6 Things I Learned from Our Ringworm Plague (book length....)

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bunnelina

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Oh, I'm so sorry! When we had ringworm, I went to the doctor thinking I had it on my neck but it turned out to be an ordinary rash, probably from stress. I used Lamisil or something on it anyway.

A doctor might be able to prescribe something stronger to treat it topically but I don't think they give people need oral meds... unless they are extremely furry people!  


Sending good wishes your way....  
 

pushylady

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My sister got it as a teenager and I remember her just using a cream, not taking anything orally for it.
 

kendrickthecat

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Good evening fellow ringworm battlers, I have a dilema and need your advice on a technical and practical stance.

Dilema goes as follows, 

After much debate, a month and a half ago my wife and I decided to take in a stray kitten that we found in our front yard. We named our prince "Kendrick".

We did the necessary shots and FIV and leukemia tests, Kendrick is positive for FIV, which I had no clue existed until. a month ago...we debated if this was the road we wanted to go down, but decided that Kendrick is part of the family, and that you don't just run away at the first sign of adversity.

A 15 days ago Kendrick began to loose a lot of hair and develop a bald spot, I took him in 4 days ago and the vet suspects ringworm, tests are being done as I type this but treatment began as of the day of the vet visit.  

Needless to say my wife and I are scared to high hell, we have no clue when Kendrick became infected or if we are....we are both clear and have no lesions of any kind.  I began house cleaning immediately and seem to have the home under control. My questions are the following.

We have a two story house, all living quarters are upstairs (which kendrick hardly ever visited, 5 times at the most).  Downstairs is open living area and the laundry room.  

QUESTION ONE, WHERE TO KEEP KENDRICK

I have him in the laundry room as it is downstairs and away from all living quarters (we run two A/C systems in the house, I somehow believe keeping him downstairs limits the contamination to living quarters upstairs) 

The downside is that it is the laundry room...would we be better off keeping him upstairs in a spare bedroom instead of the laundry room?  I do keep the laundry room daily and only launder once a week, i believe I have cross contamination in control.

QUESTION TWO, IS IT OK TO KEEP KENDRICK IN A CRATE IN THE YARD WHILE I CLEAN THE ROOM

My vet said to not let Kendrick out of isolation, not even outside.  I did not specify that I would place him in a crate, please advise.

QUESTION THREE, DOES ANYONE HAVE ANY EXPERIENCE WITH FIV AND RINGWORM?

Please advise as to probabilities of recontamination, also, what is a realistic time period for healing.

QUESTION FOUR, WHAT CAN I DO TO MAKE KENDRICK HAPPY?

Having Kendrick locked up breaks my heart, is there anything I can do to make his isolation happier?

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I HAVE MANY MORE QUESTIONS, BUT WILL GO ONE STEP AT A TIME,

Thank you :)
 
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bunnelina

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Welcome to the ringworm thread, KendricktheCat. I'm sorry you are learning that no good deed goes unpunished, but adopting and caring for poor Kendrick will bring you the reward of a lifetime of his love and companionship. And you will get through this mess, you will.

Before I try to answer your questions, please go through this thread and find the links to the ringworm articles on this site and the one to the Dane County Shelter's "ringworm treatment in a nutshell" article based on the work of Dr Karen Moriello. Read up on the current best treatment protocol and the current drugs used, etc. Make sure your vet is familiar with her work. Get some lime sulfur dip (Amazon has it) and dip your kitten. After a couple of dips he will be much less contagious and you can relax somewhat about handling him and possibly rethink the isolation, too. Depending on whether you have carpets and ductwork, and how crazy your cleaning situation has to be, you might decide the isolation is not worth the stress. Not everyone isolates. It's an airborne fungus, not a droplet-spread virus. If you have air circulating through your rooms, ringworm spores are floating along with it. The trick is to eliminate all the dirt and dust you can because ringworm spores can concentrate there, too. A good filtering vacuum and microfiber wipes will help. Dipping helps. Oral meds -- Sporanox for a kitten -- will make him much less contagious with a couple of weeks.

Read up on PCR tests for ringworm if your vet isn't using them. We no longer have to wait weeks for a culture to yield results. You should be getting yours in a couple of days instead. It's a game- changing new development in the ringworm wars.

I'm typing on an iPad so please forgive typos and autocorrect and so on. I'm trapped in a library today.

Your questions:

1. That's up to you. If he's had the run of the house all those weeks, you have a ton of cleaning to do.... Put him in a place where he is safe and happy and ideally has windows to see the world, toys, boxes for playing and so on. Ideally it's not carpeted and easy to clean. Remove textiles and knick knacks and make sure he gets plenty of your company, not just for his sake but so he grows up to be a sociable and cuddly cat. And once you start the oral meds, he should be freed in a couple of weeks, tops. Dipping, as I said, also will make him much less contagious. We live in 800 square and did not isolate our ringworm kitten. It spread to our second kitten but we never got it, nor did our two elderly Persians. I cleaned like mad....

2. Would Kendrick like being outside in a crate? I'm finding that my answers to your questions are all leaning towards making him happy. Unless you live in some humid, brackish place or it's freezing or something equally extreme, I don't see why he can't get some fresh air and a change of scene. He's got ringworm, he can't very well get more. If there are mosquitos, worry about heart worm, I guess. Why is your vet so adamant about the dangers of fresh air?

3. I'm sorry I can't advise you on this one except to say that you want to avoid unnecessary stress. How young is he? It says here try
(Sorry, iPad) that he may have a false positive result from his mother because his own immune system may still be developing. Keep your fingers crossed, it can happen. Basically keep him happy and feed him a premium diet (raw, if you can) and avoid stressing him as much as possible.

