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Mange Mites - Demodex
Recurrence of Demodex in pug
Demodex - Should you treat or wait
Demodex as inherited problem in Mastiff
Demodex- Mitaban is serious medicine
Localized demodectic mange
Demodectic mange
Mange
Demodecosis and other problems
Mange mites
Amitraz
Demodex
Demodex in Pit Bull Puppy
Extreme itchiness - Demodex or allergy
Breeding dogs with Demodex
Chronic otitis and demodex
Controlling Chronic Demodecosis
Mange
Golden Retriever with Demodex and other problems
Demodicosis
Demodex as inherited trait
Demodecosis
Those pesky demodex mites
Demodectic mange
Demodex
also see Demodex Treatment
also see Parasites
also see Sarcoptic mange
also see Skin
also see Creepies and Crawlies
also see Immune
Question: Dear Dr. Richards,
I love your site and refer to it constantly. I have a spayed pug bought from a reputable breeder born July 18, 1998. When she was approximately 10 months old she developed bumps around her right eye. They were biopsyed and there was nothing except lots of demodex mites. Unfortunately it became generalized and she had some secondary infections going on as well. Although she didn't fit the profile the dermatologist vet thought she had juvenile cellulitis also so she was put on 15mg of prednisone (very risky with generalized demodex), 11.5mg of milbemycin (interceptor) and 75mg of antirobe. That combination worked and she got better after two months and a bit. I recently weaned her off of everything. She did not tolerate the interceptor (lots of vomiting and aspirating) once she was off the prednisone so even though we wanted to keep her on that we've stopped all meds. Then just one week after stopping her medications she has developed a lump around her eye again and her pads of her paws are reddish. My vet did a scraping and plucking and there was no evidence of demodex so we put her back on 75mg of antirobe and it is starting to get better. My question is I know that all of these problems are probably a result of t-cell deficiency and low immune system but how can I find out for sure exactly what she has. What kinds of tests can be done? I don't have insurance but I do want to do what's necessary to keep my pug in a happy state. Another question is how come prednisone helps dogs get better when it suppress the immune system of an already compromised dog? She also has a weak stomach and vomits quite readily and my vet wants to do an endoscopy to see if she has eosophilic enteritis as he suspects. Any thoughts? Thanks.
Answer: Marlo-
I would be careful about the possibility of a recurrence of demodecosis. It would be worth checking
a scraping again, or even a couple more times, if this problem doesn't respond well to antibiotics.Itching around the feet is sometimes associated with food allergies and these allergies can show up in
young dogs. This is also a source of chronic vomiting and sometimes diarrhea, as well. So it might be
worth checking into this. An elimination dietary trial, in which a protein source that your pup has not
been exposed to is used as the sole protein source for 3 to 8 weeks, is the usual method of trying to
rule out food allergies. Foods like salmon/rice, rabbit/potato, egg/rice or the newer hydrolyzed diets
are all possible diets to try to rule out food allergies. Our experience has been that we test for food
allergies about 30 times for every time we find it, but for the dogs we can diagnose with this
condition, there is a great deal of relief in just controlling their diet.Sometimes immune system diseases occur because the immune system is working hard -- but not
doing the right job and actually causing harm. When this is the case, corticosteroids are necessary to
prevent the immune system from causing damage. This is what happens in juvenile cellulitis. Other
times, there is true immune suppression or immune compromise and in those diseases, when the
immune system isn't working properly because of weakness, corticosteroids can cause terrible
problems because they further weaken an already weak immune system. Choosing when to use
cortisones and when not to can be very difficult. It was a difficult choice to make to treat a dog with
demodecosis with corticosteroids, but they are necessary when juvenile cellulitis is present --- this
would have been a really tough choice to make and I am glad to hear it worked out well.There are some disorders that just occur in eyelids, such as infections of the glands that produce the
mucous for tears, along the lid margins. These are aggravating but are not especially serious. So there
is some chance that this is just an ordinary problem with bad timing, since you do have to take it
seriously with the past history.I hope that things are improving. I am sorry for the delay in responding. I am just getting over an
unexpected trip to the hospital where they really didn't want me to bring my laptop.Mike Richards, DVM
11/15/2000
Demodex - should you treat or wait
Question: Dr. Mike,
Hi, I have a 5 month old puppy who has been diagnosed with generalized
Demodex mites. I have read the letters written to you on this subject and I
have several questions. Here's his history. His litter and mother had
Sarcopti mites when they were first born. I am not sure if the mother had
them when she was pregnant or not, I think that she did. The mother and
puppies were misdiagnosed as having allergies three times before my parents
finally took my puppy away from the litter and he was diagnosed with the
Sarcopti mange. He and the other puppies were treated with the Iver-mectin
shots and some kind of dip and he cleared up, grew his hair back and put on
weight. He looked awful, poor guy had super pink skin and almost no hair but
never acted sick in any way and never lost his appitite. Okay that's Chapter
one.
