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Ringworm: Hygiene And Pictures

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Wiebke

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#1
Overview
1 What is ringworm and how is it treated?
- Ringworm facts
- Available treatments (UK-US-worldwide available products)


2 Ringworm hygiene during and at the end of treatment
- When to quarantine
- Recommended disinfectants (UK-US-worldwide available brands)
- Disinfection
- Handling ringworm piggies and human hygiene


3 Ringworm progress pictures, post-treatment measures and further information
- Pictures illustrating the onset and the typical progress of a ringworm infection
- Post-treatment quarantine
- Further links



Ringworm is one of the very few things that can cross over from guinea pigs to other species. It is a fungal skin complaint that can affect other mammalian pets like dogs, cats, rabbits, small furries and also humans. Of all the transmittable problems between pets and humans, ringworm is the most common.

If you suspect ringworm or have got a diagnosis from the vet that you are dealing with ringworm, you have to make absolutely sure that it doesn’t spread. Your hygiene at home is every bit as important as any fungal treatment itself!

Please do not home treat or treat on spec, but seek vet advice unless you know exactly what you are doing. Mange mites and ringworm can often look very similar in the initial stages, especially if they are appearing in atypical locations. The wrong treatment for the wrong complaint can make things worse instead of better!
What to check and look out for in new guinea pigs (vet checks, sexing, parasites&illness)


1 What is ringworm and how is it treated?

Ringworm facts
Ringworm is the most aggressive and transmittable form of a fungal skin infection. It is most common in young pet shop or breeder guinea pigs or in guinea pigs rehomed privately or from shelters and rescues with no medical care and quarantine. It can also be transmitted from you and other species pets to your guinea pigs.

Any animal or human affected with ringworm is shedding lots of spores that can happily survive in the tiniest of cracks. The spores can stay active for up to 18 months. The incubation period is about 10-14 days between infection and outbreak. The human form of ringworm is called tinea.

Ringworm has characteristically a painfully itchy reddish ring on the outside of a developing bald, often roughly round patch, hence the name; this will not be visible on piggies with darker skin, but you may notice that the rim of the bald patch is often scratched bloody. Ringworm can look like a scratch or bite that is scabbing over at first. Ringworm often affects the head and ear area, but it can also appear in other areas.

Ringworm is an easily transmitted opportunist. It often affects highly stressed animals, like shop piggies or newly rehomed piggies, which is one of the reasons why we recommend to quarantine any newly arrived piggies that haven’t undergone a mandatory quarantine at a good rescue. It can also hit a guinea pig that is struggling with health problems or recovering from an illness/major operation. Ringworm can also appear out of the blue without any obvious course or source.


Available treatments
- oral treatement
By far the most effective and least stressful for your piggies with the least risk of infection for yourself!

Oral systemic fungal treatment with itrafungol(UK)/sporonox(US) (active ingredient: itraconazole) or newly ketaconazole (US) is now increasingly more widely prescribed by exotics vets and general vets with access to an exotic consultant vet.
gets to all places, especially in very sensitive areas like eyes, ears and mouth and can also be used to treat for candida. It is prescription-only and not cheap, but well worth it, especially when you have a number of guinea pigs or frailer ones.

- topical (i.e. on the skin) dips and shampoos in order of effectiveness
- imaverol/enilconazole dip is in our own experience the most effective and the mildest when it comes to sensitive areas and skin, as well as very young guinea pigs.
Please ask your vet for it if they won't/can't prescribe oral treatment. A dip needs to dry on the skin and should not be rinsed off for full effectiveness.

There are other dips and shampoo products that can also do the job, but they can be harsh on the skin and can cause an eye to swell painfully if applied right next to it or may have been overtaken by more effective new products.
Medicated topical products prescribed by a general UK vet may include:
- malaseb (still very useful for fungal/bacterial/microbial skin infections, especially when the nature is not clear and does work for ringworm)
- surolan (can be used, but is not as effective as and harsher compared to imaverol)

Recommended ONLY if you not have access to any decent vet care at all as very harsh on the skin for a full course of treatment.
- nizoral or any generic human dandruff shampoos (over the counter 1%, prescription only: 2% - the efficiency depends on the concentration)

- NOT RECOMMENDED: fungal skin/athletes foot creams
Do NOT cream before you have seen a vet for a diagnosis!
Creaming does not reach the whole affected area in a ringworm outbreak, which is always much wider than visible. It does not prevent spores from spreading and infecting other parts of the body and transmitting the infection further.
A thick layer of cream can also be problematic, especially in warm weather.
We strongly recommend to not use creaming for ringworm treatment. It is now a very outdated way of treating from a time when knowledge and available safe options for guinea pigs were extremely limited.

Topical fungal treatment, especially in warm weather or in tropical areas, may not be enough.

