I still remember it like it was yesterday. The day back in 2004 when I looked at my then 3-year old orange and white tabby cat Jasper and thought “Uh-oh.” Nothing looked blatantly wrong, exactly, it’s just that I knew something wasn’t quite…right.
Up until that day, Jasper had always been a healthy, rambunctious, playful little guy with a mischievous sense of humor and a penchant for hiding things around the house. Sweet and affectionate, he loved to snuggle up against our necks and lick our noses, purring loudly, then drape himself across us with looks of utter contentment.
It was his facial expression I noticed that day. What I call his typical “kitten face” was not there, replaced by a look I hadn’t seen before. When I began scrutinizing him with the laser focus of a concerned cat mom, I noticed that his hair coat also seemed a little dull. Was I imagining things?
The next day, Jasper vomited after breakfast. Taking no chances, I took him to see his regular vet, who examined him but was unable to find anything out of the ordinary. We drew blood to be safe, and she suggested a hairball remedy.
When Jasper’s bloodwork results came back normal, it only made me more perplexed. Always the first to show up for dinner, he was now picking at his food. I took him back to the vet again, only to be told they couldn’t find anything wrong with him.
The next morning, I was alarmed to see Jasper attempting to climb the stairs, but unable to make it past the third step. Every movement looked like it was causing him excruciating pain. This time when I took him in, the vet referred me to an Internal Medicine Specialist, and we got an appointment immediately.
Racing the Clock
When Jasper and I first met Dr. Keven Gulikers, I had no idea what a crucial role he would come to play in our lives. Dr. Gulikers was soft spoken, thoughtful, and insightful, with the best bedside manner of any vet I had ever seen. After examining Jasper head to toe, he ordered x-rays and an abdominal ultrasound. Within the hour, results were in.. and they were heartbreaking. Jasper had enlarged lymph nodes throughout his abdomen, and the initial diagnosis was intestinal cancer.
Dr. Gulikers wanted to run additional tests to confirm the cancer diagnosis, as he wanted to make very sure that’s what we were dealing with. He sent us home with prednisone, a steroid medication used in animals with cancer to alleviate pain and inflammation by suppressing the immune system. I gave Jasper his first dose that night.
The next day, poor Jasper was dramatically worse. He was listless, could barely move normally, and didn’t want to eat. I was monitoring him closely at home; his heart sounded normal, there was no fever, and he had no other symptoms that would point to what was causing these mysterious symptoms. I was alarmed at how quickly he seemed to be deteriorating. Not wanting to subject him to another stressful ride in the car, I left him with my husband while, in desperation, I drove back to the hospital to talk with the doctor.
Dr. Gulikers met with me immediately. I was distraught, knowing that we didn’t truly have a definitive diagnosis and seemed to be running out of time. I told him the prednisone had made Jasper worse instead of better. We spent almost an hour brainstorming… it felt like a surreal episode of “House, MD”. Spinal tumor? Neurological disease? Nothing seemed to fit.
Dr. Gulikers noted that we had run almost every test possible, except one. A fungal titer.
A titer is a blood test used to check for the presence of infection by measuring the amount of antibodies the body is making against a foreign invader. The blood sample is continuously diluted by 50% (1:2, 1:4, 1:8, 1:16, 1:32) until it no longer tests positive. The higher the ratio numbers, the worse the infection.
Miraculously, the hospital still had some of Jasper’s leftover blood from previous tests, and we immediately overnighted what was left to a specialty lab. However, it was going to take 3 full days to run the test.
Time to Decide
The next morning, Jasper couldn’t move around on his own. I couldn’t bear to see him in so much pain. We had attempted to manage his pain with a medication called Torbugesic, but his body had such a bad reaction to it that we had to stop using it.
My husband and I stayed home from work that day and spent the entire day with Jasper, loving on him and saying our goodbyes. Any pet parent who’s been in this situation knows exactly how devastating it is. I called the hospital that afternoon and made an appointment for 6:00pm to have his pain and suffering ended for good.
