Ringworm

[baileytc]

I've looked at Shockwave and may get some. I've got several cleaners and disinfectants that are effective against ringworm: Benzarid, Accel, plus various bleach-based cleaners that studies have shown will kill trichophyton mentagrophytes (the fungus that causes athlete's foot and ringworm) within 10 minutes. But all but the Benzarid have a strong odor, although the Accel smell dissipates pretty quickly. Many vet clinics use Accel for cleaning/disinfecting because it only requires a 5-minute contact time to kill fungi.

I know how to clean and how much. I just don't know how anyone with a full-time job does it. I'm up at 6 or 6:30 and out of the house until 7 or 8 at night. When I get home, I'm tired and still have to feed the cats and myself, take care of bills and other stuff around the house, etc. Cleaning on top of that is exhausting. I can't run on 4-5 hours of sleep at night and be effective at work. It's all I can do to finish the piles of laundry (my sheets and towels, the clothes I wear to clean, the towels in the iso rooms with the cats, plus the sheets covering the cloth furniture).

I have no idea when I'm going to know if the house is clean of the infection because I still haven't gotten a culture that's positive for ringworm from any of the cats or kittens. This strain of ringworm or whatever it is doesn't glow under the Woods lamp, either. So I still don't really know if it's ringworm. I haven't gotten any other spots besides the two red spots on my back and arm, which faded pretty quickly with the antifungal cream, so I'm not sure it really was ringworm. The itchiness I'd been feeling subsided when I took Allegra-D, so it may have been caused by an allergen rather than ringworm. Plus I have psoriasis, which causes itchiness. If my house really is covered with ringworm spores, it seems like I should have more lesions. Yes, I'm careful about washing my hands after touching the cats, and I shower each morning and evening after taking care of the cats, but still. It's so frustrating to not know whether it's really ringworm and whether I need to put away everything I own and spend every spare moment (not that I have many) cleaning.

And to boot, several people from the rescue group I work with who've been through ringworm trauma are telling me that I need to have all the carpet in the house bleached to kill the spores or they'll just keep reinfecting the cats. This house has wall to wall carpet both upstairs and downstairs. I'm looking at hundreds, maybe over a thousand dollars to have the carpets professionally steam cleaned and bleached. I'm going to have a hard time going to that effort and cost without a positive ringworm culture.

On the other hand, I have no idea what it could be if it's not ringworm, and neither do the three vets I've consulted so far. I have two cats who have no signs of ringworm except excessive shedding and some itchiness; I've been successfully giving them fluconazole ground up into their food for the past few days--fingers crossed they'll continue to eat it. I have another cat who has no current symptoms except itchiness but has shown some in the past (and is on terbinafine as a preventative). I have one cat (Romeo) with lesions who's on fluconazole and is healing--and his lesions are re-growing hair from the center outward, which is typical of ringworm. And I have another cat with an atypical lesion--which he got while he was on terbinafine, which is really hard to understand--that turned into an open sore, which has now healed but isn't re-growing hair. I'm taking this last cat to the vet on Saturday for an exam; the lesion healed up pretty well but is now looking red and inflamed at the edges, so I'm wondering if maybe he needs some antibiotics. It's maddening not knowing what this is and what will resolve it for good.

 

[baileytc]

Glad to hear you got the kittens out of the shelter. I know you're upset with the shelter, but bear in mind that like most shelters and rescues, they're probably running on a shoestring budget and are manned by overworked, stressed-out volunteers or staff that earns almost nothing and works long hours. When they say they only have sick cats see the vet, they're probably talking about cats/kittens with symptoms that are or can quickly become life-threatening like chronic diarrhea or vomiting, URIs, etc. Bartonella--which is tough to diagnose correctly--is usually treatable with cheap, readily available antibiotics (azithromycin), although it can take a while to clear up. Other symptoms of bartonella are a poor hair coat and eye infections.