There are other, less aggressive and transmittable fungal skin diseases. A mild fungal infection (like a fungal nose strip or a mild fungal ear spot) are often treated by your vet with a cream. Please apply a very thin layer only.

More information on ringworm and fungal medications can be found here: Guinea Lynx :: Fungus
 

Wiebke

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#2
2 Ringworm hygiene

Quarantine

Bonded pairs
It is generally less upsetting and easier for you to not split well bonded pairs and just treat both guinea pigs for fungal. With prompt treatment during the period between infection and outbreak, you can prevent an actual outbreak in the companion.

The not affected companion will require three fungal baths in all: one at the onset in order to prevent an outbreak from an infection caught before treatment, one once the acute phase of the affected companion is over (1-2 weeks) to prevent an outbreak from any infection caught during treatment and - if you want to be absolutely on the safe side - once at the end of the post-fungal observation period; in the latter two cases to make sure that no ringworm spores are carried across in the fur coat that can fall off or transmit and cause a later outbreak.

I would strongly recommend to give these latter two baths to the affected guinea pig, too, if it is only treated with cream on the affected spot (which may not prevent other patches from coming up and running their cause; a dip will prevent more affected areas from coming up) or - most effectively - with an oral medication (UK brand itrafungol). Oral medication cannot reach any spores sitting in the coat.

Groups or more than one pair
Ideally, you separate and quarantine any affected group piggy/bonded pair in another room or well away from any other pets. You may want to give all your other piggies and any pets in direct or indirect contact with piggies an antifungal bath to prevent further outbreaks and deep clean the room, but by removing the affected guinea pigs, you only have to do this once to all not affected guinea pigs.

If a single piggy is struggling badly on its own (including loss of appetite), you will need to give any piggy that joins as a companion an antifungal bath every third day for three times (three baths in all).

I would also recommend a final bath before your ringworm piggy/piggies are joining a group or go back into a room that is used by other pets, too, so you can be sure that they are not accidentally carrying any spores back in.

Please always keep any pets with ringworm well away not just from other guinea pigs but also other species animals and any children, as well as any frail or older people or people whose immune system is suppressed.


Recommended disinfectants
Vinegar and normal antibacterial pet shop disinfectants are NOT enough to cope with fungal issues!

Recommended effective vet grade antifungal disinfectants
UK:
We strongly recommend to get an antifungal disinfectant like F10 or Virkon.
Both products are internationally available online; you can find them on ebay or amazon, for instance, but also on sites that sell veterinary supplies. They come either as a concentrate or a spray. F10 is also available as a hand gel.
Unlike Virkon, F10 disinfectant is also able to kill off fungal spores, which is why it is our forum preference.
US and Canada: In addition to F10, LD disinfectant is also being recommended on some sites as a new product.
Worldwide: Virkon (and F10 - but you may have to check postage and availability)

NOT recommended disinfectants
- bleach: Leave at least 15 minutes standing. Can be used as a first measure when having to wait for more than 2 days for any online order to arrive, but cannot completely protect against ringworm.
- normal disinfectants: antibacterial, but not antifungal and cannot kill ringworm and ringworm spores
- vinegar: no protection whatsoever against ringworm


From my own experiences, investing in a good antifungal and antimicrobial vet grade disinfectant is well worth the money as its protection can prevent the risk of reinfection and save you much more expensive vet and medication cost down the line!
The same goes for ringworm hygiene - skimping can quickly become a very costly shortcut.

As far as ringworm goes:
Do it properly, spend your money in the right place and you have to do it only once!


Disinfection
In over a decade on this forum, we have had plenty of opportunity to work out what works and what not - and also to discover all the ways you can infect and re-infect yourself and your guinea pigs without noticing.
Our recommended measures are very comprehensive but if you follow them, you can get through a ringworm infection for good in one go and with minimal hassle!

Hard surfaces
Please disinfect very thoroughly any cages, hutches and any areas in your house that have been in contact with your infected piggy.
Make sure that you really reach all corners and cracks, even more so when dealing with a wooden hutch!
If your cage is on carpet, please move it to a washable area that disinfected easily during and after treatment.
If you can't, get some DIY plastic protection sheet to stand your cage on. Hoover/clean your carpet thoroughly in the area around your cage.

Fabrics
Wash any fabrics at least at 60 C / 140 F in order to kill off any spores.

This includes any of your own clothing in contact with a ringworm piggy, as well as any fleece bedding, fabric underlay, cosies, lap rugs and the towels needed for treatment and dips etc.

Toys and wooden furnishings
Please throw away any wooden hideys and chewing toys
and rather buy fresh ones after the end of the treatment or soak them wholly submerged in strong F10 for a few hours and then let dry.


Handling ringworm piggies and preventing catching ringworm yourself
Please always feed, clean and handle a fungal piggy last, so you are not accidentally carrying any spores back to your other piggies/pets by accident.

