Coccidioidomycosis, also known as Valley fever, is caused by the dimorphic fungi Coccidioides (

), which live in the soil in dry and hot environments. In the United States, Coccidioides is most common in the southwest, specifically in Arizona and southern California, where it is considered endemic, but also as far north as Washington and as far east as Texas.

 Internationally, it is also seen in Mexico and parts of Central and South America.

Arthroconidia are inhaled from the environment and phagocytosed by alveolar macrophages, where they first develop into a spherule. The spherule then develops hundreds of endospores inside it, which eventually rupture, releasing the endospores. Those endospores cause local pyogranulomatous inflammation and can disseminate via lymphatics to the tracheobronchial lymph nodes and/or hematogenous throughout the rest of the body.

 can range from asymptomatic to life-threatening. Most commonly, dogs experience mild signs such as coughing, lethargy, hyporexia, fever, and weight loss, all of which can present acutely or chronically.

 If there is dissemination, clinical signs will vary based on the site which commonly include the central nervous system, bone, eyes, skin and pericardium. Neurologic signs may include seizures, which is the most common, central vestibular signs, head pressing and back pain or paresis.

 Coccidioides osteomyelitis in the appendicular bones often presents with lameness, pain, or a visible swelling.

 Cardiac/pericardial involvement often leads to right-sided heart failure with ascites and/or pleural effusion.

The diagnosis of Coccidioidomycosis can be made using serology, cytology, histopathology, or fungal cultures. Most commonly, diagnosis is based on antibody serology, consisting of IgM and IgG titers via an agar gel immunodiffusion (AGID) assay.

 IgM antibodies are generally able to be detected within 2-5 weeks, and IgG in 8-12 weeks after initial infection.

 There is no documented correlation of initial titers and disease severity; therefore, dogs with low titers can have significant disease, and on the other hand, dogs in endemic areas can have positive titers from exposure alone.

 The author generally treats all positive dogs with consistent clinical signs, even with low titers, and will treat asymptomatic dogs with positive results if the titer is 1:8 or higher. False negative results may occur in up to 13% of cases.

Over the past few years, a point-of-care lateral flow assay (LFA), sōna Coccidioides LFA (IMMY, Norman, Oklahoma), has also become commercially available and subsequently tested in comparison to AGID in canine patients.

 In comparison to AGID, a study showed that the point of care LFA had a positive predictive value of 100% and a negative predictive value of 75%.

 This point-of-care test can be helpful in situations where teams may be looking to provide more information quickly, either prior to same-day additional procedures/testing or to euthanasia. As this is a qualitative test, and there can be false negatives, it is still recommended to submit titers for confirmation and monitoring.

Cytology from aspirates, fluid or skin impressions may also show Coccidioides spherules and/or endospores, but this has a generally low sensitivity and can be easy to miss due to low numbers of organisms.

 Fungal cultures can also be used, but due to potentially long incubation time and human health hazards to laboratory workers, this is not commonly performed.

Azole antifungal therapy is the mainstay of treatment for Valley fever, with fluconazole being most common due to its lower cost. In clinical practice, fluconazole is generally dosed close to 10 mg/kg twice daily.

 Fluconazole comes in generic 50 mg, 100 mg, 150 mg and 200 mg tablets, which can be easily halved to facilitate dosing as close to the 10 mg/kg, even in small patients. There is also a generic 40 mg/mL solution available.

Itraconazole is preferred over fluconazole in cases with bone or joint involvement due to increased bone penetration

 and is commonly used in cases with refractory disease on fluconazole. The recommended dosing for itraconazole is 5 mg/kg once daily. Itraconazole comes in 100 mg generic capsules as well as human-labeled and veterinary-labeled liquid solutions in a 10 mg/mL concentration. Newer-generation azoles such as posaconazole and voriconazole can also be considered in refractory cases.

 Hepatotoxicity can occur in up to 26% of patients on azole antifungal therapy.

It is recommended to avoid compounding these medications. In a 2018 study comparing compounded, generic and brand-name itraconazole, 95% of animals in the compounded group had subtherapeutic itraconazole blood levels,

 and a 2017 study on compounded fluconazole showed poor accuracy and precision in compounded fluconazole suspension.

For dogs with ocular Valley fever, enucleation may be required, and in dogs with Valley fever pericarditis, subtotal pericardectomy and epicardial excision may be required.

 In patients with severe infection or refractory cases, amphotericin B can be considered.

