Demodectic mange may not always require medical attention. The majority of demodectic mange infections that are contained to a limited area of the body will spontaneously disappear in 1-2 months without any medical intervention. Topical drugs like moxidectin and imidacloprid can be used to treat more localized infection cases.
For the relief of symptoms if demodectic mange spreads widely, treatment is advised. The most popular form of therapy is miticidal treatment (oral or topical), which includes the medications ivermectin, milbemycin, doramectin, amitraz, fluralaner (Bravecto), afoxolaner (Nexgard), sarolaner (Simparica), and lotilaner (Credelio). Ivermectin should never be given to dogs who have MDR1 mutations. Genetic testing can be used to identify this mutation.
Until two successively negative skin scraping or hair pulling tests take place, miticidal therapy is continued. Benzoyl peroxide-containing specialty shampoos are frequently advised as they flush and expand hair follicles, facilitating better penetration of topical and dip treatments. Before using these medications, you should go over the risks and advantages with your veterinarian.
Inflammation can lead to secondary skin infections that need antibiotic treatment. Prior to getting rid of the demodectic mange, it could be required to treat the skin infection.
As generalized demodex infections are believed to have an underlying genetic and/or immune system reason that contributes to an overabundance of mites, it is also advised to stop breeding dogs with these infections.
How is demodex mange treated in dogs?
A parasitic skin condition known as mange is brought on by tiny mites. Skin illness in dogs is brought on by two distinct mange mites. Sarcoptic mange is one of them; for more details, see the handout “Sarcoptic Mange in Dogs.” The other one lies in the hair follicles (demodectic mange). Although the two mites have some comparable traits, they also differ significantly. Because the two varieties of mange have different causes, treatments, and prognoses, it’s crucial to distinguish between them. Image by Joel Mills from Wikimedia Commons (CC BY-SA 3.0.)
What causes demodectic mange?
Demodex canis, a parasitic mite that inhabits the hair follicles of dogs, is the cause of demodectic mange. This mite has eight legs and resembles a cigar under the microscope. The most typical type of mange in dogs is demodectic mange, sometimes known as “demodex” or “red mange.”
“These mites do no harm as long as the immune system is operating normally in the body.”
Most humans and typical canines both have a few of these mites on their skin. These mites do no harm as long as the immune system of the body is healthy.
When a dog’s immune system is still developing, demodectic mange most frequently occurs, which allows the skin mite population to grow quickly. As a result, dogs who are less than 12 to 18 months old are more likely to contract this condition. The dog’s immune system develops as it gets older.
Adult dogs with the illness typically have compromised immune systems. Due to age-related immune system function reductions, demodectic mange may manifest in older dogs. Demodectic mange can also affect dogs whose immune systems are compromised as a result of disease or specific drugs.
Is demodectic mange contagious?
No, humans or other animals cannot contract demodectic mange. During the first few days after birth, puppies are exposed to demodex mites from their mother. Since the mite is almost universally present in dogs, it is safe to expose a healthy dog to one who has demodectic mange because mange cannot develop in a dog whose immune system is healthy.
Why doesn’t the immune system mature correctly in some dogs?
Immune system development is governed by genetics or hereditary factors. Frequently, a dog’s littermates are also impacted. Littermate owners should be warned to keep an eye out for the emergence of mange in their puppies. Affected dogs should not be bred, and neither should the parents of the affected dog. This is because the sickness is caused by a genetic flaw.
What does demodectic mange do to the dog?
Surprisingly, although losing hair in sections, a dog with demodectic mange typically does not itch badly. The face, particularly the area around the eyes, is where hair loss frequently starts. Localized demodectic mange is the name for the disorder when there are only a few bald patches. Generalized demodectic mange is the name of the illness when the disease affects numerous skin regions.
How is demodectic mange diagnosed?
To diagnose this condition, “your veterinarian will take deep skin scrapings and examine them under the microscope.”
To diagnose this condition, your veterinarian will take deep skin scrapings and examine them under a microscope. The diagnosis is supported by the discovery of significantly more Demodex mites than usual in skin scrapings. In some cases, dogs with persistent skin infections that have not improved with treatment can have the condition confirmed using a skin biopsy.
How is demodectic mange treated?
Topical medicine is typically used to treat the localized type. The generalized form necessitates more extensive treatment, including oral medication and specialized shampoos and dips. Prior to dipping, shampooing with specialized cleansing shampoos that contain benzoyl peroxide helps to clear up and open the hair follicles. To learn more about the dipping procedure, refer to a supplementary handout (see handout “Demodectic Mange – Dipping Instructions for Dogs).
Additionally, there are a number of “spot on” topical medications, including imidacloprid and moxidectin. These drugs are employed ‘off label’ to treat demodicosis. The use of a medicine for illnesses other than those for which it was prescribed is referred to as “off label.”
Doramectin is available in an injectable version that can be utilized for demodex treatment off-label. You and your veterinarian will talk about the advantages and disadvantages of these drugs.
