I will second the statement that Blasto is ugly, serious stuff.
I hunted SD a few years ago and shortly after coming home, my little chocolate lab started "hacking" every once in a while. It was almost a gag noise, like she was trying to spit something up from deep inside. Mostly this happened after lying on her dog bed for a while. The frequency of hacking increased and she lost her appetite. She also had a runny discharge from her eyes and also a small ulcerated lesion on her right flank that would not heal no matter what we tried. All three of these things can be symptoms of Blasto. At that point, we took her to the local vet. The local was puzzled and put her on antibiotics. The dog continued to decline so we went back and got x-rays. The diagnosis from the x-ray was cancer as there was a widespread bright undetermined mass in the heart/lung area.
At that point we immediately went to a board-certified specialist clinic and there we got very lucky. The doctor had trained at LSU and her teachers were VERY familiar with Blasto. She immediately suspected Blasto and contacted her old teachers. Various tests were run (a "Biochemistry: Chem27IDXX" test) and Blasto confirmed. In this test, the ALP, ALT and AST readings showed high. (I don't know what that means, it was just highlighted in the test results.
The Laboratory Doc wrote this:"Although blastomycosis could be considered in a dog that traveled to South Dakota, histoplasmosis and coccidioidomycosis would also be considerations, and might be more common systemic fungal infections from that region. North Dakota has a high incidence of blastomycosis, as does Minnesota and Wisconsin (Baddley JW et al, Geographic distributions of endemic fungal infections among older persons, United States; Emerg Infect Dis. 17(9);1664-1669;2011)."
Everything else was normal. The specialist vet prescribed Sporanox (itraconazole).
Here's the catch: you have to get Sporanox or any Itraconazole shipped in from outside the US or else pay an outrageously expensive price for it (90 100mg capsules ~$2500). You are going to have to bite the bullet and get some quickly, so pay what you have to pay. But also place an order from Canada and you will pay far, far less for it (90 100mg capsules $188 from planetdrugdirect.com for my order). If you order from Canada, which I did, it takes three weeks or more to get the meds. Your dog will be on this stuff for months. Your dog might well die in that amount of time. [Edit] Just found this posted yesterday: "Right now the cheapest Itraconazole is at Allivet.com it is human grade manufactured by Patriot Pharmaceutical it is $2.19/pill, purchase 30+ the price is $2.09/pill. Also ships from the US so no waiting 3 weeks for delivery like we in the US do when we order from Canada."[/Edit]
This is the vet's prescription: " (The dog's) dose of itraconazole is 150 mg by mouth twice daily for 5 days, then once daily until further direction. With this antifungal medication it is recommended to use Sporanox, rather than generic, but unfortunately that can be cost-prohibitive at times. Further, this comes as a 100 mg capsule that cannot be accurately split. Either a compounded product is used, a pharmacist is asked if they will re-size the 100 mg capsules, or give 200 mg daily (2 capsules). Owner should consider shopping Canadian pharmacies for better pricing."
I got really lucky at this point. I found a website :
https://blastomycosis.ca/forum/index.php and went looking for info. A really helpful group of people. One person had just achieved a cure with her dog and had 5 weeks of leftover itraconazole. She offered it to me immediately; Priority Mail. I was able to get started on the meds right away at essentially no cost. Our dog began to obviously improve after just two weeks on the meds. If your dog gets diagnosed with Blasto, check the site. The people are generous; you may be able to get enough Sporanox to last until your Canadian order comes in. As a side note, the delay in getting it from Canada was that the Canadians get it from the UK!
We did have to have the capsules resized at a local pharmacy.
Anyway, our dog was on the Sporanox for about six months. At that point, the vet declared her free of Blasto but we re-tested the urine for about another six months once a month to make sure it wasn't coming back. If you don't get every bit of it, it can come back on you.
Interestingly, my other three dogs that made the same trip and hunted the same fields on the same days did not come down with Blasto.
We feel VERY lucky that this was caught in time.
One other note. it is quite possible that the dog DID NOT catch the Blasto while hunting in SD. Further research led us to the mulch we have in our flower beds. All the dogs walked through and sniffed in and around the flower beds. The vet told us you don't know exactly where the mulch is coming from and much of it is from areas that have Blasto present and that our dog might have caught it from nosing around in the mulch. We removed all mulch and replaced it with gravel/decorative rock. When I raked up the mulch, there was clearly moldy looking white stuff on some of the lowest layers it where it was against the ground. I'll never have mulch in the yard again.