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Today's VeTerinary PracTice | november/december 2015 | tvpjournal.com Journal club 98 Duration of treatment for canine blastomycosis is long, and a test that could help determine when to discontinue antifungals without the need for more invasive diagnostics would be helpful. An antigen test detecting fungal cell wall galactomannan is highly sensitive and specifc for the initial diagnosis of blastomycosis. This prospective study sought to monitor urine and serum Blastomyces dermatitidis antigen concentrations in 21 dogs with newly diagnosed disease until remission, and in 27 dogs newly in remission, for one year after cessation of antifungals. Study ReSultS • At diagnosis, urine and serum antigen concentrations for Blastomyces were 100% and 90.9% sensitive, respectively. • During treatment, the urine antigen test was more sen- sitive and specific than serum antigen concentrations. • There was a slight positive correlation between baseline urine antigen concentration and time to remission. • At drug discontinuation, 48% of dogs had measureable Blastomyces urine antigen concentrations. There was no statistical correlation between this finding and later clinical relapse. • After treatment, urine and serum antigen concentrations were nearly 100% specific for clinical relapse, with sensitivities of 71% and 43%, respectively. ConCluSionS • While not recommended as the only monitoring tool, urine Blastomyces antigen concentrations can be helpful for monitoring dogs' clinical progression; testing was highly sensitive for disease at diagnosis and during treatment and highly specific for relapse. • Baseline urine antigen concentration may help predict time to clinical remission, but additional studies are needed to more fully elucidate this. • Urine antigen testing should be performed instead of serum testing for improved sensitivity and specificity. Serum and Urine Blastomyces Antigen Concentrations as Markers of Clinical Remission in Dogs Treated for Systemic Blastomycosis Foy DS, Trepanier LA, Kirsch EJ, Wheat LJ. J Vet Intern Med 2014; 28(2):305-310. There are several reports of cats developing toxoplasmosis while receiving immunosuppressive cyclosporine therapy. However, a defnitive relationship between cyclosporine and recrudescence of toxoplasmosis or worsened initial infection has yet to be substantiated. This masked, randomized study evaluated the effect of anti-infammatory cyclosporine (7.5 mg/kg PO Q 24 H) on cats experimentally infected with Toxoplasma gondii . Study ReSultS • Cats were divided into 3 groups for 126 days, and all were infected with T gondii on day 42: control group cats ( n = 10), cats that were infected and then received cyclosporine starting on day 84 ( n = 10), and cats that received cyclosporine throughout the study ( n = 10). • Clinical signs were prolonged and more severe in the cats already receiving cyclosporine when infected with T gondii . • Three cats that were already receiving cyclosporine when infected with T gondii died or were euthanized: One died of systemic toxoplasmosis; this cat had a higher cyclosporine level than the remaining cats. A second died of pancreatitis; this cat had T gondii zoites identified in the pancreatic duct epithelial cells. The third cat was found dead. • Recurrent oocyst shedding was not detected in any cat that received cyclosporine after being infected with T gondii . ConCluSionS At this dose, cyclosporine appears unlikely to reactivate toxoplasmosis in previously exposed cats or prolong oocyst shedding in cats infected while receiving the drug. T gondii naïve cats that received cyclosporine at high levels may be at higher risk for severe disease, but additional studies are needed. Efforts should be made to limit cats' exposure to T gondii while receiving cyclosporine, such as preventing the cat from hunting and avoiding raw diets. Effect of Oral Administration of Cyclosporine on Toxoplasma gondii Infection Status of Cats Lappin MR, VanLare KA, Seewald W, et al. Am J Vet Res 2015; 76(4):351-357. Information on clinical disease from vector-borne infec - tions in cats is lacking. Several studies outside the Unit- ed States have described natural infection of cats with Anaplasma phagocytophilum , but only one small study described the disease in the U.S. The aim of this retro - spective study was to describe the clinical and historical fndings of cats positive for A phagocytophilum DNA by polymerase chain reaction (PCR) on whole blood. Anaplasma phagocytophilum Infection of Domestic Cats: 16 Cases from the Northeastern USA Savidge C, Ewing P, Andrews J, et al. J Feline Med Surg 2015; epub ahead of print.