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

[blacksakura6]

 
Congratulations, you are now a dipping expert and will be able to give advice to everyone else here on technique! I'm glad it went so well!

[Edit]

 Thank you so much Bunnelina!  I still have much to learn about this!  We are hoping that the next dip will be easier.  Maybe YG will realize what we are doing and not freak out as badly.  The Vet suggested that we do Tsen and Sho even though they are not in the house just to be safe because YG visited them in December.  Their turns will be this Saturday and then Graysan and YG again on Sunday.  

Despite Graysan's itchiness the Vet did not feel that his case was severe so she said once a week was fine with the dips unless he started really breaking out worse.  Odd thing was right after he started the fluconazole a new spot appeared on his head.  Until then it was only the spot above his eye.   But as I have seen so many say that it can get worse before it gets better.   YG's spot on his arm looks almost completely healed and the tiny one under his neck is being treated.  Nothing else new on him so we are hoping that we are nipping it in the bud.

I may just continue with colloidal silver (10 ppm) on the top of his head and the slight sparseness behind his ear.  I am more comfortable with that instead of miconazole cream.  Also I can still put it above his eye on the spot that is healing without panicking if some goes into his eye.  I was really cautious about putting the lime sulfur too close on his brow.  

One thing that is great is that my husband said he now feels more comfortable petting them.  I never stopped holding and petting them (I think it is essential for healing).   We still have to be mindful of the spores that could be surviving but it does make you feel a little 'safer' because we know they were dipped.  

And I truly understand what you mean about the dust bunnies!  We always call them 'furry tumbleweeds'.  I swear I would clean, sit down with a sigh of satisfaction, look up and see one rolling by as if it is laughing at me!  "Missed me!!!  Hahahaha!"  

    So on the bright side it is nice to have a home that is starting to look like an Ikea advert but I will be glad when I won't panic when I see a fuzz ball rolling across the floor.  

Thank you again Bunnelina!  You are amazing!  

 

[blacksakura6]

Did the second dip on Graysan and Yong GI and it was much easier this time.  I must admit that I am really surprised that Graysan seems to be taking it well.  Maybe he knows we are trying to make him feel better.  We still haven't dipped Sho and Tsen.  I have been avoiding going over to my mother's house and I even fear taking anything over to them since they do not seem to be showing any signs.  I still want to do at least two dips on them to be safe.  I especially want to do it before re-introducing them when Graysan and YG are considered clear.  But right now I am going to strive for minimizing contact with them so I don't accidentally infect them in some way.  Yong GI has not been over there in 6 weeks so I think if they had it they should have started showing signs.

No lesions on my hubby or myself yet. (Keeping fingers crossed)  But I am curious about something.  I know I read somewhere on the Net that said that ringworm can look much worse before it gets better.  I swear that Graysan has started losing so much hair since we started treatment!  YG lost a little patch under his neck but the original lesion on his arm has completely filled in and the hair has grown back.  (It came back in before the fluconazole and dips)

Graysan now has a patch on his head, two behind his ears, two spots on his back, and it looks thin on his shoulders.....  Where the original lesion above his eye was hair is coming in but it is still sparse.  

Did others experience this as well???  I am just curious?  Did you start to notice more hair loss once you started treating and when did it seem to stop???  I know this is only week two of treatment but I am curious....  

 

[hatchytt]

Honestly, when I once had a hard-to-treat ringworm on my arm, (didn't respond to prescription cream), what finally worked was when I started bathing in bleach solution. So, bleach works when nothing else will.

 

[beevee]

So grateful to have found this thread, as we have been battling ringworm with our rescued 9 month old cat.
In November 2015 we adopted Flynn. Within about two weeks, he quickly developed a crusty lesion over his eye and the hair fell out. I immediately contacted the rescue home and she was kind enough to take him back to quarantine and treat him. When we brought him back home (four weeks later) in early January we thought he was over ringworm (he was treated topically and orally). Meanwhile, I bleached and cleaned everything!
In mid January, two weeks after Flynn returned home, I spotted a crusty lesion on his ear-ugh! We decided not to return him to the rescue, because of the stress on Flynn. Our vet couldn't find Sporonox for less than $340 so the rescue sent us itraconazole-28 day treatment. We are also giving weekly lime-sulphur dips/Malaseb and topical Conofite. He seemed to be recovering well and the ear was healing/growing hair.
Well, exactly four weeks later, we found a new bald spot *insert crying here*. It is on the back of his neck. Today, the vet shaved the new spot and the ear that still has some crusting. We are going to continue the itraconozale (which I believe is the compound-not Sporonox) and I will try Lamisil cream as a different topical-per our vet.
This is so frustrating! But so far, the kids, husband and dog are ringworm free. I've had a few itchy spots, but not true ring shaped areas. Tea tree oil treatment has dissolved them, but not sure if they're ringworm.
I am getting conflicting advice. I just talked to the rescue lady today and she was angry that the vet shaved Flynn and said he is now capable of spreading more active spores. She also wants me to stop lime-sulphur and use apple cider vinegar.
One encouraging thing is that the new spot is just bald...not crusty or red. Could the systemic itraconozale be working enough to keep it from being a fully active lesion?
Flynn is not confined to one room. He roams the living room, family room and kitchen, but we have all bedrooms and bathrooms closed off. I vacuum, Swiffer, wipe surfaces, wash, Lysol...every day or every other day. This nightmare has been going on since November!
My gut tells me to continue the oral for a while, continue with the lime-sulphur (Flynn doesn't mind) and try Lamisil as a different topical.
Flynn was abandoned, put in a shelter, and then rescued, so he's had a rough start. The thought of surrendering him has crossed my mind with this darn ringworm, but this thread has certainly been encouraging. Thank you!

