Evaluation of ketoconazole and itraconazole for treatment of disseminated cryptococcosis in cats

Linda Medleau From the Department of Small Animal Medicine (Medleau, Greene) and the Athens Diagnostic Laboratory (Rakich), College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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 DVM, MS
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Craig E. Greene From the Department of Small Animal Medicine (Medleau, Greene) and the Athens Diagnostic Laboratory (Rakich), College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Pauline M. Rakich From the Department of Small Animal Medicine (Medleau, Greene) and the Athens Diagnostic Laboratory (Rakich), College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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 DVM, PhD

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SUMMARY

During the first part of a study, cats were inoculated with Cryptococcus neoformans via the following routes: intradermal, intranasal, iv, and intracisternal. Only use of the iv route of inoculation consistently induced disseminated cryptococcosis. In the second part of the study, disseminated cryptococcosis was experimentally induced in cats via iv inoculation of C neoformans. One month after inoculation, 3 cats were treated with ketoconazole (10 mg/kg of body weight/d) and 3 cats were treated with itraconazole (10 mg/kg/d) for 3 months. One of the ketoconzole-treated and 2 of the itraconazole-treated cats also had cryptococcosis of the cns when treatment was begun. During treatment, serum cryptococcal antigen titer progressively decreased in all cats. Abnormalities in cbc values or the serum biochemical profile were not found in any cat during treatment. However, all ketoconazole-treated cats became anorectic and lost weight. Side effects were not seen in itraconazole-treated cats. During the 3-month posttreatment observation period, all cats remained healthy. At necropsy, histologic evidence of cryptococcosis was not found in the 3 ketoconazole-treated cats or in 2 of the itraconazole-treated cats. In the third itraconazole-treated cat, cryptococcal organisms were found in the kidneys.

SUMMARY

During the first part of a study, cats were inoculated with Cryptococcus neoformans via the following routes: intradermal, intranasal, iv, and intracisternal. Only use of the iv route of inoculation consistently induced disseminated cryptococcosis. In the second part of the study, disseminated cryptococcosis was experimentally induced in cats via iv inoculation of C neoformans. One month after inoculation, 3 cats were treated with ketoconazole (10 mg/kg of body weight/d) and 3 cats were treated with itraconazole (10 mg/kg/d) for 3 months. One of the ketoconzole-treated and 2 of the itraconazole-treated cats also had cryptococcosis of the cns when treatment was begun. During treatment, serum cryptococcal antigen titer progressively decreased in all cats. Abnormalities in cbc values or the serum biochemical profile were not found in any cat during treatment. However, all ketoconazole-treated cats became anorectic and lost weight. Side effects were not seen in itraconazole-treated cats. During the 3-month posttreatment observation period, all cats remained healthy. At necropsy, histologic evidence of cryptococcosis was not found in the 3 ketoconazole-treated cats or in 2 of the itraconazole-treated cats. In the third itraconazole-treated cat, cryptococcal organisms were found in the kidneys.

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