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

[tracie holladay]

Our kitten is 4 months old. He eats solid food...he's a PIG...and seems to be in otherwise fiercely robust health.

Hubby has a very bad temper. If I suggest deviating from the doc's instructions, he cops an attitude and throws up his hands and threatens to withdraw all help - which I need when it comes to the heavy lifting, etc, involved with sterilizing the house - from this venture. Yet HE IS THE ONE WHO ADOPTED SONNY BEHIND MY BACK!

Oh and he is extremely reluctant to go by what some website says. He believes it's easy for someone to just lie on a website. No one knows who is really on the other end of that internet connection. Someone can claim to be a doctor when they really are not a doctor. And not only that, even if they are a doctor, they haven't actually physically SEEN Sonny and his ringworm lesions. This doctor has seen Sonny and knows his individual case.

Shouting has gone on, and right now I'm not even speaking to my husband. So I don't want to ask him to help me spot treat the kitten. That's how bad and stressful this has become. It's going to drive me to drink and I am a diabetic.

Part of what I find so damn frustrating is when I see people say "I got my cat over ringworm in 2 weeks". Then what's taking so long in my cat?!

I feel like I need to offer ten thousand apologies but I really have nowhere else to go, to vent, I have no help, no emotional support, it's killing me to hear him cry in the bathroom all the time, I can't stand the sight of the lesions and he must be in misery, I want this over with so I know my entire home is safe from ringworm, I want my other cat safe from it too....sometimes even when I'm at work all I want to do is cry all day long. I can't deal with this for another three and a half months or more. I just can't. I don't have the stamina. I want to be a lot more aggressive with treatment but I don't get much help from my husband.

I'm at my wits end.

The ONLY thing I think that will get my husband to help me be more aggressive with treatment is if HE came down with it. He said he had it when he was a kid and it was easy to clear up.

But maybe if he had a tougher case, where he was infected and reinfected and reinfected over and over, THEN he'll get a fire lit under his butt and he'll move more on treating this cat.

 

[tracie holladay]

Sure enough....husband does not want to deviate from the doctor's instructions and dip Sonny 2x a week. I just got yelled at AGAIN about this. He figures "if we are not going to follow the doctor's instructions, why are we paying him?"

He also has no trust in Dr Moriello. She isn't the doctor treating this cat. The fact that she has studied ringworm specifically, and the fact that she has had great success in treating shelter cats with ringworm, means nothing to him.

Now I am terrified that our doctor will give Sonny that toxic oral medication - it begins with a g and has killed cats - and my husband doesn't know about it. He doesn't know why I don't want it given to Sonny. He just robotically does what the doctor says and if the cat dies, oh well.

I want to get Sonny to a new doctor but I can't afford it.

I don't know what to do.

BTW let the record show that I suspected ringworm from day 1. I took him to the vet, told them "I suspect ringworm" but they tested for mange instead. But they saw no mites in the sample they took. Did they test then for ringworm? NOPE. He did start the miconazole treatment right away, but they didn't do a culture or Wood's lamp until his follow-up, 2 weeks later.

Someone said "NEVER GRISEOFULVIN" but my husband is such that, if the doctor gives him this, he'll give it to Sonny and if Sonny dies, oh well.

 

[bunnelina]

I'm very sorry you are in this situation and I hope others will chime in here to give you support. I hope you can stop crying so much. You will get through this. Even if you do NOTHING, the kitten will eventually recover and the ringworm will run its course. Because that's what it does. You two and your other cat would get it, and probably pass it back and forth between you all for a while, as you say, but eventually it would go away. Most of us can’t stand that scenario, so we treat it. By dipping the kitten even once a week, you are doing a lot to prevent it from spreading on the cat and onto yourselves. (BTW, ringworm is easier to clear up on people than cats. We don't have fur.)

Remember, you can only do the best you can and you are doing it. It also sounds like you and your husband may have larger issues beyond treating this kitten . . . none of my business. I'll stick to the kitten and ringworm treatment, more or less.

Most of us here spent several months treating ringworm, cleaning, etc. Until recently, just getting the three negative cultures took many weeks. The new PCR cultures give much faster results, but you still need to get through weeks of treatment before it makes sense to do cultures. Anyone who claims to cure ringworm in two weeks could be trying to sell a quack cure, I’d say. Run away.