 

[blacksakura6]

I am starting to wonder if Graysan is having an allergic reaction to the dips or maybe the miconazole.....  He ripped his hair out from behind his ear and he is scratching his neck to the skin.  I e-collared him on Friday and left it on for three days so he could not get to his ears.  After we dipped him today I removed the collar and he started scratching at his neck again and his face.  I know we really got the dip on his neck, ears, cheeks and body.  This is his third dip but it does not seem to be soothing him at all....  

   I don't want to collar him again if I don't have to. 

When I asked the Vet if he needed a different med instead of the fluconazole she said to increase the dips and give it another week.  If he does not improve bring him in.  I plan to take him in on Friday or Thursday (our car is broken and has to be fixed first) before I even consider dipping him again.  he definitely needs something for his itch!  His Vet even said that he should be doing really well by now after 3 weeks of oral and at that time 2 dips.  Instead he seems to be itching more and has more sparse areas of hair loss.  

  

This third dip today seems to have really dried Graysan's fur and he has been scratching, licking and rubbing off and on ever since.  Yong Gi's fur is actually soft and he is not scratching at all.....  Poor Graysan seems to be going through it atm...    I will be so glad when this is over......

 

[bunnelina]

Yikes, BlackSakura6, poor Graysan sounds miserable. It sounds like he has had enough dips. If he started itching specifically where you were using miconazole to treat spots, then you probably have your answer. Our cats had problems with topicals. But it also sounds like he is reacting to the dip, which is strange. It's hard to know from here, since I can't watch him scratch. Maybe the dip is too strong and should have been diluted more? Could it be a reaction to the fluconazole? I just don't know.

I hate to put a cat in a collar in these situations because I always imagine how I would feel if I had a terrible itch I couldn't scratch. Can you see about an antihistamine for him? 

I'm also wondering about the fluconazole. Check your dosage and make sure you are giving the right amount for him. Also make sure the dip isn't too strong: Here's some info from the Dane County Humane Society, using Dr. Moriello's "Treatment in a Nutshelll" so you can check. I don't know if this info is out-of-date as she has discovered new things in recent years, but at least it's a place to start:

https://www.giveshelter.org/dermatophyte-treatment-in-a-nutshell.html

If I were you, I wouldn't do a thing that I thought might make him worse. poor guy. Let's hope he's turning the corner. It's three weeks now, so he should be!

I hope others will chime in here with ideas....

Hang in there, and give some extra treats to poor Graysan for me!

 

[blacksakura6]

Thank you for your reply Bunnelina!

I am definitely going to stop the dips on him.  I did the 8 oz. to a gallon the first time.  Then we dropped it to 4oz. but he still seemed to itch.  The Vet said to take it back to 8 oz because he may have a resistant case.  After Sunday's reaction I called them immediately today and we are taking Graysan and Yong Gi to the Vet on Thursday. (That is the first day that my husband will have the car free...  He is even going to take off from work so we can go..  I love a man that loves cats.  

 ) 

And thank you for the link to Dr. Moriello's page.  I read that when this first started and I must have referred to it at least 3-4 times trying to make sure I am doing everything right.  It is so very helpful.  

But I am also wondering if he is having a reaction to the fluconazole.  When I read up on it I saw that one of the reactions to it could be hair loss and itching. I am thinking about stopping it until Thursday when we see the Vet.  And for some reason this time the sulfur smell is extremely strong on Graysan.  Almost burns the nose a bit.   YG's smell is just light...  You have to really put your nose into him to smell the sulfur but Graysan's is noticeable as soon as you enter the room.  I really think he needs a bath...  Or some type of warm water rinse but I don't want to do anything to make things worse.  But no more dips for him...  I don't think they are agreeing well...

After I put some pure aloe vera gel on him (100 %) it soothed the itch a lot on his ears and neck.  I saw him scratch once this evening but I am going to do that 3 times a day to keep his itchiness down.  At first I did it out of sheer reaction to the situation but when I looked it up several holistic sites actually suggested to use it on ringworm lesions as an anti-fungal and to speed healing.  I wish I had known about this when his spots first formed.  He actually looked at me like "Thank you..." once it settled into his skin.    So now I just need to treat the missing spots with colloidal silver and aloe vera gel to keep them from getting infected until I can get him there.  

And Yong Gi looks so concerned.  Usually he and Graysan run through the house, wrestle and play.  YG has tried to get Graysan to play and he is not really in the mood.  He played with a feather toy a bit tonight but he is obviously not feeling up to chasing and rough housing.  And YG smells him and just wrinkles his nose a bit.  The smell is really reeking on Graysan...  It was not that strong afterwards the past two times.   Graysan's appetite is completely normal and he wants rubs and will lay next to me on the bed. (At this point if I break out I just break out...  I will deal with it if it happens)  But he is definitely not himself.....  I think he just feels miserable....

I don't want to cone him not only because of the discomfort but the missing hair is right where the cone was when I had it on him!  I don't know if it helped to rub his neck raw and I don't want to irritate him more.  Just keeping the back nails trimmed to lessen the damage.  

My poor sweetie!  I still can not believe that this is happening but I am so glad that we are able to treat him.  I am also happy that Sho let us know that something was really wrong with Graysan and we got Sho out of the house and into my mother's....  Possibly spared him from going through all of this...   My mother said Sho is happy with Tsen (who is turning 16 in March) and is enjoying Sho's company so that is a bright note.

Like so many others I will be glad when this ends...

Will update what the Vet does when we see her.  Keeping my fingers crossed that we can nip this in the bud.  x(^_^)x





 

 

[fdxr]

Hi fellow cat lovers!