At 5:30, I quietly told him “Come on baby, it’s time to take a ride.” To our utter astonishment, Jasper stood up, walked steadily on his own to the back door, then happily started watching the birds in the back yard and purring! It was the most he had been like his regular self in days. I looked at my husband and said, “We’re not doing anything yet.. he needs to be examined one more time.”
When we got to the hospital, the technician took his temperature and asked if he had been running a fever. I said no, I had taken his temp the night before and it was still normal. She took one look at the thermometer and said, “Well, it’s not now!” Overnight, Jasper’s temp had spiked to 104.5 degrees (normal body temperature for cats is around 101.5 degrees). It was then I knew that we were most likely dealing with an infection.. and an infection could be treated!
Jasper was immediately admitted to the Intensive Care Unit, where he was given IV fluids, antibiotics, and antifungal medication. On his second day in the hospital, his fungal titer came back, and it was 1:64 – the highest ratio possible for a positive fungal test. We finally had the diagnosis we had been waiting for.
Valley Fever.
“The Great Imitator”
Valley Fever is caused by a fungus called Coccidioides immitis, an organism that lives in soil mainly in the arid, hot regions of the western and southwestern United States and Mexico. Whenever the soil is stirred up, these fungal spores are released into the air, where they can be inhaled by both humans and animals.
Once inhaled, the fungus can take hold in the respiratory system. It grows and releases hundreds of endospores that travel throughout the body, resulting in a systemic infection (meaning the microorganisms are found in both blood and tissue). This affects the entire body: the lungs, heart, bones, joints, organs, eyes, skin, and neurological and lymphatic systems. Valley Fever is extremely dangerous, and can cause overwhelming infection leading to seizures and heart failure. Dogs and cats diagnosed with this disease often receive a guarded to grave prognosis for recovery.
Valley Fever is called “The Great Imitator” because it mimics so many other diseases (like cancer). Symptoms are hard to diagnose until it’s almost too late. Symptoms in cats can include weight loss and muscle wasting, loss of appetite, depression, draining skin lesions, difficulty breathing, lameness, eye inflammation, and neurological symptoms.
In hindsight, this is why Jasper worsened so quickly while on the prednisone – the drug suppressed his immune system, allowing the fungus to grow even more rapidly and unchecked. His enlarged abdominal lymph nodes (which mimicked intestinal cancer) were actually caused by his body desperately trying to fight off the fungal infection.
Valley Fever is usually more easily diagnosed in dogs, but is rare in cats. It often progresses slowly in cats over a long period of time, and affected cats may not show any symptoms until the infection has spread so significantly that it becomes terminal.
Valley Fever is aggressively treated with anti-fungal medication (Fluconazole has the fewest side effects) for at least 6 months, and often for a year or more. During this time, blood tests are done and additional titers performed every 3 months until the tests are negative (or at the lowest acceptable level) for the fungus. Relapses are common, especially if medication is not given for a long enough period of time.
The Long Road to Recovery
Jasper was in the Intensive Care Unit for 6 days, receiving excellent round the clock care. At one point his fever spiked to 106.2 degrees – the highest temp I had ever seen in clinical practice – prompting the doctors to place ice packs on his IV lines to cool the fluids that were running into his body.
We visited him multiple times a day, holding him in our arms in quiet exam rooms so he could sleep, away from the noise of the beeping monitors and bustle of the ICU. During this time I was constantly assessing him, wondering if we were doing the right thing by attempting to give his body time to recover. After the third day of treatment, I had my answer – that distinct look in his eye that I knew well from years of working with critically ill dogs and cats. The look that told me he was fighting tooth and nail, that he wanted to come home. In amazement, we watched as he recovered day by day, getting stronger, until finally we were able to do something we had only dreamed of – bring him home.
On the day of Jasper’s release, Dr. Gulikers shaved a small spot between his shoulder blades (where he couldn’t lick) and affixed a Fentanyl patch (a narcotic pain-relieving skin patch used in human cancer patients) to manage his pain over the next 3 days. He came home with antibiotics, Fluconazole, special food, and bags of IV fluid and needles so I could administer subcutaneous fluids under his skin to keep him hydrated.
I don’t know who was more thrilled the day Jasper came home, us or him! Every day he continued to improve, until one day, many weeks later, I finally saw it again.. his “kitten face.” That’s the day I finally let myself exhale and have a good, long cry.