Wash your hands thoroughly before and after handling an affected piggy.
You may want to get an antifungal hand gel (like F10 handgel) to prevent transmission, especially infecting yourself by accident when unthinkingly touching or scratching an area of skin.

We strongly recommend wearing disposable gloves when handling and treating a ringworm piggy.
You may also want to use an old piece of clothing or a dedicated apron when treating a ringworm piggy.
Please wash any clothes in contact with ringworm regularly at the recommended high temperature, so you are not re-infecting anything via your clothing.

We have also found that a regular every 3 day whole body wash with nizoral or another generic dandruff shampoo (1% ketaconazole) can help protect you from those unthinking scratches or gestures during any treatment, especially after a deep clean, piggy bath or when you catch yourself touching an exposed body part while wearing gloves. The most common spots for transmitted ringworm in humans turn up in the neck, face or on your arms.
The infection becomes transmittable the moment a fungal spot appears and spores are shed. Many people will instinctively touch the area when they notice it for the first time.

Please speak to a gp if you have small children that have handled an infected guinea pig.

PS: If you are treating your guinea pigs orally, you can also use the nizoral shampoo for a one-off piggy bath at the end of the treatment to wash any ringworm spores out of the coat before they return to their deep cleaned cage and their not infected companions.
Use a basin on a towel for grip on the floor of your shower or your bathtub for the piggy bath, then have your own last nizoral bath, hose the area carefully down and disinfect.
 

Wiebke

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#3
3 Ringworm pictures, post-treatment measures and further links

Pictures illustrating the onset and the typical progress of a ringworm infection
When dealing with ringworm, you have to be aware that it is going to get worse before it is getting better!

The area affected by ringworm is much wider than initially visible. Ringworm is sitting on the hair, especially the hair roots. This means that all the affected hair has to come out before the acute stage is over.

A ringworm attack when treated typically takes about a week or two to run its course, longer in a more advanced or severe case.
It is over when all affected hair and crusts have come off and there is no new exudate forming. The hair will grow back quickly within a month from the inside out.

Onset
Onset with bloody scratch scab looking initially like an injury
IMG_8819.JPG
Picture from day 2 as the bald area is starting to grow away from the scabbed over scratch
IMG_1137_edited-1.JPG


Onset with scaly bald area around the eye
IMG_0073_edited-1.jpg

While ringworm typically starts on the face, ears or neck, it can start elsewhere; especially in guinea pigs that have previously had ringworm or have been in contact with an acute ringworm piggy shedding spores. Advanced ringworm will also come up further down on the body in new places.

Here is a picture of a ringworm outbreak at the back end in a guinea pig that had been referred and surrendered to rescue with an advanced wrongly treated care of ringworm by a vet earlier in the year. Unfortunately in this case the rescue didn't give a final bath at the end of successful oral treatment.
Thankfully with prompt treatment and strict hygiene this piggy remained the only affected guinea pig in a room of 30 other piggies. He was immediately quarantined with his companion in another room, put on another course of oral treatment and only required one bath after the end of the acute phase. Meanwhile the piggy room was completely deep cleaned from top to bottom.
IMG_6089_edited-1.jpg


When treating topically (skin treatments)
Acute phase between first and second imaverol dip; crusty fungal exudate still forming and clearly visible
IMG_0096.JPG

After a dip; you can see that the affected area by the ear is quite large in this case. Because of a lowered immune system (irregular heartbeat), imaverol dips were ultimately unable to stop the spread and the piggy in question was put on a then (2012) pioneering course of oral itrafungol, which stopped the ringworm completely within a week.
IMG_8040_edited-2.jpg


Furthest extent and end of the acute phase (no more hair loss and exudate/new scales forming).
You can see the bloody areas where a scab from scratching has come off.
IMG_1332_edited-1.JPG


Recovery (hair growing back, starting with the initially affected area at the centre of the ring)
IMG_1515_edited-1.JPG

Hair fully grown back 5 weeks after the outbreak; the hair is pretty much grown back.
IMG_0363_edited-1.jpg


Post ringworm quarantine
Please wait another two weeks after the end of the acute ringworm phase before lifting the quarantine to make sure Topthat the fungal has disappeared and is not coming back. (see incubation period)

It is advisable to give all guinea pigs a bath and the hutch/cage and all furnishings a last deep clean to make sure that no spores are carried across; especially from guinea pigs that have been exposed to, but not affected by ringworm, so you can be sure that you have a totally clean start after the end of the quarantine period.

You are most welcome to open a thread and ask for further support.


Further links
Ringworm in guinea pigs:
Guinea Lynx :: Fungus
Gorgeous Guineas Identification

Ringworm in humans:
Ringworm Pictures, Treatment, and Tinea Facts
http://www.nhs.uk/Conditions/Ringworm/Pages/Introduction.aspx
 
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