Treatment duration can range from 6 months to many years, but in the author’s experience, the average treatment duration is 9-12 months. Antibody titers should decrease with successful treatment.

 Treatment is commonly continued until the titer is 1:2 or lower and the initial lesions have resolved.

 Titers are commonly checked every 3-6 months. Many clinicians will treat for an additional 3-6 months after the first negative or low (1:1 or 1:2) titer, rechecking the titer again prior to discontinuing treatment. Osteomyelitis and CNS cases often require long-term to potentially lifelong treatment.

A coccidioidomycosis vaccine, an attenuated live vaccine using an avirulent strain of Coccidioides, is currently in development by Anivive Lifesciences.

 A 2021 study where research dogs were vaccinated (initial + booster at day 28) and then subsequently infected with Coccidioides, showed that vaccinated dogs had a significantly reduced fungal burden and disease scores, with about 90% of those dogs having minimal measures of disease.

Keep an eye out for more information in the future for more studies on vaccine, FDA approval and commercial availability.

Although less common than in dogs, likely due to their indoor lifestyle, Valley fever can also be seen in cats. Similar to dogs, clinical signs are often related to disease localization, which can include respiratory signs, skin lesions, lameness, neurologic signs and ocular lesions.

 Dissemination is common in cats, with one study reporting dissemination in 60% of cats, with the skin being the most common site of dissemination.

 Diagnosis is generally made from antibody serology and/or cytology, similar to dogs.

 Treatment is with azole antifungal therapy, with fluconazole being the first-choice medication at 50 mg/cat twice daily, with alternative azole therapy (itraconazole and posaconazole) or amphotericin B in refractory cases.

Sykes JE. Canine and Feline Infectious Diseases. Elsevier/Saunders; 2014.

Kelley AJ, Stainback LB, Knowles KE, Moore TW, Plummer SB, Shoup OR. Clinical characteristics, magnetic resonance imaging features, treatment, and outcome for presumed intracranial coccidioidomycosis in 45 dogs (2009‐2019). Journal of Veterinary Internal Medicine. 2021;35(5):2222-2231. doi:10.1111/jvim.16243

Shaver SL, Foy DS, Carter TD. Clinical features, treatment, and outcome of dogs with coccidioides osteomyelitis. Journal of the American Veterinary Medical Association. 2022;260(1):63-70. doi:10.2460/javma.20.12.0696

Heinritz CK, Gilson SD, Soderstrom MJ, Robertson TA, Gorman SC, Boston RC. Subtotal pericardectomy and epicardial excision for treatment of coccidioidomycosis-induced effusive-constrictive pericarditis in dogs: 17 cases (1999–2003). 

Journal of the American Veterinary Medical Association

. 2005;227(3):435-440. doi:10.2460/javma.2005.227.435

Johnson LR, Herrgesell EJ, Davidson AP, Pappagianis D. Clinical, clinicopathologic, and radiographic findings in dogs with coccidioidomycosis: 24 cases (1995–2000). 

. 2003;222(4):461-466. doi:10.2460/javma.2003.222.461

Shubitz LF, Butkiewicz CD, Dial SM, Lindan CP. Incidence of coccidioides infection among dogs residing in a region in which the organism is endemic

. Journal of the American Veterinary Medical Association

. 2005;226(11):1846-1850. doi:10.2460/javma.2005.226.1846

Gunstra A, Steurer JA, Seibert RL, Dixon BC, Russell DS. Sensitivity of serologic testing for dogs diagnosed with coccidioidomycosis on histology: 52 cases (2012–2013). 

Journal of the American Animal Hospital Association

. 2019;55(5):238-242. doi:10.5326/jaaha-ms-6772

Schlacks S, Vishkautsan P, Butkiewicz C, Shubitz L. Evaluation of a commercially available, point-of-care Coccidioides antibody lateral flow assay to aid in rapid diagnosis of coccidioidomycosis in dogs. 

. 2020;58(3):328-332. doi:10.1093/mmy/myz067

Reagan KL, McHardy I, Thompson GR, Sykes JE. Clinical performance of a point‐of‐care coccidioides antibody test in dogs. 

. 2021;35(2):965-969. doi:10.1111/jvim.16087

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fluconazole for the treatment of coccidioidomycosis in dogs: 49 cases (2015–2020). Journal of the American Veterinary Medical Association

. 2022;260(10):1200-1205. doi:10.2460/javma.22.01.0006

Felton T, Troke PF, Hope WW. Tissue penetration of antifungal agents. 

