AARRRGGH! Ringworm. Advice needed desperately.

After 5+ weeks in my care, my 11-week old foster-fail kittens George and Alice were finally over their lingering URI enough to get their first vaccines today. The vet noticed a very tiny spot of something crusty looking on one of George's toes. It fluoresced bright green under the black light. So did another tiny spot near his eye, though nothing seems wrong in those areas to the naked eye (no hair loss or crustiness). The vet is calling in a prescription for oral meds, but I won't be able to pick it up until Monday. I'm treating with OTC miconozale 2% cream in the meantime.

I'm so shocked and sad and worried for my other pets. I have one dog and 5 other cats. One cat is 7 years old; the others are all only 7-8 months old. Everyone has been getting along great. The URI has been a nightmare but I thought we'd turned a corner. Now this.

I have no idea where this came from. None of my other cats have ever had ringworm to my knowledge, and surely it would have shown up on George and Alice before this? The shelter said they had been checked before I picked them up. I've googled this so much today and have learned about silent carriers and reinfection and how spores can be anywhere and everywhere. I guess I'm just in denial.

Are oral meds really effective by themselves? I asked my vet about lime dips, and she asked if I "really wanted to go down that path"? Of course I don't, but is there really a choice?

We live in a pretty big house (me, my husband, the dog and 7 cats) and the cats have had the run of the place. After reading the protocols, I am in complete despair of EVER getting it clean enough to be rid of ringworm spores.

Of course, I've read so many horror stories that maybe I'm blowing this out of proportion. The total area of George's spots together wouldn't be half the size of a dime. Surely we've caught it really early and we'll l nip it in the bud? Again, there's not even any hair loss yet. My vet seemed willing to move quickly to the oral meds - not wait for a culture - so that's good, right? Would it be a good idea to go ahead and get all the cats on oral meds as a preventative? I don't even know which med she's prescribing so can't research side effects.

I'm so scared and confused that I'm not even making sense. Would definitely appreciate any advice, though.

Maybe if you try rubbing neem oil around the affected areas? Or perhaps add neem oil into your regular pet shampoo and give you're baby a bath with that? Neem oil treats a wide range of parasites and I'm pretty sure it's harmless for pets, too! If you can, you can also boil some fresh neem leaves and wash the baby with the water that's left over (of course, let it cool to a suitable temperature first!) I hope your furbabies get better soon!!!

Did you ask all those questions of your Vet?  I thought it was extremely contagious and didn't know there might be a period of time when it might not be.  I would definitely re-discuss all your concerns with your Vet ASAP and ask what all you should be doing around your house to prevent it's spread.  In the meantime, are you keeping George and  Alice in a separate room, just until you can talk to the Vet?  I wish I knew what to tell you.  Thank fully, I've never had to deal with this issue (And hopefully if your Vet is on top of things, your dealings will be minimal )

In the meantime, here are a couple articles on it:

http://www.thecatsite.com/a/ringworm-in-cats-how-to-win-the-fight

http://www.thecatsite.com/a/ringworm-infestation-in-cats-the-housecleaning-regime

Thanks for the responses. I did ask those questions but will call first thing tomorrow to ask a lot more. I'm just trying not to freak out too much over how much this is going to disrupt ours (all 10 of us) lives.

We had ringworm with Persians (thanks to a lovely breeder that hid the fact it was running ramped in her home). When I got a cat from her it had one tiny spot that was hidden with all of the hair, but the stress of moving made it break out all over. We started immediate treatment of oral meds, miconozal cream, prescription shampoos. It took a long time to get rid of it. Thankfully she was a cat that didn't interact with others so the only cross contamination we had was environmental. We had clothing we put on to go into her room that got left in there and lots of hand washing. Thankfully we kept everyone else clear as well as ourselves. It took several months till she was clear but the vet told us she could always be a carrier.

This thread might be helpful as well. 

http://www.thecatsite.com/t/210789/6-things-i-learned-from-our-ringworm-plague-book-length

Thanks again for responding, and I apologize for the "I can't believe this is happening" attitude. I know many of you have dealt with it and the only way out is through. I've read everything I can find on this site and several others. George is on liquid (compounded) itraconazole now and topical miconazole. He's getting a lime sulfur dip at the vet's tomorrow. She didn't think that would be necessary two days ago, but reconsidered in light of my panic. I'm just glad to not have to do it myself.