I just joined and jumped into this thread, so I apologize in advance for not reading all the threads before responding.  I've read quite

a few already, but when I saw the comment about Graysan and the strong smell and possible dipping reaction I wanted to share

what I learned last night from my vet tech friend who has been in cat rescue for many years (and vet tech for 17 years).

She warned me to make sure I dilute the lime sulfur dip enough as it can make the cat sick if you don't dilute

it enough.  (I was asking her if I could do the dip myself or take to someone else who has more experience than I do).  She said the dip was

really the best thing to clear it.

She said she uses the lime sulfur dip on cats 1 X week and  Xtreme Clean to disinfect cuz it won't ruin your laundry like bleach

will....can also dilute and use to scrub floors and spray down floors and furniture.    For ringworm spots on cats she uses topical med from vet like consil.  RW lesions on herself she uses athletes foot cream or Monistat applied directly to the lesion 1-2 times a day.  I combated ringworm

on my cats and myself about 10 years ago while rescuing/fostering cats and learned I can use monistat on the cats as well.

My vet just found what he thinks is ringworm on my 6 month old kitten above his eye Monday.  Because he has herpes conjunctivitis and already lost

one eye to it, he doesn't want to use topical ointment on the lesion above his only eye.  Thus he took hair samples and sent out to

be tested to make sure its RW before proceeding with the oral medicine which for some reason has gone up astronomically in price.

He hasn't told me the price of the oral med yet for my 6 month old kitten, but test was $85.  I'm expecting the results this morning. (update: test came back positive for ringworm).

In the meantime I started my RW routine at home immediately as I know you have to jump on it.

I started putting a tad of monistat on his 2 lesions the vet found and monitored to make sure it didn't melt or go into his only eye.

I vacuumed entire house and quarantined him immediately in my spare bedroom.  I used a disinfectant spray on his bedding, etc until

I could wash (I had to go to work afterwords).  I constantly use the disinfectant spray on my hands when I touch/pet him or give

medication.  I even keep a 2nd set of clothes in his room and use only those while I'm in there.  Dusted and disinfected in there as well

but I still need to wash curtains.

I've sprayed the disinfectant on my AC filter and fired up my air purifier which is top of the line and works on mold spores.

After work I started washing bedding, etc and disinfecting the kitchen and bathroom floors.

Monday night after I got home I used a black light on him and he lit up like a Christmas tree in 3 spots, so I was able to find

a 3rd spot we didn't know about on his inner ear.  The spots glowed the apple green color I read about.

I'm into holistic, so I bought colloidal silver (Sovergeign Silver first aid gel) from Sprouts. (Can I say store and/or brand names on here?).

Pls delete if not allowed.    I was told this gel had aloe vera in it too but I can't find any reference to aloe vera on the box. The Colloidal Silver is clearing up the lesions fast (faster than monistat).  Now I have some lime sulfur dip and will dip him tonight.  I just found out a few hours ago

his RW test was positive.

Vet said I didn't need the oral med anymore now that the colloidal silver is working and that I'll be dipping him.  Also said to dip weekly.  Still waiting on word for how long but I'm hearing 6 weeks from fellow friends.  Vet also said to stop the colloidal silver since he didn't know if it would react with the lime sulfur dip.  All this was through the vet tech so I may have easily misinterpreted.

Until I can finish reading the extensive posts in this thread and call vet tomorrow, does this sound like I'm on the right track ???

 

[bunnelina]

Hello FDXR, and welcome to the ringworm thread. Some of us are currently dealing with ringworm, while others (like me) have been through it and are glad to provide info, support, and empathy.

Gee, you must be tired! Just reading what you've been up to made me want to lie down. It's great that you are experienced at this, and are not panicking, which is what many of us did when our cats/kids/dogs/selves got it. At one point, I thought that burning our place down wasn't such a bad idea....

It sounds like you have a plan and know exactly what you are doing, but since it's been a while since you last encountered ringworm, I just want to make sure you (and you vet) are aware of Dr. Karen Moriello and her work on treating the fungus. She is the country's feline ringworm expert; most of her work is directed towards helping shelters, since an outbreak in a rescue with limited resources can lead to mass euthanasia and closing down entirely in some cases. (We've had that happen here in Massachusetts. Dr. Moriello's work is saving lives. We sometimes point out to terrified newbies here that ringworm isn't fatal; it's gross but it's not that big a deal in most situations and it will go away by itself in time. In shelters, it's a big deal....)

For a short refresher course, you might look at the main ringworm article  on this site, which has a video webcast by Dr. Moriello at the end. There's also a housecleaning article that might be useful. I know you are vacuuming, but it's important that your vac has a filtration system that can trap ringworm spores; many vacs will blow them back into the air via the exhaust. A Miele with a HEPA filter will trap spores and there are other brands as well. 

Finally, you might want to look at a couple of recent posts by a new member of our group, BaileyTC (#337 and #342 on this thread, above), who was able to look up some of Dr. Moriello's most recent work about the effectiveness of different disinfectants, etc.  Disinfecting is a lot of work, so it makes sense to make sure that whatever you're using is actually working. And killing spores isn't necessarily the best tactic; often just sweeping, dusting, wiping down walls, doors, and other surfaces, and vacuuming are what it takes. 

Do you have your own Wood's Lamp? The green spots you are seeing on your kitten could be ringworm, or something else.... there's a post somewhere on this thread from someone who knows about Wood's Lamps and black lights... culturing is the most reliable way to get a diagnosis and to know when the cat is cured. Fortunately, this only takes a few days now with PCR cultures, instead of weeks, as it did in the past.

I wonder if your vet is planning on prescribing liquid Sporanox for your kitten, since it can be hard to dose small kittens safely with other medications, like terbinafine, which are less expensive. Grown cats and larger kittens can handle other ringworm medications.

