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Posaconazole and Voriconazole –  Treating Invasive Fungal Infections in Small Animals

Posaconazole and Voriconazole – Treating Invasive Fungal Infections in Small Animals

Background Posaconazole and voriconazole are next generation azoles most closely related to itraconazole and fluconazole, respectively. As compared with the prior generation azoles, posaconazole and voriconazole are more active against molds (Asper) and yeasts (Crypto) with good activity against enzootic dimorphic fungi (Blasto, Histo, Cocci). They are approved by the FDA for the prevention (posa-)...
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Itraconazole or Fluconazole – Which to Choose?

Itraconazole or Fluconazole – Which to Choose?

Case Example Figure 1: Ultrasound image showing a large hypoechoic spleen with mottle echotexture in a cat with histoplasmosis. Daphne, a 6-year-old spayed, female domestic shorthair cat presented for lethargy, anorexia, weight loss, and rapid breathing. On physical examination she had generalized peripheral lymphadenopathy with the submandibular and popliteal lymph nodes being the most obviously...
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Reliable Test Results = Confident Clinical Decision Making

Reliable Test Results = Confident Clinical Decision Making

As a veterinarian, when you submit a diagnostic test, the service lab is your business partner. You expect the same quality service from your business partner that you provide your pet-owning clients. An important part of that service is the product quality, and in this case the product is the diagnostic test result. The following...
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Antibody Testing for Histoplasma and Blastomyces ─ What, When & Where?

Antibody Testing for Histoplasma and Blastomyces ─ What, When & Where?

At a Glance – Key Points 1. The MVista® Histoplasma and Blastomyces Antigen EIA tests are highly sensitive 2. There is high cross-reactivity between Histoplasma and Blastomyces antigen 3. Urine and serum antigen testing are neg in approximately 5% of cases 4. MVista® Histoplasma and Blastomyces IgG Antibody EIA tests are indicated if antigen testing...
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What Tests Should Be Performed for Diagnosing Coccidioidomycosis?

What Tests Should Be Performed for Diagnosing Coccidioidomycosis?

Drew Hanzlicek, DVM, MS, DACVIM (SAIM); Joe Wheat, MD; Heather Largura, DDS, MS Diagnosis. The most sensitive testing option for coccidioidomycosis is a combination of tests for antibodies including the MiraVista IgG EIA (MVista® Cocci IgG) and Immunodiffusion (Cocci ID). This combination provides a sensitivity of >98%, while still being highly specific (97%). An alternate...
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Invasive Fungal Infections NOT Invasive Diagnostic Investigations

Invasive Fungal Infections NOT Invasive Diagnostic Investigations

Histoplasma antigen detection is commonly used for diagnosis, treatment monitoring, and detection of disease relapse in veterinary medicine. The gold-standard for Histoplasma antigen detection is the MVista® Histoplasma Antigen Quantitative enzyme immunoassay (EIA). First made commercially available almost 20 years ago, it has been modified since to optimize diagnostic performance, turnaround time, and cost-efficiency. More...
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Invasive Fungal Infections NOT Invasive Diagnostic Investigations

Invasive Fungal Infections NOT Invasive Diagnostic Investigations

(1,3)-β-D-Glucan Antigen Test in Dogs and Cats By Drew Hanzlicek, DVM CLINICAL CHALLENGE Invasive fungal infections (IFI) often present a diagnostic challenge in dogs and cats. A few of the most notable include variable clinical presentations without pathognomonic clinical findings; disease in organ systems that require invasive procedures for sample collection; and slow fungal culture...
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Histoplasma Antigen Detection for Diagnosis of Histoplasmosis in Cats

Histoplasma Antigen Detection for Diagnosis of Histoplasmosis in Cats

Janelle Renschler, D.V.M., Ph.D., Dipl. ACVP and Joseph Wheat, MD Antigen detection for diagnosis of histoplasmosis in veterinary patients was first offered at MiraVista Diagnostics in 2004.  The MiraVista enzyme immunoassay (EIA) has been refined to improve sensitivity and permit quantification .  The MiraVista EIA has since become a leading method for diagnosis of progressive...
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Possibility of Fluconazole Resistance During Treatment for Histoplasmosis

Possibility of Fluconazole Resistance During Treatment for Histoplasmosis

Overview: Fluconazole is frequently used to treat cats with histoplasmosis, as it is well tolerated, cost effective, and available in convenient dosage form. In one study of 30 cats with histoplasmosis, treatment with fluconazole (19.3 mg/kg/day) led to similar survival and recrudescence rates as itraconazole (10.0 mg/kg/day), suggesting that fluconazole is an effective therapy for...
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