Tiger Day 54 – the sporo story (a library of sporotrichosis stories)

Disclaimer: This post is only a sharing on home caregiving and does not contain any professional advice. If your cat has sporotrichosis, please consult a vet and follow the prescribed treatment. This sharing is intended as an encouragement to sporo-cat caregivers not to give up on their cats and that recovery is possible with proper treatment and dedicated caregiving. An experienced Malaysian vet shared that sporotrichosis is 98% curable, so, please do not give up.

On hindsight, I realised that I did an “overkill” with Tiger, by doing too much! That’s because Tiger was my first case, he was FIV+, and his prognosis was poor. For healthy cats, I think the main medication is Sporanox (Itraconazole) and a liver supplement. That might just suffice. Follow your vet’s advice. Every sporo cat’s needs would be different depending on the cat’s condition. 

To summarise for everyone, this is the basic allopathic (Western) medication, to our best understanding:

1. Sporanox (Itraconazole).
2. A liver protectant.
3. Give Sporanox with some oil for optimum absorption.
4. An immune booster (for eg. Vetri DMG).
5. Continue meds for another 30 days after full recovery.
6. Every cat is different, so the vet might prescribe other medication with need be (for eg. antibiotics).

An update: The use of TCM has also been found to be very effective in supporting the treatment of sporotrichosis: https://animalcare.my/2024/05/15/yunnan-baiyao-a-tcm-for-sporotrichosis-cancer-wounds-and-poisoning-a-sharing/

My vet had often reminded me that in healing, the vet and the medicines play a role, but so does the caregiving. This post is a sharing on the caregiving part.

Homecare plays a very important role in a successful recovery of a sporo cat.

Here’s my original 2014 post about Tiger:

Time flies, and it’s already Day 54 for Tiger’s sporo treatment.

He doesn’t allow me to take photos of his sores now, but I want to write this post right now because a lady has just written in saying her cat has been diagnosed with sporotrichosis and her vet has advised her to have the poor cat euthanised because her vet contracted sporotrichosis herself and had a tough time recovering from it. The lady is at a loss and doesn’t know what to do. She wrote to ask if there is any vet we could recommend who would be willing to treat her cat.

I replied asking her to please not give up on her cat and to take her cat to a vet who is compassionate and willing to treat her cat. And I shared the many, many cases I have compiled through the years we’ve encountered sporo cases, from Morton’s, Wong Wong’s, Blacktail’s, Fitri’s, Puteri’s, Rascal’s, Merdeka’s, Houdini’s, Thong-c’s, etc, and now, Tiger’s. I have always had a ready list to send to readers who ask for help for their sporo-cats but this time I can speak with more conviction as I’ve personally nursed Tiger (and am still nursing him).

However, for professional advice, all sporo-cat caregivers must get a proper diagnosis from their vet and adhere to the advice of their vets. Every case is different and the vet knows best. Please do not self-medicate or compare your cat’s case with any of the cases shared here, especially where dosages are concerned.

We must always follow the vet’s advice.  

I have compiled Tiger’s photos here in this blogpost so that I can send it to this lady to encourage her to get her cat treated – visuals help, but sporotrichosis is still a deep muscle infection and the actual healing takes place “inside”. Even after the sores have completely “disappeared”, I was told that medication must continue for another 30 days post-healing.

Tiger is very lucky that his vet is so very compassionate and has never been known to give up on any sporo-cat.

So here goes, in a nutshell and the comparison photos are below.

Tiger was discovered to have early-stage sporotrichosis 54 days ago. The sores were found on his left front paw, the insides of his left hind leg and right hind leg. I started him immediately on Sporanox (note: it is highly recommended to use only the original and not the generic one, as advised by the many, many sporo-cat caregivers). The cost ranges from RM6.90 to RM9.50, depending on the various pharmacies.

I also gave Tiger RetroMAD1 (recommended by his vet) as he is FIV+ and the prognosis for recovery is usually poor for immune-compromised cats, what more, when it’s a hard-to-heal disease like sporotrichosis.

