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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

Need pet health advice? Ask a vet

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Ask a Vet

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Jumbo,LILO,stitch, and pleakley

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Feline

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7 Weeks

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Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Lesions

We are fostering 4 kittens who all have ringworm. The vet gave us terbenafine liquid and lime sulfur dip to apply to the affected areas . We were told to give them the oral medication daily and apply the topical solution every 3 to 4 days . It’s been 7 days and there has been no improvement. Can we have some advice please ?

June 7, 2018

Jumbo,LILO,stitch, and pleakley's Owner

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Dr. Michele K. DVM

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0 Recommendations

Ringworm can take some time to resolve, as it is a slow growing, and slowly resolving, fungus. If the lesions are not getting worse, you are giving very appropriate therapy, and it may just take more time. Sometimes these kittens need to be on anti-fungal therapy for 4-8 weeks.

June 8, 2018

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Luna

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short haired

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7 Months

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Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Scabs On The Nosebridge. Spread Quickly
Scabs Nose Area,Lathargic Not Eating

I recently had my cat at the vet for ear mites and an allergic reaction to them. The doctor noticed a small scab on her nose and within 2 weeks the scab has spread almost to her eyes.

June 5, 2018

Luna's Owner

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Dr. Michele K. DVM

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It would probably be a good idea to have Luna re-examined by your veterinarian, as that is uncommon to have a reaction to ear mites, and she may have larger problems. Since I cannot see her or determine what might be going on, having her examined will allow your veterinarian to see her, figure out what is happening, and get her appropriate treatment.

June 5, 2018

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Mandrake

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tabby

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8 Weeks

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Fair severity

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Fair severity

Has Symptoms

Areas Of Ring Work Above Eye
Ringworm Spot To Stomach

I have a foster kitten from our local shelter. Today I saw a bald spot and we had him blacklist. It glowed around the eyes and ears. I gave him a chlorhexidine bath. And have topical medication. They also gave me itrafungol, however their vet said not to give until 10 weeks old. The literature says it can be used based on weight from 0.5lbs and up. Also, speaking with a few fellow fosters that are vet techs, they say it's ok to start at his age (8weeks about 1lb). Is it ok to start ? He is in a wire crate up and away from all my animals. Any other tips to prevent spreading? How long should we quarantine?

June 5, 2018

Mandrake's Owner

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Dr. Michele K. DVM

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I can't advise on when to start the medication, as I have not examined Mandrake, and there may be a reason that the shelter veterinarian wants to wait - it would be best to call and ask if you can start earlier. Otherwise, you are doing all the right things - bathing with an antifungal shampoo might be better than chlorhexidine, but the act of bathing is the significant benefit to that, regardless. Washing bedding frequently also helps. He should be quarantined until all signs of the fungal infections are gone, most likely until the medication is stopped.

June 5, 2018

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Bentley

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Ragdoll

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3 Months

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Moderate severity

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Moderate severity

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Rash

My kitten got diagnosed with ringworm and they gave him the oral antifungal medicine. I have three other cats that have been exposed should I go ahead and start them on treatment and what would be the dose?

May 7, 2018

Bentley's Owner

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0 Recommendations

You should keep Bentley isolated from the others and you should clean all bedding and anything else Bentley may have come into contact with; if the others are not showing signs of ringworm you should bathe them all and as I mentioned keep Bentley separate. You could treat all cats, but it may be unnecessary. Regards Dr Callum Turner DVM

May 8, 2018

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Nebula

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short hair

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6 Months

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Mild severity

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Mild severity

Has Symptoms

None

My cat is on micaved for ringworm but it's on a weird spot on her neck that we can't cover or use collar. she seems to lay head on paws then lick them. Is it dangerous for her to ingest a little from licking? what should I be watching for?

March 2, 2018

Nebula's Owner

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Dr. Michele K. DVM

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0 Recommendations

Thank you for your email. A small amount shouldn't hurt her, and that cream tends to taste bad which is a deterrent for her to eat it or lick at it. If she develops any vomiting or diarrhea, it may be related to that and another form of therapy may be needed. If she is eating, drinking, playing normally, then you should not need to worry.

March 2, 2018

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