Keep us posted on how you are doing and best of luck to you. Be sure to take care of yourself through all this. The cleaning and treatment can be exhausting.... I hope it's over soon!

 

[blacksakura6]

We took Graysan and Yong Gi to the Vet on Wednesday (she had an earlier opening and fit us in! YAY!) and the doctor was really surprised at the difference between the two.  Yong Gi looks great.  Hair is shiny.  Lesions have healed and fur is back in place.  Everything looks great.  

But when she saw Graysan she actually said,"Wow... not what I expected to see."  When she looked at the lesions that are now on his ears, top of his head, back, neck, elbows, and shoulders she sighed.  When the Vet first saw him December 31 he only had one lesion above his eye.  She looked at the one under his neck and said it looked like it may have a bacterial infection so she did a taped rub and checked it under the microscope.  There was some bacteria but nothing significant but she said she could still see ringworm spores as well.  And she also mentioned that the sulfur smell was strong on him but almost faint on Yong Gi despite being put into the same solution.  We measured everything exactly and followed every instruction so she has no idea why Graysan had such a strong reaction to it.  But the conclusion was no more dips for Graysan.  So now we are going to do the miconazole shampoo on him and hope for the best.  She said that Graysan had three dips and hopefully that was enough along with my cleaning to get the spore count down in the house.  Now it is just to get Graysan to heal.

He was also running a low grade fever (103) and she gave him a shot of Convenia because she suspected an infection.  I know a lot of people do not like Convenia but it has saved two of my cats lives in the past so I will keep my fingers crossed that it works well for him.  She also recommended 5mg of Zyrtec (cut a 10mg in half) once a day for his itchiness because we believe it is due more to an allergic reaction rather then the ringworm itself.  Remember that his first noticeable lesion popped up the first week of December.  And while he has been itchy since he came in our home as his skin was trying to heal from flea infestation he was not scratching himself into mutilation until after the dip.  Also she advised for me to continue with 100% aloe vera gel on the lesions to speed healing and colloidal silver if I would like.

We ran blood work to check his liver and everything came back normal except a high globulin level.  She said that in his case it usually indicates inflammation and the body's response to infection.  But everything else was completely normal.  We even ran another FeLV/FIV test to be certain that we would get a second negative 5 months later and we were so happy that it came back negative.  Also, Graysan has really bad issues with his gums.  I had started the full Oratene regimen (antiseptic gel, maintenance gel, water additive, spray) a few weeks ago but the whole ringworm thing has thrown me off and I have to get back to it again.  So she said that the inflammation in his gums may be adding to the high globulin levels as well.  We will have to look into a dental for him but we are trying to deal with one thing at a time.  She is also going to keep him on the fluconazole unless he does not show improvement and then we will discuss the options.  

She already informed me that itraconazole is almost $300 where I live and the best option if we change medicines would be terbinafine.  But she feels that fluconazole is very safe and would prefer for him to stay on it if he starts responding to it.  

Last night he started behaving more like himself.  Interested in things again rather than looking sleepy and depressed.  He even came over with the eyes of hope to beg for my husband's chicken.  My husband even said today,"Did you notice that the smell is not strong on Graysan anymore?"  We actually stood in the room inhaling and the smell that was so strong yesterdays has become faint.  Even as I am typing this I have YG and Graysan sleep on the sheets on the couch and I am right nest to them and I smell nothing....  He and Yong Gi were also back to wrestling again today.  I haven't seen them wrestle since last Thursday.

The Vet told us to wait until this weekend to bathe Graysan and if we can do it twice a week that would be incredible but if we could only do it once a week it is still better than not doing it at all.  She also advised that if we wanted to continue dipping YG we could or we could discontinue and just keep him on the medicine (they have been on fluconazole for 4 weeks and will be on it for another 4-6 weeks at least) and monitor him closely for lesions.  We may just spray YG  down to the skin every 7-10 days to be safe until we get a negative culture back.  He absolutely hates the dips.

I knew something was really wrong and I am glad that I pressed on it.  You know your furry babies behavior and when something is not right it is not right.   Hope that some of what I am going through may help others if something similar arises with them!!   Graysan will have to go back in a week for a check on his fever and the lesions to see if there is improvement.  

I will let everyone know what happens when we go!  Wish us luck!   

 

[blacksakura6]

 
 At one point, I thought that burning our place down wasn't such a bad idea....

 I just had to respond to this and say that I laughed so hard I spit out my almond milk!!!   I feel the frustration!    

 

 

[fdxr]

Update:

Liasion above my kittens eye looked worse today so I rushed him to the vet.  I'm such a mama cat lol.

Vet reminded me that cats heal differently than we do.  I had forgotten that.  So even though it looked worse to me than yesterday, good stuff happened at vet.

We put him on Fluconazole 100 mg since the vet had this in house. Have a script for 30 days worth.  I understand its much weaker than the liquid Sporanox so maybe its good for him since he is only 6 months old and has herpes conjunctivitis.  I'm told it takes 7-10 days to know if its working.  Made an appointment 7 days later to check.  If its working we'll continue with it.  Only $29 for 30 days worth.  If its not working, vet will order the generic Sporanox ($95) which takes at least a week to get I believe.  We can have him on the Fluconazole in the mean time while the order comes in so we're at least treating it with something in the meantime.  The brand name Sporanox would be $500.  I believe I read that Sporanox is the only way to go, but would that be for major outbreaks?  My guy only has 3 spots right now.

We're continuing with the Famciclovir 125 mg tablets for 30 more days as that is working well for his herpes conjunctivitis. Yeah!  The vet saw some stuff in his only eye that bothered her so we added Terramycin Ophthalmic ointment gel for the bacteria herpes.  Gel seems to be less invasive as my guy is fed up with the eye drops he's been given for almost 5 months since he was 1 month old.