It's wise to be skeptical; wiser still to intelligently evaluate and decide whom to believe and distrust. It’s good to doubt and question anything that claims to be "authority" or "truth" until you do your own background check, applying critical thinking and research skills. (Never ignore your gut instinct, either; it can be a reliable judge of certain situations.)

It’s smart for your husband to be skeptical about what he reads online. In the case of Dr. Moriello, however, I think he is mistaken because he likely failed to do any research. I suggest that he get on PubMed, the portal for the National Center for Biotechnology Information (U.S. National Library for Medicine) and look her up. Do that here. This is where doctors and vets go to find recent, peer-reviewed journal articles. You can find similar info about her work at ResearchGate. 

Your husband should go through her lists of publications and determine whether your kitten is getting optimal treatment. It should become quite clear to him that she is a national expert, if not THE expert on feline ringworm. Then you should both make sure your vet is up to date on her work. If your vet hasn’t heard of her, you have a problem. (But the fact that he’s ordering lime-sulfur dips suggests he has.) When my kittens were diagnosed, I did my research and came to my vet with printouts showing Dr. Moriello’s treatment protocol, having spent some long nights sifting through other treatment protocols and realizing that, finally, there was a vet in Wisconsin who knew what she was doing. My vet already knew all about her; I was SO relieved that we were on the same page. It gave me confidence and hope. It’s important: Make sure you have similar confidence in your vet, as the treatment can be unpleasant, difficult, annoying, and frustrating. (It’s also a great excuse to avoid people you don’t like, eat chocolate, order take-out, binge-watch good TV, wear ratty clothes . . . and drink, if you can. Do what you need to do to get through this!)

Where was I?  Oh. Most vets, for example, have stopped using griseofulvin years ago because research published, by Dr. Moriello and others, shows it’s more toxic but no more effective than other ringworm medications. All oral ringworm treatments are powerful and can have side effects so you need to be careful. Always double-check dosages, especially for small kittens. (Ask another vet or a vet pharmacist to make sure it’s right.)

Be a good advocate for your cat at the vet and do everything you can to take care of yourself at home. Best of luck!rngworm 

 

[tracie holladay]

Trust me I wish I could drink. Diabetes forbids....

 

[tracie holladay]

So I don't think I understand the healing stages. When my cat is covered in crusty stuff and there's flaking going on, what's going on there? Is it healing? Is the miconazole and lime sulfur working? In a lot of ways, my Sonny looks a little better but for the flaking part. 

But when we shampoo him, and get the flaky stuff off of him, underneath it looks a little better. 

 

[tracie holladay]

 
I'm very sorry you are in this situation and I hope others will chime in here to give you support. I hope you can stop crying so much. You will get through this. Even if you do NOTHING, the kitten will eventually recover and the ringworm will run its course. Because that's what it does. You two and your other cat would get it, and probably pass it back and forth between you all for a while, as you say, but eventually it would go away. Most of us can’t stand that scenario, so we treat it. By dipping the kitten even once a week, you are doing a lot to prevent it from spreading on the cat and onto yourselves. (BTW, ringworm is easier to clear up on people than cats. We don't have fur.)

Remember, you can only do the best you can and you are doing it. It also sounds like you and your husband may have larger issues beyond treating this kitten . . . none of my business. I'll stick to the kitten and ringworm treatment, more or less.

Most of us here spent several months treating ringworm, cleaning, etc. Until recently, just getting the three negative cultures took many weeks. The new PCR cultures give much faster results, but you still need to get through weeks of treatment before it makes sense to do cultures. Anyone who claims to cure ringworm in two weeks could be trying to sell a quack cure, I’d say. Run away.

It's wise to be skeptical; wiser still to intelligently evaluate and decide whom to believe and distrust. It’s good to doubt and question anything that claims to be "authority" or "truth" until you do your own background check, applying critical thinking and research skills. (Never ignore your gut instinct, either; it can be a reliable judge of certain situations.)

It’s smart for your husband to be skeptical about what he reads online. In the case of Dr. Moriello, however, I think he is mistaken because he likely failed to do any research. I suggest that he get on PubMed, the portal for the National Center for Biotechnology Information (U.S. National Library for Medicine) and look her up. Do that here. This is where doctors and vets go to find recent, peer-reviewed journal articles. You can find similar info about her work at ResearchGate. 