Secondary skin infections can exacerbate the illness in some circumstances, especially in dogs with global demodectic mange, necessitating antibiotic therapy. Dogs with skin diseases can have extremely red, inflamed skin, which is why demodectic mange is frequently referred to as “red mange.” In addition to demodectic mange, your veterinarian can assist you in determining whether your dog has a skin infection.
Are there any problems with topical treatment?
Amitraz, an insecticide, is a common ingredient in the dip used to treat demodectic mange. It must be handled with extreme caution because it is a potent insecticide that, if used improperly, can have terrible negative effects on both you and your dog. Following each application, your dog may experience vomiting and drowsiness for 24 to 36 hours. The majority of these issues will go away on their own without treatment. If your dog behaves in this way, you should add 25% extra water to the following dip. If your dog licks the medication while you are doing a topical “spot on” therapy, you can notice drooling.
“Amitraz must be used extremely carefully because it is a potent insecticide that, if improperly used, can have major negative effects on both you and your dog.”
Your dog is less likely to experience side effects with each consecutive treatment since most dogs become tolerant to the dip as they receive it repeatedly. Skin scrapings should be repeated and checked for the presence of live mites or mite eggs seven days after having two to three dipping treatments. If more therapy is required, it will be determined by the outcomes of these skin scrapings.
I heard that there is a drug that can be given orally for demodectic mange. Is that true?
Heartworm disease in dogs and cats can be prevented with a class of medications called ivermectins. Cattle parasites are treated with specific ivermectins. Some dogs with demodectic mange have received oral administration of the cattle preparation. Ivermectin is used off-label to treat dog mite infestations because it is not licensed for treating dogs with mange.
Ivermectin is a very potent medication that, if improperly used, can have serious negative effects, even death. It is crucial to carefully adhere to your veterinarian’s instructions and warnings since they may differ significantly from those on the label. Collies, Shetland Sheepdogs, Australian Shepherds, Old English Sheepdogs, and any other herding breed are sensitive to ivermectin, hence veterinarians typically do not advise using it on them.
There are a few additional oral drugs that can be used off-label to treat demodex mites. These include fluralaner, afoxolaner (NexGard), and milbemycin oxime (the active component of Interceptor and Sentinel) (Bravecto). You can choose the finest medication for your dog’s oral or topical needs with the assistance of your veterinarian.
What is the prognosis for my dog?
Demodectic mange is typically successfully treated. But if the immune system is compromised, neither the infection nor the mites might be treatable. Successful therapy for generalized demodicosis could take a while, and it might necessitate frequent skin scrapings to monitor the healing process.
Following successful treatment, is it likely to recur?
“It is crucial to seek treatment as soon as a relapse takes place to reduce the risk of unmanageable difficulties.”
A dog with demodectic mange may experience relapses up until the age of 12 to 18 months since the immune system does not fully develop until then. Additionally, immune-suppressed canines may be more prone to relapses. As soon as a relapse happens, it’s critical to get treatment to reduce the risk of unmanageable issues. Relapses are typically identified three to six months following the end of treatment.
What eradicates demodectic lichen?
Depending on whether a dog or cat has a localized or generalized mange infestation (demodex), the treatment differs.
Even if they are not treated, 90% of young, healthy pets with localized mange infections recover within two months. A topical antibacterial agent, such as Be Super Clean, may be beneficial for these animals. Although the shampoo doesn’t get rid of demodex mites, it does assist in preventing bacterial skin infections brought on by excessive scratching.
Less than a year old animals with generalized mange infection have a 30-50% chance of recovering from the infection, despite the fact that it is severe. These animals do not always require medical attention since their immune systems work to eradicate the infection. A prescription medicine, such as sulfurated lime or amitraz (Mitaban Dip for dogs), is used for animals that do not naturally clear an infection.
Sulfur and lime are combined to create sulfurated lime, which is used to treat pets for bacterial, parasitic, and fungal illnesses such ringworm, sarcoptes scabiei mites, and mange demodex mites. Additionally, ringworm and parasitic irritation are reduced by sulfurized lime.
Every 5-7 days, sulfur and lime solutions are applied as a rinse or dip to treat mange (demodex) infections. Until skin scrapings have been free of mites for at least a month, the treatment is repeated multiple times over a period of weeks. When diluted in one gallon of water with four ounces of sulfuric acid, sulfuric acid can be safely applied to dogs, cats, puppies, and kittens. Eight ounces of sulfurated lime can be used per gallon of water if this concentration is ineffective in curing the mite infection.
Unfortunately, sulfur has an unpleasant smell, thus the dip should be applied in an area with good ventilation. As the dip dries, the fragrance gradually fades. Your pet is not cleaned or allowed to get wet in between sessions; the dip is simply kept on the skin without being towel dried. Jewelry, porous surfaces like cement, and the white or light-colored coats of dogs are all stained by sulfurated lime dips. Over time, the discolored coat changes back to its original hue. Benzoyl peroxide shampooing your pet prior to dipping improves mite exposure to the dip by opening skin follicles.
