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As many of you are all aware I had some experience with
ringworm two years ago, many in the cat fancy have asked me to write about my
experiences so I thought I would give an account of what occurred.
One day in October 2004 I noticed a small bald patch on
my beautiful Murphy’s head just above the eye; it was the size of a pin prick.
I immediately isolated him but felt it was probably nothing. Over the weekend
the patch got slightly bigger, so on Monday morning I rushed him off to the vet.
It was felt by my Vet (and there were valid reasons why though remain unfounded)
that I had bought a carrier cat into my home. (This cat was returned less than
one week later to the breeder). My then vet performed an in-house culture test
for ringworm. Upon a positive result (only 4 days later) he and all my other
cats were prescribed griseofulvin.
Just ten days after beginning this treatment I found
Murphy collapsed and laying in his own urine. My son had checked Murphy at 5pm
and all was well. I went out to give him his medication and a cuddle at 7pm to
find him in this desperate state. My usual vet’s emergency facilities were 24
miles away and all my instincts told me that Murphy would not make that journey,
so I phoned the nearest Vet to my home with emergency facilities. This journey
was only 15 minutes but the most harrowing car ride I have undertaken. By the
time I got him to the Vet Murphy’s breathing had ceased and restarted (with help
from Rosie my daughter then only 11 years old) 3 times. The Vet (Chris) was
stumped, and then asked what Murphy’s CBC results were prior to taking the
griseofulvin; I did not know what he was talking about. Chris discussed a
number of possible options, poisoning, heart problems etc and asked me to sign a
form permitting euthanasia should he deem this a last resort option. I and my
son left in tears and returned home to my distraught family. I sat by the
telephone all night.
At 6am I phoned Chris, he told me Murphy was bearing up,
his initial blood results were relatively normal (however, this apparently
happens with griseofulvin poisoning), they had him on a drip but things did not
look good. During the course of that day Murphy perked up, but as soon as they
attempted to take him off his drip he would deteriorate again.
I put posts on many Yahoo forums asking for help and then I
got one from a wonderful lady Roe in the US who had lost a cat to griseofulvin
poisoning 5 years before. She told me to check the dosage. I immediately phoned
Chris, when I told him the dosage there was stunned silence initially then
outcry. He now felt sure this was what we were dealing with. He told to me to
ensure all medication to the other cats ceased and he wanted to see them to
check their health.
Eventually Murphy came off the drip and seemed to be
holding his own. Chris felt that he would do much better at home, there was no
more they could do for him and we were basically playing a waiting game. We
bought Murphy home late at night on that Saturday. I sat all night and day with
Murphy on my lap; all ideas of barrier nursing were forgotten as I watched the
life of my boy go out. By evening it was apparent to me he was in pain, so we
rushed him back to the Vets. More tests were done and they clearly showed
multiple organ failure. It was felt the best decision was to put Murphy to
sleep. My boy died in my arms, a quiet and very dignified death. I talked to
him the whole way through, because it is believed that the hearing is the last
thing to go and I wanted him surrounded by words of love. The two vets in
attendance and my husband sobbed, three big grown men, but my heart had done all
the crying it could in the days before. I was numb by this point.
The emergency vet Chris has now become my regular vet, he
has explained to me that he has not used griseofulvin for years. He has seen
too many cats ill or dead even at normal dosages, and even after all tests have
been accurately performed. A number of professionals have explained to me that
in-house tests are easily contaminated and should not be used. Some of them
feel it unlikely that my boy ever had ringworm in the first place. However, as a
result of that initial diagnosis I spent hours reading all I could on the
subject. I experienced what it must be like for people going through the hell
of ringworm, the disease itself and the associated stigma attached to it. I
have had masses of communication since with people living through it, so here is
my experience.
If you have a cat diagnosed with ringworm and you have a
GCCF registered cat in your home then you must inform the Governing Council of
the Cat Fancy (GCCF) as ringworm is a reportable condition. Their rules are
that no cat can leave or join your home until all cats have been treated and all
cats have been cultured and microscopically examined twice with tests taking
place 8 weeks apart. In the interim period between tests no topical treatments
must be used though systemic treatments are allowed. The cattery is placed into
a quarantine situation and nobody living in the home may even visit a show as a
visitor and certainly cannot show their cats. If any person in a quarantine
situation fails to abide by these rules hefty fines are imposed and in some
circumstances there may be a lifetime ban. So, whilst I only ever had one cat
showing any signs/symptoms all of my cats were
prophylactically treated and
tested.
In the UK ringworm has a
lot of stigma attached to it, perhaps because of our strict rules people often
keep it a secret, as you all probably know I did not and went public with my
problem. In many ways I feel this has helped stop some of the negativity about
ringworm. Over the last year I have been overwhelmed with emails and phone calls
from breeders (one a Judge here) going through the hell that is ringworm.
When I first got my
diagnosis, I had little knowledge about ringworm and spent many hours surfing
the Internet in an attempt to find out more. The most important thing I
discovered was the importance of cleaning the environment. Everything that can
be must be bleached daily in a 1:10 bleach and water solution. If you have
carpets they must be vacuumed and then vacuumed again daily. For this reason I
chose to rip up and throw out all my carpets, I was lucky enough to have
wood-flooring downstairs in my home anyway, so it only entailed me ridding my
home of the stairs and bedroom carpets. All cat toys that cannot be bleached
daily must be thrown, so all cat activity toys went to the dump with the
carpets! I washed my bedding daily because the cat’s love to lie on my beds.
