The reasons for routine labwork while being treated for Valley Fever are varied but necessary and is really not something to mess around with or cut corners on. VF untreated can and will kill your dog.
1:32 VF titer tests is rather significant. Ideally you want 1:4 or less than 1:4 for a period of time before you can even THINK about weaning off the antifungal - even off the meds you would be wise to recheck the bloodwork - including a VF test about 3-6 months after stopping to make sure there is not a resurgence of the disease. If the titer remains high in spite of being on antifungals - time to consider changing the antifungal.
As for lack of symptoms - that is another reason for labwork - as the labwork can show us what the body is doing and how it is responding to the meds since the symptoms can be very subtle to begin with.
At our clinic - we first test 4 to 6 weeks after starting antifungal - we do Chemistries/CBC to make sure the antifungal is not wreaking havoc with the liver as they can be liver toxic.
Second test - about 3-4 months later - same reason as above (in addition to seeing if the proteins usually affected by the VF are changing/decreasing) only this time we would normally add on a VF titer test to see if there has been any positive change.
We would then usually rec'd labwork every 4-6 months while on antifungals until we get a negative result, resolution of symptoms with a 1:4 or less than 1:4 titer, or both. As long as you are on an antifungal - labs need to be done at least every 6 months or so as you do not want to kill your liver in the process or dmage it to a point of no return.
Sadly some dogs will have to be on low doses of anitfungals for life as their immune system can not build a proper response and heal itself - especially if it settles in the brain, bone or an organ. And yes - that means lab work at least once if not twice a year.
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