4. Your instincts sound great, so follow your heart. If you really think isolation is hell for him, consider alternatives. I don't know if you have kids or other cats in the house, but if you don't, your situation is a lot easier. (Years ago, there was someone here, but not on this thread, who had kids, dogs and 26 cats, plus ringworm, and limited resources. That scenario made me realize I was taking my own situation way too hard. It's a fungus, it's not the apocalypse.) if you decide to isolate him, give him loads of stuff to play with, like boxes, that you can toss later. And spend all the time with him that you can. Consider playing soft music for him when he's alone. Kittens like things they can climb and soft, warm spots to sleep. And things to chase and roll, and chew on. When you aren't feeling heartbroken anymore, you'll know it's all right, you are a born cat person, clearly.

Sorry to drone on, I hope some of it was helpful. Hang in there, and please make sure you have a vet who is up to date on the latest treatment, so you can get through this as soon as possible.

:vibes::vibes:
 
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kendrickthecat

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Bunnelia,

You are so kind to reply to my post, I have to apologize for the typos and errors in punctuation as I was typing in a hurry.

Kendrick has been in ISO for 5 days, he has had two dips in that time and hair has begun to regrow, also, Ken is 8 months old so according to the vet the FIV test was pretty conclusive, we will be testing again at a later date.

We have yet to receive the results in regards to the ringworm culture done, we should be getting that today or tomorrow at the latest.  I have no previous experience with ringworm but hair began to grow back almost immediately, and both me and my wife are clear as of now so I'm hoping it might be something else.

It is my understanding that oral meds are hard on the system and that compiled with the FIV can complicate the situation a bit, I can be wrong in the respect and will have to wait until we get the test results back to see the appropriate course of action.

Kendrick isn't doing very good in ISO.  He has an iPad with videos throughout the day but other than that he has no toys, the vet advised against having a scratching post and toys until the second week of treatment given the possibility or re-infection.  Good news is he'll soon be there and hopefully we can get his a couple of things to toss around. 

Does anyone have any experience with FELIWAY? Does it really calm the cats and make them more comfortable under stressful situations? Would you recommend it?

As far as to where we live, I am in brownsville texas, current climate is mid 80's at the most, a bit humid but nothing unbearable, I would just be for the daily cleaning of the laundry room, I really don't see another option at this moment and will be the course or action I will take.  He will be placed in his carries for a couple of hours outside while I clean (the carrier is built for a large dog, so he has plenty of room in there).

QUESTION, DOES SUNLIGHT KILL RINGWORM, AND IF SO, IN HOW LONG?

I cleaned extensively and placed all furniture outside from 9AM to 6PM on saturday, all our furniture is either plastic, wood, or fiberglass with the exception of our sofa which was washed with a professional machine, then placed in the sun as well, we did roller brush the sofa every day after kendrick was on it religiously before the ringworm was suspected. We have two cowskin rugs which were also washed, sprayed with anti fungal spray and placed outside (they are still there to this date), would that take care of the remaining spores?

QUESTION, IS THE RINGWORM IN THE HAIR ITSELF, OR IS IT INVISIBLE TO THE HUMAN EYE?

If the enemy is invisible, then is our only option to re-mop and swiffer seemingly clean surfaces?  

We have some work to do, but I know we will come out of this.

A quick pic of Kendrick, from the streets to the high life :)

 
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bunnelina

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Oh, he's darling! I hope he has a long and happy life with you.

What oral medication is he getting?  

No TOYS?  Give him some toys. Your vet sounds like a meanie. Toys are cheap; you can always throw them out. I actually laundered a bunch of ours, even mylar balls and anything short of a catnip or furry mouse. Kittens need toys! They need boxes to hide in, too. 

You could get some of those corrugated cardboard inexpensive scratchers and put those around, tape one vertically on a wall or door, and again, toss them when he's out of the slammer. And it sounds like he doesn't need to be there after about two weeks.

I haven't tried a Feliway diffuser because my vet warned me it could trigger my asthma. We use Feliway wipes when some of our cats go to the vet and the others don't recognize them when as they arrive home. This always amazes me — cats are so sensitive to smell that physical appearance seemingly means nothing to them. As far as they're concerned, the cats they've lived happily with for years disappeared for a couple of hours and were replaced by total strangers.  We use the same wipe to rub down all the cats a few times to distribute a common scent on everyone and they all settle down and stop hissing. (Well, not our Harris, but Harris is very special.)  I'm not sure it would be calming for a kitten who is quite naturally high-energy and rightfully upset about being bored and alone. I only know that it's helpful in multi-cat environments when things get tense. You could try it, certainly, and I hope others will chime in here about their own experiences (or look elsewhere on this site), but I don't know how calming it might be for a kitten who is simply alone. 

I recommend that you read  the housekeeping article here on the site  to help you get a handle on how and what to clean. Ringworm spores are invisible, so the trick is to attack them as you would dust mites. While there are ways to kill them — with standing bleach solutions and high heat, you will find it easier to just think about gathering them up and getting rid of them along with all the dust and dirt that gathers in your house, too. Where there's dust and tumbleweeds and dirt, there might be a concentration of spores, too. They are airborne, like pollen and float through our environment all the time. We are around ringworm spores all the time but it's only when it gets out of control, on a kitten or cat with a weak immune system, that there's a problem. 

For cleaning, I recommend swiffering as many surfaces as you can, from ceilings and walls to windows, and also using damp microfiber cloths on furniture. Vacuuming upholstery with a vac like a Miele, with a good HEPA or similar filtration is another important technique, as you'll read in the article. I don't think sunlight makes a lot of difference although baking something in hot sunlight might kill spores. But the most important steps for those rugs might be airing them out and also vacuuming the heck out of them, too. Ringworm likes damp, warm, humid environments. 