About four weeks ago I gave him a bath and noticed that he had spots of
allopecia (right word for dogs?) along his body. I took him to the vet and he
did a scraping and sure enough tons of Demodex. Now, I have read all of the
stuff about immune deficiencies and at this point I think that I have to
assume that my puppy has some type of immunocompromise. My question is where
do I go from here? If it is genetic is it a recessive gene? The father is my
family dog who I know has no problem and from as far as I know the mother has
no outward signs of immune problems either. Could this problem have happened
during gestation if the mother had Sarcopti during pregnancy and nursing?
His littermate was just diagnosed with Demodex as well. They are both healthy
acting, full of energy, super smart (of coarse) and growing like weeds. My
puppy (Indy) has doubled his weight to over 40 pounds in the last two months.
He has also had alot of exposure to many other dogs (after all of his shots),
the wilderness and people and has had no other problems.
Indy is currently getting a Iver-mectin shot and a dip every two weeks.
My husband and I love this puppy like the child that I can't have right now
because I am in medical school. We don't have much money but we are both
ready and willing to do whatever it takes to get him as healthy as possible.
I want to do the most aggressive preventative and diagnostic treatments I can
possibly do. We live in the LA area and I am sure that there are lots of
specialists out there. Should I go find out exactly where his deficiency is ?
Is finding out sooner better so that we can get him some sort of immunoglobin
replacement therapy early while he is still developing? Would that make any
difference? Is there any chance that his condition won't be lifelong? I know
that in people it takes some pretty bad deficiency for normal flora to become
an "infection" and he just doesn't seem that sick and like I said he has had
alot of exposure.
Like I said, I am willing to go just about to the ends of the earth to
help this dog and I want to be sure that I am doing the best thing right now
and not find out later that I should have done something earlier. My parents
will help us with money issues if neccessary. Also, any ideas on the best
food out there? Please help! I am feeling so helpless just treating the
symptom and not the underlying cause!
Thanks,
Tawnya
Answer: Tawnya-It is a bummer to have a puppy who had sarcoptic mange and then developed
demodectic mange but there is probably no link between these events.Sarcoptic mange (scabies) is a highly contagious mange that does not
require any sort of immune suppression to infect dogs and can affect dogs
of any age. It is relatively easy to treat and most dogs can readily be
cleared of this mite infection.Demodectic mange is also contagious, in that most dogs acquire the
infection from their mother. The mite usually lives in relative harmony
with the dog and it is assumed that most dogs have Demodex canis mites on
their body. If the dog's immune system is competent the mites are
suppressed and never achieve large enough numbers to cause
damage. Sometimes, local areas of the skin are affected by hair loss
(alopecia) and secondary bacterial infections are common. When there are a
number of spots, or the spots have spread over large areas of the body and
when these spots do not clear up without treatment in four to eight weeks,
the dog is said to have generalized demodectic mange. Localized demodectic
mange is thought to occur due to transient stress or a decrease in local
immune function at the affected sites. Generalized demodectic mange is
thought to be due to a specific deficiency in T-cells that suppress these
mites. This is thought to be a hereditary condition but if the exact
mechanism by which inheritance occurs is known, I am not aware of it.The best way to tell if the condition is severe enough to warrant the
assumption that it can be passed on to future generations is to wait and
see if it clears up on its own. For this reason, we try not to treat
demodectic mange until it is evident that it will not get better on its
own. At least 80% of dogs will outgrow this condition. The dogs that do not
get better and require treatment can usually be cured, or at least managed
and controlled, in about 80% of cases -- so the risk of this being a life
long infection is not so high that you should worry excessively about it at
this time.I am not aware of any evidence that there are benefits to immune system
therapy, probably because this does appear to be a pretty specific defect
in the immune system. The odds are very good that this will all turn out
OK. If you intend to breed Indy, it is much better not to treat, in order
to be sure of whether the problem is generalized demodectic mange. If you
do not intend to breed Indy, it probably doesn't matter if you treat at the
localized stage but amitraz dip, the only approved medication for
demodecosis, has serious side effects, including causing death in up to 3%
of patients treated with it. Considering that waiting to see what happens
is successful therapy in 80% of dogs, taking this risk prematurely does not
seem justified, to me.I know that many people disagree, but I think that the major brand name dog
foods are all reasonable choices for most dogs. I am not aware of any major
benefits or problems with treatment or occurrence of demodecosis that have
been linked to diet.Hope this helps in your decision making.
