Hello All - I am new to the board.... I usually hang out on The Cat Site board, but am not getting much response to my lastest issue with my Simba.
Simba was diagnosed with Aspergillus fungus inside his ear. He is doing really well on his anti-fungal medication and seems to be back to his old self. However, after reading about "Attila's Story" (the only other cat I've been able to find that had this fungus) I am scared and very worried that this fungus could spread elsewhere.
In doing some research I am able to find out plenty on this disease in humans, but cannot find much on cats.
My vet tells me due to Simba's behavior and response to the medications, she feels that the fungus is localized to the ear, however, I am not convinced. How will I ever know for certain if and when it is gone, or if it has spread elsewhere?
If anybody has any info. on this fungus (Aspergillus) please pass it along.
Aspergillus inside cat's ear
Re: Aspergillus inside cat's ear
How old is Simba? Can you provide a brief health history? Is he immunocompromised? (i.e., had or has viral infection, etc) Does he have any other primary disease like renal disease, diabetes, etc? Other than the antifungal medication, has he ever been on immunosuppression drugs, continued antibiotic therapy etc?
The most important thing is your vet's competence/experience level, how exactly did she diagnose aspergillus? Exactly what tests were done? (i.e., fungal culture, biopsy, PCR, etc). Some tests can cause false positives or false negatives, so they should always be used in combination, and repeated during therapy.
What other tests were done unrelated to aspergillus, such as immunology for FELV, FIV or other fungal serology? Was cryptococcosis ever ruled out, or any other yeast-like organism? What did a CBC and full blood panel reveal if anything? Urinalysis done?
Does Simba have lesions or plaques inside the ear canals, is one or both ears affected? What is the antifungal medication your vet has prescribed, and for how long has it been used?
What is your vet's theory of transmission? (i.e., like a grass spur, or inhalation or oral ingestion etc) Have you investigated your home, his food, other things in the environment that might suggest spores in the environment? Is or has he been allowed outdoors?
Lastly, have you sought a second opinion with a specialist?
To answer your question directly, the best diagnostic combines the use of a culture (NEVER use this as a sole diagnostic!), serology, biopsy/histopathology, PCR (fungal antibody test from blood serum), and CT imaging to determine location/activity/spread/damage) -- most of these are generally used to diagnose nasal aspergillus, but there might be concern as well if this involves the ear(s). Some of these tests MUST be repeated during therapy (more than once), to determine response to treatment, effectiveness of treatment, or to warrant additional treatment if necessary. Equally as important are to add other tests to rule out other things (differentials) that could be mistaken for aspergillus (i.e., like fungal penicilliosis, cryptococcosis, other yeast-like infections, even secondary infections).
The most important thing is your vet's competence/experience level, how exactly did she diagnose aspergillus? Exactly what tests were done? (i.e., fungal culture, biopsy, PCR, etc). Some tests can cause false positives or false negatives, so they should always be used in combination, and repeated during therapy.
What other tests were done unrelated to aspergillus, such as immunology for FELV, FIV or other fungal serology? Was cryptococcosis ever ruled out, or any other yeast-like organism? What did a CBC and full blood panel reveal if anything? Urinalysis done?
Does Simba have lesions or plaques inside the ear canals, is one or both ears affected? What is the antifungal medication your vet has prescribed, and for how long has it been used?
What is your vet's theory of transmission? (i.e., like a grass spur, or inhalation or oral ingestion etc) Have you investigated your home, his food, other things in the environment that might suggest spores in the environment? Is or has he been allowed outdoors?
Lastly, have you sought a second opinion with a specialist?
To answer your question directly, the best diagnostic combines the use of a culture (NEVER use this as a sole diagnostic!), serology, biopsy/histopathology, PCR (fungal antibody test from blood serum), and CT imaging to determine location/activity/spread/damage) -- most of these are generally used to diagnose nasal aspergillus, but there might be concern as well if this involves the ear(s). Some of these tests MUST be repeated during therapy (more than once), to determine response to treatment, effectiveness of treatment, or to warrant additional treatment if necessary. Equally as important are to add other tests to rule out other things (differentials) that could be mistaken for aspergillus (i.e., like fungal penicilliosis, cryptococcosis, other yeast-like infections, even secondary infections).
..........Traci
-
2furbabies
- Posts: 4
- Joined: Thu May 22, 2008 9:34 am
Re: Aspergillus inside cat's ear
I’ll do my best here to provide some history. Here goes… this is going to be a long post. Simba is a male Persian and is 9 years old, soon to be 10 in July. He is definitely immunocompromised. He is a carrier of ringworm which we have battled off and on since the day I got him. He has had viral and bacterial infections over the years. He had some type of eye surgery a few years back and I was told by my vet at that time it was a Herpes virus. He deals with eye infections on and off, but that is generally when he has a URI. He struggles with URI’s quite frequently – a few a years. He has dealt with an overgrowth of yeast in both ears for years. He has chronic cystitis, which we have been able to control for over a year now with special diet and Cosequin for Cats.