. 2014;27(1):68-88. doi:10.1128/cmr.00046-13

Shubitz LF, Schlacks S, Vishkautsan P, Butkiewicz CD, Worthing KA. Posaconazole treatment of refractory coccidioidomycosis in dogs. Journal of Veterinary Internal Medicine. 2021;35(6):2772-2777. doi:10.1111/jvim.16282

Raghu C, Reagh C. Novel Treatment of Disseminated Coccidioidomycosis in a Dog with Voriconazole. 

. 2018;2018:1785748. Published 2018 Apr 5. doi:10.1155/2018/1785748

Mazepa ASW, Trepanier LA, Foy DS. Retrospective comparison of the efficacy of fluconazole or itraconazole for the treatment of systemic blastomycosis in dogs. 

. 2011;25(3):440-445. doi:10.1111/j.1939-1676.2011.0710.x

Renschler J, Albers A, Sinclair-Mackling H, Wheat LJ. Comparison of compounded, generic, and innovator-formulated itraconazole in dogs and cats. 

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Biologics: Anivive Lifesciences. Biologics | Anivive Lifesciences. Accessed June 3, 2025. 

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Articles

Learn about the impact of Valley fever on pets, including symptoms, diagnosis, treatment options, and emerging vaccine developments in veterinary care.

From soil to systemic disease: Understanding and managing Valley fever in veterinary patients

Photo: Mapodile M./peopleimages.com/Adobe Stock

A survey conducted by Banfield Pet Hospital of 5000 pet owners across the United States looked at state-by-state pet ownership trends. The survey, which was conducted in celebration of the hospital’s 70th anniversary, found that South Carolina pet owners were most likely to prioritize preventive care for their companion animals.

According to Banfield, survey participants from South Carolina claimed the top spot in never missing their pet’s flea and tick treatments (48%) and having a wellness plan. Additionally, 39% of South Carolina pet owners said they never miss their pet’s vaccine due dates, and 21% never miss their pet’s biannual checkups.

Arizona, Oklahoma, and Missouri lag behind in preventive care for their pets, specifically in flea and tick treatment, with 87% of Arizona pet owners being likely to miss this preventive measure.

 In Oklahoma, 75% of pet owners were likely to miss flea/tick preventive treatment, and 68% of pet owners in Missouri were likely to miss this preventive care. 

Despite these findings, Oklahoma and Arizona both ranked No. 5 in spending the most amount of time per day with their pet, with pet owners in both states spending an average of 12.2 hours (not including sleeping) with their pets.

 In Arizona, almost a quarter of survey participants said they spend 24 hours a day with their pet.

 Twenty-three percent of survey participants in Oklahoma said they bring their pet everywhere that is pet-friendly, and 16% have only taken vacations that could include their pet.

Tennessee, Wisconsin, Virginia, and Minnesota are also skipping preventive care for their pets; these states, according to survey findings, are not brushing their pet’s teeth. In Minnesota, Tennessee, and Wisconsin, nearly 9 in 10 (89%) of survey participants reported skipping brushing their pet’s teeth.

 Virginia trailed close behind, with 86% of pet owners forgoing brushing their pet’s teeth.

Many pet owners cannot afford veterinary care, survey finds

Additional findings from pet owners in Tennessee include the following

Most likely in the nation to have more wellness apps on their phone for their pet than for themselves (13%).

Twenty-six percent prioritize their pet’s physical wellness, with the same percentage saying their pet is at an ideal weight recommended by a veterinarian.

Meanwhile, in Wisconsin, findings include the following

Survey participants ranked No. 3 among states where pet owners reported feeling happiest staying in with their dog or cat.

Fifty-nine percent reported having traveled out of state with their pet.

Sixty-two percent said their pet wants to be in the same room as them at all times.

Virginia followed closely behind Wisconsin in enjoying life at home with their pet, with the state ranking No. 4 in reporting feeling happiest when being at home with their animal companion. Participants from this state also reported the following

Spending 24 hours a day with their pet (19%)

Their pet wanting to be in the same room as them at all times (51%)

Having only taken vacations that include their pet (16%)

Having traveled out of state with their pet (63%)

A new survey reveals that South Carolina pet owners lead the pack in prioritizing their pet's health--ranking highest in US. News release. Banfield Pet Hospital. June 20, 2025. Accessed June 23, 2025. 

https://prnmedia.prnewswire.com/news-releases/a-new-survey-reveals-that-south-carolina-pet-owners-lead-the-pack-in-prioritizing-their-pets-healthranking-highest-in-us-302485877.html