If you look backward on this thread, you will see some posts from recent months with updated info about Dr. Moriello's findings on cleaning. They should be enlightening. Apparently, one of the real purposes of cleaning is to prevent false positive cultures. Your cat might be negative, thanks to meds and dips, but is picking up spores in a "dustmop" way because they are still in the environment. It's really all about good, meticulous housekeeping rather than trying to kill the spores. Just eliminate dust and dirt and other particles and you'll be eliminating the ringworm, too.

I hope this is helpful, and I hope you will hear from some of the others here, who have more recent experience with the ringworm plague than I do, and who may be more up-to-date on the latest research on cleaning and so on. Hang in there. This will be over soon, I hope!
 

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I found ringworm on  my neck.  Treating with Monistat 7 topically. 

I had it 10 years ago and can't remember if I need to go to DR and treat orally as well ??
Isn't Monistat for yeast infections? You might want to try one of the creams for foot fungus, like Lamisil (terbinafine). I know some folks in our foster program use Lotrimin and clotrimazole.

My understanding is that if you should go to the doctor if either you have multiple lesions OR the lesion doesn't respond to topical treatment within a couple of weeks. The doc will probably prescribe a prescription-strength topical (Naftin is popular) and maybe an oral med. People take the same oral meds as animals, so it would probably be terbinafine or fluconazole, maybe griseofulvin.
 

baileytc

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Kendrickthecat,

Good for you and your wife for adopting a FIV+ cat! He's a very handsome boy.

FIV+ cats can live long, healthy lives, and they can also live safely with other cats. Some vets are not up on the research and will tell you they must be only cats so they can't transmit the disease. That's not true. FIV is transmitted only through deep bite wounds. Let me know if you want more info.

QUESTION ONE, WHERE TO KEEP KENDRICK

Anyplace you can clean easily and where he's happy or can be made happy. The laundry room is a good choice if you don't have a spare bathroom.

QUESTION TWO, IS IT OK TO KEEP KENDRICK IN A CRATE IN THE YARD WHILE I CLEAN THE ROOM

Sure, as long as he's not left in the sun and is treated with a flea preventative like Advantage or Revolution. Not sure what your vet is thinking, but there's no reason not to put him outside in a crate for a while as you're cleaning his room. I did the same with one of my cats when she was in isolation in the bathroom suspected of having ringworm. 

QUESTION THREE, DOES ANYONE HAVE ANY EXPERIENCE WITH FIV AND RINGWORM?

Please advise as to probabilities of recontamination, also, what is a realistic time period for healing.

I haven't had personal experience with it, but I volunteer with a rescue that often deals with FIV+ cats. FIV+ cats have a compromised immune system, so it's likely that Kendrick will have a tougher time getting over ringworm than an FIV- cat. Typical time periods for healing vary. Most cats are on meds for 21-28 days (depending on the meds). To verify a cure, the vet should do two cultures or PCR tests at least a week apart. My vet likes to do the first at the point at which the med is likely to have left their system and the next a week or two later. A culture should be kept for 14-21 days before it can be declared negative. PCR test results come back in 2-3 business days.

QUESTION FOUR, WHAT CAN I DO TO MAKE KENDRICK HAPPY?

Just what you would do if he was able to be with you. Give him toys, spend time with him, pet and cuddle him. Best practice among the fosters in my rescue is to wear a separate set of clothes and socks in the iso room. I also wear disposable gloves to avoid lots of handwashing. I also try to make my visits to the iso room at the beginning and end of the day and take showers afterward. If you can't shower, then just wash exposed areas very well. Ringworm spores take 2-4 hours to attach to the skin and begin to grow.

I have no previous experience with ringworm but hair began to grow back almost immediately, and both me and my wife are clear as of now so I'm hoping it might be something else.

It's unlikely that ringworm would self-heal so quickly, so it may be something else. My cats have been having hair loss in small areas, and all the tests and cultures have been negative so far. My vet is chalking it up to itchy skin from the dry central heat that was on all winter. Kendrick will also be more prone to various infections, including skin infections, due to the FIV.

It is my understanding that oral meds are hard on the system and that compiled with the FIV can complicate the situation a bit.

Not necessarily. All ringworm meds are hard on the liver, but if Kendrick's liver function is normal, then his system may be able to handle it. Your vet can do basic bloodwork to check his liver function.

Kendrick isn't doing very good in ISO.  He has an iPad with videos throughout the day but other than that he has no toys, the vet advised against having a scratching post and toys until the second week of treatment given the possibility or re-infection. 

Not sure what your vet is thinking. Kendrick can have any toys that can be thoroughly washed or that you're willing to throw away. Go to the dollar store (do you have Dollar Tree?) and get a package of ping pong balls. Cats LOVE ping pong balls, and you can either toss them or wash/disinfect them. Dollar Tree has other cheap toys, or you can find them on sale at Petsmart or Petco. Any plastic toys (balls, etc.) can be disinfected and re-used. Buy a couple of cheap cardboard scratchers at the pet store and then replace them periodically. 

Does anyone have any experience with FELIWAY? Does it really calm the cats and make them more comfortable under stressful situations? Would you recommend it?

I've used the diffusers and the spray. I've had lousy results with the spray and mixed results with the diffusers. I think the best thing to help him be happier would be giving him toys and spending as much time with him as you can.

QUESTION, DOES SUNLIGHT KILL RINGWORM, AND IF SO, IN HOW LONG?

