Ketoconazole and Revolution?

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Gail Futoran - 21 Jan 2005 14:30 GMT

I have a kitten on Ketoconazole for ringworm. It's
time for his Revolution application. I can't find
any contraindications for using these two drugs at
the same time (one post found in google groups
suggested both to treat mange), but I'd like to know
if anyone has any concerns. The pill is given at the
rate of 1/8 of a 200 mg tablet twice daily.

More info on the kitten: He's 8 months old, neutered,
FeLV+ but otherwise healthy, active, good appetite
(I always give him the pill after feeding canned food),
playful, healthy coat. He is showing no problems
with the pill, and I will take him in to the vet next
week to get his blood checked.

The bald, crusty spot I found two weeks ago under
his right arm was about the size of my palm (average
hand size for a female). Now the spot is almost gone.
Treatment also includes Melaseb shampoo every 5
days and the topical cream (I forget the name).

BTW, his roommate, an 8 month old FeLV+
spayed female has shown no evidence of ringworm,
which I find curious (but nice!).

Thanks for any help. Gail

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PawsForThought - 22 Jan 2005 15:04 GMT

>From: "Gail Futoran" futoran@nospam.worldnet.att.net

>I have a kitten on Ketoconazole for ringworm. It's
>time for his Revolution application. I can't find
>any contraindications for using these two drugs at
>the same time (one post found in google groups
>suggested both to treat mange), but I'd like to know
>if anyone has any concerns.

I would absolutely check with your vet and not depend on responses that you
receive on line.

Lauren
________
See my cats: http://community.webshots.com/album/56955940rWhxAe
Raw Diet Info: http://www.holisticat.com/drjletter.html
http://www.geocities.com/rawfeeders/ForCatsOnly.html
Declawing Info: http://www.wholecatjournal.com/articles/claws.htm

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Phil P. - 22 Jan 2005 20:49 GMT

> I have a kitten on Ketoconazole for ringworm.

<snip>

> More info on the kitten: He's 8 months old, neutered,
> FeLV+

*Please* do not use Ketoconazole in your cat. Its an older (>20 years) drug
and much more toxic to cats than the newer antifungal drugs. Ketoconazole's
rep is based on its efficacy in *dogs* (who handle it much better than cats)
*not* in cats.

Some vets still use Keto in cats because its so cheap compared to
Itraconazole (Sporonox) and Fluconazole (Difulcan) which are more effacious
and less toxic.

"Due to increased toxicity, ketoconazole should not be used in cats."

http://www.vin.com/VINDBPub/SearchPB/Proceedings/Pr05000/pr00110.htm

"Ketoconazole is usually not recommended for cats. Ketoconazole is capable
of numerous drug interactions due to inhibition of mammalian cytochrome
P-450."

http://www.dvmpharmaceuticals.com/dt111.html

"Also, the recent limited use of itraconazole in cats indicates that this
drug is better tolerated than ketoconazole, in that it appears to be less
hepatotoxic"

http://www.jaaha.org/cgi/content/full/39/6/543

Itraconazole (ITX) is the drug of choice for ringworm in cats and is a
breeze to administer. I found suspending ITZ in butter and giving the pats
as a treat was less stressful for the cat than pilling.

Most cats just love butter - and the fat increases absorption. I let one of
those little resturant-type butter tubs melt down at room temperature, then
thoroughly mix the 100 mg capsule in the liquified butter - then refrigerate
the tub. When the butter becomes solid, I cut the pat into four or five
equal pieces (depending on the cat) - each piece contains an equal amount of
drug - i.e., 5 pieces @ 20 mg.

A 4 kg (9 lb) cat usually gets 40 mg/day (or whatever my vet prescribes) -
so a 9 lb cat gets 2 pieces. I can cut those 2 pieces into smaller pieces
if necessary so that
the cat can gobble them right down. This method can't be used with all
meds, but it works like a charm with ITZ.

