Demodectic mange what can you do about it?

Demodectic mange, also known as puppy mange or demodicosis is caused by a little 8 legged creature called the Demodex canis. These mites are not visible without a microscope, and almost all dogs have them on their body. Mom passes the mites on to her pups shortly after birth. And in most cases this will never be an issue for the pup. However sometimes the immune system gets suppressed due to illness or malnutrition, which gives these mites the perfect opportunity to increase the population. Eventually leading to an overpopulation, the infestation can become so severe that the dog’s immune system can not handle it. This is the start of a skin disease that will make your dog feel miserable.

This condition though similar, is not to be confused with another type of mange called sarcoptic mange.

Unlike sarcoptic mange, demodectic mange is not contagious. And even in a multi-dog house hold often only one dog will be affected. Mites do get passed on between dogs, most commonly, they go from mom to her newborn pups, this happens when the pup’s immune system is strong enough that it is not at risk for an infestation, as new mites will not settle on it’s body or pose as issue.

Demodex canis mites will not settle on humans or cats, they strictly live on canines. Once they are on the dog, they will move into hair follicles. Which is one of the reasons why it is so difficult to treat mange. The mites are quite protected from products due to living within the follicles. There are different species of the demodex mites that will target felines and humans. They can cause demodicosis in cats and people.

Types and symptoms of Demodectic Mange

There are three types of demodectic mange, all three will present with symptoms of mange like hair loss, severe itching, skin infections for the dog.

Localized demodicosis

This is the version many people refer to as puppy mange. A dog, often a pup, will develop some bald patches, often on the face. The majority, approximately 9 out of 10 puppies will not need any type of treatment. On rare occasions an adult dog might present a case of localized demodicosis.

Localized demodicosis is limited to two sections of the body. Often spots on the face and maybe on the one of the legs or torso. However to be considered localized there will not be more than four spots over the body. Often the bald spots look like a polka-dot pattern.

Treatment is often not needed for localized demodectic mange. However, if you do want do something you could use an antibacterial gel. This will help prevent any secondary skin infections. Sometimes applying a gel or cream on the demodicosis lesion can make it look worse as the area might look more inflamed. Localized mange often clears anywhere between 30 to 90 days.

Sometimes a case of localized demodicosis can progress into generalized demodicosis. The lesions will spread, often accompanied by enlarged lymph nodes.

Generalized demodicosis

Often easy to recognize, the classic dog covered in patchy fur, together with skin infections. Lesions often are bald and scaly, they can be large or small patches spread over the majority of the dog’s body. Secondary infections often cause the dog to experience extreme itching. Sometimes there will be a smell with the infection that is easily recognized. Treatment of generalized demodicosis often will depend on the age of the dog.

generalized demodicosis

Young dogs, less than 18 months of age, that develop generalized demodicosis might have a had a (temporarily) suppressed immune system causing the mights to cause an infestation. However often as the the pup matures the immune system will get stronger as well and the body will take care of the mites. About 30 to 50% of these dogs tends to recover without any treatment. Although treatment will often be recommended for the dog to aid in controlling secondary infections and comfort.

Adult dogs should have a strong enough immune system that handle the mite population. If a mature dog tends to develop a case of demodicosis it has to do with a compromised immune system. Often the actual cause behind the onset of the demodicosis could be kidney or liver diseases, sometimes cancer or other illness that takes a toll on the dog’s immune system. Therefore, adult dogs with mange will often get a CBC (complete blood count). This will help the veterinarian for any signs of underlying causes.

Demodectic pododermatitis

This is where the lesions are only confined to the paws of the dog. However, serious bacterial infections can go “paw in paw” with this type of demodicosis. Shar pei and Old English Sheepdogs seem more prone to this condition. This is a very resistent type due to how deep the infections go into the tissue. Treatment and recovery can take months and can become rather expensive.

Treatments for demodectic mange

In an older dog often the treatment encompasses multiple factors. Overall health, the stronger the immune system, the better they can fight off the mites. The mites take their toll on the dog’s immune system as it is, and the excessive scratching causing damage to the skin also provides an opportunity for secondary infections. It is highly recommended not to breed with dogs that are susceptible to demodicosis. Spaying females will keep her hormones in balance and not dealing with suppression of her system due to coming in heat or pregnancy.

Ivermectin Not safe for MDR1 positive dogs

Ivermectin is the most commonly used method to treat demodicosis. However it is worth noting this is still technically considered an off label used according to the FDA. Ivermectin is a relative inexpensive treatment option as it is given orally or by injection. Daily or every other day ivermectin administration is required with the suggested dose set by the veterinarian.

Ivermectin though highly effective against demodicosis is not without some warning.

As the dosage for ivermectin given to the affected dog are much higher than the regular preventive for heartworm the dog has to be tested negative for heartworm. A heartworm positive dog given the dosage needed could potentially kill the larvae, the toxins released could cause such a shock to the body that it could kill the dog.