Your husband should go through her lists of publications and determine whether your kitten is getting optimal treatment. It should become quite clear to him that she is a national expert, if not THE expert on feline ringworm. Then you should both make sure your vet is up to date on her work. If your vet hasn’t heard of her, you have a problem. (But the fact that he’s ordering lime-sulfur dips suggests he has.) When my kittens were diagnosed, I did my research and came to my vet with printouts showing Dr. Moriello’s treatment protocol, having spent some long nights sifting through other treatment protocols and realizing that, finally, there was a vet in Wisconsin who knew what she was doing. My vet already knew all about her; I was SO relieved that we were on the same page. It gave me confidence and hope. It’s important: Make sure you have similar confidence in your vet, as the treatment can be unpleasant, difficult, annoying, and frustrating. (It’s also a great excuse to avoid people you don’t like, eat chocolate, order take-out, binge-watch good TV, wear ratty clothes . . . and drink, if you can. Do what you need to do to get through this!)

Where was I?  Oh. Most vets, for example, have stopped using griseofulvin years ago because research published, by Dr. Moriello and others, shows it’s more toxic but no more effective than other ringworm medications. All oral ringworm treatments are powerful and can have side effects so you need to be careful. Always double-check dosages, especially for small kittens. (Ask another vet or a vet pharmacist to make sure it’s right.)

Be a good advocate for your cat at the vet and do everything you can to take care of yourself at home. Best of luck!rngworm 

No no what I mean is, I've seen people on this forum claim that their cat's ringworm cleared up very quickly, in 2 or 3 weeks. Or something like that. I don't get why their cat's ringworm cleared up so fast but ours is not. 

And hubby doesn't do online reading or research. He just goes with what the doctor who has actually seen and handled Sonny says. 

 

[bunnelina]

Hi Tracie,

I've never heard of that happening on this thread. We were all slogging along for at least a couple of months doing the cleaning and medicating and dipping. 

I suggest you read this link, which is a good summary using pretty impeccable sources (i.e., Moriello), including sections on optimal treatments and so on. Pay special attention to "Verifying Cure." As Dr. Moriello says, cats can look pretty bad when they are actually ringworm negative (skin still healing) and look fine when they are not yet cured (more lesions could be coming down the pike).

 Because the fungal cultures take about two weeks to verify negative results, this means that treatment and documentation of cure will take a minimum of 6-8 weeks, and may take as long as 3-4 months. Housing and socialization of the animal during this period are extremely important considerations when deciding whether treatment in the shelter is practical.

PCR tests give quicker results but it still doesn't make sense to do them spaced very close together. Usually cats need more than a couple of weeks of oral meds before you might see a negative culture, and then you need to do another round of treatment to make sure, etc.

Maybe I once had as much faith in the infallibility of vets and doctors as your husband does, when I was much younger . . . but I no longer do. Vets are hard-pressed to keep up on the latest research on every ailment and treatment, especially when they are treating more than one species in their practice and the disease is uncommon, as ringworm can be in some parts of the country, although it's becoming more prevalent.

When our vet prescribed oral meds for our kittens, we'd been her satisfied, trusting clients for about 12 years. There had been very little ringworm in the Boston area up to that point; she'd seen only a couple of cases. When I filled the prescription (I had to get it at Boston Children's Hospital as it was an uncommon drug)  I thought the dosage seemed odd. Of course it was on a holiday weekend and her office was closed so I couldn't ask her. And I was dying to start treatment. So I called the pharmacy at our regional animal hospital, and learned that she had miscalculated the amount by a factor of 10. We would have been giving 1/10th the dosage and it would have done nothing. If she had miscalculated in the other direction it might have made our kittens sick or possibly killed them.

So I question vets and doctors all the time and do my own research using the best sources I can access. It can save time, and trouble, and sometimes lives. I hope your husband never has to learn the hard way.

You may be interested in the oral treatment section of the link above, too. 