Alice is getting combed for a culture tomorrow. My vet doesn't think starting the others on oral meds now is a good idea.

George has a bald spot on his toe now about the size of a green pea. The spot by his eye is not much worse than it was two days ago, but another spot has appeared on the other side of that eye, the size of the head of a pin. Poor little guy. He's such a lovebug.

Let's just hope that the meds and dip keep it contained, and that no one else gets it

As someone who dealt with RW and is currently still dealing with it (my post here: http://www.thecatsite.com/t/302387/urgenty-need-help-with-my-4-month-kitten) I can say that I made a HUGE difference in my cat's overall health when I started doing Lyme Sulfur dips. If you go to the thread I linked you will be astonished at the difference those dips made. Due to my location I wasn't able to get the safe orals recommended so I did nothing but weekly lyme dips and he went from being an extreme 10 to now a maybe 3. So I would suggest you do a weekly dip and be very glad you caught it early. I was helpless for the first 3-4 months and by then it was a very aggressive form of RW and had spread considerably where he looked AWFUL. He was missing fur on his eye, nose, mouth area (his whiskers completely broke off!), sides of his torso, the top of his head, his paws/nails, tip of his tail...I could go on and on. It has been AWFUL to deal with especially being my first cat. So please start a dip ASAP before you or your other animals get affected. 

I just read Raffaello's story and am so happy that the lime dips turned things around for him. Seeing is believing and I will definitely keep lime sulfur as as part of my RW arsenal. Thank you for posting.

I've been avoiding posting back on this topic but just decided it was time. I was pretty much hysterical when I posted my first note. I believed, irrationally, that all 10 of us (me, husband, dog, and all 7 cats) would get ringworm, and never be able to get rid of it. I cried A LOT the first few days. Both my husband and my vet thought I was crazy. But my ringworm experience was not nightmare I expected, even though I didn't exactly follow the recommended protocols. George was the only one who got it, and he only had 4 tiny spots that responded well to treatment. Here's what we did and didn't do:

1) I didn't isolate George for a couple of reasons. One, with what I'd read about the incubation period (7-21 days), the timing didn't make sense. He'd been out in the general population for 2 weeks, after being kept in isolation with his littermate Alice for 3 weeks (for slow introductions and because they both had URIs). This made me think that maybe one of my other cats was a silent carrier. Two, I'd worked really hard to socialize George and Alice, and George loved nothing more than to curl up on my shoulder at this point in his life. I didn't want to deprive him or myself of pets and cuddles or the company of the other cats. And knowing stress is a factor, I was totally able to justify this to myself.  :-)

2) I didn't go crazy on cleaning. Between having a full-time job as well as a large house to clean, it just wasn't possible. (Sure, if I'd isolated him, I wouldn't have had to clean so large an area, but...see above.) I know some people seem to find cleaning a good way to deal with ringworm stress, but I am, sadly, not one of those people. I DID launder beds and blankets more than usual, with bleach and/or the super-hot cycle.

3) We spot-treated George's lesions with a miconazole solution from our vet once a day.

4) We gave him oral itraconazole (generic) daily for 60 days total (two rounds). After the first round (30 days), he still had one spot that glowed green under the Wood's lamp, so we did a second round. It was liquid, compounded with "triple-fish flavor", whatever that is. Not cheap, but it so yummy that he didn't mind taking it at all. The other cats all thought he was getting a special treat. 

5) Both George and Alice had one lime-sulfur dip, a 3 or 4 days after the original diagnosis. Alice's was strictly preventative. We did a culture on her too (the slow kind) but it came back negative.

6) We didn't dip our other cats, as my vet though it wasn't necessary. We did cultures for them and our dog. All came back negative.

7) Since I knew we were dealing with M. Canis, I bought a Wood's lamp ($40) on Amazon and checked everyone regularly. 

I attribute our not-entirely-horrific experience to catching it very early, and hitting it very hard. We caught before George had even lost any hair, so I don't think the spores had a chance to become concentrated in our house. And we treated it aggressively - dip, topical, and oral meds - even though it seemed like a mild case. 

I don't encourage anyone to follow my example in regards to not isolating the patient and not cleaning like crazy, but maybe my story will help someone out - or at least save them a few tears. :-)

Suzanne

Thank you so much for your very informative and helpful information, I haven't had to deal with that yet but you have given me something to have in a fight against it. I do know that when humans contract ringworm, start the treatment with fungicide and keep the lesion covered with a bandaid, that will keep you from spreading it to others.Once again thanks!