Mike Richards, DVM
9/8/2000
Demodex as inherited problem in Mastiff
Question: I just subscribed to your site...do not want to wait to ask you a
question, I hope my question is answered here..... Purchased 8 week old
mastiff bitch $1500.00. (specif for breeding! She eats her food,
pedigree puppy and can food fine now. Noticed some very slight It
comes and goes. She plays pretty rough with our 2yr old mastiff, who is
over 200pnds and figured this could all be play injuries. Before she did
scraping the vet pre Then she said the swelling is from her body trying
to fight off the mites. The vet said the first scraping showed 5 or 6
adult mites (with that small number I would think you could remember
exactly how many) and the second scraping she couldnt get a good scraping
because the areas are new and it showed no mites But that she feels that
it is clinically safe to ASSUME I explained that a assumption in
diagnosing this is not o.k I can clearly see that the hereditary factor
is a pure assumption that most vet's quote as a fact. ba humbug. Are
we looking at a potential serious problem here I'm in a very irritating
dilemma.
Answer: Y-
I don't think that your message forwarded in its entirety, but I think I
get the gist of it.There is no question that the predisposition to develop generalized
demodecic mange is hereditary in many dog breeds and it is presumed to be
in the ones in which it has not been proven yet.So the question is this, does your mastiff have generalized demodectic
mange or localized demodectic mange?I am not sure based on the loss of some of the information in the note what
the exact situation is, so this is the information on the differences.There are a lot of definitions of localized versus generalized demodectic
mange. At this point I prefer to think of this as "likely to be inherited"
or "not likely to be inherited". My interpretation of the situation is this
--- if the dog can clear the disease on its own, without the use of a
medication to kill the mites, such as amitraz or ivermectin, then it
probably did not have an inherited deficit in specific T-cells which leads
to generalized demodecosis. I think this is true even it takes several
months for the dog to get over the demodecosis.Localized demodectic mange is usually confined to the head region but
sometimes there are a few lesions on the body, as well. Most dogs with
localized demodecosis will have less than five lesions but sometimes there
are more and a dog will clear the infection on its own. Having only adult
mites is a pretty good sign that the dog is winning the battle against the
Demodex mites on its own.Generalized demodecosis occurs when there are multiple spots, when there
are all stages of life of the mite (eggs, juveniles, adults) present. Some
cases of generalized demodex so obviously need care that it is not possible
to wait and see if they will get better on their own. If this occurs, it
should be assumed that the dog has a high probability of passing this
tendency on and it should not be bred. If the infestation is present when
the dog reaches a year of age or possibly a few months beyond that time it
should be considered to be potentially heritable and the dog should not be
bred.Dogs that are intended to be used for breeding should not be treated for
demodecosis until it becomes obvious that they must be treated or until
they are one year of age or older. If they get better on their own, it is
reasonable to assume that they do not have the specific T-cell deficiency
problem that is thought to be inherited and it is reasonable to breed these
dogs.If this is not enough information, I will try to find answers to specific
questions that you have.Mike Richards, DVM
8/27/2000
Demodex - Mitaban is serious medicine
Question: Thank you for your reply. Today I took the pup in for a second opinion First off, I do like this
lady. Here is what she said.The pup has a minor case of generalized demodex. So....we now have localized, minor
generalized and generalized. What ever. She did one scraping off her side, a nice deep one I'd
say, and she came back in and said "nasty critter's, it's demodex". She sat on the floor and
explained the program to me. She stated that the pup has few spots, and normally would only
treat with a ointment and antibiotics. But because she has some spots on her trunk, she
recommends dipping and antibiotics.I came home with $100.00 of medication:
Cephelexin 500 mg - 14 days , 2x a day.
