How do we find affordable antifungals for our dogs with coccidiomycosis?

Question: 

Dog owners in the Southwest are in crisis. How do we find affordable antifungals for our dogs with coccidiomycosis? Are there any alternative therapies that work?

Answer: 

Anti-fungal therapy for coccidioidomysosis involves the use of itraconazole or fluconazole.  Currently there are no studies that demonstrate improved efficacy of one drug over another (as in other fungal diseases such as histoplasmosis or blastomycosis where itraconazole has been shown to be much more efficacious).  In general, itraconazole is preferred, except in cases where the nervous system is involved in which fluconazole would be the preferred option.  

Fluconazole is a much less expensive medication than itraconazole as it is available in generic form and thus would be a potential alternate choice.  Itraconazole may be found at lower prices through Canadian pharmacies, and a prescription must still be obtained for these medications.  Unfortunately the need for long term treatment (6-12 months in some cases) adds to the expense of treating fungal disease.