He was tested for FELV and FIV before I got him and I was told he was negative for both. When I first took him to the vet back in March a blood panel was done to rule out all the big stuff, diabetes, thyroid, renal, etc… all came back ok. He has had many urinalysis done due to his cystitis issues but that has been over a year ago.
My vet definitely does not have much experience and sometimes as I feel as if I know more then she does. So, she doesn’t really have a theory of transmission. I really don’t think he got this from anything in the home environment. My theory is this… he came down with a very bad URI in January. Usually he is able to kick these things with one course of antibiotics, but for some reason he couldn’t get rid of it this time. He was on 3 different courses of antibiotics over a 2 month period along with antibiotic injections. During that time, he was also given a steroid shot for an ear infection he had due to yeast. I regret that now, but at the time was just looking to get him some quick relief for his itching ear. He got over the URI in February, but due to all the antibiotic use and his immune system being low he got a very, very bad case of ringworm. He lost all his hair on both ears (hair still has not grown back); a fungal culture was done and ringworm was definitely active and growing. We got over the ringworm hump and that’s when I noticed his right ear bleeding from inside around mid March. So, I do believe the extended course of antibiotics in combination with his immune system being so very low at that time was how he contracted this.
Only his right ear is affected. This is how my vet diagnosed him: when she first looked into the ear with the scope she said she could definitely see some type of mass inside the ear and that was where the bleeding was coming from. She said a biopsy would have to do done to rule out cancer. So… in went my little baby for a biopsy. After the surgery, she told me she was concerned that it may be cancerous because of the way the mass/tissue was pulling apart. The results from the biopsy (dermatologist also did a stain) revealed that it was not cancer at all, but what she called a “Fungal Granuloma”. Hmm… as soon as I heard fungus, my first thought was Ringworm since he had just gotten over a bad case of it. She put him on Intraconazole and said we would need to do some cultures to find out the exact type of fungus. So… in went my little baby for the cultures. The cultures she did were a “Culture and Sensitivity” and also a “Fungal Culture”. They were sent out to a lab. It took 1 month for the results to come back. The results finally came back last Thursday, and she said that the type of fungus he had was “Aspergillus”. She didn’t seem concerned; said that the Intraconazole he was taking did not work for that type of fungus and that he would need to switch to Ketoconazole. I was concerned about switching medications because I had definitely seen a complete turn-around in him since being on the Intraconazole. So, we switched him to the Ketoconazole and he has now been on that for one week. He took the Intraconazole for one month. She told me to give him the Ketoconazole for a month and then to bring him back in for a recheck of the ear. That will be mid June. In addition, he had been taking Zenequin after his biopsy, but I didn’t finish it out because he had been on so many antibiotics recently I was afraid. Also, she had him on Mometamax ear drops to help with the itching, but when I found out they had a steroid in them I stopped using them.
I’ve never heard of Cryptococcosis, so I’m sure that hasn’t been ruled out. As I mentioned, he does tend to have an over-growth of yeast in both ears, but I don’t know what type of yeast. Over the years he has been on Otomax ear drops which always seemed to help for a while and then it would return. The little stinker doesn’t groom much so his ears are always dirty which doesn’t help matters  I have been told that he may need to have a TECA (Total Ear Canal Ablation) if the infection doesn’t go away. I made a mental note, but am certainly not considering that in the immediate future.
He is back to his normal self, his appetite has returned, the bleeding in the ear has stopped. Hmm… but is it gone? After reading your post, is it really Aspergillus? Sigh… I’m going to finish out the Ketoconazole and go from there.
I have thought about a second opinion / Specialist. What type of Specialist does one see for something like this? I wouldn’t know where to start. Is it Dermatology or something else? My current vet certainly isn’t as proactive as I would like her to be, so I’m doing my best to stay on tops of things.
Sorry this was so long, but I tried to address all of your questions. Thank you so much for your input. I welcome any other feedback/info.
He was tested for FELV and FIV before I got him and I was told he was negative for both. When I first took him to the vet back in March a blood panel was done to rule out all the big stuff, diabetes, thyroid, renal, etc… all came back ok. He has had many urinalysis done due to his cystitis issues but that has been over a year ago.