I didn't realize your kittens were asymptomatic for ringworm yet were carrying it. That may be the case with my two who don't have any lesions but have been exposed to it by the others who do have lesions--if it's truly ringworm. I really wish there was a more reliable test for ringworm other than cultures, like a blood test. I've read that a PCR (DNA) test for ringworm has been shown effective in studies but isn't commercially available yet. I'm sure it will be expensive when it does become available, but at this point, I'd pay quite a bit to know for sure whether what I've got is ringworm or not. My other option is a skin biopsy, but that can be less accurate than a culture, from what I understand. 

Good luck with your kittens!

 

[catmom110]

Hi! I don't know how big your home is, but yes it's a lot of cleaning at least it gives peace of mind. I'm still vacuuming furniture and cleaning everyday. I think I developed some kind of germs phobia. I am a stay at home mother who is active outside of the home with volunteering and being on the board of directors in the building I live in. I drop my son off at school at 8:00 and come home and clean 1-2 hours a day - everyday. Once in a while I skip a day of complete cleaning, but I am so shell shocked from when I got infected, that I've made it a priority. I might have to see a therapist because this ringworm has rocked my world in a bad way. If you haven't gotten any more leasion a I would imagine that it would be safe to change your sheets and towels as you would normally. As for carpet and fabric furniture- when this is over maybe you can have that cleaned professionally. I was freaking out because every morning Id wake up with 2 or 3 new lesions and I felt gross and I didn't know all that I know now. If you can vacuum and dust for an hour and listen to an iPod - it's a good workout! If everyone is on antifungal oral and fur is growing back, I'm sure spores aren't spewing all over the place. All I'm saying is make sure the the spores that are there don't accumulate to contagious proportions. I know it's exhausting - at least you get out and work to get it off your mind. My kittens are back in my apartment and taking over. My Jackie who is recovering is obviously not thrilled. They eat her food and take her toys even though they have their own new toys - Jackies lesion is really growing a lot of fur back! And she will get cultured next week. But since she's home I have not had any lesions at all! The kittens somehow got into my bed last night and I woke up at 4:00am in a sweat with one of them across my neck snoring! I'm praying that everything and everyone stays fine. But you seem like you've weathered a lot of the storm already -

 

[catmom110]

Jonah and Jacob are only home for the last two days and I feel itchy but I don't know if its psychological or not. But I do know that there is an incubation period of at least a week or so I think. I'm a little skeaved out by them and am calling them the "wormy" brothers - they are adorable and the really want to cuddle like in your face cuddle.

 

[meandmycats]

Chlorine Dioxide. It really works!  Good luck everyone!

http://www.jkatinc.com/page3.html

 

[cate0]

Going through this right now with my foster kittens! It's been about a month since I identified the ringworm and started treating it. Will share some stuff about my experience in case it's helpful to anyone else.

I'd had one foster kitten (now 5 months old) living in my house for about a month with no symptoms, but we got a second foster after that (now 4 months) and I think she must have brought it in, even though she had no lesions at the time. She since developed a couple teeny spots and some flaking around her ears, but that was it. Unfortunately our first kitten hasn't fared as well—he seems much more susceptible to it and had spots all the way from his forehead to the middle of his back. My roommate got a few spots that he thought were spider bites but it wasn't until I got some myself that I finally realized what it was.

I've been keeping the two cats separated because they're very into play fighting and little scrapes and scratches make a good entry point for the fungus. Thankfully even though they both started out semi-feral they were pretty socialized by the time I caught the ringworm—would've been a nightmare treating them otherwise.

Unfortunately fostering with a rescue means I've got some limitations as to what I can give the cats, but we seem to be making progress.

An essential is going out and buying some sort of black light right away. I wasn't able to find a portable lamp, so I bought a "party bulb" at Safeway and stuck in it a small lamp of mine with the shade left off. Most ringworm fluoresces bright green under black light, but you have to get super close to see it, so something you can move around the cat's skin is best.

