Use of potassium iodide, amphotericin B, and terbinafine has been described in the cutaneous form.
Aggressive surgical resection is the treatment of choice for pythiosis in dogs and cats. Because it provides the best opportunity for cure, complete excision of infected tissue should be pursued whenever possible. When cutaneous lesions are limited to a single distal extremity, amputation is often recommended. In animals with gastrointestinal pythiosis, segmental lesions should be resected with 5-cm margins whenever possible. Unfortunately, in many dogs pythiosis is not diagnosed until late in the course of disease, when complete excision is not possible. In addition, the location of the lesion may prevent complete surgical excision.
Medical therapy for non-resectable pythiosis is usually unsuccessful. However, clinical and serologic cures have been obtained using antifungal drugs in a small number of dogs with pythiosis.
An immunotherapy product derived from antigens of P. insidiosum has been used successfully to treat pythiosis in horses and people.