My vet definitely does not have much experience and sometimes as I feel as if I know more then she does. So, she doesn’t really have a theory of transmission. I really don’t think he got this from anything in the home environment. My theory is this… he came down with a very bad URI in January. Usually he is able to kick these things with one course of antibiotics, but for some reason he couldn’t get rid of it this time. He was on 3 different courses of antibiotics over a 2 month period along with antibiotic injections. During that time, he was also given a steroid shot for an ear infection he had due to yeast. I regret that now, but at the time was just looking to get him some quick relief for his itching ear. He got over the URI in February, but due to all the antibiotic use and his immune system being low he got a very, very bad case of ringworm. He lost all his hair on both ears (hair still has not grown back); a fungal culture was done and ringworm was definitely active and growing. We got over the ringworm hump and that’s when I noticed his right ear bleeding from inside around mid March. So, I do believe the extended course of antibiotics in combination with his immune system being so very low at that time was how he contracted this.
Only his right ear is affected. This is how my vet diagnosed him: when she first looked into the ear with the scope she said she could definitely see some type of mass inside the ear and that was where the bleeding was coming from. She said a biopsy would have to do done to rule out cancer. So… in went my little baby for a biopsy. After the surgery, she told me she was concerned that it may be cancerous because of the way the mass/tissue was pulling apart. The results from the biopsy (dermatologist also did a stain) revealed that it was not cancer at all, but what she called a “Fungal Granuloma”. Hmm… as soon as I heard fungus, my first thought was Ringworm since he had just gotten over a bad case of it. She put him on Intraconazole and said we would need to do some cultures to find out the exact type of fungus. So… in went my little baby for the cultures. The cultures she did were a “Culture and Sensitivity” and also a “Fungal Culture”. They were sent out to a lab. It took 1 month for the results to come back. The results finally came back last Thursday, and she said that the type of fungus he had was “Aspergillus”. She didn’t seem concerned; said that the Intraconazole he was taking did not work for that type of fungus and that he would need to switch to Ketoconazole. I was concerned about switching medications because I had definitely seen a complete turn-around in him since being on the Intraconazole. So, we switched him to the Ketoconazole and he has now been on that for one week. He took the Intraconazole for one month. She told me to give him the Ketoconazole for a month and then to bring him back in for a recheck of the ear. That will be mid June. In addition, he had been taking Zenequin after his biopsy, but I didn’t finish it out because he had been on so many antibiotics recently I was afraid. Also, she had him on Mometamax ear drops to help with the itching, but when I found out they had a steroid in them I stopped using them.
I’ve never heard of Cryptococcosis, so I’m sure that hasn’t been ruled out. As I mentioned, he does tend to have an over-growth of yeast in both ears, but I don’t know what type of yeast. Over the years he has been on Otomax ear drops which always seemed to help for a while and then it would return. The little stinker doesn’t groom much so his ears are always dirty which doesn’t help matters  I have been told that he may need to have a TECA (Total Ear Canal Ablation) if the infection doesn’t go away. I made a mental note, but am certainly not considering that in the immediate future.
He is back to his normal self, his appetite has returned, the bleeding in the ear has stopped. Hmm… but is it gone? After reading your post, is it really Aspergillus? Sigh… I’m going to finish out the Ketoconazole and go from there.
I have thought about a second opinion / Specialist. What type of Specialist does one see for something like this? I wouldn’t know where to start. Is it Dermatology or something else? My current vet certainly isn’t as proactive as I would like her to be, so I’m doing my best to stay on tops of things.
Sorry this was so long, but I tried to address all of your questions. Thank you so much for your input. I welcome any other feedback/info.
Re: Aspergillus inside cat's ear
How long have you had him? Re-occuring ringworm is indicative of inappropriate treatment, ineffective treatment or cessation of treatment before it has had a chance to resolve. Cats aren't "carriers" of ringworm, not in the infectious sense like a viral disease. Cats can aquire ringworm and spread it before, during treatment, but they are not carriers. Successful treatment of rinworm is available, and it sounds like your vet has failed.
Did she teach you how to effectively clean/disinfect the household and prevent new spores from forming/spreading in the environment? If proper cleaning techniques weren't used, it will re-occur, but it's doubtful that it re-occured due to immunosuppression. It is either failed or wrong treatment, or failed disinfection measures in the home.
Chronic URI's are indicative also of failed or inappropriate treatment, or immunosuppression, and stress. Did she bother to test for herpesvirus, calicivirus, chlamydia? (with a swab cytology). Is there undue constant stress in the home/environment?
What exactly was the eye surgery for?
Why wasn't FELV and FIV tested again, especially during the course of the diagnosis for aspergillus?
Likewise, with any bloodwork done, urinalysis should ALWAYS be included, because some bacteria of a primary source can also be found in the urine, helping the diagnosis.
If she tested for diabetes, she HAD to test the urine AND blood glucose to rule out diabetes. If she never tested urine when ruling out diabetes, you've got to seriously question her level of competence.
You think he didn't aquire aspergillus from the home or environment, but did the vet bother to tell you to check potential sources in your home? If not, I've got to repeat the comment above. There are several ways this can be found, mold spores in the home, reaction to allergy-like symptoms, spores in pet foods or other foods, older buildings or older homes, airborne dust, soil, etc. By not even attempting to rule out potential sources, your vet was negligent in remembering that a contaminated source would prohibit re-infection and make treatment nearly futile.
