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Once a diagnosis of valley fever has been made, treatment with fluconazole is started. Fluconazole is an anti-fugal medication that targets the membrane of susceptible fungi including Candida, Cryptococcus, Histoplasma, Coccidioides and Blastomyces. It penetrates tissue much better than its predecessor, ketoconazole. Fluconazole is excreted through the kidneys. Adverse reactions include vomiting, diarrhea and nausea. In rare cases, liver toxicity, skin reactions and decreased platelets have been reported. Most dogs with valley fever will need months of treatment with fluconazole. I recommend regular blood tests to monitor liver and kidney function as well as platelet levels.
Other medications that can be used for valley fever include ketoconazole, itraconazole and amphotericin B. I rarely use these medications because fluconazole works well with the fewest unwanted side effects.
Sources:
-Brooks, Wendy. Valley Fever (Coccidioidomycosis), The Pet Health Library, VIN Published 9/26/07 and reviewed in 12/1/09.
-Plumb, Donald. Veterinary Drug Handbook, 4th Edition, Iowa State Press.