My settee’s all had throws placed on them and yes you’ve guessed it they were
washed daily too. I have never done so much housework in my life!!
As Murphy was the only
cat I had with a diagnosis he was isolated from the others. Luckily I have an
outside play run with more than adequate housing, so much to the disgust of my
other cats who were then banned from using it he was quarantined there. When I
went out to visit Murphy I wore protective clothing and gloves. Everything I
touched was placed in bleach (including the keys to the run), his bowls were
bleached and his bedding thrown. The clothing I wore was boil washed and shoes
bleached.
All of my cats except Issy
who was pregnant were prescribed what is a fairly standard treatment for
ringworm here, Griseofulvin. I would personally never use this treatment while
I am aware that my cats were prescribed a ludicrous dosage I have had contact
with breeders all over the world who have had sick or dead cats at even normal
doses of this stuff. Here is a little of what I found about it:
- All my cats had been
given a massive overdose of griseofulvin. The recommended dosage from
Edinburgh University is 10-30mg per kg daily, from Bristol Vet School
10-50mg/kg daily. My boy was prescribed and taking double the maximum
recommended dose of a drug that should be known by Vets to be potentially
lethal. ALL of my cats were taking dosages way above recommended amounts,
with one kitten being prescribed 4 x the recommended dosage despite the fact
that I only ever had one cat with symptoms of ringworm.
- This drug is
contra-indicated in breeding cats, male or female.
- It is recommended that
full blood checks be done prior to starting this medication.
- CBC checks are needed
regularly (weekly or bi-weekly at least) since bone marrow suppression with
anaemia and pancytopenia may occur.
- Pregnant women should
avoid handling griseofulvin.
- You should avoid
cutting/crushing pills; if unavoidable a face mask must be worn and double
layer latex gloves. (500mg tablets had been prescribed which I had to cut).
- Once the protective
layer has been pierced via cutting or crushing, the toxicity of the drug is
heightened since this action increases the speed with which the drug enters
the blood stream, therefore, if it is entirely necessary to cut tablets,
dosages should be LOWERED to allow for the increase in toxicity that cutting
promotes.
- This drug has been
banned from use in cats in many EU countries, New Zealand, and many US
states. It’s license for use in the UK has apparently not been renewed.
There appear to be much
safer alternatives to griseofulvin such as Itraconazole (Spronox®), Terbinafine
((Lamisil® Tablets, Novartis) and Lufenuron (Program®,
Novartis). I obviously cannot recommend the use of any drug as I am not a vet
but I have spoken to breeders in the USA who have recounted good results with
these alternatives.
Since my cats had all
suffered from an overdose of this drug my new vet decided their systems should
be left to recuperate. My vet had had some good experiences with the use of
Program, which is actually a flea treatment that has been found to be helpful in
some instances. It has no known side effects at even quite high doses, so we
decided to try this as a prophylactic treatment. It’s use is still a little
controversial because it has not been fully researched in ringworm cases but
there is some circumstantial evidence that it has some success. My vets good
results had come from Persians and these are apparently a nightmare breed to rid
of ringworm. So my cats began a course of Program (there is a lot of data on
this including dosages on the files section of the Fanciers Health yahoo list).
Before my cats embarked on their first set of tests I used Malaseb anti fungal
shampoos as a topical treatment. My pregnant Queen only ever had shampoo
treatments due to her condition; sadly Issy reabsorbed her kittens later on.
On the 18th
October 2004 my first set of cultures were taken and whilst I still had no other
cats with signs of ringworm I awaited the results with some trepidation.
Thankfully all 7 cats proved clear. I then had a long 8-week wait where no
topical treatments were allowed. The second sets of tests were done on the 15th
December 2004; because of the Christmas holidays the results were delayed.
Imagine my disappointment when one of my cat’s results was returned after being
contaminated at the laboratory! Thankfully all other cats’ tests were ok and
proved clear but it meant I had to re-test the cat with the contaminated
sample! This eventually proved clear too. This obviously delayed things by a
few weeks. It was not until the 26th January that my Vet finally
signed my ringworm clearance form and I was free from quarantine.
If you would like to know
more here are some good links
http://www.newmanveterinary.com/Facts%20About%20Ringworm.html
http://www.petalk.com/drug-dosages.html
http://www.vetmed.ucdavis.edu/CCAH/Prog-ShelterMed/ringworm.htm
http://www.vetinfo.com/cringwrm.html
http://www.pandecats.com/x/ringworm_battle_plan.htm
Important
note: Murphy was diagnosed by use of
an in-house test, I have since learnt from Dr Susan Little DVM that these are
unreliable. There is a question mark over whether Murphy actually ever had
ringworm at all. It is highly unlikely that only one cat in a multi cat
household would contract it, it is highly contagious. All the other cats tests
were sent to Glasgow.
I would like to
dedicate this article to my beautiful boy Murphy who died a needless and tragic
death, God bless you my darling you have left a hole in all our hearts, 14th
November 2003 - 3rd October 2004. He was had a personality like no other
and a fabulous pedigree from old English lines which are all to rare these days.
Rest In Peace my beautiful boy.
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