At the time of the last URI, was when the vet should have known to be looking for other things other than herpesvirus (or at least confirming herpes or ruling it out), including fungal disease, or mycobacteria, sinus problems, other eye problems. 3 different antibiotics in 2 months was pushing it, and the second course of treatment should have prompted her to be looking for something else. Did she identify the type of yeast found in the ear? What was the course of treatment other than a steroid injection? An ear flush? Daily cleaning and topicals at home on your part?
As stated earlier, one cannot and MUST not soley use cultures to diagnose aspergillus, the other tests mentioned previously MUST be considered and used in conjunction to get an accurate diagnosis. Did she mention these at all, or request them, and perhaps you declined?
It should NEVER take one month for a culture to come back. Did the vet ever call the lab on that? Are you sure you got the right results on the right patient? (yes, this occurs sometimes). Something is not quite right with this.
Actually, and I'm not an expert on this disease, but I believe itraconazole is the preferred treatment for aspergillus (at least for the disseminated type -- common with immuno-suppressed patients). I have to strongly urge you to get a second opinion before you make a commitment to using the ketaconazole. That does NOT mean you should cease medications on your vet's orders at this point, it means, you should be getting a second opinion with a feline specialist, and your vet should have referred you in the beginning. If there is a veterinary university near where you live, that would be the first course of action for a referral. Otherwise, she can consult a specialist on your behalf, and darn well should be doing so, immediately.
In the same vein, you cannot just cease medications based on your own theories, you may be partially responsible for failed treatment. Vets expect their clients to follow directions, finish medications, and if there are any concerns, they expect you to contact them immediately to discuss alternatives or cessation of medications. In the future, do NOT cease any medications without discussing them in full with the vet!!
Did the vet ever mention the possibility of pseudomonas as the infection in the ears? This is a sort of infection 'within' an infection and can be difficult to treat and resolve, but with a concerted effort, effective treatment, and compliance on your part, pseudomonas can be resolved. I suspect this might be an infection your vet never looked closely for.
What food are you feeding him, what have you fed within the last two years? Anything other than FLUTD diet? Is the diet veterinary-prescribed or a commercial brand? Were food allergies ever ruled out? Was miliary dermatitis ever ruled out?
Cryptococcosis is a fungal infection that is either localized or systemic, both of which are nasty infections and treatment is specific, long and arduous, but effective if done correctly. It is ALWAYS amoung the differentials when suspecting aspergillus!
Is your vet asking to test Simba at least on a monthly basis, to check blood levels? Any fungal medication has the potential to be hepatotoxic, so liver values MUST be checked FREQUENTLY while on a course of fungal medication. A CBC must also be done as frequently. Have either been done???
Just reading your post, it sounds like your vet doesn't have a clue, and it doesn't make sense that Simba has had so many problems and treatment failures. It's time you see a feline specialist and start over, she needs ALL of Simba's health records, including ALL treatments. Start over, get at least CBC, full chemical profile and urinalysis done, and opt for the aspergillus antibody PCR, right away. A feline specialist will be much more experienced and able to identify what is going on, and why Simba seems to be so immunocompromised (if he in fact is, but it appears so at this point). There could be something else going on as well and everything needs to be addressed more effectively NOW.
Don't wait for next month, get that second opinion with a feline specialist THIS WEEK, demand of your vet to refer you. I'd skip having her consult with one, since it appears she is too inexperienced to manage this problem, so get an opinion with a feline specialist RIGHT AWAY.
This also does NOT mean to cease using the ketoconazole, but the sooner you get a feline specialist on Simba's health case, the sooner you will know what treatment is going to be most effective, not to mention proper diagnostics to even confirm aspergillus or something else entirely.
Did she teach you how to effectively clean/disinfect the household and prevent new spores from forming/spreading in the environment? If proper cleaning techniques weren't used, it will re-occur, but it's doubtful that it re-occured due to immunosuppression. It is either failed or wrong treatment, or failed disinfection measures in the home.
What do you mean viral, and bacterial? What viral? Other than URI's, what bacterial?2furbabies wrote:He has had viral and bacterial infections over the years
Chronic URI's are indicative also of failed or inappropriate treatment, or immunosuppression, and stress. Did she bother to test for herpesvirus, calicivirus, chlamydia? (with a swab cytology). Is there undue constant stress in the home/environment?
What exactly was the eye surgery for?
Why wasn't FELV and FIV tested again, especially during the course of the diagnosis for aspergillus?
Likewise, with any bloodwork done, urinalysis should ALWAYS be included, because some bacteria of a primary source can also be found in the urine, helping the diagnosis.
If she tested for diabetes, she HAD to test the urine AND blood glucose to rule out diabetes. If she never tested urine when ruling out diabetes, you've got to seriously question her level of competence.
