Ringworm (Dermatophytosis)

In my time as a veterinarian in Darwin, and especially since we founded the rescue A Safe Place for Meow, I have diagnosed and treated A LOT of ringworm!

This fungal skin disease has had me fascinated from the very beginning.

When we were in our very early days of the rescue, we didn’t realize just how common ringworm infections in the stray population of Darwin truly was. Until we had a pretty major outbreak within our foster network!

We then had a very steep and fast learning curve when it came to ringworm. I am still constantly working to expand my knowledge on this pesky fungal disease, however my knowledge levels on ringworm (compared to just over a year ago) is pretty substantial!

As a rescue, we are very passionate about treating stray cats and kittens that have been diagnosed with ringworm. We always struggle to find foster carers who will foster cats with ringworm and cat flu (so if you’re reading this and considering fostering for a rescue, please consider offering to foster cats with ringworm! I can assure you they will be over the moon to find a ringworm carer!). I think it may be because the foster carers are worried they will catch ringworm, however as I explain the disease below, you will find it is relatively easy to treat in humans and it’s actually not as scary as everyone thinks!

So, pleas enjoy the information about ringworm below. I have also included some pictures I have taken during the diagnosis of ringworm (the ringworm glows a spectacular apple green colour!) and some amazing ‘before and after’ shots of one of my very special foster cats called Ash. Ash had the worst ringworm I have ever seen, however after 8 weeks of treatment, we successfully cleared it and he went on to find the purrfect forever home.

What is ringworm?

Despite its name, ringworm is not caused by a worm!

Also known as dermatophytosis, ringworm is a fungal infection of the skin.

What does ringworm look like?

In humans, ringworm lesions are often red, circular and itchy. In animals (and in particular cats), lesions can vary in appearance. Some lesions will appear red and hairless, whilst other lesions can be grey and scabby, or more rarely can present as small lumps under the skin. They very rarely present as the typical ‘ring’ appearance that occurs on humans.

How is ringworm transmitted?

Ringworm is transmitted by arthrospores. These spores are created by the fungi splitting up into small microscopic fragments, and are very infective.

The most common way for these spores to spread to other hosts is by direct contact with an infected cat, however they can also be transmitted by contaminated bedding, brushes, and exposure to a contaminated environment.

Can ringworm be transmitted to humans?

Yes, ringworm can be transmitted to humans however usually only to those that have an impaired immune system (e.g. HIV positive, undergoing chemotherapy, on immunosuppressive medications) and young children

If you do become infected with ringworm, it is easy to treat – usually involving treatment with topical creams only

If you have a cat in your home that has been diagnosed with ringworm, it is unlikely you will catch it if you maintain good hygiene (hand washing, regular cleaning of environment, frequently removing dust, etc.)’

How does the veterinarian diagnose ringworm?

It is relatively easy to diagnose ringworm, as in most cases, when the lesions are inspected under a UV light, the spores fluoresce a bright green apple color!

This is my favorite part about ringworm. I have seen some pretty spectacular glowing cats! Although from a rescue perspective, it always makes your heart sink a little when you are checking out a suspect lesion and you see those characteristic apple-green spores.

Other ways to confirm the diagnosis that the veterinarian may opt to perform is skin cytology (taking samples from the lesion and looking for spores under the microscope) and fungal cultures (sending samples to the external laboratory for analysis).

How do you treat ringworm?

Treatment of ringworm generally involves a combination of whole body washes, topical creams and oral medications depending on how severe the infection is.

If there is only one single lesion, your veterinarian may only prescribe a cream and a wash, however if there are multiple lesions, your veterinarian will probably recommend a combination of medications.

The oral medication most commonly used is called itraconazole due to being the most effective and safe oral treatment available for dermatophytosis.

Here are some photos below of just a few of the many cats I have bathed for ringworm! The wash I have used is a miconazole/chlorhexidine wash (the brand we currently use is Malaseb). It is important to leave this wash on for ten minutes, and then rinse it off thoroughly. Do not allow them to lick the wash before it is rinsed off!

In addition to medications, it is important to reduce contamination of the environment by the spores created from the fungal lesions.
This includes regularly cleaning surfaces, floors and bedding. Previous studies recommend a general clean of the environment should be performed twice weekly for the duration of treatment.

One of the most effective and easily accessible antifungal cleaning products is household bleach (diluted with water at a dilution rate of 1:100) or any over the counter bathroom or general disinfectants with a label claiming to be effective against Trichophyton mentagrophytes (Athlete’s foot).

As always, consult your veterinarian if you suspect your cat may have ringworm. In addition to having your veterinarian create a personalised treatment plan for your cat, it is also important they are seen for regular check ups throughout the course of treatment to ensure the ringworm is clearing!

