Dear Sinéad, Siouxsie and Thomas:
I was hoping that you could offer some advice regarding a new kitten I received a little over a week ago. Vincent, as we call him, was given to me for free at a local flea market, and two days afterward I became aware that his health was not as good as first seemed.

Last Tuesday we visited the vet, and he was diagnosed with ringworm. He also has scab like areas all over his face, head, neck, chest and abdomen. The vet thought that these may be from fleas and so I began a flea treatment regime. The vet also gave me medication (topical and oral) to treat fungal infections. Vincent's paw, which was affected by ringworm, seems to be doing better, but the scab like, yellow spots continue, and a new one even developed on his little nose. When I tried to remove it, the hair in the area wiped right off with a few swipes of a moistened cotton ball. Within his ears is a waxy brown substance, which when I tried to remove it, also resulted in the same loss of hair. I am very concerned.

Also, for the past few days his stools have become quite larger and very dry and hard. He passes them everyday, but with great difficulty and they often become matted in the fur around his anus. I have removed these, with warm baths, but the problem is getting worse as the rectal area is now inflamed, red swollen and a discharge has now formed. Also, the hair directly around the anus as well as alongside the base of his tail is now gone. The skin in this area appears pink and without scabbing.

I am at my wits' end. I have given him baths with Malaseb, as directed by my vet, and have done everything that I was told to combat his ringworm. Because I have another cat, a female named Lydia, Vincent has been quarantined to my bathroom, so that she is not exposed to ringworm etc. Poor Vincent's life is miserable, and I just do not know what to do. Any advice that you could offer would be greatly appreciated.

Thank you so much,
S Ketelsen

Sinéad: Awww, the poor little guy! You should be sainted for taking this kitty home and caring for him through all these unexpected health problems.

Siouxsie: This is one of the unfortunate things that can happen when you bring home free kittens. It's sad but true that a lot of people don't take very good care of their cats, and so these cats keep bringing unwanted kittens into the world...

Thomas: And these unwanted kittens keep getting dumped in abandoned lots to become ferals or they get given away to (hopefully) kindhearted humans who may be able to give them a better life than they would have had otherwise.

Sinéad: Part of the reason little Vincent has so many health problems is because he was raised in a place where fleas and other infectious agents, such as the fungus that causes ringworm, were endemic. If he had stayed with his littermates, the odds are good that he wouldn't have lived to see six months.

Siouxsie: So we're really glad that you rescued him, S, and we hope we can give you some tips that will help you help him become the happy, healthy kitten that he can be.

Thomas: Ringworm, as your vet probably told you, is a fungal infection, not an actual worm. It is highly contagious to other cats, and to humans, so it's good that he's being treated for that disease. Any bedding he uses should be washed in hot water, preferably with bleach, to make sure that none of the fungus survives. Likewise, his litterbox should be cleaned regularly with bleach -- and rinsed very well afterwards, so the smell of bleach doesn't keep him out of his box.

Sinéad: Ringworm causes a lot of itchiness, and some of the poor little guy's scabs could simply be due to overscratching of his itchy skin.

Siouxsie: He could have gotten the fungus into his ears by scratching, too. If Vincent carried the fungus on his paw and then scratched at his ear, then the fungus is almost certainly growing in his ears too. The ear canal, being warm and moist, is an ideal breeding ground for bacteria, fungi and yeast infections.

Thomas: His ears could be itchy because he has ear mites. You say that there's a brown waxy substance in his ears, and this is a good indication that the little guy could have ear mites, too. Ear wax is normally a light, amber color; dark brown or black wax indicates the presence of mites. Your veterinarian can give you ear drops that will kill the mites; you will have to administer these drops for a few weeks so that the stuff will kill the mites and any eggs that hatch after the mites are gone.

Sinéad: Any cat that has fleas and ringworm probably has ear mites, too. The reason that some cats are very susceptible to parasites and infections is because they are not born into healthy circumstances. Their housing and bedding is dirty, they are not getting adequate nutrition (good nutrition makes the immune system stronger) and may not have gotten good nutrition when their mother was pregnant.

