by DR. Donna Stewart
For ringworm, I highly recommend the protocol outlined by Lorraine Shelton with a little modification. I have found fluconazole to be superior to other anti-fungals and recommend 5mg/lb once a day unless a cat is under 2#.
Don’t forget the Program. You will see a jump start in recovery when you give it, but it will not be sustained. Keep using it every 2 weeks. I give a 400 mg tab to a grown cat, 200 mg to a cat 4-6#, and 100mg to a nursing kitten.
The azoles and griseofulvin cannot be used on pregnant cats and the azoles affect male fertility. Pregnant cats are the greatest challenge. I have tried Lamosil and in one case it appeared to blister the ears. These cats require more bathing and religious use of Program until giving birth. The azoles do reach the milk, however, it does not seem to have adverse effects on the kittens that dosing them individually does. I do not recommend the azoles to kittens under 1#. It adversely affects the liver. These kittens will sit around hunched up as if they have abdominal pain and they will not eat. Discontinuing the medication and supportive care will allow them to recover, however, I would just recommend more vigorous bathing and program. I personally cannot stand the odor of lime sulfur and do not use it, but if you use it in nursing queens, be sure to rinse well.
I also recommend isolation in quarters where all surfaces can be cleaned daily with 10% bleach. That means that you not use any fabrics except a blanket for bedding that can be washed. There should be no carpeted cat furniture. Consider any horizontal surface and any litter dust to be contaminated with spores. Sweep up all dust and loose litter daily and throw away. Wipe down all horizontal surfaces with 10% bleach daily.
Bathe the cat 3x weekly with miconazole shampoo for the first couple of weeks and then when he is not getting any new spots, bathe 2X weekly. Change his bedding with every bath. If he gets lesions on his feet, throw out the litter and start fresh. If he is getting lesions on his head, dismantle the cage and clean vigorously with 10% bleach.
Think about isolation and cleaning. The vacuum cleaner, whisk broom and any other objects using for cleaning are contaminated with spores, so set aside the items to only be used around the contaminated area. Clean them with 10% bleach after using them. Use gloves around the infected cat(s), care for them last, and wash well after caring for infected cats to prevent spreading it throughout the cattery.
Good luck. I know it seems too hard, but persistence pays off. Donna