The vet also showed me he loved cheese whiz and we could put his pills in it and he'd eat it up without picking it out.  I don't even think he realized he ate a pill.  Tonight I tried it and it worked like a champ.  (He is DONE with being pilled, the poor guy).

I bought Simple Green Pro 3 disinfectant/virucidal/fungicidal from home depot today before I was able to read BaileyTC's post.  My vet suggested it.  I read on the label that it is effective against escherichia coli, HIV-1 (aids virus), athlete's foot fungus, herpes simplex type 1, staphylococcus aureus, streptoccus pyogenes, pseudomonas aeruginosa, rubella (german measles), and H1N1 flu virus!  10 minute contact timefor disinfection against fungi and bacteria claimed.  Must use protective gloves, gowns, masks and eye protection.   I think I'll get Accel next although its expensive for such a large amount.  The place I got him uses Accel 8.  I don't know what the "8" means but they are excellent in their cat care and I respect what they use.

I confirmed I need to keep him isolated for 30 days minimum from my other 9 yo cat.  He is a trooper in the guest bedroom so I can do that.

If I mentioned anything that sounds off, please let me know.

I plan on updating with happy results soon  

 

[bunnelina]

FDXR. that kitten of yours seems to be in very good hands. In a few months, this should all be a memory, you will have a big, healthy kitten, and you might even be able to laugh a bit about what you went through.

If you are going to use all that disinfectant, just please remember to rinse, rinse, rinse. You want to keep all the little animal feet in your house from any contact.

Don't spend all that time watching the ringworm video; you're getting good advice from your vet and are clearly reading up on the Moritello treatment and doing all you can. Take a nap or watch a movie instead, with a cat on your lap.

I am shocked at the price of Sporanox. I guess that the pharmaceutical companies are all taking their cues from Martin Shkreli now. It's my understanding that Sporanox is primarily prescribed for children, so it's extra horrifying.

Hang in there and keep us posted! 

 

[bunnelina]

BlackSakura6,

How great that you followed your instincts and that you were so alert and sensitive to Graysan's situation to begin with! Not everyone would be so observant; sometimes we just assume that whatever care and medication we're giving is going to do its job and we stop paying such close attention. Sometimes we simply "don't see" things we do not want to see. In this case, even the smell was telling you things weren't right. It sounds like everything is starting to turn around now, and I really hope he continues to improve and that his recovery is uneventful and fast from now on. Please let us know! And of course, since you asked, I continue wish you tremendous luck with him, and I'm sure everyone reading here joins me in that. But he already  has something far better than luck, he has you! 

 

[baileytc]

 
We put him on Fluconazole 100 mg since the vet had this in house. Have a script for 30 days worth.  

I assume you're only giving him 50 mg daily, correct? That's the correct dosage of fluconazole for an older kitten/adult cat.

Itraconazole/sporanox is considered the gold standard for ringworm treatment in cats, but it's not cheap and my understanding is that any compounded itraconazole made from the powdered bulk form of the drug is ineffective. The compounded med must be made from the capsules, which contain lots of tiny micro-beads, and the beads CANNOT be crushed during the compounding or the resulting med will be ineffective. What some pharmacists and shelters do is open up the 100 mg capsules and then divide up the micro-beads and put them into empty gelcaps. Dosage for an adult cat is 50 mg.

The other alternative is terbinafine, which is a very cheap generic at most pharmacies. At Walmart pharmacy, where I get mine, it's $4 for 30 tablets and $10 for 90. Tablets are 250 mg, and they're large and round. It's easy to divide them into quarters, and I've even cut them into eighths. Dosage is 30 to 40 mg per kg. A 6mo kitten probably weighs about 6 pounds, which is about 3 kg, so dosage would be 90 to 120 kg--a little less than half a tablet. I've had very good results with terbinafine in the former feral who was just treated with it and a littler of kittens dosed with it two years ago. They began to show improvement after two weeks, which is the right timeframe for most ringworm meds. Bear in mind that none of the oral meds--not even sporanox--kill the fungal spores directly. What they actually do is inhibit the production of a substance that the spores need to maintain their cellular structure. Without that substance, the spores begin to "leak" because they can't maintain their shape and then die. Any spores they produce once they're affected will not be viable. If the meds are working, the cat will no longer be shedding viable spores after about two weeks of treatment.

You can get terbinafine compounded into a liquid if you don't want to chop up pills and don't mind spending some money. I got an estimate from a mail-order pharmacy (Diamondback Drugs). 50 ml ranged from $60-$116 depending on the concentration. Like itraconazole, terbinafine is given daily for 21-28 days. Itraconazole can be "pulsed" after that if necessary, meaning it's given intermittently; one common pulsing schedule is one week on, one week off. Studies indicate terbinafine can probably also be pulsed because, like itraconazole, it lingers in the tissue at what's called the minimum inhibitory concentration for 2-6 weeks following the last dose. Pulsing not only saves money but is easier on the cat's liver.

Regarding Simple Green: According to Moriello's study (http://ogenasolutions.com/Support Studies/vde12074.pdf), Simple Green is effective against ringworm BUT you must spray thoroughly and have a 10-minute wet contact time.

Accel TB is the ready-to-use version of Accel, sold in spray bottles (probably 16 or 32 oz). It's not as economical as buying the Accel concentrate. One gallon of concentrate will make about 60 32 oz. bottles and costs $45-50. Each 32 oz. bottle of Accel TB is about $13-15.

 

[fdxr]

Thank you baileytc !  Awesome information.  I'm in the middle of Dr. Karen Moriello's shelter video now learning a lot!