Virbac Pyoben - Shampoo dog night before dipping. leave on 5min then rinse
Now the nasty stuff!!! mitaban dip concentrate amiytaz - mix 5.3 ml w/ 1 gallon water
sponge on dry dog. Refills -0- Flammable (are we kidding!!)I opted to go ahead with the medicine due to the fact it breaks my heart to return this puppy to the
breeder. The vet said she thought this should clear up after two dippings and see her again in 5
weeks for a new scraping. Here is what I wonder...and think: 1. Antibiotics - I figure this should
help her out 2. Dip - I question. Normally I dont put anything on myself or my animals that is
flammable. Geez this stuff sounds like SERIOUS poison. 3. I understand your idea of the wait and
see approach. Very difficult when you think of your dog possible losing more fur, maybe getting
worse. It's a concern. It's it easier to nip it in the bud, than to fight it full blown? But then of
course, how do you know. This vet felt that if it is cleared after the second dipping then she should
be fine to breed. If after the second dipping, she still has mites, then we have a problem. What do
you think? oh, one more question: If I go through with the dip. The puppy plays daily with my
older mastiff. After she has been dipped and for the two weeks to the next dip, is my older mastiff
in danger of getting any poison in his mouth from playing with her. Or even if one of my other dogs
licks her? Is this poison the fur also or it somehow is only the skin...how does this work...Answer: Y-
If you choose to use amitraz (Mitaban Rx) to treat the demodectic mange at this stage you will have
eliminated the possibility of determining if the mange would have cleared up on her own, unless the
amitraz doesn' t work. I do not believe that you can use the ease of treatment as a gauge to
determine whether or not a case of demodecosis would have resolved on its own. There is probably
room to argue this point but I think it is better to be sure of this situation prior to choosing to breed a
dog with demodecosis.Amitraz (Mitaban Rx) is a very toxic medication. This is the other thing that makes me reluctant to
treat a patient for a demodecosis prior to the time it is obviously necessary to do so. In order to
understand how a medication this toxic ever got approved, you have to understand the whole
situation. Prior to the time that amitraz was available most dogs that developed generalized
demodectic mange died from the disease. When I was in veterinary school this was a serious threat
to affected dogs, as there was no effective treatment at the time. So when amitraz killed 3 out of the
1100 test dogs and caused other dogs to have adverse reactions, including, incoordination, severe
lethargy and seizures, this was an acceptable risk -- compared to the high likelihood of death from
the demodecosis. However, this risk is not as easily justified when looking at the population of dogs
who will get over the mange all by themselves, which is approximately 80% of the dogs affected by
demodecosis. I am opposed to putting my patients and their owners at risk for severe side effects
when there may be no reason to do so.Unless there is new information that I am unaware of, the percentage of the amitraz which is applied
to the dog's skin that is then absorbed into the dog's system is unknown. Amitraz is more toxic if it is
ingested than when applied to in a pour-on or "dip" solution. I do not think that the other dog is at
significant risk after the puppy is dry since it would be hard to ingest a significant amount of the
amitraz orally from the puppy's hair after that time.I know that it is very tempting for both veterinarians and their clients to treat demodecosis early on
but I think it is better to wait and see what happens in most cases but especially in dogs that may be
used for breeding in the future. Obviously, your veterinarians disagree with me and you have to
consider that in your decision making.Mike Richards, DVM
8/29/2000
Question: Hi Dr. Mike,
We adopted our beagle mix from the Humane Society 2 months ago, when she
was 6 months old. She had a vomiting problem (which I had written you
about) which is now cleared, but now has been diagnosed with localized
demodetic mange. She has 2 tiny spots--one on her right cheek/neck and
another on her right calf. Both spots looked like little scrapes but we
decided to have them checked out to be on the safe side. Our vet did the
scrapings and confirmed mites in both places. He has placed her on
Primor 240 mg once a day and an ointment which he was out of that we
will get tomorrow. She has an app't again in 2 weeks. I have read all
that is in your archives about this mange and am worried. Our vet seems
to think it will clear up and I know you said up to 80% of localized