Ongoing Treatment (and Lessons Learned)
Jasper’s infection was so severe that he remains on Fluconazole twice daily, and will be on it for the rest of his life. He’s on the lowest dose possible to minimize any challenges to his liver, and he has bloodwork drawn periodically to monitor his liver function (which at age 14, so far, thankfully, has been great). His first negative titer came back 6 months after his hospitalization, and it’s been negative ever since.
Because Jasper’s case was so unusual (most animals with an infection as severe as his do not survive), he was written up in several veterinary medical articles, and Dr. Gulikers featured his case in numerous presentations to other veterinarians highlighting how tricky a Valley Fever diagnosis can be. We were lucky. Because Jasper was so young, strong, and healthy prior to his infection, he had a better chance than most for experiencing a full recovery.
We were able to learn many valuable lessons from this experience. First, know your pet and trust your instincts. No one knows your pet like you do… his demeanor, facial expressions, attitude, and interactions with you and other pets in your household. If you think something is wrong, trust yourself and get it checked as soon as possible. There’s no such thing as being too cautious when it comes to the health of our pets.
Second, if you know something is wrong and you don’t get the answers you’re looking for, don’t take “I Don’t Know” for an answer. Keep searching, get that second opinion, do research using credible veterinary sources, and don’t give up until you know exactly what you’re dealing with. Find a veterinarian who will listen and fight for your pet’s life as hard as you will.
And although not all cases will turn out as well as Jasper’s, if you are fortunate enough to find top quality veterinary care, with a little luck, faith, and determination, your pet just might be the next medical miracle.
1 Photo: Centers for Disease Control/Flickr/Creative Commons License
Do you have any miraculous stories you’d like to share about your pets? Please tell us about them in the comments below!
Jaime says
Thank you for this article. My name Is Jaime im 41 years old. I contracted Valley fever 6 years ago in the California San Joaquin valley. By the time the discovered what i had the VF had already disseminated through my body and skin. Fast forward 6 years and im slowly getting worse. Ive taken all the medications possible to no avail. I’m currently on Fluconazole again. This didease has changed my life and who I am completely. I hate what it has done to me. I hate it with a passion. Enough of me this is about cats. 6 months ago my cat Lucy was getting a growth in her neck and her eyes were very watery, doctors gave her antibiotics for a while. They finally took a sample from her neck and i returned positive for VF her titters are at 1: 32. shes only 2 years old. and like me before the disease, she was the life of the house always being active and happy. And now once again, like me, all she does is lay down. The vet visits, the organic food, the medicine is super expensive. I can barely afford my medical insurance and now this. Is there an alternative we can give her to help her. What did you give your baby to help her immune system?
Camille Schake says
Hi Jaime! I’m so very sorry to hear about your struggle with Valley Fever. It’s truly an awful disease, and my heart goes out to you and what you’re going through. And then for your kitty to contract it too – that’s just heartbreaking. 🙁 Regarding your kitty Lucy, if it’s only been 6 months, I would say give it a little more time for her to start feeling better. Fungal infections are very difficult to get under control, and with Jasper, I know it was at least 6 months of being on the Fluconazole for him to start having more energy and really feel like his old self again. Every dog and cat is different when it comes to Valley Fever – some get deathly ill and don’t recover, some survive and are able to return to normal, and some experience varying degrees in between. So I would suggest just keeping Lucy on the medication, having the vet monitor her, and giving her body some more time to fight it off. With fungal infections, the medications to fight it don’t actually kill the fungus – they are called “fungistats”, which means that instead of killing the fungus, they keep it from reproducing and spreading. Then eventually the body’s immune system fights off whatever fungus remains, so it can take awhile for affected animals (and people) to recover.
Regarding alternatives to her medication, unfortunately I don’t know of any. Based on the research I did for Jasper, Fluconazole is the best medication that she can be on to help her recover. It sounds like you’re doing everything you can to help her, feeding her a high-quality diet and having regular vet visits. Once her titer comes back negative and you know she’s feeling better, you may only need to have her checked and have blood work done once a year, which is what I did with Jasper (unless she starts not feeling well again), so that should help with the expense. As to whether she’ll need to be on Fluconazole long-term, I would definitely discuss that with your vet.
