Clinical features of cats diagnosed with coccidioidomycosis in Arizona, 2004 - 2018

Abstract

Objectives: The goal of this study was to describe the clinical presentation, diagnosis and treatment of coccidioidomycosis in cats residing in a region endemic for Coccidioides species. Methods: A retrospective review of records was performed at both primary and tertiary care veterinary practices in Tucson and Phoenix, AZ. Data collected included signalment, clinical signs, physical exam findings, diagnostic test results, treatment and outcome. Results: Fifty-one feline cases were identified from six different veterinary hospitals. Cats presented with clinical signs and laboratory abnormalities similar to what has been seen in dogs, including respiratory illness (20/51), neutrophilia (24/31), monocytosis (17/31), and hyperglobulinemia (16/30). However, cats at diagnosis were typically significantly ill, with 31/51 having disseminated infection, most commonly to the skin (n=22). Additionally, 43/44 cats that had serum antibody tests performed were positive, and median titer at diagnosis was 1:32 (range 1:4 – ≥1:256). Serum antibody titers reduced significantly (P ≤0.001) in cats that responded to treatment compared with cats that did not clinically improve. 40/46 cats that were treated with oral flucaonzole responded and did not require additional therapy. Fourteen cats developed recurrent disease and all but 1 had antifungal therapy successfully reinstituted. Conclusions and relevance: Coccidioidomycosis is a disease of concern for cats residing in the region endemic for Coccidoides spp. Disease is most often disseminated at the time of diagnosis, possibly due to delays in presentation for care and recognition of the infection. Suspicion of disease, serum chemistries, blood cell counts, presence of antibody, and imaging aid in diagnosis of coccidioidomycosis in cats. Serum antibody reduction during treatment frequently correlated with an adequate response to medication. Consideration of coccidioidomycosis as a cause of illness will lead to earlier diagnosis and potentially better treatment outcomes in cats.