mange does, but I am wondering why this happened 2 months after we got
her and have given her the best of care possible after having a rocky
start (she was a starving stray) and if there is anything else we can do
at this point or if there is any type of preventative medicine or
booster to the immune system that would help in her healing and her
remaining symptom-free. She itches more than is normal, although nothing
is red or oozing or infected and if you didn't look carefully for these
2 little spots, you wouldn't notice them and if you did, wouldn't think
they were anything. We really expected the vet to say she just scraped
herself playing as she seems so healthy now and playful. Is there
ANYTHING we can do to help her get better and not get an outbreak again
(assuming this is going to clear up). We love this dog like a child and
want her to get the best treatment available. Why is sarcoptic mange so
much easier to treat and cure than this? Should Belle have any bloodwork
done to see if anything else is wrong with her system? If I understand
correctly, her immune system is not doing its job well enough and we are
concerned as to the cause of this, esp. since she has had a pretty good
life with us the last 2 months. She is just over 16 lbs and the vet says
this is an ideal weight for her as she will remain a small beagle mix.
She appears to be in good health in every other respect--her ear
infections when we got her have all cleared up (after steroid
drops--could that have triggered a suppressed immune system??) and her
vomiting stopped after she was de-wormed again (even though her tests
were negative, she must have had something). Please tell us what else we
can do to give her as good a life as possible. We are not rich by any
means, but we love her deeply and want to do everything possible.Thank you,
LindaAnswer: Linda-
It is hard to figure out why localized demodectic mange occurs in a
particular dog. Hormonal changes as puppies age may have some effect. Local
skin conditions may favor the mite, giving it a chance to reproduce
excessively until the dog's immune system is stimulated to respond.
Localized demodectic mange is a minor problem and it is not indicative of
an overall immune system deficiency. There does seem to be evidence that
controlling secondary bacterial infections is helpful so that is probably
the reason that your vet chose to use an antibiotic. The ointment most
commonly used for localized demodecosis is Goodwinol's Ointment (tm) but I
think of this mostly as a placebo since localized demodecosis will clear up
without any treatment in most cases. Some vets use other gels, such as
benzoyl peroxide.There is a growing trend among vets to go ahead and treat localized
demodecosis cases with amitraz (Mitaban Rx) or ivermectin (Ivomec Rx) but I
really believe it is better to wait and see whether the mange will clear up
on its own. I think it is better for the dog if medications do not have to
be used and it also allows an assessment of the severity of the problem and
the likelihood of a recurrence later in life. Waiting and doing nothing is
really hard for many of my clients but I truly believe it is the best
approach. Obviously, there are many vets that disagree with this assessment
since treatment for localized demodecosis is fairly commonly attempted now.It is unlikely that you will find a problem by doing blood testing in a dog
that appears to be healthy and is in her age range but there is no reason
not to check the blood chemistry and cbc values if it makes you more
comfortable.Some dogs do absorb enough corticosteroid when eye or ear drops are used to
cause some degree of immune suppression but there doesn't seem to be a
strong correlation in our practice between the use of corticosteroid
containing ear medications and later occurrences of demodectic mange. In
general, this effect is slight enough that it doesn't cause problems.I really don't know why sarcoptic mange mites are so much easier to kill
and so much more contagious. They are an entirely different species, though.It sounds to me like you are providing a good life for Belle and that you
don't need to make any major changes right now to ensure that will continue
to be the case.Mike Richards, DVM
7/9/2000
Question: Hi Dr Mike
I have two dogs (mixed breeds) who stay outside our house most of the day.
1 dog, Ginger had a rawish rash at her mouth and started to limp so I took
her to the vet. They did skin scrapes and skin tests and told me that she
had the beginnings of demodetic mange at the mouth and eye area, and a
fungal infection in between he hind foot toenails. I now have to apply an
amitraz solution to the mange areas once a week and I have to give her baths
in Ketaconazole Shampoo (that's usually for fungal dandruff here) 2x a week.