As far as the expense of the Fluconazole, are you getting your medication from the vet or from a pharmacy? There are special compounding pharmacies that can mix up the medication in a flavored liquid (Jasper’s was mixed with fish extracts, his favorite!) A supply of his medication (which usually lasted us around 45 days) cost about $32 when I got it from Diamondback Drugs, a national compounding pharmacy. They have locations here in Phoenix, but they also do mail orders and ship medications, so if this is a less expensive option that what you’re paying, you can talk to your vet about getting a prescription for the compounded liquid. Their website is www.diamondbackdrugs.com.
Since you’re already doing everything you can to help Lucy, I only have one last piece of advice. Cats are very sensitive to stress, so creating a very low-stress environment for Lucy can really help bolster her immune system. For the next several months, I would suggest avoiding any unnecessary visitors to the house and any changes in her normal routine (new pets, new people, new food, even moving furniture in your house). If you have other cats, try to give Lucy a place in your home that’s quiet and separate from the rest of the cats so she can have a place to escape if she needs to. Since you know her best, do anything you know how to do to make her feel secure and relaxed, as this will only help her.
I hope this is helpful. Please keep me posted on how Lucy is doing, and I wish the very best for both of you!!
Barbie Boehler says
I also have a 2-3 year old kitty I rescued that has valley fever. The owner of Sun City Pet Market encouraged me to give my cat Hemp Oil 100 with CBD to boost his immune system. My cat when first tested had a titer 1:32 and now a month later after giving him the Fluconazole 2X a day along with the Hemp Oil 100 2X a day his titer is now 1:16. I really think the Hemp Oil 100 is speeding up his healing by supporting his immune system. You can read about this amazing product at petreleaf.com
Barbie Boehler
marker001 says
My little Mio has been diagnosed with Valley Fever. This kitten is a fighter! I live in a modular home, common in the area south of Tucson where I live and he was born under my house to a feral mother and father (sometime during the first week of August, 2015). I don’t know what happened to mom or other litter mates if there were any, but at about 6 weeks old this tiny kitten came up on the porch crying for attention and food. I put him back under the house 3 times and each time he came back in less than 5 minutes. So, I was chosen. I got him to my vet the first available appointment. Mio had a fairly large open wound on his chest which looked like a slice right down his middle. Look like he had open heart surgery! It wasn’t deep but the skin was spread wide open. The vet cleaned it and said it should be ok, and it was. You cannot even tell it was ever there now. So we got him all up to date on his vaccinations and rabies shots and thought all was well. However, about 2 weeks ago, he started limping. At first I thought he had hurt his foot, climbing trees or such, or maybe twisted his front let somehow. When it didn’t improve, off to the vet we went. X-rays showed a lesion on his right arm, halfway between his paw and elbow. So, we talked about all the things it could be including bone cancer. Then his Valley Fever titer came back positive. Although a very scary and deadly disease for cats, it was a better diagnosis than bone cancer so I feel somewhat relieved. I will be starting him on Fluconazole when it comes in (mail order prescription). The outlook is very positive and I will post again as he heals.
Camille Schake says
Oh, your little Mio is definitely a fighter! I’m so glad to hear that the lesion wasn’t bone cancer. Valley Fever is so tricky since it presents in so many different ways, which is why they call it “The Great Imitator”. Jasper’s initial symptom was that he was so painful while trying to go up the stairs, but there is a whole slew of symptoms that can show up – making it very difficult to diagnose.
I am SO sorry for the delayed response to your comment…for some reason, on the day that you sent it, the website sent your comment (and several others that were sent that day) into limbo, and I just now saw them today! Sometimes technology is NOT our friend. 🙁 How is Mio doing?? I hope he’s responding well to the Fluconazole!
marker001 says
Thanks for your response. Mio is doing great! Within a couple of weeks of medication he was walking and climbing like he had never had a problem! We will be testing again at the end of April so I will update more at that time.