Yes, but it's unknown how long it takes to kill it. Fungus in general hates sunlight, so leaving anything contaminated outside in the sun should help kill the spores. But you can't rely on sunlight alone. Clean and then disinfect the contaminated surface with one of the products mentioned in Dr. Moriello's study on cleaning products. I use Accel (accelerated hydrogen peroxide). Other effective products include a 10% bleach solution, Clorox Clean-Up, and Formula 409. All require a clean, dry surface and 10-minute wet contact time (meaning you will need to reapply the disinfectant if it dries before 10 minutes has elapsed).

QUESTION, IS THE RINGWORM IN THE HAIR ITSELF, OR IS IT INVISIBLE TO THE HUMAN EYE?

It's not visible to the eye. The spores attach to the cat hair, and removing the cat hair will help to remove the spores or at least strip them of a protective coating.

If the enemy is invisible, then is our only option to re-mop and swiffer seemingly clean surfaces?  

The most effective course of action is to remove the spores via swiffer, mopping, sticky rollers, etc. Then disinfect the surface to kill whatever is left. Disinfectants will likely kill about 80% of the spores on the surface, so you want to remove as many spores as possible before disinfecting.

Here is a transcript of a speech by Dr. Moriello: http://www.winnfelinefoundation.org...ial-skin-diseases-transcript-(1).pdf?sfvrsn=0. She talks about "reasonable" confinement for cats/kittens with ringworm, stressing that cats are part of a family and need that interaction with people--especially kittens. She also talks about environmental contamination, and some of what she says seems to be controversial but she's probably the leading researcher working in the field so what she says carries some weight:

"The major problem with environmental contamination is not transmission of the disease. This is the only documented case report I could find of transmission from environment to a kid. I have seen it in shelters when people have grabbed one infected cat and then grabbed another, or have used a contaminated clipper, but just a cat in an environment, even in our experimental studies where the rooms were contaminated, they did not get infected. They needed cat-to-cat transmission. So, the problem with environmental contamination is it makes it difficult to interpret when your cat has a cure, and you end up overtreating."

"So, myth-busting. This is in a book, out of a textbook, for veterinarians. Once you get in the house, you cannot get rid of it. That is so false, and this is what really freaks clients out is you tell them the cat, that, you know, there is environmental contamination and their mind immediately goes to...what is on TV right now? The black mold of everything. All these terrible storms, all this terrible damage. Ringworm spores just lay on the ground like M&M’s, waiting to get swept up. They cannot multiply in the wood, in the environment, anywhere. They cannot do that. They can only live in cat hair, so unless you are living in a house with cat hair like the old lady who lives in a shoe, it is not going to multiply! It is just going to lay there."

Per another study by Moriello: Anything that can be washed can be decontaminated. Wash twice on a long wash cycle (at least 14 minutes), and don't overload the washer to ensure good agitation. You can use any temp water, any detergent, and dry on any temp heat. Bleach is not necessary.

Keep us posted on Kendrick's progress!
 
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baileytc

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A couple of info updates:

--Apparently, some vets aren't familiar with the PCR test for ringworm. It appears to be available only through IDEXX, which is one of the primary labs used by vets. Vets that use other labs, such as Antech, are less likely to be aware of the ringworm test. Here is a link to the test info: https://www.idexx.com/files/small-a...reference-laboratories/ringworm-pcr-panel.pdf

--Dr. Moriello just published her study on decontaminating carpet! Here's the abstract (http://jfm.sagepub.com/content/early/2016/02/29/1098612X16634390.abstract)

Abstract


Objectives  The objective of this study was to evaluate the efficacy of vacuuming and three carpet cleaning methods for the removal of Microsporum canis  spores and hairs from experimentally contaminated carpets.

Methods  Sterile Berber carpeting was artificially contaminated with naturally infectiveM canis  hairs and spores. Carpets swatches were vacuumed for 10 s, 30 s and 60 s, and then cultured. Three carpet cleaning methods were evaluated on area rugs experimentally contaminated with infective material: a beater brush carpet shampooing, beater brush carpet shampooing post-disinfectant application and hot water extraction. Home cleaning products labeled as having efficacy against Trichophyton  species were used in addition to 1% potassium peroxymonosulfate. Carpets were cultured at 24 h, 48 h and 7 days after cleaning. Good efficacy was no detectable spores at post-cleaning culture.

Results  All pretreatment carpet samples were culture positive for M canis  (>300 colony-forming units [cfu]/site). Vacuuming did not decontaminate carpets but did remove intact hairs. Spores were not detected by wipe samples after two washings with an upright beater brush carpet shampooer or pretreatment with a disinfectant prior to carpet shampooing. Carpets cleaned with one hot water extraction technique had a decrease from 300 cfu/site to a mean of 5.5 cfu/site at 24 and 48 h post-cleaning and 2 cfu/site at day 7. The use of disinfectants was associated with odor, even when dry, and permanent discoloration. Hot water extraction cleaning was associated with the fastest drying time and no discoloration.

Conclusions and relevance  Carpets exposed to M canis  can be disinfected via carpet shampooing or hot water extraction cleaning. Vacuuming of carpets is recommended to remove infective hairs. For homes, exposed carpeting can be decontaminated by routine washing with a carpet shampooer (twice) or hot water extraction. Use of pretreatment with a disinfectant is recommended when a high level of overall decontamination is needed in an animal facility with necessary carpeted surfaces (eg, entryway carpet mats).
 