Good catch:  Yes I'm giving 1/4 tablet of Fluconazole every 12 hours (50 mg per day for 30 days).  If no signs this is working (I'm told its weak), vet will order the generic Sporanox.  They have had excellent results with the generic.  I believe its compounded by their compounding facility they use (I thought I had to bring the script to my compounding pharmacy which I have the option to).  I'll ask about how its compounded. TY for the excellent info.

I love to know how things work, and am so appreciative you explained that the oral meds don't kill the RW spores..that they just starve the RW spores of the substance that maintains their cellular structure.  I liken that to natural "food grade" DE which dries out the waxy outer layer of fleas so they dehydrate and eventually die.  TY !

Also I liked reading that "If the meds are working, the cat will no longer be shedding viable spores after about two weeks of treatment."  -->   so I could bust my RW kitten out of my guest bedroom after two weeks ??  I bet the kicker is how to confirm the medication is working.  I've read (or heard on video ?) that often times the cat/kitten is "cured" long before the hair/fur starts growing back.

TY for the Simple Green research!  The statement "Simple Green is effective against ringworm BUT you must spray thoroughly and have a 10-minute wet contact time. " is a big gem I got from the video and this thread.   Also the fact I need to do old fashioned cleaning FIRST as well.  You guys saved me a lot of work not worrying so much about taking the curtains down and washing walls as I'm not near to that point. 

Ref Accel TB (no such thing as Accel 8 ? ), I think the smaller bottle will be better for me as I only have the 1 RW kitten.  I won't foster until it gets cleared up.  If I get into a situation where I need more, I'd certainly get the larger amount to save money.  TY!

Burning questions I haven't been able to find answer to yet:

1) I was hoping I could allow both cats to have free roam of the house together once I started giving the RW infected kitten a lime sulfur dip.  (I just received the dip today !!  Yeah).   But so far in Dr. Moriello's video I see that it isn't a good idea as the RW spores come from the infected brittle hairs that drop off the cat.  By keeping the RW kitty isolated in my guest bedroom I can contain the RW infected hairs by picking them up, cleaning, washing and disinfecting just this one room.  Sound right ?  My precious little kitty has the worst RW sore directly above his only good eye, so I was gonna avoid this one spot with the dip to protect his only good eye.  I think I can lightly treat the spot on his outer ear and the 3rd spot on his inner ear.  I was thinking the dip killed the live spores on his coat and I'd be catching/killing those bad guys from infecting more areas on my kitty.  This sound right too ??

2) Granted the following info comes from a human toe-nail fungus website (pediMD), it said Terbinafine Lamisil Tablets are only 38% effective in clinical trials and Sporanox Tablets even less at 14%.  Is there research that someone has found which shows Sporanox does better in cats with RW since its the gold standard ?  My apologies if its already listed in a thread here I haven't gotten to yet. 

3) I know we are not vets here on this site, but would anyone recommend I put my RW positive kitten on Terbinafine or  Sporanox immediately instead of trying the Fluconazole first like we started Wednesday ?

I wonder if Fluconazole has less side effects since its weaker ?  The side effects for humans aren't too good from both Terbinafine and sporanox, I know.

4) I don't understand why it takes so long for a vet to order/receive the Terbinafine or sporanox.  Not cost effective ?  Would it be worth it to go to a vet school/college to get ?  Or is my vet being proactive and protective by trying the weaker one first to avoid the bad side effects I wonder ?

5) I noticed my 9 yo cat itching his ear which is kinda unusual.  Is this the first sign that RW may be taking hold ?  Does RW itch ?  I know that was the first question my vet asked me before he told me that he thought RW was present.

 

[fdxr]

 
We took Graysan and Yong Gi to the Vet on Wednesday (she had an earlier opening and fit us in! YAY!) and the doctor was really surprised at the difference between the two.  Yong Gi looks great.  Hair is shiny.  Lesions have healed and fur is back in place.  Everything looks great.  

But when she saw Graysan she actually said,"Wow... not what I expected to see."  When she looked at the lesions that are now on his ears, top of his head, back, neck, elbows, and shoulders she sighed.  When the Vet first saw him December 31 he only had one lesion above his eye.  She looked at the one under his neck and said it looked like it may have a bacterial infection so she did a taped rub and checked it under the microscope.  There was some bacteria but nothing significant but she said she could still see ringworm spores as well.  And she also mentioned that the sulfur smell was strong on him but almost faint on Yong Gi despite being put into the same solution.  We measured everything exactly and followed every instruction so she has no idea why Graysan had such a strong reaction to it.  But the conclusion was no more dips for Graysan.  So now we are going to do the miconazole shampoo on him and hope for the best.  She said that Graysan had three dips and hopefully that was enough along with my cleaning to get the spore count down in the house.  Now it is just to get Graysan to heal.

He was also running a low grade fever (103) and she gave him a shot of Convenia because she suspected an infection.  I know a lot of people do not like Convenia but it has saved two of my cats lives in the past so I will keep my fingers crossed that it works well for him.  She also recommended 5mg of Zyrtec (cut a 10mg in half) once a day for his itchiness because we believe it is due more to an allergic reaction rather then the ringworm itself.  Remember that his first noticeable lesion popped up the first week of December.  And while he has been itchy since he came in our home as his skin was trying to heal from flea infestation he was not scratching himself into mutilation until after the dip.  Also she advised for me to continue with 100% aloe vera gel on the lesions to speed healing and colloidal silver if I would like.

