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Old 08-10-2011, 04:23 AM   #1 (permalink)
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Default Ringworm! Is ketoconazole toxic???

My cat (Joshua) has ringworm on his lower tummy and it itches. The vet has prescribed Ketoconazole and Clemastine. I stopped the medication after 2 doses cuz he foamed in the mouth and kept drooling while taking medication.

Ketoconazole shampoo and nizoral seemed to have helped in the first 2 weeks, and cleared the surface, but I still can see some black specks and redness on that patch of skin, and it seems that the black specks have spread a bit (or maybe I didn't notice that before since only the original place is red)
Is it possible to cure ringworm without oral medication?
Joshua is old, and I'm afraid the oral medication is bad for his liver.
should I give him the oral medication? or should I be patient with shampoo and cream?
Any advice would be appreciated.

Thanks!
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Old 08-10-2011, 05:53 AM   #2 (permalink)
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When an older cat gets ringworm its a sign that he has a compromised immune system. It sounds like the medication is hurting your cat. The drooling as a sign. Try athlete foot cream. Plus colloidal silver on ringworm areas min. 3 times a day. See if that helps. Colloidal silver helped a kitten I was fostering turn the corner when nothing was working on him.
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Old 08-10-2011, 06:05 AM   #3 (permalink)
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Thanks for the reply.I'll try to get Colloidal silver.

The vet said he drooled because Clemastine is bitter, but it still worries me to give him oral medication.
I've tried 2 kinds of athlete food cream, Lamisil and Nizoral. Lamisil made it worse, but Nizoral, which contains ketoconazole, has cleared the surface a bit after 6 days.
I'm wondering if it will ever go deep into the skin to kill the ringworm.
It has been over one month, with all the frustrations, I nearly give in to the oral medication, but I'm still hoping there is a better remedy than that...
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Old 08-10-2011, 02:17 PM   #4 (permalink)
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Hey there!

I've been dealing with a ringworm nightmare for about a month too. Right now I have two kittens at home, isolated in a room, under treatment.

I started with Itraconazole 3 weeks ago. First week, nothing. Second week, some improvement. Right now their lesions are almost completely gone and they are perfect. A week ago the vet got blood samples to see how were they tolerating the medicine, and everything was more than perfect.

Have you considered Itraconazole? I also bathe them, but the bigger they get the more chaotic baths have become (I got a huge scratch in my neck and now I'm seriously considering not bathing them anymore).
Maybe itraconazole is not recommended for older cats, but I advice you to star oral medication asap, 'cause topic treatment could work, but will be slow and it may fail completely.

Hope that helps!
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Old 08-10-2011, 02:44 PM   #5 (permalink)
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Ringworm doesn't go away right away, I had ringworm and it took a month of using a topical cream (Canesten) twice a day before I stopped applying it, even though I was worried I should've gone longer, since the skin was still looking reddened (not inflamed or ring-like though)... the skin was damaged and that takes a long time to heal on top of the fact that there is ringworm. From what I've read of the store bought creams they are totally safe to use, if you think you or a pet has ringworm you can apply them just to be on the safe side with no side effects. Well, unless you or your pet has a reaction to the active ingredients. In that case figure out the ingredient causing the problem and get a different brand of cream that doesn't use it.
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Old 08-10-2011, 03:57 PM   #6 (permalink)
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Here is information from The Pill Book Guide to Medication for Your Dog and Cat -

Regarding Ketoconazole:

"Ketoconazole may cause decreased appetite, vomiting, and liver damage, and is poorly tolerated by most cats. Fluconazole and itraconazole are newer antifungals that are better tolerated by cats, but are fairly expensive ..."

Regarding Clemastine:

"It is commonly used in dogs and considered accepted practice. Other antihistamines are more commonly used to treat cats."

It sounds to me like your vet may be primarily a canine practitioner. I assume this is also an older vet who is used to prescribing older meds or who deals with a lot of low-income clients who can't or don't want to pay for newer drugs with fewer side effects. Regardless, I recommend asking your vet about switching to itraconazole or fluconazole, as well as to a different antihistamine. It typically takes 10-14 days to start to see improvement with any of the antifungals - they are NOT a quick fix. All antifungals have the potential to cause liver damage. Fluconazole is also excreted through the kidneys, so there is potential for damage in those organs, as well. Since your cat is old, it's important to have a blood panel run before and during treatment with any of these drugs to keep a close eye on organ health.

Laurie
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Old 08-13-2011, 07:47 AM   #7 (permalink)
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Thanks for the replies. I discussed about Canesten with a pharmacist, and she told me to use Nizoral for another week so the ringworm doesn't get resistent to this drug. If Nizoral doesn't work after another one or two weeks, I should try Canesten. Thank you.

I'd like to talk to my vet about itraconazole or fluconazole, thanks for the information. I hope I don't offend him by suggesting any drug to him lol. He is very good in treating difficult surgical cases, and he has saved Joshua's life years ago after Joshua had been given up by 20 vets.
I still haven't given Ketoconazole to Joshua yet because I'm trying to see if there is a milder way to cure, hoping he might develop antibody to fight the ringworm... (My family has started yelling at me because of this.) Is it possible?

I'm also looking into anything that can help boost his immunity. Does anyone here have any suggestion? I heard a few drops of vinegar in water might help.. Has anyone tried other methods?

I'm not sure if Jushua has any improvement. The entire patch is a bit more red than other part of skin, and it itches. Whenever I touch that part, he would keep licking his Elisabeth collar. I thought ringworm is supposed to have ring shape, but besides two smaller red circles, his groin has entire patch of redness with tiny scattered black specks, which can be seen only under strong light. Has anyone seen that before?
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Old 08-13-2011, 12:03 PM   #8 (permalink)
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I have seen that. Two weeks ago, after two weeks of starting treatment with itraconazole. Now that stage is completely gone and my kittens have hair growing in the lesions. I might be wrong, but I think that what you are seeing it is some improvement, but after a month it is not a great improvement.

I strongly suggest you consider oral medication. Blood tests (a lipid panel among others) are advisable before starting the treatment. If tests results are fine, then you can start for a week or two and then repeat the tests to see how your cat is tolerating the medication.

I know topical treatment may eventually cure the disease, but it has been a month and I think starting oral medication is the best you can do now. How expensive is itraconazole in your country? 120ml of Itraconazole here cost around 25 - 30 dollars.

Good luck, keep us posted!
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Old 08-14-2011, 04:00 AM   #9 (permalink)
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Thanks Lenkolas, I wonder what the black specks are. Are they dead fungi or active fungi? Some affected area is smooth but red, and have lots of tiny black specks. The black specks seem increased (or perhaps my imagination) Does it mean it is improving?

I will do blood test first before I give oral medication.
I'm not sure how much itroconazole costs. I thought we have to get it through a vet...
I'll check with the vet next week.
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Old 08-17-2011, 03:53 AM   #10 (permalink)
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Joshua has sat in the sunlight for 1-2 hours each day in the past 2 days. The red patch has turned darker red. I can't tell if it is better. Or could it be sunburn?
If it was sunburn, wouldn't other area turn red as well?
Does anyone one know if ringworm would turn darker in the sun? Are they dying?
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