But shes worrying at her foot and is starting to bite it raw. What I did
was clean the wound with hydrogen peroxide and betadine, and I let her wear
a satellite-dishlike thing on her head so she doesn't bite or see her foot.
Is there anyway to prevent itching? I bought a "hotspot itch reliever" at
the vet and its made of camomile, and tea tree oil but I am not sure if I
should use it because it might make the situation worse. Is there anything
else I can ask my vet about re: the mange and the fungus? I think Kinky, my
other dog - who's always with her - is starting to limp as well.Please advise as Im worried about them and would like to prevent any further
injury / pain.Thanks. Mia
Answer: Mia-
How old is Ginger? Demodectic mange in a puppy is a lot different than
demodectic mange in an older adult dog, so it would help to know which is
the case.In either case, we find that using antibiotics in dogs that itch when they
have demodectic mange is very helpful in relieving this syndrome. The
demodectic mange itself is not usually very itchy so most itchiness comes
from secondary infections. Fungal infections can itch, so that is also a
possible cause -- but our experience is that the itchiness is most often
bacterial in demodectic mange cases.We usually use 4% chlorhexidine shampoo when we try to treat skin yeast
infections as has worked a little better for us than ketaconazole shampoo.
In some cases it is necessary to use systemic (oral) medications for the
yeast infections, though.If there are Demodex mites in scrapings from the mouth and the feet it
would probably be better to treat the whole body by following the
directions on the package insert. If that doesn't work, there are
alternative treatments that might.It is important not to use cortisone products in a dog with demodecosis and
since these are anti-itch and available over the counter, they do sometimes
get used. I know of no problems with tea tree oil or camomile in
conjunction with demodecosis, though.There is a lot of information on the site about demodecosis but if you have
questions about it and especially if Ginger is an older dog, please write
back.Mike Richards, DVM
7/3/2000Dr Mike - Ginger is 2.5 yrs old.
Answer: Mia-
In this situation it is important to try to look for an underlying cause for the demodecosis.
Most dogs with immune system disorders that allow demodecosis to occur
develop it at a younger age, usually less than one year of age. In dogs in
which demodecosis occurs later, there is often something causing
significant compromise of the immune system. Cushing's disease, liver
disease, diabetes, high doses of prednisone or other cortisones, cancer and
other strong suppressors of immune function can lead to adult onset
demodecosis. It is worthwhile to put a good effort into eliminating as many
of these causes as is possible through lab work and physical exam. This is
a situation in which asking for referral to a veterinary dermatologist can
be a good idea, too.I missed the part about Kinky limping. Demodex mites can be
spread from one dog to another but it takes an immune system deficiency for
the mites to cause problems, so demodecosis is not considered to be a
contagious disease. If there is a disease or environmental problem
stressing both dogs at once it is conceivable that they might both develop
demodecosis but this is really unlikely. On the other hand, allergies
leading to interdigital (between the toes) skin infections is a pretty
common problem in dogs and something like this could be affecting both of
them, with the demodecosis being secondary to damaged skin in Ginger. There
are an awful lot of causes of lameness so it is actually more likely that
they have different problems, though.Hope this helps some.
Mike Richards, DVM
7/4/2000
Demodecosis and other problems
Q: Hi...It's me again! I am the one that wrote you several weeks ago about
my 7 month old Boxer that had the Small Intestinal Bacterial Overgrowth, well,
now she also has demodectoc mange. Could this be the reason for the bacterial
overgrowth or the intusseception(oops.spelling?)? We are so upset, because it
has been one thing after another with this poor dog and we don't know
where to draw the line...Please help!
Thanks,Mindy
A: Mindy-
It is unlikely that the demodecosis and the intestinal problems are
directly related but multiple problems like this do tend to make me wonder
about underlying genetic disturbances or immune system problems that will
lead to continual problems. We have seen puppies who just barely made it to
a year old turn into healthy adults and have seen very healthy puppies
develop chronic health problems later, so it is possible that some day your
problems will slow down. I hope so.Mike Richards, DVM
Q: Dr. Richards,
We have a labrador retriever who is 1 year old. She was recently diagonosed with mites. She was given antibotics and the situation appeared to be cleared up and "regrowing" the fur that she had lost. We recently saw the same bald spots on her paws and are wondering if the situtation has come back. Is this possible that we didn't get rid of it all the first time?