We ran blood work to check his liver and everything came back normal except a high globulin level.  She said that in his case it usually indicates inflammation and the body's response to infection.  But everything else was completely normal.  We even ran another FeLV/FIV test to be certain that we would get a second negative 5 months later and we were so happy that it came back negative.  Also, Graysan has really bad issues with his gums.  I had started the full Oratene regimen (antiseptic gel, maintenance gel, water additive, spray) a few weeks ago but the whole ringworm thing has thrown me off and I have to get back to it again.  So she said that the inflammation in his gums may be adding to the high globulin levels as well.  We will have to look into a dental for him but we are trying to deal with one thing at a time.  She is also going to keep him on the fluconazole unless he does not show improvement and then we will discuss the options.  

She already informed me that itraconazole is almost $300 where I live and the best option if we change medicines would be terbinafine.  But she feels that fluconazole is very safe and would prefer for him to stay on it if he starts responding to it.  

Last night he started behaving more like himself.  Interested in things again rather than looking sleepy and depressed.  He even came over with the eyes of hope to beg for my husband's chicken.  My husband even said today,"Did you notice that the smell is not strong on Graysan anymore?"  We actually stood in the room inhaling and the smell that was so strong yesterdays has become faint.  Even as I am typing this I have YG and Graysan sleep on the sheets on the couch and I am right nest to them and I smell nothing....  He and Yong Gi were also back to wrestling again today.  I haven't seen them wrestle since last Thursday.

The Vet told us to wait until this weekend to bathe Graysan and if we can do it twice a week that would be incredible but if we could only do it once a week it is still better than not doing it at all.  She also advised that if we wanted to continue dipping YG we could or we could discontinue and just keep him on the medicine (they have been on fluconazole for 4 weeks and will be on it for another 4-6 weeks at least) and monitor him closely for lesions.  We may just spray YG  down to the skin every 7-10 days to be safe until we get a negative culture back.  He absolutely hates the dips.

I knew something was really wrong and I am glad that I pressed on it.  You know your furry babies behavior and when something is not right it is not right.   Hope that some of what I am going through may help others if something similar arises with them!!   Graysan will have to go back in a week for a check on his fever and the lesions to see if there is improvement.  

I will let everyone know what happens when we go!  Wish us luck!   

So Graysan was allergic to the lime sulfur dip?    I'm soooo glad you followed your instincts and Graysan is feeling better already

If that is the case of allergies, I find it interesting about the strong smell he had and Yong Gi did not.  Reminds me of when I was investigating perfumes for myself and the sales lady told me that if a perfume worked well with my body chemistry (and smelled good on me), I wouldn't smell it after I applied it (but others would).  If a perfume wasn't working well with my body chemistry, I would always smell it long after I applied it (and wouldn't really smell good on me).

Sounds like I need to follow your posts as my 6 month old kitty started Fluconazole as well. Can I find pictures on internet of what healing spots look like ?  I know cats wounds heal the opposite of humans.

I received my Lime Sulfur dip today in the mail.  I'm too tired to dip tonight and a little nervous about the process for when I do apply it.  Any tips or tricks to offer ?  I saw a youtube video a vet did but my computer locked up and wouldn't finish it.

TY for your posts!  Definitely very helpful to me!

 

[fdxr]

 
I assume you're only giving him 50 mg daily, correct? That's the correct dosage of fluconazole for an older kitten/adult cat.

Itraconazole/sporanox is considered the gold standard for ringworm treatment in cats, but it's not cheap and my understanding is that any compounded itraconazole made from the powdered bulk form of the drug is ineffective. The compounded med must be made from the capsules, which contain lots of tiny micro-beads, and the beads CANNOT be crushed during the compounding or the resulting med will be ineffective. What some pharmacists and shelters do is open up the 100 mg capsules and then divide up the micro-beads and put them into empty gelcaps. Dosage for an adult cat is 50 mg.

The other alternative is terbinafine, which is a very cheap generic at most pharmacies. At Walmart pharmacy, where I get mine, it's $4 for 30 tablets and $10 for 90. Tablets are 250 mg, and they're large and round. It's easy to divide them into quarters, and I've even cut them into eighths. Dosage is 30 to 40 mg per kg. A 6mo kitten probably weighs about 6 pounds, which is about 3 kg, so dosage would be 90 to 120 kg--a little less than half a tablet. I've had very good results with terbinafine in the former feral who was just treated with it and a littler of kittens dosed with it two years ago. They began to show improvement after two weeks, which is the right timeframe for most ringworm meds. Bear in mind that none of the oral meds--not even sporanox--kill the fungal spores directly. What they actually do is inhibit the production of a substance that the spores need to maintain their cellular structure. Without that substance, the spores begin to "leak" because they can't maintain their shape and then die. Any spores they produce once they're affected will not be viable. If the meds are working, the cat will no longer be shedding viable spores after about two weeks of treatment.

You can get terbinafine compounded into a liquid if you don't want to chop up pills and don't mind spending some money. I got an estimate from a mail-order pharmacy (Diamondback Drugs). 50 ml ranged from $60-$116 depending on the concentration. Like itraconazole, terbinafine is given daily for 21-28 days. Itraconazole can be "pulsed" after that if necessary, meaning it's given intermittently; one common pulsing schedule is one week on, one week off. Studies indicate terbinafine can probably also be pulsed because, like itraconazole, it lingers in the tissue at what's called the minimum inhibitory concentration for 2-6 weeks following the last dose. Pulsing not only saves money but is easier on the cat's liver.

Regarding Simple Green: According to Moriello's study (http://ogenasolutions.com/Support Studies/vde12074.pdf), Simple Green is effective against ringworm BUT you must spray thoroughly and have a 10-minute wet contact time.

Accel TB is the ready-to-use version of Accel, sold in spray bottles (probably 16 or 32 oz). It's not as economical as buying the Accel concentrate. One gallon of concentrate will make about 60 32 oz. bottles and costs $45-50. Each 32 oz. bottle of Accel TB is about $13-15.