You think he didn't aquire aspergillus from the home or environment, but did the vet bother to tell you to check potential sources in your home? If not, I've got to repeat the comment above. There are several ways this can be found, mold spores in the home, reaction to allergy-like symptoms, spores in pet foods or other foods, older buildings or older homes, airborne dust, soil, etc. By not even attempting to rule out potential sources, your vet was negligent in remembering that a contaminated source would prohibit re-infection and make treatment nearly futile.
At the time of the last URI, was when the vet should have known to be looking for other things other than herpesvirus (or at least confirming herpes or ruling it out), including fungal disease, or mycobacteria, sinus problems, other eye problems. 3 different antibiotics in 2 months was pushing it, and the second course of treatment should have prompted her to be looking for something else. Did she identify the type of yeast found in the ear? What was the course of treatment other than a steroid injection? An ear flush? Daily cleaning and topicals at home on your part?
As stated earlier, one cannot and MUST not soley use cultures to diagnose aspergillus, the other tests mentioned previously MUST be considered and used in conjunction to get an accurate diagnosis. Did she mention these at all, or request them, and perhaps you declined?
It should NEVER take one month for a culture to come back. Did the vet ever call the lab on that? Are you sure you got the right results on the right patient? (yes, this occurs sometimes). Something is not quite right with this.
Actually, and I'm not an expert on this disease, but I believe itraconazole is the preferred treatment for aspergillus (at least for the disseminated type -- common with immuno-suppressed patients). I have to strongly urge you to get a second opinion before you make a commitment to using the ketaconazole. That does NOT mean you should cease medications on your vet's orders at this point, it means, you should be getting a second opinion with a feline specialist, and your vet should have referred you in the beginning. If there is a veterinary university near where you live, that would be the first course of action for a referral. Otherwise, she can consult a specialist on your behalf, and darn well should be doing so, immediately.
In the same vein, you cannot just cease medications based on your own theories, you may be partially responsible for failed treatment. Vets expect their clients to follow directions, finish medications, and if there are any concerns, they expect you to contact them immediately to discuss alternatives or cessation of medications. In the future, do NOT cease any medications without discussing them in full with the vet!!
Did the vet ever mention the possibility of pseudomonas as the infection in the ears? This is a sort of infection 'within' an infection and can be difficult to treat and resolve, but with a concerted effort, effective treatment, and compliance on your part, pseudomonas can be resolved. I suspect this might be an infection your vet never looked closely for.
What food are you feeding him, what have you fed within the last two years? Anything other than FLUTD diet? Is the diet veterinary-prescribed or a commercial brand? Were food allergies ever ruled out? Was miliary dermatitis ever ruled out?
Cryptococcosis is a fungal infection that is either localized or systemic, both of which are nasty infections and treatment is specific, long and arduous, but effective if done correctly. It is ALWAYS amoung the differentials when suspecting aspergillus!
Is your vet asking to test Simba at least on a monthly basis, to check blood levels? Any fungal medication has the potential to be hepatotoxic, so liver values MUST be checked FREQUENTLY while on a course of fungal medication. A CBC must also be done as frequently. Have either been done???
Just reading your post, it sounds like your vet doesn't have a clue, and it doesn't make sense that Simba has had so many problems and treatment failures. It's time you see a feline specialist and start over, she needs ALL of Simba's health records, including ALL treatments. Start over, get at least CBC, full chemical profile and urinalysis done, and opt for the aspergillus antibody PCR, right away. A feline specialist will be much more experienced and able to identify what is going on, and why Simba seems to be so immunocompromised (if he in fact is, but it appears so at this point). There could be something else going on as well and everything needs to be addressed more effectively NOW.
Don't wait for next month, get that second opinion with a feline specialist THIS WEEK, demand of your vet to refer you. I'd skip having her consult with one, since it appears she is too inexperienced to manage this problem, so get an opinion with a feline specialist RIGHT AWAY.
This also does NOT mean to cease using the ketoconazole, but the sooner you get a feline specialist on Simba's health case, the sooner you will know what treatment is going to be most effective, not to mention proper diagnostics to even confirm aspergillus or something else entirely.
..........Traci
-
2furbabies
- Posts: 4
- Joined: Thu May 22, 2008 9:34 am
Re: Aspergillus inside cat's ear
Wow, your email is overwhelming. I have had Simba since he was 4 years old, so about 6 years now. I got him from the SPCA, and at the time I got him he was living in a foster home.
You’re right in your assumption that my vet doesn’t have a clue. So, as far as all of these tests you have mentioned, No… he has not been checked for any of this. Re: the Herpesvirus, I am going by what my old vet said that did his eye surgery and that was that the eye issue was due to Herpesvirus and it may reoccur or stay dormant. So far he has not had any other issues with that eye other then the eye being very cloudy since the surgery. The eye surgery was to remove an ulcer that he had on the eye.