The images of these diseases helps identify what may be happening to our dogs. As you know, vet bills can be expensive and having this great tool helps.
Thanks. This website is priceless!!!!Sharon
A: Sharon-
Unfortunately, it is not unusual for demodecosis to persist or to appear to recur. Sometimes sarcoptic mange will do this, too, especially if there is a source of the mite (like a neighboring dog) that is still there after the dog is treated the first time. So the best thing to do is have skin scrapings done of the new areas of hairloss and then make a treatment plan based on the results of the skin scrapings.
Mike Richards, DVM
Q: I need Help. I have a yorkie terrier, which is having a demodex illness.
I am in Bangkok,Thailand. I check with the veterian for MITABAN. But they
don't have in Bangkok. Is their any alternative on curing my dog.
Thanks
David
A: David-
You may be able to find amitraz, the active ingredient of Mitaban (Rx) in
other formulations. It is sold as a peach orchard spray in the United
States and veterinarians used that prior to FDA approval of Mitaban in some
instances. Also, ivermectin may be available as it is a commonly used
deworming medication for agricultural purposes and it can be used in high
dosages with some success. Lastly, milbemycin, a once-monthly heartworm
preventative medication, will also kill Demodex mites if given daily for
about eight weeks. These are the only other alternatives that I am aware of.Mike Richards, DVM
Q: Dear Dr. Mike,
I have a 2.5 year old male Great Dane, Ike, who was born in Australia in
a farm. No need to say he is very important for me. I work with an
American women's group in Istanbul to help stray dogs. 3 months ago I
adopted 2 puppies from different litters. One was very healthy and the
other was about to die when I found him and his siblings which we
couldn't save. The puppy was diagnosed with distemper and parvo and he
also had mange. Thanks to our vet's efforts he recovered after a long
treatment. His mange treatment started after his recovery from both
diseases as the vet didn't prefer to put too much work on his immune
system. Once the vaccinactions of the other puppy were completed, I had
to bring him home and we tried to keep him seperated from my Great Dane
and the puppy. Unfortunately they both contracted mange from him. The
healthy puppy had localized demodectic mange with only one patch on her
front leg and the other one had generalized demodicosis with several
patches all over his body. They had ivomec injections and mitaban dips
whilst Ike who wheighs 55 kgs was orally given 3cc ivomec daily and had
two mitaban dips every two weeks. I had two mitaban bottles shipped by a
petshop in New York for $ 100- a bottle which I found very expensive.
Then I had Ectodex (equivalent of Mitaban) shipped from Germany which
has a reasonable price. Ike had only two small patches on his body and
the hair started to grow soon after we started the treatment, but his
back and his neck area are full of small buttons which look like insect
bites. Some of these look red like a rash and some look like pimples
which become scabs and sores. He started to lose hair and although his
skin doesn't have any hairless patches, his coat looks awful when looked
in the opposite direction of hair growth in the sunlight. After four
weeks treatment with Ivomec and Mitaban, I gave him an Ectodex dip in
the morning which has to be repeated every week according to its
prescription. In the evening I gave him 3 cc Ivomec orally along with
vitamin E and EFA capsules. He was also on Tavegil to prevent him from
scratching (2 pills daily). It is a medication from Bayer which causes
drowsiness in humans. Half an hour later he vomited and then had somefood
and water. I took him out for some fresh air and when we returned
home he leaned towards the wall and collapsed with his eyes rolled. He
stood up in 10 seconds but he seemed very dizzy and couldn't walk
straight. I couldn't find the vet and I didn't want to take him to the
emergency service of an animal hospital as I do not trust the knowledge
and skills of most vets in Turkey. I spent the night at his bed side and
he went to his food bowl many times, but I stopped him with fear of
bloat. I called the vet first thing in the morning. He asked me to stop
the treatment. I always suspected Ivomec to cause appetite loss and
white gums and tongue at Ike, but the vet insisted that it is safe. He
believes that amitraz is the reason for his fainting. He had had his
blood checked the previous morning for liver and it was OK. Yesterday,
he also had carried out a urine test and said Ike has bladder infection
(pH level is 8). Now he is on antibiotics. He switched his diet from
Lamb and Rice to Response Formula from Eukanuba. Ike is also very red