Ash – ‘Before and After’ photos:

Before

Ash with ringworm as a newcomer to the rescue – he was missing clumps of hair everywhere, and his skin was so scabby and sore that it hurt him to walk! He was basically a walking ringworm lesion!

After

Ash after 8 weeks of treatment! Ringworm free and ready for his forever home.

Please feel free to leave comments below if you would like me to create a more detailed post about anything I have mentioned above, or if you have any questions or feedback!

Feline Idiopathic Cystitis

Also known as:

  • Stress cystitis
  • Feline interstitial cystitis
  • Pandora syndrome
  • Idiopathic feline lower urinary tract disease (FLUTD)

This is my favourite disease of all time to educate clients about!

Whilst it can be a very frustrating disease, with some patients experiencing recurrent bouts of FIC throughout their lifetime, there are many different options for management and treatment.

Environmental modification and enrichment has been shown to reduce the frequency and severity of clinical signs by 70-80%, which in my opinion is pretty outstanding! Just by improving your cats home environment, it is likely you can effectively manage this disease for the rest of their lives with very minimal long term costs.

This post is just an overview of the fascinating topic of feline idiopathic cystitis, and treatment options will be elaborated on in future posts – so stay tuned!

About:

Feline idiopathic cystitis is a chronic sterile inflammation of the bladder. Although they may show symptoms of having a urinary tract infection, there is no infectious component (i.e. bacteria) contributing to the bladder inflammation.

Studies have shown that in young cats showing urinary tract symptoms, less than 2% will actually have a true urinary tract infection.

It is likely that there are multiple factors that lead to sterile inflammation of the bladder including interactions between the bladder wall, the nervous system, the adrenal glands and the environment.

Symptoms may include:

  • Increased frequency and/or urgency of urination
  • Straining to urinate
  • Urinating in unusual places (towels, sheets, sinks, showers)
  • Excessive grooming
  • Blood in the urine
  • Behavior changes (aggression, hiding)
  • Distressed crying (while urinating or near the litter tray)

FIC can be classified into ‘obstructive’ or ‘non-obstructive’

Non-obstructive FIC occurs in approximately 80-95% of cases, and symptoms will usually resolve within 1-2 weeks

Obstructive FIC occurs in approximately 15-25% of cases. Obstructive FIC causes the urine to be unable to drain from the bladder. This is a potentially life-threatening condition, and symptoms include, in addition to those listed above, lethargy, vomiting and/or inappetance. Obstructive FIC predominantly occurs in male cats due to their narrow urethra, however can still occur in female cats.

Diagnosis of FIC:

FIC is a diagnosis of exclusion, meaning all other causes of urinary tract inflammation must be ruled out. Other causes of lower urinary tract signs include a urinary tract infection, urine crystals and bladder cancer.

First, your veterinarian will need to evaluate a urine sample from your cat. Ideally, the urine sample is retrieved via a short procedure called cystocentesis. This procedure is performed by inserting a small needle through the skin and into the bladder. The urine sample is sent to an external laboratory for comprehensive testing. Your veterinarian may also request blood tests.

Risk factors for FIC:

Some cats are more prone to FIC. As stated above, this is usually a combination of factors including genetics and the environment.

Cats that are more at risk of developing FIC include:

  • Male cats (especially neutered males)
  • Overweight cats and sedentary cats, with very little exercise
  • Cats in multi-cat household, particularly when there is tension between cats
  • Cats in a new or different environment to their usual routine
  • Cats that eat mainly dry food or cat biscuits (leading to inadequate water intake)
  • Cats that do not have adequate number or size litter trays

Treatment:

There is currently no cure for FIC, and due to the waxing and waning nature of the disease, goals of therapy are to reduce the severity and duration of clinical signs. Treatment also aims to prolong the time between FIC episodes in cats that experience recurrent FIC.

Treatment includes a multi-modal response, including:

  1. Environmental modification to reduce stress
  • Multiple and separate resources such as food and litter trays (particularly in multi-cat households)
  • Hiding places and high viewing points
  • Increased play, exercise and human-cat interaction
  • Outdoor runs and enclosures
  1. Increasing water intake and diet management
  • Low calorie weight loss diets
  • Specific urinary health diets
  • Pet fountains to promote drinking water
  • Increasing wet food component of diet
  1. Litter tray management
  • Increasing the number and locations of litter trays in the house – particularly in multi-cat households (one litter tray per cat PLUS one)
  • Regular cleaning
  • Trialing different types of litter – your cat may have a preference!
  • Increasing the size of the tray
  1. Use of medications (over the counter and prescription from your veterinarian)

I always recommend an examination by a veterinarian each time your cat has a recurrence of FIC to ensure that they are not experiencing a life-threatening urinary obstruction. By working with your veterinarian, the aim is to reduce the severity of symptoms during a FIC flare up, and reduce the frequency of recurrence long term.