I’m not a vet, so I still don’t completely understand viral vs. bacterial. The health issues that he struggles with repeatedly are: URI’s, Ringworm, and Ear Infections which I’ve been told are due to an over-growth of yeast. The type of yeast has never been identified in the ears and I’ve been to many different vets over the years. They always say it is an overgrowth of yeast which he seems to be prone to and give me ear drops of some sort. Usually the Otomax which seems to work the best for him. His ears get constant cleanings/topicals etc.. at home. We have tried everything for the ears. These ear infections come and go, they are not constant.
Re: Ringworm - I’m confused as to what you’ve said about Ringworm. I’ve been told by many different vets that cats can certainly be carriers. The research I’ve done indicates that as well. It can remain dormant for long periods of time, but then certain circumstances will make it become active again – i.e, extensive antibiotic therapy, stress, suppressed immune system etc… Is that not correct? Simba has been on every single treatment known to man for Ringworm. Everything! The only thing that gets rid of it is giving him the Lym Sulphur baths. Matter of fact, we just did it last night. Even when he doesn’t have ringworm, I do the dips every couple of months as a preventative. I have been doing this for years and it is the only thing that keeps it away. As far as the environment, I am constantly on top of that as well. Ugh... it can be exhausting. Not sure what else to do since you really can’t see where this stuff is. I have another Persian cat also and she doesn’t seem to be affected by it, although I dip her as well just in case.
Re: Stress… he lives like a king and is under no type of stress whatsoever. I live alone, in a condo, with no kids, and it is very, very quiet. He is way too spoiled and seems very content overall.
Re: Aspergillus - I’ve researched this fungus from top to bottom. It’s my understanding that it is all around us… inside and outside. 99% of humans and animals are able to fight it off, but those that are sick, suppressed immune system, etc.. can pick it up. To answer your question, my vet has not mentioned anything about the source or how it was transmitted. I really don’t think she knows much about it. When waiting for the culture results to come back from the lab, I was checking in with her every week. She contacted the lab several times and they would tell her it was pending. It was exactly one month before I received the results. In regards to the treatment… I have read many mixed reviews on the type of treatment… some say Intraconazole and then others say something else. Who knows… I do know that when he was on the Intraconazole I saw a drastic change for the better, so it must have been doing something. He continues to do well on the Ketoconazole also.
RE: Food - he has been eating the dry Hill’s Prescription C/D Multicare for the past 1 ½ years since his FLUTD issues. He eats nothing else at all other then this. He won’t eat any type of wet food and doesn’t like anything else but dry. Prior to that he ate the dry Purina Hairball Formula that you get at the grocery store. When I got him his foster Mom told me that was all he would eat so I kept him on that until the FLUTD.
As you mentioned, I am concerned that my vet has never mentioned checking his liver functions while on the anti-fungals. I do know that these medications can be strong, and he has already been on them for 5 weeks now. I am very bothered she has never mentioned this.
I don’t mind starting over with a new vet, but want to make sure it is someone who is knowledgeable on all this. When you say “Feline Specialist” what type of specialist are you referring to? Specializing in what?
You’re right in your assumption that my vet doesn’t have a clue. So, as far as all of these tests you have mentioned, No… he has not been checked for any of this. Re: the Herpesvirus, I am going by what my old vet said that did his eye surgery and that was that the eye issue was due to Herpesvirus and it may reoccur or stay dormant. So far he has not had any other issues with that eye other then the eye being very cloudy since the surgery. The eye surgery was to remove an ulcer that he had on the eye.
I’m not a vet, so I still don’t completely understand viral vs. bacterial. The health issues that he struggles with repeatedly are: URI’s, Ringworm, and Ear Infections which I’ve been told are due to an over-growth of yeast. The type of yeast has never been identified in the ears and I’ve been to many different vets over the years. They always say it is an overgrowth of yeast which he seems to be prone to and give me ear drops of some sort. Usually the Otomax which seems to work the best for him. His ears get constant cleanings/topicals etc.. at home. We have tried everything for the ears. These ear infections come and go, they are not constant.
Re: Ringworm - I’m confused as to what you’ve said about Ringworm. I’ve been told by many different vets that cats can certainly be carriers. The research I’ve done indicates that as well. It can remain dormant for long periods of time, but then certain circumstances will make it become active again – i.e, extensive antibiotic therapy, stress, suppressed immune system etc… Is that not correct? Simba has been on every single treatment known to man for Ringworm. Everything! The only thing that gets rid of it is giving him the Lym Sulphur baths. Matter of fact, we just did it last night. Even when he doesn’t have ringworm, I do the dips every couple of months as a preventative. I have been doing this for years and it is the only thing that keeps it away. As far as the environment, I am constantly on top of that as well. Ugh... it can be exhausting. Not sure what else to do since you really can’t see where this stuff is. I have another Persian cat also and she doesn’t seem to be affected by it, although I dip her as well just in case.
