Treatment of ringworm in adult dogs

Re: Treatment of ringworm in adult dogs

James Laidlaw — Wed, 13 Feb 2013 10:50:38 GMT

Sorry for being "bloody lazy".

I recall being taught that griseofulvin was removed from use as treatment due to side effects and that most specialists (after a quick lazy check on VIN) tend to use the conazole type drugs now.

Incidentally if you go far enough back in textbooks you can probably find blood letting and trephining as appropriate techniques. Some of the texts evolve over time, would you not question why it's no longer in the formulary?

But, you know, go ahead and use what you want - this was just my opinion.

Re: Treatment of ringworm in adult dogs

Michael Woodhouse — Wed, 13 Feb 2013 09:50:12 GMT

James - just because you can't find a dose rate in the first book you have to hand is just bloody lazy. The issue is with pregnant women (and animals) but griseofulvin has been used very successfully for very many years in people and animals.

Incidentally BSAVA must be on an ink saving exercise, because its there in the 4th edition 15-30mg/kg PO Q24 hours for 3-4 weeks.

The Cascade is based on the principle that, if there is no veterinary medicine authorised in the UK for treating a disease, the veterinary surgeon responsible for the animal may, in particular to avoid unacceptable suffering, treat the animal with a product from one of the following categories in descending order of suitability:
a) A veterinary medicine authorised in the UK for the same condition in another animal species or for another condition in the same animal species;
b) Either:
(i) a medicine authorised in the UK for human use; or
(ii) VMP not authorised in the UK but authorised in another Member State (MS) for use in any animal species in accordance with an import certificate issued by the VMD (for further information on the Import Certificate Scheme please refer to VMGN 5 Import Certificate Schemes, which is published on the VMD website:
http://www.vmd.defra.gov.uk/public/vmr_vmgn.aspx
c) A medicine prescribed by the veterinary surgeon responsible for treating the animal and prepared extemporaneously by a veterinary surgeon

Personally I think the cascade is unnecessarily restrictive, but it is law so I do follow it, rather than go on a whim.

Re: Treatment of ringworm in adult dogs

James Laidlaw — Wed, 13 Feb 2013 07:55:56 GMT

Well, for starters it hasn't been removed from treatment in cats and dogs due to (I think) teratogenic effects, an second there is an indication and dosage listed in the small animal formulary, while griseofulvin is nowhere to be seen in there.

Re: Treatment of ringworm in adult dogs

Michael Woodhouse — Tue, 12 Feb 2013 22:49:10 GMT

[quote user="James Laidlaw"]Easier to justify than griseofulvin though I'd think.

[/quote]

How so? Do we have a vet licensed ketoconazole?

There is griseofulvin with a horse licence, and ALL vet medicines come higher in the cascade than human medicines.

Re: Treatment of ringworm in adult dogs

James Laidlaw — Tue, 12 Feb 2013 19:37:47 GMT

Easier to justify than griseofulvin though I'd think.

Re: Treatment of ringworm in adult dogs

Helen Wallace — Tue, 12 Feb 2013 17:53:50 GMT

I have usede ketaconazole tabs quite sucessfully in the past, but you'd struggle to justify it under the cascade at the moment.

Re: Treatment of ringworm in adult dogs

Michael Woodhouse — Tue, 12 Feb 2013 17:20:15 GMT

[quote user="nobbygonzo"]

Any recent ideas? Three dogs and owner does not want to go topical Thanks!

[/quote]

Just because the owner can't be arsed is not a reason to deviate from the cascade. Had similar and offered to bath the dogs for the owner in Imaverol.

A quick bit of mental arrhythmic and they were suddenly able to bath them themselves.

Re: Treatment of ringworm in adult dogs

James Laidlaw — Tue, 12 Feb 2013 15:08:30 GMT

Is ketoconazole not used still? Oral tablets and less nasty side effects compared to Gris from what I can recall.

Long course required (can be 1-2 months) and need to treat 2 weeks beyond resolved signs on dermatophyte test, but can do a script if cost is an issue before resorting to hose based medications...

Re: Treatment of ringworm in adult dogs

Virginia Campbell — Tue, 12 Feb 2013 11:17:36 GMT

[quote user="nobbygonzo"]Three dogs and owner does not want to go topical [/quote]

I would be ordering a tub of horse griseofulvin powder

Re: Treatment of ringworm in adult dogs

Virginia Campbell — Tue, 12 Feb 2013 11:16:46 GMT

[quote user="Robin Grimmer"]underlying immune deficiency,[/quote]

[quote user="Robin Grimmer"]JRT about 11yo that has chronic ringworm. [/quote]

Cushings? I once saw a JRT that had what I think had iatrogenic chronic ringworm as it had been going elsewhere and getting big doses or pred for its skin for months - fungal hyphae were seen on biopsy.

Re: Treatment of ringworm in adult dogs

Karen Eggleton — Tue, 12 Feb 2013 10:32:31 GMT

Any recent ideas? Three dogs and owner does not want to go topical Thanks!