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I've been dealing with ringworm since the end of October. We rescued a kitten from outside. She was treated for fleas, got her shots and blood tests, and was given the OK to run around with her new cat/human family. She has long hair so both me, my husband and the vet did not see any signs of ringworm until it was too late! We both got it, and our  other rescue kitties did as well. It was gone for the past month but my 17 year old got it again. (she's prone due to illness/age). Has anyone here tried spraying furniture with apple cider vinegar mixed with water? All the Lysol made my throat hurt, and I'd like to try a safer approach. I read on the internet that this can work, but I don't know anyone who's tried it. Reading all of your stories makes me feel so much better!! I have been losing my mind these past few months!
 
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bunnelina

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Wow, so you had two or three negative cultures and the ringworm came back? I'm not sure we've had that report here. This is probably this thread's collective Worst Nightmare and I'm sorry you are experiencing it!

I'm not sure what you're reading on the Internet, but if you want the most effective treatment methods, check out all of Dr. Karen Moriello's research. You can start here.  She is considered the veterinary expect for ringworm in cats, and her protocol includes oral meds (Sporanox, terbinafine) combined with lime-sulfur dipping, culturing (newer PCR tests can give results in days rather than weeks) and, of course, a thorough housecleaning regimen. It's important to clean correctly and strategically so you aren't wasting your time. And, unlike the info sheets some vets hand out, her plan recognizes that we all don't live in a kennel and we therefore can't bleach the heck out of every surface in our home. Her plan is more about gathering up the spores, as one would with dust mites — so vacuuming (with a HEPA filter or similar), and wiping everything down with microfiber or swiffer cloths to trap spores rather than kill them. Lots of laundry, and targeted disinfecting where it's most necessary.

I'm not sure Lysol kills ringworm spores — remember, it's a fungus, not bacteria or a virus. Cider vinegar won't do a thing, however. I suggest you look at baileytc's posts above, assuming you've already looked at this cleaning article. Baileytc has been updating us on Dr. Moriello's most recent research, and, as you'll see in one of the posts above, Accel and Formular 409 are supposed to work on ringworm.
 

baileytc

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ChrissyH,

Apple cider vinegar has not been shown to have any effect on ringworm spores. For upholstered furniture, several fosters in the rescue I volunteer with swear by a product called Benzarid: http://www.naturasil.com/benzarid/. They've used it on sofas, chairs, and even cat trees. It has little to no odor, and I don't think it discolors fabric.
 

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Hello Everyone!

Just giving an update on Graysan and Yong-Gi!   Some good and some not so good....

Yong-Gi has had two negative cultures!! 
  All of the hair in his two lesions came in beautifully and his coat is healthy and shiny!  We still have him on Terbinafine for the time being.  We have been bad ringworm parent's and did not dip him this week (I felt he needed a break) but we are supposed to dip him every 7-10 days until Graysan gets his first negative.

Graysan's culturing was delayed due to the mild infection that he had (we think one of the lesions may have become infected) and the fact that he was still breaking out with lesions even after 5 weeks on Fluconazole.  He has been on Terbinafine since March 2, 2016.  The lesions have stopped breaking out so we cultured him on March 29.  So far there appears to be no ringworm growth in the tube but the Vet wants to wait the full 4 weeks to be certain.  He is due to be tested again in next week.

However, we are having a setback once again (and this may be for another board).  Graysan started itching furiously!!!  We have no idea why.  In the past 3 weeks he started over grooming and chewing to the point of abrasion.  Our Vet re-tested him for FeLV and FIV and for the second time (he was first tested October 2015)  he came back negative.  His blood work came back normal except a slightly high protein level but at that time he had an infection. (I am sure that she feared it may be FIP but he is showing no signs of it at all atm... )  He is eating normally and heartily, very playful, bathroom habits are fine, no eye discharge or anything to report except that he has extreme pruritis and we have no idea why.  Especially so far into the treatment.

After the allergic reaction to the lime-sulfur we switched him to Miconahex+Triz shampoo.  He was still itchy.  We put him on antihistamines.  He is still itchy.  I decided to try Veterinary Formula Clinical Care Antiseptic & Antifungal Shampoo with my Vet's approval to see if it would help.  Made the remaining fur soft and shiny but he is still itching!!!  The Vet said it could still be the ringworm but we are also treating for fleas and mites (doubt that is what it is but we want to be safe).   I questioned if he could be allergic to the anti-fungal.  She said that with Graysan's history of being allergic to things that appears not to bother other cats it may be possible but she doesn't want to take him off of the Terbinafine until she sees him.

Tonight he chewed his back legs and made small one inch abrasions on them so we sprayed him down with Banixx and put an e-collar on him.  It seemed to calm down the itch but with the collar on he cannot get to the wounds so we are not completely certain.  I wrote the Vet to let her know and hopefully will hear from her later today.  Other than the itching he is completely normal. 


The next thing we plan to look into is food allergy.  The one thing I fear is that he may be allergic to chicken...  That is his favorite.  I rarely give my cats foods that have a lot of fish.  Mostly chicken and turkey.  But even some of these foods have fish oil.  And I feed no foods with wheat, corn or soy.  But that is for another thread...

The first 'lesion' that broke out on Graysan was in the beginning of December 2015.  We are still clueless as to why it took so long for him to break out since he has been in our home since October 2015. He may have picked it up from a Vet visit in early December but I am not sure?   It does seem that by now it should be getting better....  The original lesions on Graysan are all filled in now.  His face looks normal, the one on his head and under his neck are gone.  But he is still scratching behind his elbows, licking his sides, chewing at his thighs and nibbling at his lower back.  Could it still be ringworm issues even 5 months later and on oral meds and baths???   I am clueless at this point.

My hubby nor I have broken out at all.  So I guess we are some of the lucky ones...  Very happy and grateful about that...