Re: Stress… he lives like a king and is under no type of stress whatsoever. I live alone, in a condo, with no kids, and it is very, very quiet. He is way too spoiled and seems very content overall.
Re: Aspergillus - I’ve researched this fungus from top to bottom. It’s my understanding that it is all around us… inside and outside. 99% of humans and animals are able to fight it off, but those that are sick, suppressed immune system, etc.. can pick it up. To answer your question, my vet has not mentioned anything about the source or how it was transmitted. I really don’t think she knows much about it. When waiting for the culture results to come back from the lab, I was checking in with her every week. She contacted the lab several times and they would tell her it was pending. It was exactly one month before I received the results. In regards to the treatment… I have read many mixed reviews on the type of treatment… some say Intraconazole and then others say something else. Who knows… I do know that when he was on the Intraconazole I saw a drastic change for the better, so it must have been doing something. He continues to do well on the Ketoconazole also.
RE: Food - he has been eating the dry Hill’s Prescription C/D Multicare for the past 1 ½ years since his FLUTD issues. He eats nothing else at all other then this. He won’t eat any type of wet food and doesn’t like anything else but dry. Prior to that he ate the dry Purina Hairball Formula that you get at the grocery store. When I got him his foster Mom told me that was all he would eat so I kept him on that until the FLUTD.
As you mentioned, I am concerned that my vet has never mentioned checking his liver functions while on the anti-fungals. I do know that these medications can be strong, and he has already been on them for 5 weeks now. I am very bothered she has never mentioned this.
I don’t mind starting over with a new vet, but want to make sure it is someone who is knowledgeable on all this. When you say “Feline Specialist” what type of specialist are you referring to? Specializing in what?
Re: Aspergillus inside cat's ear
Feline specialist, as in feline-only vet, or a feline vet with a specific degree in veterinary internal medicine, or a university veterinary specialist. It doesn't matter at this point what study of medicine the vet specializes in, you need a specialist who is experienced in all forms of internal medicine, which encompasses nearly everything. Your vet should have referred you to one in the beginning. It is incumbent upon any vet who cannot accruately diagnose a condition, to refer the client to a specialist. She failed, miserably, on all counts.
Why are you bathing another cat in lyme sulpur when there is, or has never been confirmed ringworm in that cat? Was she ever tested? How many times? Bathing with lyme sulphur dips is NOT "preventative" for ringworm, and you need to cease doing that. Lyme sulpur is not without harm to skin.
The ear conditon requires a totally new evaluation. If I'm reading your posts correctly, this has been going on for some time, and your vet did basically nothing to define it specifically, let alone treat it properly. There are numerous reasons why infection occurs, it was up to your vet in the beginning to determine the problem and treat it effectively the FIRST time. Some infections/yeast require very specific treatment protocols, and Otomax is probably never going to target most of them. Essentially, the wrong treatment, and prolonged treatment of the wrong treatment is what is causing the condition to re-occur or never resolve. And, now she thinks this is apsergillus, but has done NO other testing other than a culture. Unacceptable and appalling on her part.
Chronic upper respiratory infections, possibly herpesvirus, chronic ear infections and phantom ringworm on a constant basis. Something is horribly wrong here and it sounds like your vet has missed everything. I'm not saying immunosuppression can't cause such a situation, but this is rediculous. As individual conditions occur, they should have been diagnosed properly and treated EFFECTIVELY at the first onset of symptoms, thereby preventing all of the OTHER infections and other conditions. Add to the fact that apparently, your vet cannot even identify the underlying factor for the "immunosuppression". There is always an underlying cause, whether that is viral, bacterial, fungal, or organ-related, it sounds like she just simply makes a halfbaked attempt to treat a symptom when it occurs, but neglects the underlying cause!
See a specialist IMMEDIATELY, rule out food or contact dermatits, cryptococcosis, retest for FELV/FIV and other viral disease, get an aspergillus blood serum PCR done -- the specialist will know where to start, what tests are most diagnostic, what treatment is best. Once you do, however, follow treatment suggested and do NOT cease or change or omit any treatment he/she has initiated. Ask questions so you understand what is ensuing and so that you understand the condition(s), what is involved and what to expect with treatment/resolution, etc. Please, waste NO time in this, demand of your vet to refer you, or ask other vets in the area for specialist referrals. THIS WEEK.
