Valley fever can present itself differently in different dogs. Normally a vet wants to see 2 straight negative titers before they take them off the meds, so am curious as to why this dog had been taken off. Usually once they are free of the disease, they are immune to it, it doesn't return. The drug of choice right now is Fluconazole, it's relatively inexpensive (I was paying around $60/month when one of my dogs was on it), it may be more since the dog in question is so large. His present titer is low, which is good, but sometimes even with a low titer, some dogs are very symptomatic. Like I said, they are all different. Most cases of VF are treatable, some dogs need to be on the Fluconazole for life, some get over it and are able to stay off the meds, in my only experience with it with my dog, his case got very severe and it went into his eyes. I have a friend that has dealt with numerous cases, most were successfully treated and the dogs are fine or went on to live normal, happy lives. You are right to be cautious in taking on this dog, there's no telling how severe his symptoms will become, but if you like the dog and can afford the meds, chances are he will recover, most do eventually. Hope that helps.....