I am still cleaning as much as I can.  Swiffering floors, walls, and surfaces at least 5 days a week. (Life gets in the way sometimes).  Mopping with vinegar in between and disinfecting once a week floors and surfaces. Even I have hit the point of "when will this be over"?!?  
  Thinking about getting the real Malaseb shampoo.  Maybe that will help Graysan some but I am starting to suspect that Graysan's itching is internal and nothing that I put on him will really help until we find the source.

Will update when we get the culture results!  I am actually praying that he will stop itching once he gets off of the meds and he can just play, eat, cuddle and enjoy life.  
 
 
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baileytc

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BlackSakura6:

Sorry to hear that your cat is having such a tough time with itchy skin. I recall reading in at least one study on terbinafine that itching/pruritus can be a side effect of the medication and sometimes doesn't even show up until the cat is finished the course of meds. So it may be very well be the meds, not the ringworm, which is causing the itchiness. Allergies are also terrible this year.

Have you tried giving him an antihistamine? Chlorpheniramine (Chlor-Trimeton) is safe for cats at 4 mg per day. Zyrtec (or the generic equivalent, cetirizine) is also safe at 5 mg per day. You may want to ask your vet about them. Even if the cause of the itching isn't allergies, the antihistamine might be able to give some relief.

With so much going on with the meds and ringworm, you may want to wait a little while before changing his food as well. When you change a lot of things at once, it's tough to figure out what caused the problem or helped to resolve it.
 

blacksakura6

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Thank you so much baileytc  for your reply!  

I agree with you completely.  The Vet wrote me back and said that she wants us to see a Veterinary Dermatology Specialist and agreed that Graysan is taking a long time to heal from this.  We tried him on Zyrtec for a week but unfortunately he will not let me pill him.  He has some dental issues (I am using Oratene Antiseptic gel for that) so I believe his mouth may be sore.  He will most likely need a dental but we don't want to stress him with all that is going on.  We put the Zyrtec in Pill Pockets.  It worked for a few days then he refused them.  

We then switched to a compounded liquid version of Chlorpheniramine. (Cost us $60... *sigh*  But he is worth it...) so we could put it in his food.  I have not had a problem giving it to him twice a day but he is still itching even after being on it for almost two weeks.    I am going to continue giving it to him until he returns to see the Vet next week because if he is still itching on it I can not imagine what he would be like off of it.  And it does help him to sleep so he is not constantly scratching himself. 

While I do not have a problem taking him to see a specialist, I told her that I personally wanted to wait until he was off of the Terbinafine and had at least two cultures to make sure that it is not ringworm and that it is not an allergic reaction to the meds.  Also, the cost of a specialist is a lot of limited ingredient diet food if we needed to go that route after he is done with the Terbinafine!  But if he is still itchy after he is done with the meds and considered clear of ringworm then we will definitely take him to the specialist.  I just hate to see him itching so badly while we are waiting...  :(

She did not mention his culture but the last time she spoke to me when it was incubating for two weeks she said that there was no sign of ringworm growth.  She wanted to wait to see if any growth would manifest.    It has been three weeks and she did not report anything in the e-mail yesterday.   Good sign I hope.  x(^_^)x

Again thank you so much for your reply!  Hearing someone that has the same feelings about what course to take makes me feel a lot better about my decision.  I truly trust your opinion as well!  



 
 

kristenann

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Hey guys, I've been following this post for awhile and I am at the end of my rope with my kitty. You guys have offered excellent advice to each other and maintained a level of sanity that is hard to maintain with ringworm. It is the plague. Okay so for some background on my situation. I adopted my kitty in the beginning of December, he had ringworm when I adopted him. It has been nearly 5 months now - I'm so done.

When I first adopted him he was kept in isolation in the bathroom to avoid contamination. I bleached everything often and he received twice weekly lime sulfur dips. I could only keep up that level of crazy for about 3 weeks, then I removed him from isolation but continued dipping and cleaning. Another month or so goes by and he had really flaky skin and hairless on his ears from the miconazole typical I was using so I took him to the vet. He was given a ringworm culture and it came back negative. Party time!

I still kept cleaning frequently but I was instructed to stop bathing him, and he had no noticeable lesions so I relaxed. Then another month goes by and they're back! I was giving him a bathe because was covered in diarrhea, yes he's having horrible undiagnosed digestible issues as well - and I found like 5 lesions. So the next day I rush him to the vet and he was re-cultured and what do you know it comes back positive. Turns out they only cultured his ears last time. Ughh.

So I'm instructed that because of his tummy troubles and unknown issues that I should go back to topical's only. So 6 weeks or so goes by with miconazle tri-Hex bathes twice a week left on for 10 minutes each time and daily wipe downs with medicated wipes on lesions. No real success. I was finally given itraconazole for him which I was to pulse 1 week on 1 week off for another 6 weeks with continued cleaning and bathing. Didn't work. Now he is on itraconazole daily. I found a new lesion today.

He has had 2 complete blood panels, nothing shows up as being wrong with him. He was tested for FIV/FELV and they came back negative.I don't know why he's having digestive issues and its costing me, along with the ringworm, a fortune.

I thought at some point the cat was suppose to have an immune response and they would eventually get better even without treatment? But I'm seriously wondering if he simply cannot get better. I cannot have a cat with a zoonotic disease forever. I have immuno-compromised family members who I'm putting at risk every time they visit. 

I'm sorry this is so dramatic, I need help.

EDIT: I forget to mention that he was shaved after his positive result. Now his hair is a couple inches long and its hard to see the lesions again. I almost feel like he needs to be shaved again but it didn't seem to help and its so expensive.
 
