Ringworm is difficult and confusing to deal with — you're fighting an invisible enemy, often with invisible weapons. So I thought I should share a few things I learned, in hopes of helping others who are dealing with ringworm, especially in a multicat household.
I'm sorry this is so long, but I suspect that people who are reeling from ringworm will read it anyway!
1. Get going. If ringworm is suspected and a culture is done, start treatment right away. Don't wait (up to 3 weeks) for the culture results. Time's a-wastin' — don't let the spores keep spreading for weeks.
While your vet probably won't recommend starting oral meds before you have a diagnosis (they can have bad side effects), you can start treating the cats with lime-sulfur dips, which are disgusting but not dangerous. The lime-sulfur kills spores in the fur and that keeps them from spreading through your home, to other animals, and to you. If you're concerned about isolating infected cats, lime sulfur can make that unnecessary.
Ringworm is airborne. Chances are good that all of your cats and your whole house have been exposed by the time you find a lesion on someone. You can also start putting antifungal cream on those lesions. While this may not be a very effective treatment, a cream will at least coat the area and help keep the spores contained.
Also: begin your housecleaning regime NOW, which will further reduce the spore population. More on this, below.
2. Don't obsess. Avoid over-Googling "ringworm" on the Internet. Along with all the varying treatment approaches, there's a ton of misinformation, useless products for sale, and scary stuff I wish I hadn't read. Ringworm may be gross, but at least it is not deadly. Deep breaths.
Here's the best source of info I found, by one of the leading vet experts on dermatophytosis: http://www.giveshelter.org/resources/dermatophyte.pdf
Although this info is geared to shelters, it gives clear, useful, up-to-date advice about how to diagnose, treat, and cope with the fungus.
I found help, encouragement, kindness, and commiseration here on TheCatSite! Discovering this community was the silver lining of my ringworm odyssey.
3. Clean. A LOT. The PDF above gives commonsense cleaning advice. Much of what you'll read elsewhere tells you to soak everything in your house in 10% bleach solution, rip out ductwork, and toss carpeting — which isn't practical for most of us. If you don't live in a kennel, you'll need a more doable approach, and you'll find some hints here. If you can't kill the spores with bleach or a blowtorch, you need to gather them up and dispose of them, as you would with dust mites or other allergens. Think of ringworm spores like that, and you'll understand what you need to do.
For me, it meant sending my carpets out to be cleaned, sanitized, and stored for the duration. I also removed, washed, and stored curtains, pillows, bedskirts, and other textiles, to make daily cleaning easier. I covered my upholstery with Indian bedspreads and washed them often, drying them in a hot, steamy, condensation dryer to kill spores. I dusted my ceiling molding and dry-swiffered my walls, doors, and windows once a week.
I wiped down everything in the apt with a damp microfiber cloth I rinsed often in very hot water. And I vacuumed my floors daily and damp-mopped them weekly.
I also vacuumed upholstery, including the undersides of the sofa, chairs and boxsprings, where my kittens would go. I hate cleaning, but one does need an outlet for all the nervous energy that ringworm anxiety generates.
On the advice of people here, I bought Health Laundry Additive and Disinfectant from RevivalAnimal.com. It contains a controversial fungicide/disinfectant called Triclosan (Vibax), found in everything from Dial soap to toothpaste, that may cause cancer. I didn't care: I put it in our laundry and sprayed a mist of it all over everything in the house a few times. Then I stopped. I don't know if it worked or not, but it made me feel like I was fighting fire with fire.
4. You need a serious vacuum cleaner. My vet's "Ringworm Fact Sheet," which was copied from popular sites on the Internet, recommended buying a cheap vacuum cleaner, tossing the bag every day, and throwing out the vac after treatment ended. This seems very wrong: a cheap vacuum will suck in spores — and then blow them back into the air in the exhaust. You need a really good vac, like a Miele, which has self-sealing, 9-layer bags and a HEPA filter that filters particles a fraction of the size of m. canis spores. A Miele actually purifies the air as you vacuum. And you don't have to toss the bags, either because they seal themselves when you turn off the vac. I'm replacing my HEPA filter now that we're clear. Most Miele dealers sell refurbs at good prices.
5. Treat ALL animals at once — and do everything at the same time. This means oral meds (after the diagnosis), topical cream, and dips for everyone together — and you are cleaning the whole time, so that you're attacking the monster from every angle. If you follow the plan outlined in the PDF above, you may not have to clip your cats — and can start culturing your cats WEEKS sooner than most vets recommend, and this will save time and money in the long run. It might help to show your vet the PDF — I was lucky that mine knew all about Dr. Moriello's work and uses her protocol. (Some variation seems to be okay: in our 4-cat household, we had all the cats dipped once, not twice a week, in the more dilute concentration, for example.)
6. Use the right medications. Don't fall for miracle products you read about online that aren't backed up by scientific research. Don't use bleach on your cats. Don't use griseofulvin: it's dangerous and there are equally effective, safer alternatives. Don't use generic itraconazole, use the patented Sporanox, which is more effective. Or use generic Lamisil (terbinafine), which is relatively new. It is also effective, less expensive, safer, and you only need to dose for 2 weeks.
We got discounts on our Sporanox (for little kittens) and terbinafine (for larger kittens and cats) from CVS with our AAA card.
Use lime-sulfur dip even though you hate it. The cats don't seem to mind, and although it reeks, it works! I was less allergic to the Vet Solutions brand than the DermaPet stuff. I was blessed to find a groomer to do it for us.