New survey reveals Arizona pet owners prioritize quality time and adventures with their pet--but majority are skipping crucial preventive care. News release. Banfield Pet Hospital. June 20, 2025. Accessed June 23, 2025. 

https://prnmedia.prnewswire.com/news-releases/new-survey-reveals-arizona-pet-owners-prioritize-quality-time-and-adventures-with-their-petbut-majority-are-skipping-crucial-preventive-care-302485874.html

New survey reveals Oklahoma pet owners prioritize quality time and adventures with their pet--but majority are skipping crucial preventive care. News release. Banfield Pet Hospital. June 20, 2025. Accessed June 23, 2025. 

https://prnmedia.prnewswire.com/news-releases/new-survey-reveals-oklahoma-pet-owners-prioritize-quality-time-and-adventures-with-their-petbut-majority-are-skipping-crucial-preventive-care-302485893.html

New survey reveals tech-savvy Tennessee pet owners monitor their pet's wellness digitally--ranking No. 1 in US--but majority are skipping an important preventive care habit at home. News release. Banfield Pet Hospital. June 20, 2025. Accessed June 23, 2025. https://prnmedia.prnewswire.com/news-releases/new-survey-reveals-tech-savvy-tennessee-pet-owners-monitor-their-pets-wellness-digitallyranking-no-1-in-usbut-majority-are-skipping-an-important-preventive-care-habit-at-home-302485881.html

New survey reveals Wisconsin pet owners prefer cozying up at home with their pets--but majority are skipping crucial at-home preventive care. News release. Banfield Pet Hospital. June 20, 2025. Accessed June 23, 2025. 

https://prnmedia.prnewswire.com/news-releases/new-survey-reveals-wisconsin-pet-owners-prefer-cozying-up-at-home-with-their-petsbut-majority-are-skipping-crucial-at-home-preventive-care-302485991.html

New survey reveals minnesota pet owners prefer cozying up at home with their pets--but majority are skipping crucial at-home preventive care. News release. Banfield Pet Hospital. June 20, 2025. Accessed June 23, 2025. 

https://prnmedia.prnewswire.com/news-releases/new-survey-reveals-minnesota-pet-owners-prefer-cozying-up-at-home-with-their-petsbut-majority-are-skipping-crucial-at-home-preventive-care-302485882.html

New survey reveals tech-savvy Virginia pet owners monitor their pet's wellness digitally--but majority are skipping an important preventive care habit. News release. Banfield Pet Hospital. June 20, 2025. Accessed June 23, 2025. 

https://prnmedia.prnewswire.com/news-releases/new-survey-reveals-tech-savvy-virginia-pet-owners-monitor-their-pets-wellness-digitallybut-majority-are-skipping-an-important-preventive-care-habit-302485879.html

A survey by Banfield Pet Hospital revealed statistics about state-by-state pet owner trends across the US.

Survey finds many US pet owners are skipping preventive care

Kyle Bartholomew, DVM, DACVAA, discusses how a multimodal plan for treating pain with analgesics can lead to improved outcomes.

Using multimodal analgesic plans to manage pain

 interview at the North American Veterinary Community (NAVC) SkillShop in Orlando, Florida, Kyle Bartholomew, DVM, DACVAA, clinical assistant professor of veterinary anesthesia at the University of Wisconsin School of Veterinary Medicine, discusses how multimodal analgesic plans can benefit patients experiencing pain. Bartholomew recently served as an instructor for the Small Animal Anesthesia for the Practice Team course at the continuing education event. He presented lectures and provided lab instruction with colleagues over 4 days, including a session on balanced anesthesia and analgesia.

The following is a transcript of the video:

Multimodal analgesic plans can benefit patients by combining multiple analgesics for 1 painful condition. The reason we use multimodal analgesia is because pain is incredibly complicated, so each patient can benefit from attacking it via different pathways with different analgesics. Also, the analgesics we use often have some [adverse] effects. People think of ileus or nausea, [gastrointestinal] upset with opioids—those will also increase the higher the dose goes. So, we use multiple analgesics combined...to help reduce the negative [adverse] effects that patients can experience with high doses of each individual analgesic.

Training new leaders with CPR instructor certification course

Kenichiro Yagi, MS, RVT, VTS (ECC, SAIM), program director for the RECOVER Initiative; and Dan Fletcher, DVM, PhD, DACVECC, cochair of the RECOVER Initiative, discuss the RECOVER CPR course. Additionally, new instructors Jennifer Dow, RVT, VTS (ECC); and Anita Parker, RVN, AVN, VTS (Anesthesia & Analgesia), CVPP, talk about what they’ve gained from hands-on experience.