Since they're kittens the rescue director wasn't comfortable using oral medication, so I've been using topical clotrimazole twice a day—rub into the spots, then put on a cone for an hour so it can be absorbed without the cats licking it off. For the topical medication I think it's really important to have the fur trimmed so that the cream can actually get into the skin. The first week or two of treatment all the skin starts flaking off around the ringworm and it's super gross, but then the irritation subsides and the fur starts growing back. BEWARE, though, just because fur's growing back doesn't mean the lesion's gone, just that the infection is weaker! This worked really well on the younger kitten, but is going very slowly on the older one with more extensive lesions.

Originally the people who helped me shave around the lesions used a drugstore battery bikini trimmer. It's less loud than a normal trimmer (though a bit less efficient), so it doesn't scare the cats as much. Since then I've been very carefully using little nail scissors to keep the hair short in any area that lights up under black light.

I've also been bathing the cats twice a week in an antibacterial/antifungal pet shampoo given to me by the rescue. Dunno if it works as well as sulfur dip, but it certainly gets rid of a lot of the green stuff on their skin, and it smells nice, too!

For myself and my roommate, we started out using the same cream we put on the cats, but that works even more slowly on people. My understanding from the internet is that there are a few topical drugs (Lamisil and Lotramin Ultra) that work as fungicidals (killing the ringworm) as opposed to the others, which work as fungistatics (keeping the ringworm from reproducing). Unfortunately, the stronger topical drugs don't seem to be available OTC in Canada, but I was able to pick some Lotramin Ultra up visiting some family in the U.S. last week, which my roommate is using. As for myself, I discovered a little patch on the side of my finger a week and a half ago, decided that was the last straw and went to a clinic to get oral medication. The stuff I'm taking is terbinafine, and I haven't had any side effects but I've read about some truly nasty ones in people (nausea, exhaustion, liver failure, losing your sense of taste for months, severe anxiety/depression) so I'd be cautious in giving it to cats. It seems to be pretty effective, though.

Other stuff I've been using, though I'm not sure how helpful it's been: Dr Bronner's tea tree oil soap as a body wash and rubbing alcohol (to dry out & disinfect lesions after showering.

Jeez, this is getting long. Onto the cleaning! I live in a basement suite, so there was no chance of isolating the cats. I've been using a lot of this non-bleach fungicidal spray (again, obtained via the rescue) on everything—surfaces, carpets, and furnishings. Not sure how safe that is. Oh well. Vacuuming everything regularly as well, and bleaching out the canister once a week. Bleach in all the laundry I'm comfortable using it on. Everything else just gets washed as often as possible—hoping enough runs through the washing machine will rinse away whatever spores don't get killed. I also soak their litter boxes with bleach for at least ten minutes twice a week when I change the litter. I tend to clean the whole house the same day I give the cats baths so that they don't immediately get re-contaminated.

Since the treatment has been pretty ineffective on the one kitten I am trying out some of the Lotramin Ultra on him today to see if it helps. My understanding is that it's pretty dangerous if ingested, so I've limited it to very small amounts only where the ringworm is still glowing under black light, and will wipe him off with a damp cloth as soon as I take the cone off.

Here are some pictures, all of the older kitten with the worse lesions:

about a week and a half into treatment (with a sock sweater because the trimmed fur made him cold!)

today, about three and a half weeks into treatment (much better, but you can still see a small lesion behind his left ear, and there's more lurking underneath the hair, which you'll see in the next picture)

today, the back of his neck under black light

Sorry about the essay, hope this is helpful to someone!

 

[cate0]

Whoops, those picture links don't seem to be working. Here they are again, in the same order:

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[cate0]

...Apparently that didn't work either. Sorry, I can't figure out how to delete posts! They're just at imgur, not sure why that's being blocked.

Let's try this one more time with embedded pictures.

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• cate0
• Oct 20, 2013

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• cate0
• Oct 20, 2013

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• cate0
• Oct 20, 2013

 

[catmom110]

Honestly I feel that intraconazol, yes it's an oral liquid that needs to be obtained through a compounding pharmacy and ordered by your vet....is the best. Everyone exposed even if they are showing no lesions is the best way to get rid of ringworm along with dipping in Lyme sulfur or even at the very least antifungal shampoo. Lyme sulfur can be purchased on line and I hear it smells like rotten eggs. My vet bills cost me a trip to Paris for my 50th birthday but I need my animal as well as my human family and house a safe haven. So pay the vet, I did. At the very least Lyme sulfur dips and then 3 all over toothbrush cultures that are 10 day cultures. Good luck!

