medicine

Question
Dr. Gotthelf,
What do you think of giving a 28 pound pug Ketoconazole, 200mg, tab teva, 21 days for ringworm. I'm afraid of liver damage.  Isn't there anything better.  I thought Keto was banned in Europe and Australia, and not approved by the FDA.
Thanks,
Paul

Answer
If there is a culture confirmed ringworm case, then ketoconazole 200 mg or fluconazole 100 mg for 3 weeks should help.  Daily shampooing with a ketoconazole or chlorhexidine shampoo for 10 minutesd daily will also really help.  Ketoconazole has been associated with some types of liver disease in humans, but it is rarely found in dogs.  It is not banned in the US as far as I know. The price for ketoconazole has skyrtocketed in the last few months because fewer manufacturers are producing it since there is a very much more limited use for it.