Dear Sinéad, Siouxsie and Thomas:
Mila has had a fungus in her paws. It was there a few years ago and was treated with antibiotics and then finally went away. It seemed to be gone for a year. Mila is my neighbor's cat and she is very, very sick today. The last time she has the fungus infection, it spread to all of her paws and she had to go in for surgery to have the fungus scraped off. She seemed fine when she was on the antibiotics, but as soon as she came off the antibiotics, which she took for a few months, the fungus returned and every time is worse than the time before. The vets (she has been to more than one) my neighbor has seen says that the cat is allergic to herself. Her paw area around her claws is infected and full of dried pus; this is where the infection appears to start. Then she has black lines going toward her midsection, kind of like blood poisoning would happen in a human. This time she has the infection traveling into her ears and they also have dried pus on them. Her coat is beautiful and soft and looks very healthy. Her eyes also look very healthy; she eats fine and goes to the bathroom fine. She has been using newspaper rather than cat litter for months, to no avail. Her vet says it is time to put her down and no one knows what this is. She is nine years old and many years ago jumped two stories off the balcony. The first time this happened was after that. If you have ever heard of this or know what is might possibly be please let me know so that I can tell her.

As I was reading here I thought it might be ringworm, but it is not as she has two other cats and neither one of them have gotten it. Please help.

~ Darrel

Sinéad: Well, Darrell, it sounds like Mila is certainly experiencing a lot of distress and pain. We'll give you what insight we can, and we hope you'll share this information with Mila's human.

Siouxsie: Fungal infections can happen in cats, but they're really not all that common. If a cat develops a fungal infection (other than ringworm, which can be contracted from other animals or even people), this may indicate that the cat has an underlying immune system problem or that his body chemistry is out of balance.

Thomas: Humans and animals live with fungi in and around their bodies all the time. Usually our immune systems will keep the population of fungi under control, but if for some reason our immune systems don't work properly, fungal infections can flare up.

Sinéad: Fungal infections are generally treated with antifungal drugs, not antibiotics. Antibiotics are designed to kill bacteria, and may be used to treat secondary infections that arise because of the cat's scratching or biting at the itchy fungal infection. We recommend that your neighbor look at the drug information sheets on the medicines she's giving her cat. She can find these sheets (similar to the drug information sheets given to humans when they get prescriptions filled at the pharmacy) at the 1-800-PetMeds website.

Siouxsie: We're not surprised that the fungal infection is appearing in Mila's paws and ears. It's actually hard to know which infection came first. This cat may have been incubating the infection in her ears and it manifested in her paws -- or it may have gone from her paws to her ears. But those two areas of the body are very closely related, as cats use their claws to scratch and clean their ears.

Thomas: Cats actually can develop yeast infections (candidiasis) in their ears, particularly if they get ear mites and produce a lot of wax. The warm, moist, and alkaline atmosphere inside a diseased ear can be a great breeding ground for yeasts and other fungi.

Sinéad: If the cat's vet hasn't tested for the specific type of fungus that's infecting the cat's paws, we would suggest that as the next option. Some antifungal drugs work better on certain infections than others, and if the cat's vet knows what type of fungus is attacking the cat, the cat can get the most effective antifungal.

Siouxsie: If, on the other hand, this is a bacterial infection, then antibiotics are appropriate for treatment. We are concerned with the fact that the infections go away when the cat is taking antibiotics, and then seem to return when she goes off them. This indicates that the cat may have an immune system deficiency.

Thomas: Has Mila had blood tests for feline immunodeficiency virus (FIV) and feline leukemia(FeLV)? If she hasn't been tested recently -- particularly if she hasn't been tested since her adventure of leaping off the balcony -- we would suggest that she be tested. If it turns out that Mila has a chronic immune system deficiency, that will change how your vet treats her infections, possibly by using stronger antibiotics or antifungals to make sure all the germs are gone from her system.

Sinéad: It certainly is possible that Mila has developed a systemic allergy as well. Cats are very sensitive to chemicals in their environment and physical and emotional traumas in their lives.

Siouxsie: If Mila was injured in her fall from the balcony and had to have extensive medical treatment, this could have had an effect on her body's immune system. Surgery and any antibiotic and anti-inflammatory drugs -- although they may have been necessary to save Mila's life if she was grievously injured -- can traumatize the body and throw our system out of whack.

Thomas: We are not saying that cats shouldn't receive drugs and treatment when they're severely injured! We are, however, saying that when animals need to be given invasive medical treatment and large doses of drugs, a period of "detox" after recovery is complete can really help the body get back into its natural balance.