There are many more helpful posts on this site that cover worst-case scenarios, and I urge anyone dealing with ringworm to read them, especially Bunnelina's ringworm thread. We were very fortunate to experience a best-case scenario, and I credit this site with giving me the information I needed to make decisions. I took a couple of risks, but a least I understood that they WERE risks and did not take them lightly.

Belated reply but I just found this thread. Thank you suzannef, It's actually super comforting to read some better-case scenarios in the midst of my personal ringworm hysteria. These days with the internet, it's hard to figure out what exactly is a "typical" scenario because people tend to write more when things are going worse than usual than better. As far as facts go, I've read that minimum "cure" time is 42 days, which makes me think you could expect minimum 2 months for a multi-pet household if you catch all the lesions early and treat "aggressively" and thoroughly. They say even with aggressive treatment (what constitutes aggressive treatment at minimum, anyone know?), pets can remain contagious for 3 weeks. But does that mean 3 weeks while the pet is dipped 2x/weekly, given oral medications, topically treated twice a day onto the lesions, AND thorough spic and span daily house cleaning? Or does it start with any combination of the above? Does that mean that for the 3-6 weeks after that timeframe, you just keep treating but can have your pets safely interact with each other? See, these timeframes are so hard to interpret! All the vets seem to have a different take. There doesn't seem to be a consistent "go to" answer on timeframes or what to do or how much to worry. So; just being able to read from all these examples (and some of the luckier examples) does provide hope that maybe not all ringworm cases turn into the horror stories we worry about, even though many of them do.

Your list actually helped me assess where we are currently:

1) Reading about George helps me feel a little more comfortable decision-making regarding continuing my affected (dog's) isolation in spite of her stress and the toll of it on her and our family. We will talk to the vet but I'm not sure if it's sensible to keep her out there for a full 3 weeks (or more?). She is so stressed; it can't be good for her. She has had some treatment for the past 2 weeks already; starting with topical only, then dips, and then finally the itraconazole.

2) I also am struggling with how crazy to go with the cleaning. We caught ringworm early with the dog, but not as early with our original culprit (foster kitten). She'd been running around for two weeks before we realized what was going on! We did do an initial full cleaning, but maintenance I'm at a loss at "what is enough"? Our house is a moderate sized one (one-storey; three bedroom). I too am not one of those people who find cleaning a good way to deal with ringworm stress. Just doing what I can but sometimes beat myself up if I don't have the energy to do more. I'm glad I'm not the only one who feels like this!

3) We are also spot treating twice daily, but with different things as we're not sure what is working. Some days terbafine; other days miconazole; other days clotrimazole; and other days just dabbing some lime-sulfur dip.

4) Our symptomatic dog is on itrafungol; but just for a week, then a week off, then the vet wants to switch to ketoconazole which freaks me out a bit. Every vet either says "it's fine" or "it's too risky, I'd never use it." No happy medium. But current vet has limited supply of itrafungol, and gosh that stuff is expensive when you're giving it to a 55 lb dog! And our dog does not like the suspension at all.

5) We're dipping both dogs (only one is symptomatic; the other preventative), so similar to your George and Alice. We've done two dips. Last weekend we did a maleseb bath instead because of all the lost hair and powdery residue on my symptomatic dog made us worry about irritating her skin. We have the J-kat Ciderm Shampoo on order. I haven't done cultures on my asymptomatic pets. Might just get some toothbrushes to submit. Is that how you did it, or did you bring each of your pets in individually?

6) I also have an asymptomatic cat; possibly (environmentally) exposed to the kitten that started our fiasco, but we have not dipped or cultured him as he shows no symptoms. Vet feels we should "cross that bridge when we get there."

7) I got a handheld blacklight off amazon. Definitely showed the ringworm areas on our original foster kitten. But it also spooked me a little because my asymptomatic dog shines a yellow-green (not apple green like the kitten) around his paw pads, and I'm thinking maybe that's all the excess dip, cleaning product, and other stuff he's been exposed to in the past few weeks. His feet do look a little irritated but no real hair loss. It's hard to tell, but hard to decide if it's worth more $$$ just for a 2nd opinion. People tell me it's only ringworm if it's apple green.

So, lots of parallels. Anyways, thanks again for posting your experience. I hope there are more stories like yours, and I hope our story turns out more like yours.