Siouxsie: But the good news is that you can do a lot to make up for Vincent's rough start in life. We strongly recommend that you get some nutritional supplements for your kitten and feed them to him. Usually these vitamins are formed into a powder or pill that is tasty to cats. If you get a powder, sprinkle it on his food; if you get pills, you may want to break them into pieces -- unless, that is, he loves the taste so much that he'll eat them right up. The vitamins will help Vincent's body get stronger, and in combination with the medicines you're giving him, they will help him fight off his ringworm infection and make him less attractive to parasites. Your vet can probably give you some advice on the best vitamins to give Vincent.

Thomas: If you feed Vincent the best quality cat food you can afford, that will help too. Make sure you get cat food that's specifically made for kittens, because it contains extra calories and nutrition too.

Sinéad: One of the best things you can do to help Vincent's ringworm to keep from spreading is to soak his feet. He's been digging at his itchy skin and ears with his feet, and that waxy, dirty, infective gunk has built up around his cuticles. In order to keep Vincent from reinfecting himself, it's very important to soak his feet in a solution that will dissolve the gunk and kill the germs.

Siouxsie: But remember, cats lick their feet more than any other part of their body, so be sure to wash off anything you put on those paws!

Thomas: Here are the instructions for creating a foot soak for your kitty; we got this information from Anitra Frazier's wonderful book The New Natural Cat, which has lots of herbal remedies and nutritional solutions to tricky medical problems.

Sinéad: First, you'll need the following equipment: 2 large heavy ceramic mugs, the foot-soaking solution, a terrycloth towel or 2-3 dry washcloths, and large bowl of clean, warm water.

Siouxsie: The foot-soaking solution Anitra Frazier recommends for treating ringworm is as follows:

• 1 cup warm water
• 10 drops tincture or extract of echinacea or goldenseal (goldenseal is a well-proven natural antibiotic, and echinacea is an herbal immune system strengthener)

You could use the following solution as well:

• 1 cup warm water
• 1 teaspoon Betadyne solution

Thomas: Whichever solution you use, you must soak each foot for four to five minutes in the solution. You do not need to rinse the paws if you use the echinacea or goldenseal soak, but if you use the Betadyne soak, rinse well and then follow with the echinacea or goldenseal soak.

Sinéad: Frazier also suggests a solution for dissolving cuticle dirt, to wit:

• 3/4 cup warm water
• 2 teaspoons dishwashing detergent or Murphy's Oil Soap (we'd recommend the dish detergent, preferably one with little or no scent)
• Soak each paw for 5 minutes or more and then rinse extremely well. Do not use this solution if Vincent's paws are injured in any way.

Siouxsie: The procedure for foot soaking is very much like the procedure for giving a bath. Bring Vincent to the therapy area (the kitchen or bathroom, most likely). Stand him in the dry sink -- or alternately, if he's very nervous, kneel with him in the bathtub. Explain to him what you're doing and why and ask him to cooperate with you. Fill each mug one-third full of the warm soaking solution and put it alongside the foot to be treated. Lift the foot to be treated and place it inside the mug, but not necessarily down in the warm fluid. Press gently against the opposite side of his body (for example, if the foot to be treated is on the left side, press on his right side), which will cause Vincent to put his weight on the foot you want him to soak. Replace the soaking fluid every two minutes or so with fresh, warm fluid (which you've put in the other mug and set in the bowl of warm water so that it will stay warm).

Thomas: To clean Vincent's cuticles, Frazier recommends the following procedure:

1. Extrude each claw and clip the tip (find out how to clip your cat's claws safely here). This will help keep the damage he can do with his scratching to a minimum.
2. Extrude each claw again and, using your thumbnail, try to scrape away some of the dirt. Be gentle -- this area of his paw is very sensitive and you don't want to hurt him. Don't scrape the cuticle and don't try to be thorough right now.
3. Extrude each claw again and soften the waxy dirt by massaging warm olive oil or almond oil into the dirty areas.
4. Wait about three minutes, massage the oil in again, then clean away the softened dirt with cotton swabs. This may be all you need to do.
5. If stubborn, hardened dirt still remains, do the foot soak for dissolving cuticle dirt. Use the solution Sinéad mentioned above and the foot-soaking procedure. During the five-minute soak, repeatedly extrude the nails and gently massage the solution around in the dirt. Then, once again, clean away the remaining dirt with cotton swabs.
6. Rinse very well! No soapy solution may be left on the legs and feet. A final rinse in one cup of warm water and 1/2 teaspoon of white vinegar will assure that all the soap is gone. Then rinse a last time in clear water.
7. Dry with a fluffy towel or washcloths. Thank Vincent for his help and give him a treat and a catnip party for being so good.

Sinéad: Poor Vincent's anal irritation is the next task to take on. It sounds like Vincent is becoming constipated -- you mention that his stools are very dry and hard and he struggles to pass them. This is most likely why his anus area is red and irritated. We're sure you humans have some idea that it hurts when you pass large, dry, hard stools!

Siouxsie: It's quite possible that the medicine he's taking to treat his ringworm infection is causing him to become constipated. It is not uncommon for cats to be very sensitive to such things. Even if you're not giving it to him as a pill, he is licking off whatever you're bathing him in.

Thomas: Since you can't stop giving him the baths and medicine until his ringworm is gone, the best thing you can do is make sure that Vincent is staying hydrated. Make sure he always has lots of fresh water, and give him food with a higher moisture content. Also, groom him regularly, at least 30 seconds a day, to prevent him from swallowing too much hair -- another common cause of constipation in cats. You might try a stool softening treat (which we also found in The New Natural Cat):

• 1 Tablespoon baby food vegetables and meat mixture
• 1/2 teaspoon melted butter (unsalted or "sweet" butter, preferably -- and it MUST be butter, not margarine or an other faux-butter type stuff)
• 1/8 teaspoon ground psyllium husks (you can usually find this at health food stores)
• 1/8 teaspoon powdered or fine bran
• 2 Tablespoons water (or more -- use your judgment).

Sinéad: You can also mix 1/2 teaspoon of powdered bran with 1/2 teaspoon of butter and serve it as an occasional treat. Basically, the butter lubricates and the bran gets the mojo working, so to speak.

Siouxsie: If you get Vincent's stools softer and his bowels working better, that should solve the irritation around his anus. The discharge you mention could be either from his anal glands (located on either side of the anus), or it could be from the anus itself because of the irritation.

Thomas: Has your vet given you any estimate of Vincent's age? It's possible that he was removed from his mother before he was fully weaned. If this is the case, you might consider giving him some Kitten Replacement Milk (available at pet stores and veterinarians' offices) along with his usual food. This might help his digestion, too.

Sinéad: You're doing wonderfully well so far, and you can rest assured that once Vincent gets his health back, he will be a happy and loving kitty. Just don't forget to spend time with him, love him and play with him. He needs your love and attention as much as he needs medical care. If he doesn't get his emotional and social needs met, he may lose his will to live, and then all your hard work and all the money you've spent on vet care will be pointless.

Siouxsie: We know it's hard to want to touch an ugly, scabby-looking cat -- even though it's through no fault of his own. But we trust you know that he needs touch and kindness anyway, and that you are giving him the time and care he needs. The more you can touch him when you're not administering medical treatments, the more he will look forward to your touch and attention when he is finally released from his "quarantine."

Thomas: We suggest you tell your vet that you suspect Vincent has ear mites. We also think you should talk to the vet about Vincent's constipation problem. He or she might be able to give you some other ideas about how to treat his constipation and prevent it in the future, and you can get some medicine to kill the ear mites too.

Sinéad: So, we hope that if you can give Vincent some of the home treatments we've come up with, and we hope that Vincent emerges from his rough start in life as a sweet, beautiful and wonderful addition to your family. Bast bless you for taking the poor little guy in and giving him a better life. Please let us know how things turn out.

Got a question? Need some advice? E-mail us at advice@paws-and-effect.com. None of the material in this column is meant to be a substitute for regular veterinary care.