Besides these, Tiger was immediately started on Biopure (the new version of Liv-52, from Himalaya). This is to protect his liver as Sporanox is known to be toxic to the liver. I also gave Tiger Vetri DMG, which is a natural immune booster. Later, upon consulting his vet, I gave Tiger the following supplements as well: Omega-7 and Transfer Factor (both to boost his immunity). Please note that Tiger is taking more supplements than usual only because of his FIV+ condition and his poor prognosis. These supplements are totally optional and probably not required for cats who do not have any immune-compromised condition.

All supplements were all given after consulting Tiger’s vet. Please do not self-medicate. Always seek professional advice.

I was told that the key to treating sporotrichosis is the medication Sporanox (which contains Itraconazole as its active ingredient), to be given with some oil for optimum absorption. I used coconut oil.

For topical application, initially I used Lamisil Cream (terbenafine) for his sores. But please note that Lamisil is toxic to the liver and I had to use the e-collar to prevent Tiger from licking it. Later, I changed his topical treatment to a pet spray which is non-toxic and biodegradable. This is an anti-fungal and anti-bacterial spray which contains bioflavonoids, hence totally safe even though licked. But sporotrichosis is a deep muscle infection (the spores are located in the deep muscle) so Sporanox is the medicine that will address the infection from its roots. Any topical application is only to prevent further spread and from other secondary fungal infections from setting in. Whether any topical application really helps or not, I don’t really know.

The sores did not quite show improvement for the few weeks. In fact, on Days 7 and 9, new sores flared up, suspected to be the existing spores germinating from the deep muscle, manifesting as new sores. Though these looked scary and intimidating, it’s “good” that the spores germinate rather than stay dormant in the muscle (that would literally be a “time-bomb” of sorts). You’d want all the infection to “come out” rather than hide inside. So you need not be alarmed if you see new sores appearing even after starting treatment. If in doubt, always seek your vet’s advice.

Tiger was quarantined from the rest of his friends. I was also advised that sporotrichosis, which is zoonotic (can spread to humans), spreads and starts through an open wound. I wore gloves while applying the Lamisil Cream onto his sores. But I did not have any open wounds, so that wasn’t so worrying. Morever, Tiger did not have the infamous “Clown Nose” (red nose, which is very characteristic of sporotrichosis). The presence of the “Clown Nose” normally indicates that there is infection in the mucuous membrane inside the nostril (which can spread to the lungs). If this happens, the spores can spread from sneezing and through the air. Thank goodness Tiger had not got to this stage.

The Sporanox dosage is based on weight. Tiger was 5.6kg when first diagnosed, so his dosage was 1/2 cap once a day.

Sporanox – 1/2 cap once a day (the medication) – depends on the cat’s weight
Biopure – 1 tablet twice a day (a liver protectant)
Vetri DMG – 1 tablet once a day or 0.5ml once a day (an immune booster)
Lamisil Cream/anti-fungal petspray – topical application once a day (only to prevent further topical spread, not to cure sporotrichosis)

The following are extras only because of Tiger’s FIV+ condition:
RetroMAD1 – 0.2ml thrice a day (an antiviral to help FIV+ cats heal)
Omega-7 – 1 capsule once a day (to help skin healing)
Transfer Factor – 1 capsule once a day (further immune booster, because of the FIV+ condition)

On hindsight, all the extra supplements may not have been necessary, but Tiger was my first hands-on case and being FIV+ with a poor prognosis, I decided to go all out and give him the best possible fighting chance. But please do remember that more isn’t necessarily better!

How Sporanox works

Sporanox capsules contain the active ingredient itraconazole, which is a type of medicine called a triazole antifungal. It is used to treat infections caused by fungi.

Itraconazole works by preventing fungi from producing a substance called ergosterol, which is an essential component of fungal cell membranes.

The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. Without ergosterol as part of the cell membrane, the membrane is weakened and damaged, and essential constituents of the fungal cells can leak out. This kills the fungi and hence clears up the infection.

Itraconazole is used to treat a number of different types of fungal infections, including those of the genitals, mouth and skin. It is also useful for treating systemic (whole body) fungal infections and to prevent them from developing in people with an underactive immune system (for example, due to AIDS).