Lose the Keto.

Good luck.

Phil.

"How long does a cat stretch?
From one end of my life to the other"
--Me
Feline Healthcare - http://maxshouse.com
http://groups.yahoo.com/group/Feline_Health_and_Behavior/

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Gail Futoran - 23 Jan 2005 14:08 GMT

>> I have a kitten on Ketoconazole for ringworm.
>
[quoted text clipped - 10 lines]
> cats)
> *not* in cats.

[snips ahead]

Phil - I read the literature *after* the diagnosis and by
that time the kitten was already on ketoconazole. I'm
taking the kitten back in for a recheck on Monday and
will (1) ask for a CBC + liver enzyme, (2) ask about
switching to itraconazole. So far I have seen no
problems but he's only been on the drug for a bit
more than two weeks.

I will print out the information in the links you provided
to take to the vet, but I doubt it will make any
difference in their recommendations. Most pet owners
around here seem to want to do the absolute
minimum for their pets (if that!), and the vets have little
choice other than to do the best they can given those
constraints. (San Antonio euthanizes about 50,000 stray
and abandoned cats and dogs per year.)

> Most cats just love butter - and the fat increases absorption.

I add butter to the kitten's dish when I feed him prior
to giving him a pill and he eats it along with the canned
food. I give him the pill *after* he has eaten, and not
that long after. (I don't wait hours...)

Thanks for the information.

It would be nice if someone out there had a response
to my original question, but I guess not. I'll apply the
Revolution and hope for the best. :(

Gail

Reply to this Message

Phil P. - 23 Jan 2005 19:48 GMT

> >> I have a kitten on Ketoconazole for ringworm.
> >
[quoted text clipped - 14 lines]
> Phil - I read the literature *after* the diagnosis and by
> that time the kitten was already on ketoconazole.

Its not too late to correct the vet's poor choice of drugs since ringworm
can take several weeks to resolve.

Also, environmental decontamination is a *very* important part of treatment
because hair shafts containing infectious spores can remain infectious in
the environment for up to 18 months. So what seems like a persistant
infection may actually be reninfections. Remember, ringworm is zoonotic -
you and other family members at risk of infection, too.

I'm

> taking the kitten back in for a recheck on Monday and
> will (1) ask for a CBC + liver enzyme, (2) ask about
> switching to itraconazole. So far I have seen no
> problems but he's only been on the drug for a bit
> more than two weeks.

Even if his liver enzymes are normal at the time of testing, that is no
guarantee he will not develop hepatotoxicity with continued use.

> I will print out the information in the links you provided
> to take to the vet, but I doubt it will make any
[quoted text clipped - 4 lines]
> constraints. (San Antonio euthanizes about 50,000 stray
> and abandoned cats and dogs per year.)

I don't see how other peoples' treatment of their pets affects how you treat
yours. You should listen to a vet's suggestions but the final decision
regarding treatment is *yours*.

> > Most cats just love butter - and the fat increases absorption.
>
[quoted text clipped - 8 lines]
> to my original question, but I guess not. I'll apply the
> Revolution and hope for the best. :(

That's an ill-advised decision. Whenever you're unsure about a drug's
interactions, you shouldn't use it. Fortunately for your cat, Revolution
has no known drug interactions.

Phil

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Gail Futoran - 23 Jan 2005 20:13 GMT

>> >> I have a kitten on Ketoconazole for ringworm.
>> >
[quoted text clipped - 17 lines]
> Its not too late to correct the vet's poor choice of drugs since ringworm
> can take several weeks to resolve.

Didn't I already say I was taking the kitten to the
vet on Monday and asking about a change of
drugs? I don't know what the hell else I can do.
It's Sunday where I live, and no vet is open other
than the emergency vets, and they probably can't
help in this situation (which isn't an emergency).
Am I suppposed to unilaterally take the kitten
OFF the drug??? Don't bother answering that.