 

[baileytc]

Update: Romeo's been on the fluconazole for 4 weeks and his fur has grown back almost completely and he hasn't developed a new bald spot in about 2 weeks. He's still isolated in the bathroom, which I'm cleaning thoroughly about once a week. He gets very distraught in the carrier I keep him in while I'm cleaning, rubbing his nose and face against the door so hard that he tears up his skin. Broken skin + ringworm = not good, so...cleaning his room once a week only. So far so good, particularly now that he has to be virtually non-contagious after 4 weeks of meds. I'll probably take him back to the vet next week sometime for a toothbrush culture, which I'll ask them to keep for 21 days vs. the typical 10 days.

Due to not getting a positive culture on Romeo, the vet wants to continue the food trial; she thinks the lesions were more typical of an eosonophilic granuloma from a food allergy than ringworm. So he'll stay on Hill's hypoallergenic diet for at least another 2-4 weeks, probably longer. If the vet wants to discontinue the fluconazole after 8 weeks, then I want him to stay on the diet so if he develops more lesions, there will be no way to mistake it for a food allergy.

Two of my other cats are on a pulse schedule with terbinafine. One is completely asymptomatic, and the other had a nickel-sized circular bald spot above his eye that has now healed--but hasn't regrown hair. The vet still thinks it's not ringworm but isn't sure what it is. She thinks the hair isn't regrowing because it's in the telogen (resting) phase and prescribed some antihistamine that might help to encourage it to regrow. He's been on it for a week and no regrowth yet.

I've managed to get the other two cats--who I can't catch to medicate in a standard fashion--to take fluconazole in treats (one of them loves the Nature's Balance rabbit treats) or ground up into wet food. They wouldn't do that with the terbinafine, which requires a larger dose and apparently has a very bitter taste. Fluconazole is more expensive than terbinafine, but nowhere near as expensive as itraconazole. They've been on it almost 2 weeks now. They're completely asymptomatic--but they have been ever since this started, other than being a little itchy and shedding a lot. I'm planning to keep them on it for at least 8 weeks.

As for cleaning the house, I'll admit that I've slacked off. Work is crazy right now and will be for at least another month, as I prepare for a major product launch in early December, so I'm working longer hours. I'm vacuuming every few days, swiffering a little less than that (I've only got a few areas with non-carpeted floors anyway), and slowly disinfecting and storing books, CDs, knick-knacks, etc. to make the flat surfaces easier to wipe down. I've got a LOT of books and CDs, so it's very slow going. I've started changing the bedsheets every other day vs. every day but am still washing them in bleach (they're old and will get tossed when I'm confident this is over). I'm only showering at night (in addition to the morning) when I've done some intensive cleaning but am still changing towels every day and washing them in bleach, too. The fabric couch has a slipcover on it and then old sheets draped on top of that; I change them every few days and wash them in bleach. The leather furniture is getting wiped down thoroughly with leather cleaner and then covered with plastic drop cloths to prevent more spores from settling on it. I'll need to spray the underside with an antifungal as well. And all the clothes I wear to clean or handle the cats get washed in bleach as well. I don't touch the cats after I get dressed for work in the morning, and then I change as soon as I get home into cleaning clothes.