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baileytc

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kristenann:

I'm so sorry to hear that you've been battling ringworm for so long with your adopted kitty. I read through the other thread you posted in and it sounds like he does indeed have IBD. One of my cats has it and a foster also had it, so I have a couple of suggestions about that as well as ringworm.

First, the ringworm:

--Some breeds are more prone to get it and harder to cure, and unfortunately, I believe ragdolls are among them. Long-haired cats generally take longer to cure. So that may be part of the problem.

--With such a long-standing infection, I don't think it's going to be cured with topicals alone, so it's good that your vet started him on an oral.

--While itraconazole is the gold standard for ringworm oral meds, it must be dosed correctly AND be compounded correctly to be effective. Per Dr. Karen Moriello of U of Wisconsin, one of the leading authorities on ringworm in cats, the typical dosage is 10 mg/kg (or 50 mg for most adult cats) daily for 21-28 days. Pharmacies often use bulk powdered itraconazole for compounding; studies indicate this does not have good bio-availability. Instead, pharmacies should use itraconazole capsules, which contain small micro-beads. The micro-beads MUST be kept intact during the compounding process for the resulting medication to be fully effective. Alternatively, you could buy the 100mg capsules, open them up, and divide the beads in half. You can put the beads into an empty gelcap.

However, the easier (and cheaper) solution may be to switch him to terbinafine (the generic of Lamisil), which is considered to be highly effective in treating ringworm. Dr. Moriello uses it and itranconazole when treating ringworm. Terbinafine is a $4/$10 generic at most pharmacies so you can treat a single cat for less than $10 total. It comes in 250 mg tablets, and you will need to get a pill splitter or do some chopping to get the right dosage for him. The best protocol is 30-40 mg/kg daily for 21-28 days. I think you said in the other thread that he's about 11 lbs, which is 5 kg on the nose. So dosage would be 150-200 mg a day, which would be about three-quarters of a pill. Obviously, you'll need a prescription from your vet, who may not be very familiar with terbinafine because it only recently became available in generic form and was previously very, very costly. 

With either med, you may not notice results until at least two weeks into the treatment and he may not look significantly better until after the treatment concludes. All of the ringworm oral meds work by inhibiting the reproduction of the ringworm spores, which means they take a while to have an effect.

I noticed that you had him shaved and he's now wearing sweaters to keep warm. Make sure you wash the sweaters frequently and either wash them twice or wash them once with bleach to remove and kill the ringworm spores. While it usually takes direct contact with another infected cat (or dog or human) to transmit ringworm, prolonged close contact with an infected sweater might be enough to re-infect your cat.

Are you or anyone in your household showing signs of ringworm or athlete's foot? I'm not sure you're aware, but the infection can be transmitted from people to animals, so if you have a lesion that he comes in contact with, you could be infecting him.

For the IBD:

Unfortunately, he probably can't be on steroids (prednisone/prednisolone), at least until the ringworm is long gone, because it suppresses the immune system and makes ringworm MUCH harder to resolve. (My vet compares it to throwing gasoline on a fire.) So I would talk to your vet about putting him on hypoallergenic food. I had great results with Hill's z/d. Royal Canin also makes hypoallergenic food. Your vet may be able to give you samples to try. Both of my IBD cats ate the z/d without issue; one ate both canned and dry, and the other didn't care for the canned (which is truly gross-looking and -smelling stuff). One tried the Royal Canin but preferred the z/d to it.

IBD is, in the crudest sense, an allergic reaction to protein. Some cats might be allergic to certain kinds (chicken or turkey); others might be allergic to ALL proteins. The hypoallergenic foods get around the problem of having to figure out which proteinsyour cat is sensitive to because they contain hydrolyzed protein, which has gone through a process that reconstitutes the protein into a form that the cat's body doesn't recognize as protein--and thus doesn't react to. So any cat with IBD should be able to eat hypoallergenic food without it causing the intestinal inflammation. Most cats with IBD can be treated long-term with hypoallergenic food alone, although it's helpful to have the steroid as well initially to quickly reduce the inflammation.

Yes, the food is pricy, but with a single cat, a bag that costs $50 should last a couple of months and result in fewer vet visits.

While I'm generally on the "wet food is better than dry" and "high protein, low carb, little or no grain" bandwagons when it comes to cat food, IBD is the exception. With IBD, protein--potentially ALL protein--is the problem, so you need a food that solves that problem. The hypoallergenic foods with hydrolyzed proteins do. My foster with IBD went from vomiting up everything she ate and ultimately not eating at all for 6 days to eating regularly and almost never vomiting, as a result of steroid treatment and switching to z/d. She was ultimately weaned completely off the steroid and maintained without incident on z/d until she was adopted.

A couple more suggestions:

1. You mentioned on the other thread that he'd been de-wormed. Was he de-wormed for tapeworms as well as roundworms/hookworms? The standard dewormer (pyrantel or Strongid) doesn't kill tapeworms. For tapeworms, you need praziquantel, which is sold without a prescription as Tapeworm Tabs online or at Petsmart, Petco, etc. A brand-name dewormer called Drontal also contains it. It's probably worth checking with the vet to figure out which dewormer was used. 

2. You also mentioned coccidia and/or giardia were suspected. While Albon has been used for years to treat coccidia, the best current treatment is a product called Marquis, which is sold as a horse dewormer. It's used in cats and dogs off-labe for coccidia. t's highly effective and requires only three days of treatment because it  actually kills the coccidia organism, while Albon simply impairs its ability to reproduce and thus requires longer treatment. For giardia, my rescue uses a product called Panacur aka fenbendazole. It requires five days of treatment. Metronidazone can also kill giardia but may not be as effective as Panacur.

