Use of corticosteroids for treating dogs with airway obstruction secondary to hilar lymphadenopathy caused by chronic histoplasmosis: 16 Cases (1979-1997)

Objective - To examine use of corticosteroids in treating dogs with airway obstruction secondary to hilar lymphadenopathy caused by chronic histoplasmosis. Design - Retrospective study. Animals - 16 dogs. Procedure - Records for dogs with airway obstruction examined from January 1979 through December 1997 were reviewed. Dogs were included in the study if they had hilar lymphadenopathy documented radiographically and bronchoscopically, had serum antibodies against Histoplasma capsulatum, and did not have organisms in any cytologic or histologic samples. Dogs were assigned to groups on the basis of treatment given (5 dogs, corticosteroids only; 5 dogs, corticosteroids and antifungal medication; 6 dogs, antifungal medication only). Results - Clinical signs resolved in < 1 week in dogs treated only with corticosteroids. In dogs treated with corticosteroids and an antifungal medication, improvement was evident in a mean of 2.6 weeks. In 5 of 6 dogs treated with only an antifungal medication, clinical signs resolved in a mean of 8.8 weeks. Dogs receiving corticosteroids did not develop active or disseminated histoplasmosis. Clinical implications - Corticosteroids can be used successfully in the treatment of dogs with hilar lymphadenopathy secondary to histoplasmosis. Affected dogs must be carefully evaluated for active infection. Specimens obtained by means of bronchoalveolar lavage, tracheal washing, or other methods should be examined to exclude the possibility of an active infection, which could result in corticosteroid- induced dissemination of disease.