> Also, environmental decontamination is a *very* important part of
> treatment
> because hair shafts containing infectious spores can remain infectious in
> the environment for up to 18 months. So what seems like a persistant
> infection may actually be reninfections. Remember, ringworm is zoonotic -
> you and other family members at risk of infection, too.

I spend three hours every five days thoroughly cleaning
their 8x10 room, which is constructed on the patio. I
use a 10% clorox solution on every surface that can
handle it, which is just about every surface out there,
in addition to vacuuming (separate vacuum for the
kittens' room only), mopping (separate mop), sponging
(separate sponge . you get the idea??), etc. etc. I
have noticed zero spots on myself, or the male kitten's
female companion (both FeLV+), or my husband or
any of the three cats living in the house. And the large
bald spot under the male kitten's arm is almost
completely furred over - healed - after less than 3
weeks (not three months) of treatment.

Without taking the kittens out back and shooting them,
I can't do any better in protecting them and myself
and the rest of the family.

I'm not perfect, I'm intelligent but I don't have a
damned vet degree, I've done a sh*tload of research
but obviously not enough, I'm doing the best I can
but obviously falling far short of your standard, and
don't appreciate being attacked (treated like someone
stupid and/or irresponsible toward my cats) when I
ask for help.

So I won't ask again.

[big frelling snip]

Bye bye.

Gail

Reply to this Message

Phil P. - 24 Jan 2005 01:09 GMT

> >> >> I have a kitten on Ketoconazole for ringworm.
> >> >
[quoted text clipped - 21 lines]
> vet on Monday and asking about a change of
> drugs?

Yes you did. You also said you read the literature after the kitten was
already on Keto. That's why I said its not too late to correct the vet's
poor choice of drugs. What part of that did you not understand?

> I don't know what the hell else I can do.

Chill out, perhaps?

> > Also, environmental decontamination is a *very* important part of
> > treatment
[quoted text clipped - 20 lines]
> I can't do any better in protecting them and myself
> and the rest of the family.

I'm glad to hear you're doing so a bang-up cleaning job. I mentioned
environmental contamination only because many people don't know that
ringworm spores can remain infectious in the environment for > 1 year.

Given the fact you approved of the use of Keto in your cat, I didn't think
you were aware of the treatment protocols for ringworm and the prolonged
infectious nature of ringworm spores.

> I'm not perfect, I'm intelligent but I don't have a
> damned vet degree, I've done a sh*tload of research
> but obviously not enough,

Obviously. At least we can agree on that!

I'm doing the best I can

> but obviously falling far short of your standard,

"My standard"? LOL! I've worked with a lot of vets and I can't think of one
who used Keto in cats since the 80s.

and

> don't appreciate being attacked (treated like someone
> stupid and/or irresponsible toward my cats) when I
> ask for help.

I wasn't attacking you - If I was, you'd damn sure know it! Neither was I
implying you are "stupid and/or irresponsible" toward your cats. Do you
have any other delusions of persecution you'd like to share with us?
Perhaps you're projecting your opinion of yourself onto others.

> So I won't ask again.

Another ill-advised decision.

Reply to this Message

Phil P. - 24 Jan 2005 01:09 GMT

> >> >> I have a kitten on Ketoconazole for ringworm.
> >> >
[quoted text clipped - 21 lines]
> vet on Monday and asking about a change of
> drugs?

> I don't know what the hell else I can do.

Chill out, perhaps?

> I'm not perfect, I'm intelligent but I don't have a
> damned vet degree, I've done a sh*tload of research
> but obviously not enough,

Obviously. At least we can agree on that!

I'm doing the best I can

> but obviously falling far short of your standard,

"My standard"? LOL! I've worked with a lot of vets and I can't think of one
who used Keto in cats since the 80s.

and

> don't appreciate being attacked (treated like someone
> stupid and/or irresponsible toward my cats) when I
> ask for help.

> So I won't ask again.

Another ill-advised decision.

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