Good luck with your kitty, and keep us posted!
 

kristenann

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@baileytc  Thank you so much for your thoughtful response. I really appreciate the time you took to address my concerns and to read over Tiberius's history. You brought up some really good points I'll do my best to address.

As far as the origin of the itraconazole - I'm not really sure how the pharmacy compounded it. I do know it was a special order for them so hopefully that means they ordered the effective kind, although I can't be sure. I suspect it wasn't though, since it is now in liquid form?

If this round doesn't work I really like your idea of using terbinafine. The price is definitely appealing! I have a pill splitter already, I bought it for his metronidazole but I'm glad it could serve double duty. 

That's a good point about the sweaters, although now that he has a nice fuzz going he hasn't been wearing them for awhile. Even when he was I washed them pretty often just to be on the safe side with that too.

Yep, I'm aware it can be transmitted between species which is really the only reason I care so much about getting rid of it! Otherwise he doesn't seem to notice in the slightest. Nope, no one in the house had any suspicious lesions since December/January thankfully. 

As far as the tummy troubles, he cannot be put on prednisolone ever. We did try it for a week a couple months ago and he had some really serious reactions to it, I sincerely thought he was going to die. He ballooned up like a goat, which made it appear that he had FIP, and he was incredibly lethargic and grumpy. So that does pose a real concern if he does have IBD, because I fear it's really hard to control without steroids. 

He's tried a couple prescription foods and I believe the Royal Canin hypoallergenic is our next step. He's currently on a prescription low residue food for a month to see if that helps. I'm really worried about the price of the Royal Canin, although if it stops the constant vet visits then it'll be worth it. It's over $50 for a 5.5lb bag here, which only lasts about a month if that. But if it helps then I suppose that's what I'll do. Do you know a way to get it cheaper? I looked on Chewy.com and it was still quite pricey.

As for your remaining pointers:

1. Good thought - but yes, he has been dewormed with Drontal x3 since October. Twice at the rescue, and once in my care and I haven't seen any worms in his feces so I think we're safe on that front.

2. I've never heard of Marquis but that is definitely something I'll look into. I have heard of Pancur, but some sources I've read say its more effective than metronidazole and some say less. I suppose if this doesn't work I'll be willing to give it a shot!
 

foxxycat

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@kristenann- since I see you have been having issues with food-have you tried Daves food? I have seen a few members on here have issues with diet reactions to ingredients-I have seen this brand recommended as alternative to expensive prescription foods=also natural Balance limited ingredient duck/rabbit or other novel protein has been tried with success.

I can relate to the anxiety to not having to use steroids-the water retention sounds very scary and I am sure he was very grouchy on it-I don't particularly care for steroids BUT sometimes its best-in your case=there are different types of steroids=IF you had to go down that route-there are other steroids that are not as strong-one is used for animals with heart disease=of course I cant remember the name of it off the top of my head.

I agree its best to stay away from steroids especially after that scary incident-my question is how high of a dose did they have him on? Or was it low dose or a shot? Stay clear from the shots-those don't wear off as fast-

make sure that your vet puts a note in his file to make sure anyone else who has to treat him knows not to use it-also if you use ER vets=call them and update his file so if something happens in an emergency-they don't give him a steroid shot=I have a note on the cat carrier with clear tape over it-DO NOT GIVE STEROIDS-  Hoping that your kitty gets some relief soon from IBS. Its got to be one of the most challenging things to deal with.
 

baileytc

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kristenann:

Just the itranconazole being liquid doesn't mean it's been compounded incorrectly. Did you get it from a local pharmacy or via mail order from a pharmacy like Roadrunner? The major mail-order pet pharmacies usually know how to handle itraconazole. I'd be less confident in a local compounding pharmacy.

You may want to ask your vet whether there are any non-steroidal anti-inflammatory drugs as an alternative to prednisolone. I've also read that Cerenia, which is an anti-nausea drug that is very effective in treating vomiting, can help with IBD, but it's not clear whether it can be used long-term. Another thing to ask about is vitamin B12 shots because cats absorb B12 through their food--and if they're vomiting a lot, they may not get enough. Based on my own experience, I would say that IBD can be treated effectively through diet alone but it will take longer than if you could use steroids or some kind of anti-inflammatory.

Prescription foods are very pricy, and I don't know of a way to get them cheaper other than to look for sales and/or ask your vet for any kind of price break she can give you. If the prescription diets aren't helping (and you probably need to give them a few weeks), then there are a number of other diets, commercial and homemade, you can try. 

Vets will almost always be reluctant to recommend raw diets because the raw meat could have bacteria (E. coli) that's just as dangerous to cats as it is to humans AND meat alone doesn't give cats all the nutrients they need, some of which come from things like bone marrow. Some will be OK with commercial raw-food diets because the factories test regularly for contamination. Some will recommend cooking the raw meat, at least initially, to kill any dangerous bacteria.

As for homemade diets, there are two types, generally. One is an introductory diet meant to rebuild the bacteria in the gut that IBD is suspected of depleting. The other is a long-term diet. The intro diets often consist mainly of bone broth from boiling a chicken or fish until the bones dissolve and the marrow absorbs into the broth. The long-term diets are usually some form of raw food.

I know one person who used the bone-broth diet to great success with a cat with IBD so bad she thought she would have to euthanize him because he was just wasting away. The cat now eats a commercial raw diet and is much better. For a single cat, a commercial raw diet will probably not be much more expensive than a good-quality canned food. Primal and some other manufacturers (Stella and Chewy, for example) make freeze-dried raw diets as well.
 
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