: La'Toya Latney, DVM, DECZM (ZHM), DABVP (Reptile & Amphibian), CertAqV, senior veterinarian at The Schwarzman Animal Medical Center in New York, New York, provides insights for general practitioners caring for chelonians and how practices can use tools they already have in the clinic to examine turtles, terrapins, and tortoises.

Using total intravenous anesthesia in certain cases

: Marlis Rezende, DVM, PhD, MSc, DACVAA, an associate professor of anesthesia and pain management at Colorado State University College of Veterinary Medicine and Biological Sciences in Fort Collins, discusses total intravenous anesthesia and the common conditions she sees in practice that best utilize this method of pain management.

Kyle Bartholomew, DVM, DACVAA, discusses how combining treatment options can lead to improved outcomes.

Happy Monday dvm360 readers! Did you know that the dvm360 team attended the 2025 American College of Veterinary Internal Medicine (ACVIM) Forum in Louisville, Kentucky last week? The team took the conference by storm with lecture coverage, interviews with faculty, and news coming from the ACVIM Forum! You can check out dvm360’s conference coverage on our dedicated 

 and if you are looking for coverage on WVC, VMX, Fetch Conferences, and other veterinary conferences, check out our 

After checking out our conference coverage, be on the lookout for these articles, interviews, and podcast episode this week:

Kelly Chapell, DVM, DACVIM (Small Animal), takes readers into a deep dive to get a better understanding and management of coccidiomycosis, also known as Valley Fever, in veterinary patients.

Medetomidine, a racemic mixture of dexmedetomidine and levomedetomidine, is a rising concern for health officials in the United States because it has become a dangerous adulterant in the United States illegal drug supply.

On this week’s episode of The Vet Blast Podcast presented by dvm360, Adam Christman, DVM, MBA, welcomes veterinary student and dvm360 student ambassador Sophia Jodka to the podcast to discuss her role in planning the APVMA 2024 symposium, and how other students can get involved in organized veterinary medicine.

Pet Poison Helpline recently shared its latest installment of its 

which details the story of Kaya, a dog from Amana, Iowa, who ingested dalfampridine, which helps improve walking in patients with multiple sclerosis and ataxia, which can impact coordination and balance.

During an interview with Christman, Carolina Monk, DVM, DACVO, from Blue Pearl Malvern, breaks down some topics that general practitioners can come across for ophthalmology cases in the general practice.

Banfield Animal Hospital announced that it has surveyed over 5000 pet owners in the United States to learn more about pet owner superlatives state by state such as South Carolina being ranked number 1 for never missing their pet’s flea and tick treatment as well as having a wellness plan.

Here is a sneak peek at this week’s headlines 

Sneak peek: Medetomidine now identified in the US illegal drug supply, and other news 

Resident researchers were recognized and applauded at the 2025 American College of Veterinary Internal Medicine (ACVIM) Forum in Louisville, Kentucky, during an awards luncheon on June 20, 2025. The special event was sponsored by Purina Institute, with many of the winners in attendance. The winning abstracts were among the research presented to ACVIM Forum attendees throughout the conference.

Resident Research Abstract Award winners gather on stage to be recognized at the 2025 ACVIM Forum in Louisville, Kentucky. 

The 2025 ACVIM Resident Research Abstract Award winners and their recognized works are as follows:

Cassidy M. Coats, DVM; Colorado State University in Fort Collins—“Coronary Ostial Eccentricity, Aortic Rotation, and Cusp Symmetry in Dogs Evaluated by Cardiac Computed Tomography”

Kiersten K. Forsyth, DVM; Purdue University in West Lafayette, Indiana—“Effects of Zenalpha (Medetomidine/Vatinoxan) on Blood Pressure, Echocardiographic Measurements, and Cardiac Rhythm in Healthy Dogs”

Eline Nijveldt, DVM; The Ohio State University in Hilliard—"Echocardiographic Evaluation of Aortic Root Size in Cats With Hypertrophic Cardiomyopathy”

Florence Dupuis-Dowd, DVM, MSc; University of California, Davis—"Effect of Ertugliflozin on Glucose and Insulin Dynamics in Healthy Horses Receiving Dexamethasone”

Evelyn Hodgson, DVM; University of Queensland in Australia—“Prolongs Wireless Measurement of Intragastric pH in Foals”

Large-Animal Medicine Internal Medicine (Food Animal)

