German shepherd overcomes rare fungal infection

Riley, a 7-year-old German Shepherd, was diagnosed with disseminated aspergillosis. (Image courtesy of UC Davis College of Veterinary Medicine)

In the Spring of 2023, Anthony Lan and his partner Elora Paule, noticed their 7-year-old German shepherd, Riley, had slowed down and appeared to be in pain sometimes. At first when they brought Riley to the veterinarian, they suggested it was due to age-related joint issues and prescribed her with anti-inflammatory medication, but it did not seem to improve Riley's condition.

“Then on a walk one day, I noticed she was markedly slower,” said Paule, in a news release.¹ “By that afternoon, she lost function of her hind legs.”

For nearly 2 hours, Lan and Paule searched for an emergency room open to bring Riley to and when they finally found one and brought her in, Riley was diagnosed with disseminated aspergillosis. According to the release from UC Davis College of Veterinary Medicine,¹ disseminated aspergillosis is a widespread and severe mold infection that results in discospondylitis, the infection of the vertebra and intervertebral discs, kidney infection, and left eye infection. In Riley’s case, her vertebra was damaged and led to instability of her spine, leading to spinal cord damage and paralysis.

Aspergillosis is an infection that is caused by the Aspergillus fungus, which grows on dead leaves, stored grain, compost piles, or other decaying vegetation. Aspergillosis is considered an ‘opportunistic pathogen’ and usually affects pets whose immune systems are compromised or suppressed. The Aspergilus fungi shed microscopic spores that float in the air and can then be easily inhaled.²

Once Riley was diagnosed, Lan and Paule were told she would not likely survive and should consider taking her home for a final night. However, not wanting to stop fighting for their pet, Lan began researching the condition and discovered a paper talking about a different German shepherd with the same predicament. That German shepherd survived 5 years with the intervention of a certain antifungal medication. Lan went back to the veterinarians treating Riley and asked about this medication. The team did not have access to it but told Lan that it was available at UC Davis.

Lan and Paule brought Riley to the UC Davis veterinary hospital where her diagnosis was confirmed. The emergency room specialists consulted with the neurology/neurosurgery service, and then performed an MRI on Riley. According to the organizational release,¹ the results of the MRI showed veterinary professionals that the infection led to a compression of her spinal cord, causing her to lose her ability to walk and declared her not a candidate for surgery.

The UC Davis team also consulted with its ophthalmology services, who concluded Riley was blind in her left eye and if she survived the fungal infection, her eye should be removed. Despite all the challenges and considerable bad news, her owners never gave up hope and continued to advocate for her survival.

Riley was eventually transferred to the internal medicine services and Sarah Michalak, DVM, began working with faculty with backgrounds on infectious diseases to begin treating Riley, and hopefully improving her health. Riley was hospitalized for a month on 2 IV antifungal therapies, pain medications, 2 oral antifungal therapies, fluids, and supportive care.

“We visited her almost every day,” said Paule. “She would get so excited to see us. I think that gave her a lot of willpower to continuing fighting.”

Riley’s left eye was removed during her hospitalization, and she was placed on a feeding tube when she was unwilling to eat. She also began being treated by Ronald Koh, DVM, MS, DACVSMR, CVA, CCRV, CVCH, CVFT, CCRP, CVMMP, and Sayaka Shiomitsu, DVM, who used passive modalities such as acupuncture and range of motion exercises.

Riley was eventually moved to inpatient/outpatient care, with weekends at home, over the next several months, leading to various levels of outpatient care as they continued to provide her with antifungal medication and rehabilitation exercises. She was also given a home-cooked diet plan from the nutrition service at UC Davis that was appropriate for her kidney disease. Riley showed signs of enjoying the new diet and began to gain the weight needed to remove the feeding tube.

“We never second-guessed anything we had to do throughout the process,” Paule said, in the release.¹ “We even moved from a second-floor apartment to one on the first floor to ease getting Riley outside, since our building doesn’t have an elevator.”

As her rehabilitation progressed, Riley became strong enough to move herself with her front legs. Because of this, it was suggested that she would be a good candidate for a wheelchair, and Riley adapted to the wheelchair with "great success." Riley’s owners also began to notice that her hind legs were moving, something they had not seen in weeks.

“When we told [Koh], he said to us, ‘We’re going to get her walking again,’” said Paule.¹

The team continued Riley’s rehabilitation sessions and were able to work to her walking with assistance on the underwater treadmill. She gradually improved her mobility and strength and by October 2023, Riley was able to support herself while standing and walking with support. Then in late November 2023, she was walking on her own and no longer needed her wheelchair and the antifungal medication worked to ease the compression on her spinal column.

“Her vertebra are still not normal, but they have remodeled and stabilized, easing the compromising of her spine,” said Michalak.¹ “While we’re unlikely to cure Riley of the infection, we’re stopping it in its tracks and keeping it from causing further damage to her vertebra and kidneys.”

The team at UC Davis believes Riley will stay on the antifungal medication for the rest of her life. However, with a year since her first visit to UC Davis, Riley appears to be winning her battle against this disease.

“She’s like a completely different dog now,” Lan concluded.¹ “Her personality has changed, and she has different reactions to little things like receiving scratches that we’ve never seen before. It’s like she knew she got a second chance at life.”

Reference

1. Dog with Fungal Infection Beats Overwhelming Odds. News release. UC Davis College of Veterinary Medicine. September 23, 2024. Accessed September 24, 2024. https://www.vetmed.ucdavis.edu/news/dog-fungal-infection-beats-overwhelming-odds
2. Weir M. Aspergillosis in Dogs. VCA Animal Hospitals. Accessed September 24, 2024. https://vcahospitals.com/know-your-pet/aspergillosis-in-dogs#:~:text=The%20deadliest%20form%20of%20aspergillosis