same for the drug that Shanti is taking?

Claudia-noo-siggie.jpg

Missing my little Misty who took a huge piece of my heart with her on 5/2/09, and Ekko, on 6/28/12

 

 

:candle For the sick, the lost, and the homeless

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Shanti is suppose to be on Itraconazole, but we got Fluconazole through Hemopet and a very low cost. We wanted to get her started ASAP so we went with it. From the studies she and the specialist have seen, there tends to be a higher success rate with Itraconazole faster. So, she is doing some research and if need be we switch to that. Then we play the game of what will Shanti do best on. Who stinking knows! :P I am guessing the most expensive. <_<

 

I just talked to the vet. Yes, it could be but strange that it is only one leg, the bad one. It could be her lymph nodes firing off after being off prednisone for 3 days and causing it. It is a little better tonight. She had 20mg of prednisone this morning. I am going to ice it and give her benadryl in case it is a bite reaction we are missing and see how she looks in the morning. I will try massage too to see if that helps. The vet will be in tomorrow doing paperwork if I need her.

 

Jordan, you should be writing your book. :D You know my girl, she likes the strange, rare, obscure stuff. Just to see if she can stump us all. Isn't she fun?!?!?!?

 

 

The Girls

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The first article from human literature refers to "azoles" in general - fluconazole, itraconazole, etc. The second article mentions intraconazole, with the dog eventually doing well on fluconazole.

 

But interesting that this occurred after she came off the pred, Jenny - that could certainly be a factor.

 

I surrender, Shanti! :whiteflag You are what we call a "diagnostic dilemma"! :lol

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Sending my many prayers. :grouphug

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The swelling is gone this morning. YEAH!!! So I am guessing either the prednisone or the benadrly worked. Not sure which. We will go another 3 days off prednisone and see if it happens again. If we do well, no more prednisone after that.

The Girls

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:yay:yay Great. Now Shanti, we all know you are the prettiest girl in the world. And we also know that you are a princess, BUT enough already

Claudia-noo-siggie.jpg

Missing my little Misty who took a huge piece of my heart with her on 5/2/09, and Ekko, on 6/28/12

 

 

:candle For the sick, the lost, and the homeless

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The princess has lost her crown for a bit. She bit me today while cleaning her belly. :( My own fault for trusting her and not muzzling like I have been.

 

But the foot looks good! I am leaning towards the benadryl helping. Guessing she got bit or stung.

The Girls

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The princess has lost her crown for a bit. She bit me today while cleaning her belly. :( My own fault for trusting her and not muzzling like I have been.

 

But the foot looks good! I am leaning towards the benadryl helping. Guessing she got bit or stung.

But she can't lose her crown for something that wasn't her fault :lol Her crown remains in tact

Claudia-noo-siggie.jpg

Missing my little Misty who took a huge piece of my heart with her on 5/2/09, and Ekko, on 6/28/12

 

 

:candle For the sick, the lost, and the homeless

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:rofl:rofl Good point. My own fault. Live and learn...and never trust a dog that has been in pain no matter how nice they look. ;)

Here's a good example of never trust by looks. See my little Misty? I was getting bitten ever time I did her nails. Now does she look like a dog who would bite? Little pip-squeek nailed me so many times until I got up my nerve to muzzle her.(I have a real problem using a muzzle)

Claudia-noo-siggie.jpg

Missing my little Misty who took a huge piece of my heart with her on 5/2/09, and Ekko, on 6/28/12

 

 

:candle For the sick, the lost, and the homeless

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