I still have no spots that appear to be ringworm, after that apparent false alarm on my back. My upper back and neck are red and itchy, as are parts of my hairline, but from what I've read, this is most likely my psoriasis acting up or a related condition called seborrheic dermatitis. The itching subsides when I take OTC antihistamines like Allegra or generic Zyrtec, so it's very manageable. My failure to develop ringworm is one of the primary reasons I think it's likely this isn't ringworm: Ringworm invades through broken or traumatized skin, and I've had a ton of scratches from the foster kittens all over my arms and legs for the past few months to the point where I look like I've been through the war. And there's the psoriasis, which has created minor fissures in the skin on my feet. My immune system is also somewhat compromised (psoriasis is an auto-immune condition). Put all of that together with a house supposedly full of ringworm, and I should be covered with spots. I took terbinafine for five days, but that was about three weeks ago; maybe it's still preventing the ringworm from developing, but I doubt it. I guess we'll see. The incubation period for ringworm in people is 4-10 days, from what I understand. 

Regardless, I'm going to continue to clean, albeit slowly. I'm also getting the HVAC ducts cleaned and sterilized in about two weeks. It's a 40-year-old house, about 2400 square feet, and I've lived here for six years and never had the ducts cleaned, so it's a good idea regardless (although not cheap at all). At that point, all the cats will have been on meds for at least 3.5 weeks so they should be shedding only non-viable spores at that point. I'm aiming to get all or most of the wall to wall carpeting professionally steam cleaned (maybe with bleach or an antifungal like Shockwave) a week or so after that, depending on how booked the carpet cleaning companies are before Thanksgiving. The HVAC will be serviced and the filters changed the week before Thanksgiving. So that combined with a slow but thorough cleaning of the house will, I hope, get rid of the majority of whatever spores there might be. I'll never get all of them out, but I need to remove or kill enough to prevent there from being a "critical mass" that could reinfect the cats once they go off the meds. IF this is ringworm. Man, I wish there was an easy, affordable way to identify it in the environment.

cate0: Don't be afraid of terbinafine for your cats, if you're looking for a cheaper alternative to itraconazole or fluconazole. Do a google search, and you'll turn up several studies that found terbinafine to be a good alternative to itraconazole at the proper dosage (30 to 40 mg per kg daily for at least 21 days, then you can either continue daily dosing or go to a pulse schedule--I'm pulsing at one week on, one week off) with a similarly low incidence of side effects, mostly vomiting. Terbinafine is a $4/$10 generic at most pharmacies. The drawback is that the pill is large, and the dosage for an average-sized adult cat is about 5/8 of a pill. One of my fosters didn't tolerate it well; she vomited every few days after being dosed. But the others have had no problems. Even the one who vomited checked out fine on a test of her liver and kidney function. I had five-month-old kittens on it, and none of them vomited or showed any side effects. One of the vets conducting some of the studies--Dr. Karen Moriello, one of the leading authorities on ringworm--said she'd had kittens as young as eight weeks on it.

When I took terbinafine, it did affect my sense of taste for certain foods (some kinds of cheese but not others), but that wore off within a week or so after I finished the meds. I'd had similar side effects from antibiotics, so it was no big deal. 

Good news: Three of my six foster kittens have been adopted! The other three are still in the adoption center waiting for their forever homes, but I'm confident they'll get adopted. The two that were the most timid around people have gotten friendlier, which is great. No one understands why the third hasn't been adopted: He's a purry lap cat and very handsome as well (buff tabby). None of them have shown any signs of the ringworm (or whatever it was--we never got a positive culture from any of them, even after 21 days and taking samples from active lesions on two kittens) recurring, which is great. 

 

[catmom110]

No one works harder than a rescuer and I commend you for your dedicated work saving the lives of animals and finding their forever homes! You seem to have everything under control and great knowledge! Thank you for sharing!

 

[baileytc]

Thanks, catmom110. How are your kittens and Jackie doing?

After being on fluconazole for almost 5 weeks, Romeo developed another lesion on his back. It grew REALLY fast and was red and somewhat raw-looking like the one on my orange tabby's forehead. I took him to the vet last weekend, and she thought it looked like eosinophilic granuloma, not ringworm. The normal treatment for that is prednisone, which would send ringworm into overdrive. So she suggested doing a skin biopsy first, which I was very much on board with (I was going to suggest it if she didn't). Romeo had the biopsy done today, and we should get the results by the end of next week. I'm trying not to be too optimistic that it will come back negative for ringworm. If I expect the worst, I won't be disappointed.