Re: Treatment of ringworm in adult dogs

Stephen Courtney — Fri, 11 Nov 2011 13:42:42 GMT

Pre cascade I once went to our local chemist to order 21 bottles of nystatin oral suspension - for a flock of racing pigeons with crop thrush.

That was the wierdest look I ever got at the chemists. 'What on earth do you want to much for!'

Re: Treatment of ringworm in adult dogs

Evelyn Barbour-Hill — Thu, 10 Nov 2011 22:35:24 GMT

[quote user="Stephen Courtney"].canestan ointment is probably the way to go with localised lesions.[/quote]

Generic clotrimazole cream is both much cheaper and less likely to be "out of stock" than Canesten.

Re: Treatment of ringworm in adult dogs

Stephen Courtney — Thu, 10 Nov 2011 22:13:07 GMT

I'd use malaseb in the first instance, in theory ringworm is self limiting and should eventually resolve anyway. how this might work out with persistent reinfection by farmyard spores, I'm not sure...and I'm not sure how I'd react to an animal living in a home either...canestan ointment is probably the way to go with localised lesions.

Re: Treatment of ringworm in adult dogs

bob lehner — Thu, 10 Nov 2011 17:30:37 GMT

[quote user="Robin Grimmer"] I suspect there may be some underlying immune deficiency, is this a known problem in JRT's?[/quote]

I remember a farm JRT with a very bizarre and frustrating skin problem round the face which defeated all of us - but turned out to be a variant of ringworm normally only found in hedgehogs. I guess that might fit with a farmyard JRT lifestyle.

Re: Treatment of ringworm in adult dogs

Martin Atkinson — Thu, 10 Nov 2011 16:53:44 GMT

[quote user="Dagmar Steele"]

I'm afraid this has been proven wrong long ago. There are studies supposing that Program does not work in any animal with ringworm - fits my own negative experiences.

[/quote]Oh well so much for that, never tried it myself anyway.

Re: Treatment of ringworm in adult dogs

Dagmar Steele — Thu, 10 Nov 2011 16:45:55 GMT

I'm afraid this has been proven wrong long ago. There are studies supposing that Program does not work in any animal with ringworm - fits my own negative experiences.

Re: Treatment of ringworm in adult dogs

Martin Atkinson — Thu, 10 Nov 2011 16:39:51 GMT

How about Program tablets?, the oral stuff is supposed to work in cats.

Re: Treatment of ringworm in adult dogs

Robin Grimmer — Thu, 10 Nov 2011 14:42:21 GMT

I've been seeing an older JRT about 11yo that has chronic ringworm. We've been using malaseb and long courses of griseofulvin.

It seems to improve a lot but never really clears up. I suspect compliance isn't great as we don't see the dog for ages and it's skin is

awful by then. He also lives on a farm and sleeps in a barn - although there have been no cattle there for 6 years - but presumably the spores

could still be there. I suspect there may be some underlying immune deficiency, is this a known problem in JRT's?

Re: Treatment of ringworm in adult dogs

David Mills — Thu, 10 Nov 2011 14:17:15 GMT

Bloody expensive too. Horse griseofulvin would be the cheapest option. Or canestan cream can work very well if not too many lesions (SID for 2-3weeks)

Re: Treatment of ringworm in adult dogs

Alice Courtney — Thu, 10 Nov 2011 14:11:49 GMT

[quote user="Clive Ansell"]

[quote user="Alice Courtney"]

Sporonox?

[/quote]

Itrafungol, which is licenced for use in cats, would come before Sporonox in the cascade if one decided to use Itraconazole.

[/quote]

Yep, though tricky to get 15-20mls down a big labrador each day

Re: Treatment of ringworm in adult dogs

Niall Taylor — Tue, 08 Nov 2011 16:58:33 GMT

[quote user="Sarah Mark"]

Thanks everyone. I will start with Imaverol and go from there.[/quote]

Malaseb - used as a general shampoo to treat and reduce spread or as a topical application for local lesions in conjunction with systemic agents. If using griseofulvin remember it is highly teratogenic (humans and animals). Also can cause generalised hypersensitivity reactions (for example, in me!).

Cheers,

Niall

Re: Treatment of ringworm in adult dogs

Sarah Mark — Tue, 08 Nov 2011 15:31:30 GMT

Thanks everyone. I will start with Imaverol and go from there.

Re: Treatment of ringworm in adult dogs

Clive Ansell — Tue, 08 Nov 2011 13:47:52 GMT

[quote user="Alice Courtney"]

Sporonox?

[/quote]

Itrafungol, which is licenced for use in cats, would come before Sporonox in the cascade if one decided to use Itraconazole.

Re: Treatment of ringworm in adult dogs

Rob Loxley — Tue, 08 Nov 2011 13:45:44 GMT

[quote user="Alice Courtney"]Sporonox?[/quote]

Feline licensed itraconazole would surely come higher up the Cascade?