Camille Schake says
That’s great news, I’m so happy to hear that he’s doing so well!! Please keep us posted! 🙂
Julie Morgan says
November 2015 I adopted Kitty Cat from the Humane Society to be a trucker kitty. She is now approximately 1.5 years old and was described as having a unique personality. She slept most of the time and had no interest in toys She did not eat much, made no sounds and did not purr. I did notice a little cough that got worse daily. I thought it was a hairball. Took her to the vet who gave her a shot, she was dehydrated and had fever. X-rays showed no hairball. Tested for leukemia, negative. A week later a friend told me to have the cat tested for Valley Fever. I was in Pensylvania and the vet had never heard of Valley Fever. A week later the results came back and it was positive for Valley Fever. Kitty has been on Fluconazole twice daily since then. The second test done a couple months ago showed improvement however x-rays showed that Kitty has a collapsed lung. She is a changed Kitty Cat though. She behaves like she is a healthy cat, loves to run and jump. For the first time a couple days ago she went under the covers on the bed and lied there for hours, she used to hate confined spaces. Her coughing has not improved, in fact, it seems to be getting worse. Approximately once a day she will have a bad coughing spell, it breaks my heart. It is so random that I have been unable to figure out what triggers the cough even though I am with her 24/7. Her nose lost hair but that seems to be coming back, however, it does look spotty as if lesions about to come out and the edge of her nose doesn’t look right. Vet didn’t want to treat her nose as sh e felt steroids would not be a good combination with Fluconazole. It looks like Kitty is gaining weight and has a very healthy appetite. She continuously talks making little “purr” sounds I call chatter and loud meows when she is hungry. On the rare occasion she actually now purrs (which makes me wonder of the lung is getting better). She truly behaves like a healthy cat, loves to run, jump and throw toys in the air. I just wish the cough would go away.
Camille Schake says
Hi Julie, thank you so much for sharing Kitty’s story! First, it’s amazing (and very fortunate) that your friend told you about Valley Fever…unfortunately, there are many people outside of the desert southwest who’ve never heard of it (as evidenced by the fact that even the Pennsylvania vet didn’t know anything about it). I’m so glad Kitty was diagnosed quickly and got on Fluconazole right away. Regarding her nose, I agree with the vet who didn’t want to treat it with steroids, since those can make any other type of infection in the body dramatically worse. As far as her cough, that’s a tough situation since the cough could be caused by lingering Valley Fever lesions in her lungs, or by something different altogether. Since she’s still recovering from Valley Fever, it’s probably very likely that it’s the VF causing the issue, but to be safe, are you able to have her checked by a veterinarian since you said her cough seems to be getting worse? Sometimes the symptoms of VF can take many months to go away, but it’s always better to be safe and try to rule out any other causes of the coughing if possible.
That being said, the most telling thing is that Kitty is feeling better, actively playing, at a healthy weight, and eating well. With any patient recovering from Valley Fever, those are the best signs you can hope for! 🙂 I hope she continues to improve and that you can confirm the cause of the cough – if it’s truly entirely due to the VF, it should resolve in time as her lungs become less inflamed. Sending warm wishes to Kitty for continued healing, and I wish you both safe travels and good health! 🙂
Patricia Aceves says
Did your cat ever have diarrhea with the vomiting?
jax2127 says
I am just beginning our journey with VF in my 2+ year old female cat. The nodes chosen to swell put pressure on her heart – either fortunately or unfortunately – as this allowed us to catch it very early – before vomiting or sores or fevers. She is still critical, because of the location of the swollen nodes mostly… but I am seeing a brief sparks of her old self. Thank you for sharing your story.
Camille Schake says
Glad you caught her Valley Fever early, that will definitely help her prognosis! The fact that she is young, and she appears to be fighting, also tips the scales in your favor. The vast majority of cats go undiagnosed, so you are way ahead of the game in that respect. Symptomatic Valley Fever is a long road to recovery, but it can be overcome. With antifungal medication, time for the body’s immune system to fight back, and good veterinary support, I’m hopeful your little girl will make a full recovery and be back to her old self as soon as possible!
And thank you for sharing your story as well… the more people who are educated about this infection in cats, the better the outcome!