 

[tracie holladay]

By the way, I have a question about handling a ringwormy cat. My husband was just snuggling Sonny and he didn't wear gloves. He was also scratching the crusty stuff on Sonny and itching his itchy areas. He also wanted to brush Sonny. I'm wondering if he's spreading the spores all over Sonny's body when he scratches Sonny. He tends to scratch him all over. I told him "you're putting spores all over him and making it worse" but he doesn't believe me. He just doesn't seem to GET this ringworm thing. He also often forgets to wash his hands after touching Sonny, and he goes and touches other things in the house - his tablet, his computer keyboard, his coffee cup, books, etc etc etc. 

What is the best way to handle a ringwormy kitty? I insist he wash his hands every time he handles Sonny. I do it when I handle him, and I put the shirt I was wearing directly into the wash. I also don't touch Gus, my older cat, until I have washed my hands and changed my shirt. 

What else should I tell hubby about touching/scratching Sonny while he's covered in ringworm?

Update: it's spreading to the other side of his body. He's been on ketoconazole for a week now. Still on miconazole 2x daily. We're going to 2x weekly lime sulfur dips now. 

 

[tracie holladay]

I thought I'd show you what I got when I clicked on that link

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• tracie holladay
• Dec 4, 2016

 

[tracie holladay]

sonnypostdip.jpg

• tracie holladay
• Dec 4, 2016

I got a photo of Sonny post-lime sulfur dip. I think I know what that face is saying...and it's not G rated. 

 

[bunnelina]

Tracie,

Try this link.

Or copy this: http://www.sheltermedicine.com/library/ringworm-dermatophytosis

Same thing.

As far as handling the cat, I don't know what to tell you. We didn't touch the affected areas on our cats except to treat with ointment or extra dip. We didn't handle them much during the first few weeks of treatment, except to deal with their other illnesses. After two weeks of oral meds and a few dips, our vet said they should be much less contagious, if at all, so we started cuddling them again.

Ringworm lesions are not usually itchy, so scratching isn't necessary. I'd leave any scabs or lesions alone to heal. Your husband sounds like a guy who learns by doing. If he gets ringworm, he may learn to listen to you.

 

[tracie holladay]

Ya know...it's funny....that web page says to not pre-wet the animal before using lime sulfur. However, the directions on the bottle we have say to shampoo the animal first so that's what we do. Are we doing something wrong? 

 

[tracie holladay]

Oh and Sonny licks his coat when he's out on the porch drying. Should I get an e-collar for him, to put on him after the dip? Is he not supposed to lick the stuff off?

 

[bunnelina]

I'd follow Dr. Moriello's instructions. She knows what works for cats.

Cats hate e-collars, so I'd try not add to the stress they're already experiencing with the treatment. He's licking to dry and comfort himself and chances are he's still getting plenty of the dip's good effects. If he's licking actual lesions, I'd consider it but otherwise . . . he's going to be licking himself whether he's dry or wet so it is what it is.

Under normal conditions, cats will remove random ringworm spores from the fur as they lick themselves.(Spores are floating in the atmosphere all the time, just like pollen; when conditions are all wrong, it gets out of control and becomes in infestation).  I wouldn't worry about it.

I hope he gets some negative cultures soon!

If you have any more questions, ask away. . . you're welcome! 

 

 

[tracie holladay]

Here's another question - and bear in mind, Sonny is getting topical treatments (miconazole 2x daily & 2x weekly lime sulfur dips) as well as ketoconazole 1x daily....

Is it unusual for ringworm to spread, even in the face of all these treatments we're putting Sonny through? The ringworm seems to have resolved on one side of his body but it seems to be spreading to the other side, as well as up the back of his neck & behind his ears. 

Is it possible this ringworm is resistant to all of these treatments?? If it is, what then??

 

[tracie holladay]

I have noticed some people have used colloidal silver to treat their cats' ringworm BUT given what I have read here on the Mayo Clinic's site....I think I'll not take a chance with this stuff with my cat. It just strikes me as pseudoscience. 

http://www.mayoclinic.org/healthy-l.../expert-answers/colloidal-silver/faq-20058061

 

[bunnelina]

Precisely! Does not work.

 

[bunnelina]

First, if your vet did a culture, he knows which type of ringworm Sonny has. Some are harder to treat than others, but those are rare.

Second, it does take a couple of weeks for the oral meds and dips to be effective. It can hard to know whether a cat is still infested or healing without doing cultures, but if it's actively spreading as you say, I'd double-check that you are doing the dipping correctly and that the dosage of oral meds is correct....