Yes.  50mg a day (25mg every 12 hours).  He is 7 lbs at 6 months.  

Is it okay to crush up and put in wet food ?  My guy has been pilled and eye-dropped for 5 of his 6 months and is SO OVER IT.

Ok to hid in cheese whiz ?  I know its not healthy, but does it have any additional side effects on cats anyone know of?

Vet also told me to dip pill in tuna water.

 

[fdxr]

Any experience on monistat and colloidal silver first aid gel applied directly to the RW spots (with or without simultaneous oral medication) ??  I've seen posts with folks using

Colloidal silver, but haven't seen monistat mentioned yet.

Today I heard from a vet tech from years ago say they used Iodeine Tincture on the RW spots.  Obviously hold the cat until it dries.  She said it worked great and fast.

Anyone else hear of this old remedy ?  Says *poison* on the bottle and to contact poison control in case of accidental ingestion.  I feel most safe with the true colloidal silver

I get from Sprouts.

 

[baileytc]

FDXr:

To my knowledge, it's fine to crush the fluconazole, put it in cheese, etc. I've had good luck with putting small tablets in soft Whisker Lickins treats. One of my cats has been getting his daily dose of fluoxetine (Prozac) that way for years.

Re the spores not being viable after two weeks of meds: I wouldn't take that to mean that you can let the cat out of isolation. What it means is that the cat is beginning (if the meds are working) the healing process. All of the spores he shed up to that point are still infective and are likely on his coat, on the floor or other surfaces of his room, etc. According to Dr. Moriello, those old infective spores are not a danger in terms of reinfecting him or infecting your other cats, but they can cling to his coat and then cause a ringworm culture to turn positive when the cat is actually negative. I'm not sure if you're familiar with how vets take cultures: When there's an active lesion, the vet will take samples (hair, skin scales, etc.) from the lesion and its margins for the culture. When the cat is healing and there are no active lesions, the vet will take what's called a toothbrush culture--using a clean toothbrush to brush the cat's entire body and then either press the toothbrush bristles into the culture medium or (what my vet does) cut the bristles off and put them on the culture medium. This obviously gets material from all over the cat's coat--so if the fully healed cat walked through a spot with some old infective spores, the culture would turn positive even though he was no longer infective. That would lead the vet to tell you to continue to isolate him and give him meds even though he was cured.

Re the Accel TB: You go through a LOT of disinfectant when cleaning. I use at least one bottle when cleaning after ringworm. You have to make sure the disinfectant covers every area you want to disinfect to be effective. If you can afford the Accel concentrate, it's far more economical in the long run and will last for about two years if you keep the bottle capped. If not, then consider using bleach, which is much cheaper. Use a 1:10 dilution when you want to disinfect and make the diluted solution fresh each time you want to use it. Diluted bleach solution has a very short shelf life. Also make sure you use a fresh bottle of bleach--it only maintains its effectiveness for about 6 months.

Re letting the cat out of isolation after beginning dips: Not a good idea, for the reasons stated above. Best to keep him isolated until you get a negative culture back from the vet. Also remember that the primary mode of transmission is direct contact between cats. Any cat in direct contact with a ringworm-infected cat is quite likely to get ringworm--and because it grows so slowly, you won't see the lesions on the cat for about three weeks.

Re keeping the dip away from the lesion above the eye: No, that's precisely where the dip needs to go most--on the lesions. to keep it out of his eye, save a little bit of the dip and use something like a makeup sponge, cotton ball, even a q-tip to dab it on that area and keep it out of his eye.

Re effectiveness of terbinafine/lamisil: Toenail fungus in people is very difficult to treat, as are ringworm infected claws on cats. But these are skin infections and are thus MUCH more susceptible to oral drugs like terbinafine (the generic of Lamisil). Moriello said recently her two main oral drugs are itraconazole (sporanox) and terbinafine. That's a pretty good endorsement.

Re fluconazole vs. sporanox: Fluconazole is effective but it may take longer to work. I think many vets use it because it used to be a relatively cheap alternative to itraconazole. But it's gone up in price recently. Plus, terbinafine (lamisil) only recently became available as a cheap generic, so many vets don't have much experience with it. And it can be a challenge to cut up the terbinafine tablets to make the right dose for a cat. The dose for a 7-lb cat would be right about 125 mg--half a tablet.

Itraconazole is not widely available, to my knowledge, and it usually has to be compounded, which means a special order to a compounding pharmacy, which is why it takes a while to get. Any pharmacy--Walmart, CVS, Target, Walgreens, etc.--will have terbinafine tablets, usually very cheap. If it needs to be compounded into a liquid, that may require a special order to a compounding pharmacy.

Re your other cat scratching his ear: Some cats itch with ringworm. I haven't noticed it in any of the cats that were infected. Sometimes, the first sign is that the skin will become red. This appears to depend on the type of ringworm. M. canis is more likely to cause skin redness, I think. The former feral who was infected with Trichophyton rubrum had only skin discoloration and some scabbing--no itchiness, no redness, and no hair loss until we were a few weeks in.

I'm not sure what area you live in--I assume you're in the U.S.--but here in the southeastern U.S., it's been a bad year (according to my vet) for pet allergies. It's also the height of winter, which means dry air from indoor heat causing dry, itchy skin. That's my vet's working theory for what's causing hair loss on the ears and nose of a couple of my cats who have had negative fungal cultures and ringworm PCR tests. I have eczema, and it goes into high gear at this time of year. So your cat scratching his ear could be due to dry skin and/or allergies.

Re iodine for ringworm: My understanding is that iodine is not effective for ringworm.