Amitraz is a substance (triazapentadiene) that eliminates spiders and insects from plants, animals, and homes. Mitaban Dip is one of the amitraz formulations (for dogs). Amitraz is used in veterinary medicine to eradicate ticks, mites, and lice. The FDA has given the drug amitraz approval for weekly use in dogs that are at least four months old. Utilizing amitraz in cats is “off-label.” Veterinarians may recommend more frequent dips or dips with higher concentrations than usual for animals with illnesses that do not respond to weekly dips. Both of these procedures are regarded as “off label” uses of amitraz. Up to 20% of adult pets with widespread demodex infection do not improve despite these changes.
Because amitraz is somewhat poisonous, amitraz dips should only be performed under a veterinarian’s supervision. The tips below will help make the dip efficient and secure for both you and your pet:
- Use with caution on animals with draining, deep bacterial infections. First, treat skin infections.
- If your pet’s hair isn’t already short, clip it.
- Before dipping, give your pet a benzoyl peroxide bath. This washing enhances mite exposure to the dip and opens skin follicles.
- To prevent getting dipped, put cotton balls in the ears of your pet and protective eye ointment in the eyes. Avoid getting water in your pet’s mouth or lips; instead, gently sponge the area around its head.
- Dip the rest of your pet completely.
- Do not wipe off the dip with a towel or rinse it off. In between treatments, avoid letting your pet swim or get wet.
- Repeat the dip every one to two weeks until there are no live or dead mites in skin scrapings for at least a month. Skin scrapings are collected from locations with and without hair.
- Wear protective clothing and take off your jewelry before applying the dip to your pet because amitraz will discolor it.
- Work somewhere with good ventilation, but keep your pet from getting too cold.
Some vets advise soaking your dog’s paws in amitraz mixed with mineral oil if they have demodex paw infections. Although this is “off label” use, it can be very successful.
Amitraz is a potent drug that can have negative effects on canines. After being dipped, the majority of dogs get drowsy. Toy breeds, elderly, frail, and weak animals, cats, and rabbits are more prone to be poisoned by amitraz. High blood sugar, vomiting, diarrhea, ataxia, and a slowed heartbeat are all toxic symptoms.
Diabetes patients and those using MAO inhibitors like parnate and selegiline shouldn’t use amitraz. On dogs on Anipryl or Selegiline for Cushing’s disease or canine cognitive dysfunction syndrome, Amitraz should not be administered (senility). For these animals, sulfurated lime is a safer treatment.
If sulfurated lime or Mitaban Dip do not successfully treat the mange (demodex) infection, or to hasten the healing process, the following steps are taken:
- relieve pressure points like pregnancy
- Boost your immunity
- Underlying underlying illnesses or infections
- Give your dog Heartgard Plus Chewables (ivermectin) or any other medication that your vet has given to you.
Sulfuric acid or amitraz are the recommended treatments for mange (demodex), but if those do not work, veterinarians may advise administering high doses of prescription drugs like Heartgard Plus Chewables (ivermectin).
For 2-3 months, Heartgard, which is administered at a dose of 6 micrograms/kg/month to prevent heartworm infections, is given at a dose of 600 micrograms/kg/day, which is 100 times the heartworm dose. Treatment is continued for at least a month after dogs’ skin scrapings show no live or dead mites. The medicine Interceptor (0.5-0.9mg/kg/month) is frequently used to stop heartworm infections. Veterinarians recommend using greater doses (0.5 to 2.0 mg/kg) every day for several weeks to cure demodex mites. Until skin scrapings have been free of live or dead mites for at least a month, the interceptor is kept in place.
Two crucial safety measures are implemented due to the high doses of Heartgard or Interceptor that are required to cure pets of demodex. Before receiving therapy, dogs are tested first to rule out the presence of heartworms and then, whether they are purebred or mixed-breed herding dogs, to rule out the presence of the MDR1 gene:
- Australia Terrier
- Cross-country dog
- German Shepherd
- English Shepherd
- Sheepdog in Old English
- Whippet with long hair
- Windhound Silken
Heartworm and demodex infections in dogs can still be properly treated. These dogs are first given mild doses of heartworm medication to treat their heartworm infections, and then they are given large doses of ivermectin (Heartgard) or milbemycin to treat their demodex infestations.
Some veterinarians advise using the Preventic Amitraz Tick Collar for Dogs “off-label” to help treat mange demodex mite infections because it includes amitraz. The collar works best when worn in between applications of Mitaban Dip or sulfurated lime.
Because amitraz might cause allergic reactions in cats, your veterinarian may advise combining it (1:3) with mineral oil or propylene glycol and treating only the problematic regions.
Give your pet no oral steroids, such as Prednisone and Prednisolone, unless specifically prescribed by a veterinarian to treat mange. Additionally, you shouldn’t treat pets with mange infestations with topical drugs.
Supplements containing fatty acids and immune-boosting antioxidants are beneficial for pets with mange.