Also MDR1 mutated dogs have a low safety tolerance for ivermectin and giving the suggested dosage could potentially cause the dog to die.

Due to the increased dosage given it is also worth noting that certain flea and tick products like Comfortis® or Trifexis® can potentially cause neurologic side effects. And during treatment a different product should be used.

Milbemycin Oxime (Sentinel®, Milbemax®) Safer for MDR1 positive dogs

Milbemycin oxime falls under the same category as ivermectin. Unlike ivermectin even though both are very effective it is much safer for use in dogs with the MDR1 mutation. Treatment of against demodex mange requires daily oral administration. Due to the increase in dosage it is important that the dog is tested for heartworm and the MDR1 mutation.

Moxidectin (Advantage multi®) Not safe for MDR1 positive dogs

Moxidectin has been used quite succesfully when treating for demodicosis, however dogs with the MDR1 mutation should not be given moxidectin. As a dewormer Advantage Multi®, suggests the topical treatment once a month against heartworm, hookworm, whipworms and fleas. Moxidectin can work against demodex mites and often will be applied on a weekly basis. However results are not as consistent compared to Ivermectin. This is especially true for older dogs or severe demodectic mange infestations.

Mitaban/Amitraz Safe for MDR1 positive dogs

Please take caution when using this product, as it can interact with other medication.

Wear gloves and apply the dip with a sponge on the dog’s coat. Ideally the dog has short or no hair, a long haired dog would benefit from being shaved. Leave the dip to dry on the dog, don’t use a towel, just let it air dry.

Prior to applying the dip make sure you give your dog a bath with a shampoo containing benzoyl peroxide. This will first of all heal the lesions and possible skin infections, as well as open the hair follicles which will allow the dip to reach the mites.

Our preferred choice of shampoo is Veterinary Formula Clinical Care Antiseptic & Antifungal Shampoo

Treatment is recommended every two weeks according to the FDA approved label. Though research shows that cure rates increase significantly when the recommended dosage is doubled and the dips are increased to once a week. If your veterinarian recommends a Mitaban dip they might suggest the more frequent and stronger dosage, unless it is a toy breed or a young puppy. Mitaban can be a good alternative for dogs that have the MDR1 mutation, Collies, Aussies, closely related breeds and mixed breeds, and as such preferably are not treated with Ivermectin.

Try to prevent your dog from getting wet in between dip sessions, as it will reduce the efficiency of this product. One of the side effects of Mitaban, especially in smaller breeds, is becoming sedated, in response to an allergic reaction. As such, having the dips done at a veterinary click with staff on hand might be beneficial.

Warning:

Amitraz should not be used on dogs less than 4 months of age or on toy breeds.

Amitraz is a monoamine oxidase inhibitor. Which can cause interaction with certain medications and medical conditions. People how are diabetic or taking select serotonin reuptake inhibitors (Prozac/fluoxentine) should take extreme caution handling Amitraz. Likewise if your dog is diabetic or prescribed a SSRI please consult the vet prior to using Amitraz. If your dog wears a tick/flea collars, remove it during the course of treatment with  Amitraz dips.

Lime Sulfur dip Safe for MDR1 positive dogs

One of the traditional treatments against both demodectic mange and sarcoptic mange. Lime sulfur provides great relief to the dog. Though it must be applied frequently, and has to be done in a well ventilated area. Depending on the dog sulfur dips are recommended anywhere from every 3 days to once a week. Until there will be at least 2 negative skin scrapings.

The smell of sulfur is very potent, as well as the sulfur can (temporarily) stain furniture, carpet and skin. Dipping the dog in lime sulfur does work, it is cheap but the trade off is that it is labor intensive. You still will have to prewash the dog. After you thoroughly cover him in the dip, you will have to watch your dog. Do not dry your dog by using a towel or wiping his skin, let them just dry naturally. Prevent your dog from licking his coat it is wet. Avoid any contact with sensitive areas, eyes mouth and nose. And make sure you wear some old clothes and gloves!

Our preferred brand for lime sulfur dip.

Outcome and prognosis

Younger dogs (puppies) tend to recover from demodectic mange very easily and permanently. Although, for an older dog it depends on the root cause. Sometimes it can become a chronic condition that might be manageable with a customized treatment plan for your dog.

During the treatment for demodectic mange, it is important to follow up with your vet and repeat the skin scraps once or twice a month. This allows your vet to make an assessment and change the treatment or dosage of the medications used. And to continue the treatment long enough after the dog seems cured.

Relapse of demodectic mange in older dogs is possible, especially if the underlying cause is not addressed or if treatment is stopped to quickly. The key is to kill every Demodex mite on his body, if that is not the case within months your dog can have a re-infestation and you are basically back at square one.