Caitlyn Mullins, DVM, MS; Kansas State University in Manhattan—"Dual-Center Retrospective Review of 204 Transfusions in Camelids”

Jessica Linder, DVM, BS; Purdue University—“Spinal-Only Meningomyelitis of Unknown Etiology: Clinical Presentation, Diagnosis, Treatment, and Outcome in 23 Dogs”

Alejandra Mondino, DVM, PhD; North Carolina State University in Raleigh—“Dissolution Characteristics of Split and Crushed Levetiracetam Extended-Release Tablets in Comparison With Immediate-Release Formulation”

Dana Ford, DVM; The Ohio State University in Columbus—"Increasing Dietary Fiber Intake Improves Fecal and Clinical Activity Scores in Dogs With Chronic Enteropathy”

Kayla Neiderfer, DVM; Oregon State University in Corvallis—“Comparison of Pooled vs Single Samples Measuring Urine Protein: Creatine Ratio in Dogs Receiving Toceranib Phosphate”

Carly Iulo, DVM; Auburn University College of Veterinary Medicine in Alabama—“Plasma Plasminogen Activator Inhibitor (PAI-1) Activity in Dogs With Immune-Mediated Hemolytic Anemia”

Kayla Prentice, DVM; Tufts University in Grafton, Massachusetts—"Do Serum Pro-Inflammatory and Pro-Coagulant Biomarkers in Dogs With Gallbladder Mucoceles Predict Disease Progression?”

Max Randolph, DVM; University of California, Davis—“Outbreak of Leptospirosis in Dogs From Los Angeles County, California, USA 2021”

Colin Smith, DVM; University of Tennessee in Knoxville—“Effect of Low Dose Azithromycin on the Fecal Microbiome and Fecal Bile Acids in Dogs”

Sierrah Travis, DVM, BS; Virginia-Maryland College of Veterinary Medicine in Blacksburg, Virginia—“Plasma ADAMTS13 Activity in Dogs With Severe Thrombocytopenia and Presumed Immune Thrombocytopenia”

2025 ACVIM Resident Research Abstract Awards. Presented at: American College of Veterinary Internal Medicine Forum; June 18-21, 2025; Louisville, KY.

Fifteen honorees were recognized for their investigative work in various specialities. 

Resident Research Abstract Award winners are celebrated at 2025 ACVIM Forum

Jeffrey N. Bryan, DVM, PhD, MS, DACVIM, discusses the need for a new treatment option for dogs with osteosarcoma in a dvm360 interview.

Considering treatment options with canine osteosarcoma

Treatment of canine osteosarcoma is advancing with recently released data showing enhanced outcomes for patients with a combination of chemotherapy and ELIAS Cancer Immunotherapy (ECI). In a 

2025 American College of Veterinary Internal Medicine (ACVIM) Forum 

in Louisville, Kentucky, Jeffrey N Bryan, DVM, PhD, MS, DACVIM, professor of oncology and associate director of the Ellis Fischel Cancer Center at the University of Missouri in Columbia, Missouri and principal investigator for the pilot trial for ECI, discussed current treatment options for bone cancer in dogs and how science and technology are providing new avenues of care, such as ECI.

New data for novel bone cancer therapy demonstrates improved outcomes

: Osteosarcoma is a primary cancer of bone, and unlike most cancers that are not terribly painful, it is extremely painful. So the patients that come to us, we talk about having problems of life and limb and the limb part really is pain and severe life limiting discomfort. So removal of that tumor, either by surgery on the tumor itself, or amputation or using radiation to control it, becomes primary in managing the limb part of it. However, the majority of these patients, when they present, will already have microscopic spread of their tumor elsewhere in their body, particularly to their lungs, and that is what really limits their survival, their life.

If we only amputate dogs, half of them will be gone in the first few months after amputation, which is a terrible outcome, and the rest of them will almost certainly be gone long before a year happens if we add chemotherapy to amputation, they live two to three times longer than if they have amputation alone, based on the published literature. And so now, adding a dose of chemotherapy while we wait to start the immunotherapy, and having survivals that are well out over a year in this group of dogs, as well as more than half of them being alive at the 1 year mark, appears to be a very substantial advance forward. The fact that this is a well-tolerated treatment that invokes the dog's own immune system to try to control the disease long term is a substantial advancement over what we have had in the past to treat these patients.

Videos

Jeffrey N. Bryan, DVM, PhD, MS, DACVIM, discusses current methods and the need for advancement in how bone cancer is managed in dogs