But, speaking of that:  I hope you read what Dr, Moriello says about ketoconazole in the shelter medicine pdf; as you know, she's researched these treatments more thoroughly than anyone:

Itraconazole is a good choice due to its demonstrated efficacy, relative safety, and long half-life in the skin. We do not recommend compounded itraconazole as it has repeatedly been shown to be less effective and may result in treatment failure.

Fluconazole and terbinafine are also reportedly effective. Griseofulvin is effective, but more likely than itraconazole to cause toxic side effects. Ketoconazole should be avoided in cats if possible, as it can cause hepatotoxicity in this species. Lufenuron (Program) has been shown in repeated studies to be ineffective.  

Not sure why your vet is giving your cat such a risky drug when others are safer and probably less expensive. Liver toxicity is far worse than ringworm and I wouldn't risk it. Ringworm doesn't kill, but some of the medications do.

You're welcome!

 

[erinc]

I've been dealing with ringworm in my apt for the last 3 months. I originally found a few rash spots on myself, then saw a scab on my cats ear that hadn't healed so I took her in to get checked. Only one of my cats has had any lesions but I took both of them in to get the dips, we did that 4 times. And Piper, the one with lesions, took 7 days of oral terbinafine. She had 2 cultures over this time period (one at the first checkup and one towards the end of those treatments) and both came back negative, but her ears were still a little flaky looking after all the treatments.

Anyway, before thanksgiving I assumed we were all cleared up because of the 2 negative cultures, but as soon as I got back from visiting family for the weekend, I noticed 2 new rash spots on myself. I've been to my dermatologist and they took a bacterial and fungal culture...I'm still waiting to hear back on both. I also took Piper back to the vet on Saturday and they did a dip and started her on a month of oral meds and she's due back for follow-up and another dip in 2 weeks. Yesterday I super cleaned, vacuumed everything, bleached floors, walls, and non-textured ceilings and sprayed the furniture with Tek-Trol antifungal spray. I can't cover the couches with sheets because my kitten, the one with no lesions, thinks it's an invitation to climb under all the sheets and play, so they don't really protect the furniture from fur. So I'm hoping just regular vacuuming and spraying with Tek-Trol will work.

This is the most stressful experience I've ever had to deal with. I stress over every tiny bump or red spot on my skin now thinking it's another ringworm rash (the last spots I had before thanksgiving left white scars). I just found a slightly pink spot above my eyebrow that I can't tell if it might be a new spot starting or if I just burned my forehead with my hair straightener. :/ I'm so anxious thinking about all the cleaning ahead of me for the next few months and still not having any concrete proof that it's even ringworm we need to be treating since both the cats cultures were negative and mine are still in the lab.

I'm thinking of having Piper tested for ear mites or scabies next time she's in because her flaky skin and scabs are localized to her ears and one scab spot above her eye, and she does have really dirty looking inner ears. I'm sort of hoping that's what we're dealing with and my rashes are a completely unrelated thing so that we don't have to deal with ringworm. I have absolutely no idea how it could have even gotten into my house because both my cats are indoor and the kitten was a stray but he'd been with me for 4 months before any of this came about and he was totally indoor that entire time as well.

It's great to know so many on this thread have gotten through this and not had re-infections but I'm still so stressed right now being in the middle of it.

 

[tracie holladay]

Well...apparently itraconazole has effects on the liver too.

"The most serious adverse effect is that which affects the liver (hepatitis). Signs of decreased appetite, jaundice, vomiting or diarrhea should be reported to your veterinarian."

All medications have to be processed through the liver. My metformin that I take for my diabetes is processed by the liver. So it seems to me any drug can be harmful to a little liver like Sonny's.

Getting despondent again....maybe I should give up and let it run its course. Maybe I should rehome him but no one will take him now, not covered in crusty junk as he is. Maybe I should also let Gus go too, as he is coming down with it. He would have to be put down, as his personality is such that he only loves me. No one else.

I am losing hope.

If someone wants to help me pay for a new doctor let me know.

I don't know how much more I can take.

I swear, other people here must have lied when they said they got their cat's ringworm under control inside of a few weeks. Lied!