Bingo. Rinworm is hard to eradicate in the environment, and any other cat in the home is 99.999 % likely to get infected. If she hasn't ever been infected by ringworm, then you have to wonder if Simba ever had it! It does not make sense that it never eradicated, and immunosuppression for any other condition is not an excuse for re-occuring ringworm infection. Either treatment has failed, was inappropriate to begin with, not given for an appropriate time frame and double-checked with subsequent cultures DURING and AFTER treatment, or it remains in the environment, thus causing re-infection.2furbabies wrote:I have another Persian cat also and she doesn’t seem to be affected by it, although I dip her as well just in case.
Why are you bathing another cat in lyme sulpur when there is, or has never been confirmed ringworm in that cat? Was she ever tested? How many times? Bathing with lyme sulphur dips is NOT "preventative" for ringworm, and you need to cease doing that. Lyme sulpur is not without harm to skin.
The ear conditon requires a totally new evaluation. If I'm reading your posts correctly, this has been going on for some time, and your vet did basically nothing to define it specifically, let alone treat it properly. There are numerous reasons why infection occurs, it was up to your vet in the beginning to determine the problem and treat it effectively the FIRST time. Some infections/yeast require very specific treatment protocols, and Otomax is probably never going to target most of them. Essentially, the wrong treatment, and prolonged treatment of the wrong treatment is what is causing the condition to re-occur or never resolve. And, now she thinks this is apsergillus, but has done NO other testing other than a culture. Unacceptable and appalling on her part.
Chronic upper respiratory infections, possibly herpesvirus, chronic ear infections and phantom ringworm on a constant basis. Something is horribly wrong here and it sounds like your vet has missed everything. I'm not saying immunosuppression can't cause such a situation, but this is rediculous. As individual conditions occur, they should have been diagnosed properly and treated EFFECTIVELY at the first onset of symptoms, thereby preventing all of the OTHER infections and other conditions. Add to the fact that apparently, your vet cannot even identify the underlying factor for the "immunosuppression". There is always an underlying cause, whether that is viral, bacterial, fungal, or organ-related, it sounds like she just simply makes a halfbaked attempt to treat a symptom when it occurs, but neglects the underlying cause!
See a specialist IMMEDIATELY, rule out food or contact dermatits, cryptococcosis, retest for FELV/FIV and other viral disease, get an aspergillus blood serum PCR done -- the specialist will know where to start, what tests are most diagnostic, what treatment is best. Once you do, however, follow treatment suggested and do NOT cease or change or omit any treatment he/she has initiated. Ask questions so you understand what is ensuing and so that you understand the condition(s), what is involved and what to expect with treatment/resolution, etc. Please, waste NO time in this, demand of your vet to refer you, or ask other vets in the area for specialist referrals. THIS WEEK.
..........Traci
Re: Aspergillus inside cat's ear
I concur with Traci- Simba needs a feline specialist looking into his symptoms, not an overworked, frustrated and perhaps not knowledgeable vet.
Please stop the dips- they are never supposed to be used long term and you are putting harmful chemicals into this wonderful cats. Ringworm is frustrating, but it isn't a death sentence. If you clean your home and environment adequately enough, the fungus will die off and go away.
Please stop the dips- they are never supposed to be used long term and you are putting harmful chemicals into this wonderful cats. Ringworm is frustrating, but it isn't a death sentence. If you clean your home and environment adequately enough, the fungus will die off and go away.
The smallest feline is a masterpiece.
Leonardo da Vinci
Leonardo da Vinci
Re: Aspergillus inside cat's ear
I am at work, so cannot read through everything....but I trust Traci has given sound advice, as she always does!!
I did skim back when I saw ringworm and dips....I had a cat years ago who was a carrier and kept giving it to the kids....our vet confirmed ringworm, and did a ONE time bath in Iodine (he even gave him a blow dry afterwards)....now, this was back about 16 years ago, so I am not sure if that is standard and acceptable protocol these days....Traci can give more detail on that....
But....I tell you, we NEVER dealt with ringworm on the kids or the cat ever again!!
I did skim back when I saw ringworm and dips....I had a cat years ago who was a carrier and kept giving it to the kids....our vet confirmed ringworm, and did a ONE time bath in Iodine (he even gave him a blow dry afterwards)....now, this was back about 16 years ago, so I am not sure if that is standard and acceptable protocol these days....Traci can give more detail on that....
But....I tell you, we NEVER dealt with ringworm on the kids or the cat ever again!!
Re: Aspergillus inside cat's ear
NO, iodine wouldn't be used now (can't believe it would have been used then!). And, there are risks with iodine too, especially in sensitive tissues, potential for reaction.
..........Traci
Re: Aspergillus inside cat's ear
Thanks Traci...as I said, I was not sure about today's standards.....
I do know that he did not totally dip Tigger, it was more of a bath where he got all of his fur thoroughly wiped down with the iodine bath (diluted) and then thoroughly rinsed and dried as well....
I do know that he did not totally dip Tigger, it was more of a bath where he got all of his fur thoroughly wiped down with the iodine bath (diluted) and then thoroughly rinsed and dried as well....