Foster cats with Ringworm... Ketoconazole or Fluconazole?

piper11

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I am in a bit of a predicament. We are fostering about 20 cats/kittens for a local rescue. We live on an old farm with a huge house so I promise that is not as crazy as it sounds. They range in age from 4 months to a few years old but most of them are under 6 months old. I had 4 of them at an adoption event at Petco last month and a lot of other foster homes for the rescue had kittens and cats there too. Well, people were holding and petting all the cats, so I think this is where they picked it up since we have never had a case here before. About a week later one of the cats who went to the adoption even had missing hair on his ear, and then several other cats started to show signs. I talked to the rescue and they had me get a culture done at their vet which just came back positive. The vet gave me Miconosol Lotion 1% which is a topical and says "Miconazole Nitrate" on the bottle.

The vet also gave me  Lime Sulfur Dip to do on the ones with symptoms every 5 days, I have already cleaned everything in the house but I will continue to do that, and I know I need to start EVERYONE on an oral med because there is no way I can handle topical meds and dips on 20 cats... well... unless I have to. From what I have read, an oral med for everyone maybe would help keep the ones who have not gotten it from getting it. I do have the ones with obvious symptoms separated, but honestly I don't think there is any way we can keep from spreading it since I have to spend time with each group of cats and It just sounds impossible. PLUS to make it worse, my husband and I both have ringworm now too. Luckily it isn't bad and my doctor had me get a cream to apply which seems to be helping, but i have it in several places and might have to go on an oral medication myself :(

So here is my issue. The vet will only prescribe Ketoconazole or Fluconazole. I have read about Itraconazole which sounds like the better option, but he won't prescribe it because the cost is so high and the rescue can't cover it. Plus I would have to pay to get it compounded somewhere and that would be an additional cost. The calling around I did says it would cost me around $35 per cat. That is a lot of money :/

So basically my choices are Ketoconazole or Fluconazole. I have read good and bad things about both and the Fluconazole seems to be what a lot of shelters use (and god knows I feel like a shelter at the moment!) All 20 cats and kittens are in excellent health otherwise with the exception of one who has feline Herpes and seems to have flareups every other week.

What a mess! We usually only have 3 or 4 fosters at a time and have been doing this for years, but a few months ago a local rescuer fell ill and the rescue I foster for took over her fosters and had this huge influx of kittens, so we tried to help and now we are in the really crappy situation!
 

katluver4life

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Hello and welcome to TCS!

First let me say...WOW! Thank you so much for taking on such an endeavor!

The Fluconazole would be my choice. It's long term use is less toxic then Ketoconazole. Ketoconazole is deposited in the fatty tissues, making it more difficult to break down or eliminate, so it can be more toxic than the other antifungal medication.
 
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piper11

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Thank you for the reply! I had read a lot of kind of scary info on the Ketoconazole. A few websites seemed to say it was better and worked faster, but I would rather something safer than faster. It sounds like I'm going to be stuck with these 20 for at least another month or two. That is unless I can find an adoptive family who understands the ringworm risk and is OK with it (and obviously not for the cats with obvious symptoms!)
 
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