No new lesions on the other cats, at least not any that I can see. They're all a bit itchy, as am I. I'm definitely going to get the ducts and the carpet cleaned because I think there's something floating around that's causing the itchiness.

I'd still like to determine if there are ringworm spores in the house (the areas that the free-roaming cats have access to at the moment) from the foster kittens and my orange tabby that MAY have had ringworm, and the vet said that a good way to find out is to perform a toothbrush culture on one of the cats. If there are spores in the environment, they'll be on his fur, and the toothbrush will pick them up; the vet cuts off the tips of the toothbrush bristles and sends them out to a lab, where they set up and monitor the culture for about three weeks. So I'll take one of the cats--probably the one who had the lesion on his head--in for that probably next week. 

Off to clean up Romeo's room before I get too tired to do it. I'm so tired I've been falling asleep on the sofa at night before I can make it upstairs to clean.

 

[catmom110]

I know it sucks big time and your e phyically tired. I'm sure Romeo wasn't thrilled for the biopsy Jackie so far so good and has a scratch on her head that I'm hoping isn't ringworm. The kittens have been back a month and no human here had any lesions. I'm just praying. Sounds like your doctor is a good one! I think that ringworm lives in the house in small quantized especially after an outbreak. Vigorous repeated cleaning with proper solutions kill the overgrowth that makes it contagious, but I also agree with those who say it can live up to two years in the environment without being contagious. I vacuum my sofas every three days and spray a light dusting of Lysol. Not sure I Lysol really works, but it makes everything smell nice and is safe for fabrics. Is Romeo sleeping with you? Anyway - I have to go - cats are sitting on the keyboard and its hard to type!

 

[GMacy]

Hello, everyone. I know this is an "old" thread, but was hoping some of you are still monitoring and might have updates or suggestions with "new" info.... I recently adopted a 5 month old kitten through a Rescue, who came to me with a Upper Respiratory Infection and isospora tummy parasites - got him started on meds for both and was breathing a sigh of relief that he was happy, playful, getting along great with my other kitten (6 mos old, adopted at 3 mos old) ..... And theeeeeen .... I started developing ringworm lesions.

I've had it before (10 yrs ago, but only on myself - though I got it from a stray outdoor cat I'd been feeding) and it didn't look quite the same, so went to a dermatologist - still waiting on culture results - but my 2nd kitten started showing same symptoms AT THE SAME TIME as I did. Vet's culture came back negative on hers, but the ONLY thing we had in common for exposure was the new kitten, who was completely asymptomatic. NOW he's showing a little spot on one ear, though it looks more like a play scratch may be from the precautionary culture I had them do for him. That culture came back positive for "microspores" - but he was sharing a carrier with the other kitten, and I was holding him before that, so I'm still holding out hope that he isn't for sure the culprit...

But whether he is or not, BOTH of them have been free-roaming in my house, I have carpet in the bedrooms and cat-trees they semi-share with my senior cat (who is a formal feral, and I canNOT give meds or baths to), upholstered furniture, and I Am Freaking Out over things I'm reading now about airborne spores and HVAC systems and cleaning regimens and passing it to other people, since my BFF and her dogs have come over a couple of times before the symptoms started showing on the kitten, and I'm terrified I may have been unwittingly transporting spores to her place on my clothes, or to the gym, or they got on Christmas presents I shipped to family and .... yeah. Not a fun start to my new year. Any advice or feedback "in retrospect" would be much appreciated, especially from anyone who had free-roaming cats that had picked it up.

Thank you all!

 

[jcat]

I'm going to refer you to a 34-page (!!!!) thread here that contains excellent information and tips on how to deal with ringworm. It's very long, but worthwhile reading, especially the links provided by our member @bunnelina
6 Things I Learned from Our Ringworm Plague (book length....)
These two articles should also be helpful:
Ringworm Infestation In Cats: The Housecleaning Regime
Ringworm In Cats: How To Win The Fight