🔍 What Is Coccidioidomycosis (Valley Fever)?

Coccidioidomycosis—also called Valley Fever—is a fungal infection caused by Coccidioides immitis or C. posadasii, endemic in sandy soils of the U.S. Southwest, northern Mexico, and parts of Central/South America :contentReference[oaicite:3]{index=3}. Cats inhale microscopic spores that settle in the lungs and may spread through the bloodstream.

⚠️ Who’s at Risk & How Infection Occurs

• Outdoor cats in endemic regions: Disturbance of dry soil during rain/dust storms releases spores :contentReference[oaicite:4]{index=4}.
• Young or outdoor-exposed cats: Greater activity) and inhalation risk :contentReference[oaicite:5]{index=5}.
• Immunocompromised individuals: Stress, illness, or predisposed breeds increase risk for dissemination :contentReference[oaicite:6]{index=6}.

🚩 Clinical Signs to Watch For

• Respiratory: Chronic cough, difficulty breathing, fever, lethargy, appetite loss :contentReference[oaicite:7]{index=7}.
• Disseminated signs (~50% of cases): Skin lesions, draining wounds, musculoskeletal pain, lameness, neurological signs (seizures, weakness), eye issues, blindness :contentReference[oaicite:8]{index=8}.

🔬 How Veterinarians Diagnose It

• History & exam: Lives in endemic zone + chronic signs :contentReference[oaicite:9]{index=9}.
• Blood work: Antibody titers (IgM/IgG), chemistry/CBC to assess organ function :contentReference[oaicite:10]{index=10}.
• Imaging: Chest X-ray or CT for lung nodules or pleural disease; advanced imaging for lesions elsewhere :contentReference[oaicite:11]{index=11}.
• Microbiology: Biopsy or skin lesion cytology for characteristic spherules; airway wash for pulmonary diagnosis :contentReference[oaicite:12]{index=12}.
• Diagnosis by response: Sometimes supportive diagnosis if antifungal therapy leads to improvement :contentReference[oaicite:13]{index=13}.

🛠️ Treatment & Medical Management

1. Antifungal Medications

• Fluconazole is the first-line choice (10 mg/kg once daily)—high bioavailability, well tolerated :contentReference[oaicite:14]{index=14}.
• Itraconazole for tissue-invasive or bone/joint involvement; serum level monitoring may be necessary :contentReference[oaicite:15]{index=15}.
• Ketoconazole has been replaced by triazoles due to safety and efficacy issues :contentReference[oaicite:16]{index=16}.
• Amphotericin B reserved for severe or refractory cases—nephrotoxicity caution :contentReference[oaicite:17]{index=17}.

2. Supportive Care

• Oxygen and IV fluids for respiratory compromise :contentReference[oaicite:18]{index=18}.
• Pain management, anti-inflammatories, appetite stimulants, liver-supportive therapy as needed.
• Regular bloodwork to monitor liver function during prolonged therapy :contentReference[oaicite:19]{index=19}.

3. Treatment Duration & Monitoring

• Typical therapy lasts months to over a year; continue 1–2 months after antibody titers normalize or clinical signs resolve :contentReference[oaicite:20]{index=20}.
• Recheck with imaging and serology every 3–6 months :contentReference[oaicite:21]{index=21}.

🏡 Prevention & Environmental Control

• Keep cats indoors during dust storms or dry conditions in endemic areas :contentReference[oaicite:22]{index=22}.
• Reduce indoor/outdoor dust; use air filters to minimize spore exposure.
• Prevent outdoor digging; wipe paws after exposure.
• Early vet review if respiratory signs appear in at-risk cats.

📅 Prognosis & Follow-Up

• Localized lung disease: Good prognosis—recovery in ~90% with treatment :contentReference[oaicite:23]{index=23}.
• Disseminated disease: Guarded—relapses common; long-term follow-up essential :contentReference[oaicite:24]{index=24}.
• Relapse risk if therapy is shortened prematurely.
• Lifelong monitoring with bloodwork and imaging may be needed.

📝 Quick Reference Table