Sporanox capsules are taken by mouth. Alternatively, itraconazole may be administered via a drip into a vein (intravenous infusion) depending on the type and severity of the infection. The length of treatment will also depend on the type and severity of the infection.

Read more: http://www.netdoctor.co.uk/infections/medicines/sporanox-capsules.html#ixzz2w1tk8XNM

We also took Tiger out for sunbaths every morning. Even though it was just a few minutes a day, the morning sun is very healing. It helps. Tiger enjoyed it too! When sunbathing, we exposed the sores to sunshine. Please do remember to take care of your own hygiene too, ie. wash hands thoroughly, take a bath (if necessary) and change all clothings to prevent the spores from spreading.

Remember to use gloves to protect yourself. When we were using Lamisil, the e-collar was placed on Tiger for about one hour after application to prevent Tiger from licking the cream (which is toxic).

Throughout the entire period of treatment, Tiger was eating very well. This is a good sign and I’m glad his case was in its early stages. We monitored his weight throughout too.

Sporanox capsule, Lamisil cream, Biopure (liver protectant).

Vetri DMG and Transfer Factor as immune boosters.

Omega-7 as an additional supplement for the skin.

 

Now, here are some comparison photos:

LEFT FRONT PAW : Gang of Four

LEFT HIND LEG: Gang of Eight

 RIGHT HIND LEG: Just one sore

In between, quite a number of sores appeared on the tail and both sides of the hips. I mistakenly thought these were sporo sores, but upon checking by the vet much later, these were actually just lick/bite sores, and not sporo-sores! Revolution spot-on solved this problem.

So today is Day 54 and I am stil waiting for the day for all the original sores to totally disappear as the vet advised that Tiger would have to continue with Sporanox for another THIRTY days post-healing. And “post-healing” means the skin has grown back and the sores are not longer visible.

Meanwhile, I just managed to take these photos a few minutes ago.

Here’s….Day 54:

Left Front Leg: What’s left of the Gang of Four.

Left Hind Leg: What’s left of the Gang of Eight.

Right Hind Leg: What’s left of the Just One.

I’ve been repeatedly reminded that relapses are not uncommon in sporo cases, so it’s still not time to celebrate yet.

Right now, Tiger and I are looking forward to the day when all these original sores disappear totally, then only can we begin our 30-day countdown (it begins the day the last sore disappears). After that, there are still a few more months to wait and pray that a relapse will not occur. I will consult the vet to see if there is any necessity to continue with all his supplements after the 30-day countdown. But Sporonox will stop after 30 days since it has a considerable level of toxicity.

Meanwhile, Tiger has put on weight (5.9kg) and this a good sign. The vet says there is no need to do a liver function test.

Tiger’s appetite is good and it is important for sporo-cats to be on the best possible nutrition as the body needs all the nutrition and strength it can get to heal from this dreadful disease.

A note to add is that even confined cats can contract sporotrichosis. Tiger lives indoor with a garden which has plants, soil and grass. He probably contracted the sporo from the soil as the fungi lives in the soil. All it takes is an open wound and the spores enter the body, get lodged in the deep muscle and the nightmare begins.

However, as scary as it sounds, I personally hope sporo-cats caregivers will not give up on their cats who have sporotrichosis. If you would just do a wordsearch on “sporo” on this blogpost, you will find so many successful cases. Wong-Wong and Merdeka’s cases were REALLY bad, and yet, they recovered. So did many others.

Whatever the disease, as long as there is a treatment protocol, we owe it to our animals to save their lives.

Hey, Tiger!

We’ll get there soon…!

For a day-by-day update and progress report on Tiger’s treatment, please wordsearch “Tiger sporo” in this blog.

Updates: Tiger Day 87: http://animalcare.my/2014/06/01/tigers-official-sporonox-treatment-ends-today/ (treatment ends!!)

Updates after 1 year: There was no relapse of the sporo in Tiger and none of our other cats contracted it too. Thank goodness for this!

Other cases: