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What is Antifungal Therapy?

Fungal infections in the cat are common. Those most likely to be encountered are ringworm (Dermatophytosis) or malassezia. Ringworm is a potential zoonosis to people, and whilst in healthy individuals it is rarely serious, for those people with suppressed immune systems it could prove a serious complication. 

Whilst a wide range of antifungals are available that are highly effective, they are not without side effects. Treatments can be topical such as a cream or ointment that incorporates an antifungal, or they can be systemic such as an oral liquid or tablet. The latter is often necessary for ringworm as it invades deep into the hair follicle.  It is also important to disinfect and clean the environment to prevent accidental reinfection or cross infection.

Antifungal Therapy Procedure in Cats

Most cats are treated as out patients in first opinion practice. 

In the case of ringworm, long-haired cats may be clipped at the beginning of therapy in order to reduce the shed of infected hairs. Cats that tolerate bathing can be washed in anti-fungal shampoo containing miconazole and chlorhexidine every three to four days, which again reduces shed of contaminated hair. 

Once ringworm is diagnosed, systemic therapy is started. This is either an oral medicated liquid or tablets. Liquid medications are better suited to the cat as it is easier to adjust to give an accurate dosage. The most frequently used oral liquid, containing itraconazole, is given on a 'week-on, week-off' basis until repeat fungal cultures come back negative. Older therapies such as griseofulvin tablets are given daily and unfortunately this older drug, although cheaper, is linked to a greater risk of side effects. 

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Efficacy of Antifungal Therapy in Cats

Modern antifungal drugs are extremely effective, although several weeks of therapy is often required, so the response is not quick.  Owners also need to be mindful of the risk of infection posed by environmental contamination. A cat with ringworm sheds infected hairs during the course of their treatment. These hairs pose a potential infection risk to other mammals, including people. 

Thus restricting the cat under treatment to one room is a good idea, to make daily cleaning and vacuuming more realistic. In addition, cats with suppressed immune systems are less able to keep fungal infections in check, so prolonged treatment may be necessary. 

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Antifungal Therapy Recovery in Cats

For a severe ringworm infection it can take several weeks for infected hair to be shed and a healthy coat grow through. For less serious infections, the cat may be able to mix with others again after two to three weeks. 

It is advisable for the owner to wear latex gloves whilst applying topical treatments to cats with ringworm. In addition collars, bowls, bedding, and toys should be considered infected and regularly washed and disinfected. 

Skin and ear infections caused by malassezia are less contagious, and usually due to an overgrowth of a normal skin inhabitant. These cats do not need to be isolated during treatment and don't pose an infection risk to people. A topical treatment such as an ointment containing miconazole or medicated ear drops is usually sufficient to bring the problem under control. A typical course of treatment for an ear infection is 10 to 14 days.

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Cost of Antifungal Therapy in Cats

The cost of diagnosis of ringworm can vary depending on the test. Shining a Wood's lamp on the cat (detects 50% of cases) may be included as part of the consultation fee. However, sending hair plucks away for culture ranges in cost from $10 to $40. 

Itrafungol solution requires a prescription and retails for around $80 a bottle. However, this provides sufficient solution to medicate several cats. Your vet may have an open bottle and be prepared to sell you just the amount needed for one cat. 

Griseofulvin tablets (prescription required) can be bought for around $30.

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Cat Antifungal Therapy Considerations

Ringworm is highly contagious and a zoonosis, therefore treatment is essential. However, the systemic treatments do carry the risk of side effects, including loss of appetite, vomiting, diarrhea, and in a worse case scenario, liver or kidney damage. It is, therefore, important to monitor the patient, stop treatment if complications occur, and speak to your vet. 

The dose of medication can be minimized by administering it with a fatty meal, such as giving a knob of butter with food. This improves the penetration of the drug into the skin where it is most needed. 

Treatment also needs to be given for prolonged periods of time. Three weeks is a common minimum, with longer needed in some cases, depending on the severity of the infection. 

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Antifungal Therapy Prevention in Cats

Key to preventing ringworm or malassezia infections are keeping the cat in optimal health. Those cats that are in good physical conditions will have a strong immune system which is better able to police the skin and fight off infection. 

Those cats most at risk are kittens, stressed cats, or those with feline immunodeficiency virus or feline leukaemia. Given the infectious nature of ringworm, places where groups of stressed cats live in close conditions is the perfect environment for spread. Unfortunately, this sets up many shelters as potential hotspots of infection. 

Observing good hygiene when groups of cats are housed together is crucial. This means not sharing brushes, frequent washing of food and water bowls along with litter trays, regular bedding changes, and disinfection of the cattery accommodation. 

It is also essential to identify infection promptly and isolate the affected individuals so they don't act as a source of infection for others. 

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Antifungal Therapy Questions and Advice from Veterinary Professionals

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Domestic short hair

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3 months

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Unknown severity

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Bloated Stomach

Hi! My kitten is 3 months old and was recently on panacur for parasites that were not confirmed but he was placed on It because his stomach was enlarged. He finished a 5 day treatment, but there is really no improvement in his stomach. It does not seem to bother him, as he is eating, playing, sleeping etc. he does have ringworm though so I do wonder if this has anything to do with It?? Thank you!!

July 24, 2020

Owner

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Dr. Sara O. DVM

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0 Recommendations

Hello, So sorry to hear that your kitten is having issues. If he had parasites, it would be best to have a fecal test to recheck and make sure that they are all gone. Many times kittens need a few dewormings to get rid of all these parasites. Ringworm usually only affects the skin and does not cause them to have a bloated abdomen.

July 24, 2020

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Max

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short hair

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8 Years

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Mild severity

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Mild severity

Has Symptoms

Small Bald Patch

I have a very healthy middle aged short haired tuxedo cat that has developed a small 1/2 inch or so bald patch on his left side. A ring worm culture was done but after 14 days was still negative and the vets office discarded it (maybe they should have kept it at least 21 days?). Coincidently, I simultaneously also developed small red flaky bumps on the side of my ring finger. Am I right then in just assuming it must be a slow growing variety of dermatophyte? I'm treating my finger with lotrimin. I don't really want to risk oral meds for ringworm or sulfer/lime baths etc. Would you suggest a topical (have already tried Tresaderm with no improvement or effect), the anti-fungal shampoo, or just see if will self resolve after a couple months? It doesn't bother him at all. He doesn't scratch or lick the area, and it doesn't appear red or inflammed in any way.

Sept. 1, 2018

Max's Owner

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Genske

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Domestic mix

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3 Months

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Serious severity

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Serious severity

Has Symptoms

Fungal Infection
Scabies
Malnutrition
Left Eye Conjunctivitis

I adopted two stray kittens, they were taken to our local vet who said one of them (Genske) had fungal infection patches and scabies, as well as malnutrition. We were prescribed with miconazole + chlorhexidine bath sol. We gave the kittens a bath twice every week using this solution. What I want to ask is, is it ok for me to apply sertaconazole nitrate cream(2%, Zalain cream) on him to speed up his fungal infection recovery? As I couldn't find literature on the dosing, on whether this concentration is appropriate topically for kittens. Kittens' current condition: though having malnutrition, has great appetite and excellent activity and vigor; almost half the size as his sibling of the same age, and we pulled out a worm from his anus last time we bathe him (topical med. against parasites were given); many bald patches along the back and face, sparse hair throughout body and limbs; bountiful ear-wax; left eye conjunctivitis treated with antibiotics eye drops.

July 17, 2018

Genske's Owner


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0 Recommendations

Sertaconazole is not a product intended for use in cats, I have no data for its use either off label; I would just recommend treating as per your Veterinarian’s instructions especially with Genske being so young. Regards Dr Callum Turner DVM

July 17, 2018

Thank you doctor!

July 18, 2018

Genske's Owner

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Timmy

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domestic short hair

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2 Years

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Mild severity

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Mild severity

Has Symptoms

Ear Infection

My newly adopted/rescued cat tested with a yeast ear infection. They prescribed drops but this cat hides most of the time and does not know us or his home yet. He does not come out long enough for us to give him the drops and when we try to pick him up he runs. Is there no oral anti-fungal medication we can give to help resolve this? I fear we are doing more harm than good as this cat gets to know us and his new forever home.

June 20, 2018

Timmy's Owner

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Dr. Michele K. DVM

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1 Recommendations

Ear infections don't typically respond well to oral medications, and usually need topical therapy to heal. If you are able to get the drops in most of the time, it may help. If you are completely unable to treat, there are gels available that your veterinarian can put in Timmy's ears that take time to absorb, and those can help with infections. You would need to talk to your veterinarian about this option to see if that is something that they offer.

June 20, 2018

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Beauty

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Hemalian Persian

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4 Months

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Fair severity

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Fair severity

Has Symptoms

Fungi
Fungi- Ringwor

My kitten has been diagnosed having fungi. She had a spot behind her ear and on the top of her ear. I took her to three vets and each gave me different medications. One gave me oral medication, flunazol,and lamizil creme. Another said that I should stop that medicine because it is harmful for her liver and started giving her weekly injections and said that these shots are for her immune system. The third said that I should stop all medications and only use the cream. I am confused. I stopped the oral medication for a week but the she had another spot. Last week I started with the oral medication and I am using the cream as well. However, I am worried about her liver. She is now 3 monthes and three weeks old. I am confused. What do you advise me to do?

June 17, 2018

Beauty's Owner

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0 Recommendations

Many different antifungal medications are contraindicated in patients with liver disease or in young kittens, the decision to prescribe any antifungal medication is at the prescribing Veterinarian’s discretion; the second Veterinarian may have been concerned with using an oral antifungal in a kitten this age. Without examining Beauty, I don’t have a doctor-patient relationship with her, so I cannot change the treatment offer by a Veterinarian after a in person examination. However, treat how you’re doing for know and monitor for improvement; generally oral and topical treatment works best for severe cases. Regards Dr Callum Turner DVM

June 18, 2018

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Dijon

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domestic short hair

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5 Years

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Mild severity

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Mild severity

Has Symptoms

Bald Spots
Dark Spots,
White Scales

Vet diagnosed my cat to have ringworm on his face (nose, eye area, and 1 paw). It's been 3 weeks of treatment (1 week of oral medication, one without, and another week with). There are dark spots where the fungus was on the face. There are dark patches (like scabs) underneath the paw with ringworm. Is this normal?

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