Sinéad: There are some things Mila's human can do to make Mila's environment less allergenic for her. The first thing we would recommend is that she discontinue all use of artificially scented cleaning or air freshening products. These are not only overwhelming to a cat's very sensitive sense of smell, but the chemicals in them can cause chemical-sensitivity and allergy problems.

Siouxsie: There are types of cat litter that can be okay for use by sensitive cats. We use World's Best Cat Litter, a clumping litter made from corn. It has no artificial scents and it clumps up very nicely so Mama can scoop the pee out of our box. It's also nice and soft on our paws. Swheat Scoop is another, similar litter, made of wheat rather than corn. We have used both of these products and believe they work well without causing chemical reaction problems. Other types of non-allergenic cat litter are available, but we don't know about these from personal experience.

Thomas: Before Mila's human puts any regular litter in her box, though, we think she should talk to her vet just to make sure it's okay for her to do that. She must have switched from kitty litter to newspaper on the advice of her vet, so we think she should ask her vet before switching back to any kind of regular cat litter.

Sinéad: If Mila's human feeds her the most natural and high-quality food she can afford, this will go a long way to helping to control Mila's allergies. Some people whose cats have allergies feed them a whole-food diet with recipes they found in books such as Natural Health for Dogs and Cats by Dr. Richard Pitcairn, or The New Natural Cat by Anitra Frazier. However, there are many high-quality, natural cat foods on the market today, and they can be found in dry, canned, and "raw food ready to eat" varieties. Some brands we suggest she look into are Nutro Natural, Wysong, Eagle Pack, and Chicken Soup for the Cat Lover's Soul. Again, there are many other perfectly good brands out there; these happen to be brands we know and can recommend from personal experience.

Siouxsie: Another very important element in an allergic cat's health maintenance is water. Cats need to have clean, pure water that is as free of chemical additives (such as chlorine and fluoride) as possible. After Sinéad developed a urinary tract infection, our vet recommended to Mama that she give us water filtered through a standard pitcher filter. These are available for between $25 and $30 in our area, and come with charcoal filters that you replace every three months. Replacement filters often cost between $15 and $20 for a pack of three. She did, and we've been UTI-free ever since (about five years now).

Thomas: Cystitis, or bladder inflammation (which often presents as a UTI), is one of the primary ways that cats manifest allergy symptoms. Drinking filtered water eliminated a potent allergen from our diets and has kept us all healthy.

Sinéad: Mila's case is one that would greatly benefit from consultation with a holistic veterinarian. We really think that this chronic, recurring infection is a sign of an imbalance at a deeper level in Mila's body. By consulting with a holistic vet trained in nutrition and other alternative therapies (such as acupuncture, herbalism, chiropractic, homeopathy, etc.), we believe Mila could have a chance at a normal life again.

Siouxsie: Holistic therapies are generally long-term processes. You won't see results overnight. With chronic conditions such as allergies, it may take up to a year to get the symptoms -- and the original disease process that caused them -- under control. But Mila will benefit by having many more happy, healthy years with her human.

Thomas: But how do you find a holistic veterinarian? The first place we'd look is the American Holistic Veterinary Medical Association website. This organization has a state-by-state listing of their holistic vet members in the United States and Canada. If you live outside of North America, there may be similar resources in your area. We don't know how up-to-date the site is, but it's definitely a good place to start.

Sinéad: Mila's human could ask her own vet if he or she knows of any holistic veterinarians in the area. Most vets are open to the idea of working with a holistic vet to help an animal get back to optimal health. In addition, many holistic veterinarians are also trained as regular veterinarians as well -- that is, they went to vet school and have a D.V.M. degree in addition to any certifications they possess for holistic treatment modalities.

Siouxsie: She could ask other pet owners if they have taken their animals to a holistic veterinarian, and if so, whether or not they would recommend that vet to a person seeking holistic care for an animal.

Thomas: If she knows any human holistic health practitioners -- acupuncturists, reflexologists, massage therapists, and the like -- Mila's human could ask them if they know of holistic vets. Mama says she got her first holistic vet recommendation from her massage therapist.

Sinéad: Some holistic vets will also advertise in "New Age" or animal-related publications and websites.

Siouxsie: And here's something else that might help. A while back, we gave instructions on how to make a paw rinse for cats. This rinse will help get rid of fungi and germs, and will help to clean off any wax, pus or other assorted goo on Mila's claws.

Thomas: We hope this information helps Mila to get back on her feet again, so to speak! At nine years old, she's barely in the middle of her potential lifespan. If her human can get her recurring infections under control, she and Mila can enjoy many more happy years together.

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.