and itchy between the webbing on his paws an toe nail rims. He
prescribed a daily antiseptic bath for his paws, but it didn't seem to
work after 3 days. His eye lids were very swollen and bleeding because
of extreme scratching (I try to stop him, but he scratches at night). Iapplied tea
compression and put Terramycin ointment and it seemd to work
well. His eyes look a lot brighter now. I am exceptionally worried for
him and ready to do anything to make him recover. Please let me know if
the teratment was correct so far, should I continue the treatment, what
would cause him to collapse? The vet says we have to continue Ectodex
dips every two months even after he recovers. Is this correct? I am
desperate for an answer. Many thanks.Engin
A: Engin-
Unless demodicosis is caused by a different strain of the mite in Turkey I
have a hard time accepting that it is contagious. Demodecosis is not
considered to be a contagious illness here in the United States. Dogs
affected by generalized demodex have an immune deficiency that allows this
normal inhabitant of canine skin to cause serious disease. Since almost all
dogs have Demodex mites somewhere on their body but only a few have
clinical signs of demodecosis the theory is that dogs don't have to be
infected with the organism because they probably already have it. The
necessary key for disease to occur is immune suppression or immune
incompetence.It is possible that sarcoptic mange could cause the symptoms you are seeing
but it is very susceptible to both amitraz (Mitaban Rx) and ivermectin
(Ivomec Rx) and is almost always possible to cure with one or the other of
these medications.Therefore, I think that it would be a really good idea to look for other
causes of the symptoms seen unless a really positive confirmation of
demodecosis is made. If demodecosis has occurred in your older dog, with no
previous history, then it is necessary to look very hard for some factor
that is decreasing his immune competence, such as a systemic illness (liver
disease, cancer, etc).Both ivermectin and amitraz can cause depression, weakness and neurologic
signs, so it would be hard to tell which one is the problem. This happens
more often with amitraz than with ivermectin but you are using a pretty
high dose of ivermectin, making a problem from it more likely. I would be
suspicious of the sedative as well if I read the email you sent correctly,
since it was given prior to the appearance of the signs.If it is possible to get a good second opinion, I would advocate doing
this. If that is not possible, at least ask your vet about the possibility
that something else could be going on. Antibiotic therapy may be necessary
to combat a secondary skin infection, there may be a fungal illness or a
systemic disease with skin manifestations. Unfortunately, to try to help
more it would be necessary to examine Ike.If demodecosis is the problem it is very likely that lifelong maintenance
therapy will be necessary given the difficulty you have had in clearing up
the problem with the treatments already underway.Mike Richards, DVM
Q: Dr., My Lab/Dane mix has obtained a skin condition in which his skin becomes
inflamed, red, and eventually bleeds. He has this all over his stomach,
bottom of his head, and most of all, his paws. He leaves blood everywhere he
sits, lies down or walks. We've tried everything. Just so you know, he had
puppy mange when he was 3-5 mths old (he;s now 10mths) and the vet treated him
with shots and dips, making him more irritated. The real; problem started
with his puppy shots, he has a bad immune system. His brother lives 2 doors
down and has no problems at all. Our other dog doesn't either. What should
we do? He's a wonderful dog and we need to do something about this problem.
Our vet treated him homeopathically and it didn't work. He was on a medicine
called RHUS TOXICODENDRUM and it seemed to get worse. What can we do? We're
running out of answers and money on him. Please help us in figuring out what
this poor animal has.Thank You,
Adi
A: Adi-
I would be really worried about the possibility that your puppy continues
to be infected with Demodex mites based on the symptoms and history in your
note.Skin scrapings to determine if the mites are still present would be a good
first step. In some cases it is necessary to do skin biopsies to confirm
mites when the skin damage has been chronic and severe.If amitraz (Mitaban Rx) dip causes problems for your puppy there are other
treatment options. Our website has information on these. Search using
"demodex" or "demodecosis".It is expensive to treat demodecosis in some cases but usually it can be
cured. There are other possible problems, such as food allergies and immune
system disease but the first thing to do is to determine if there are still
Demodex mites present causing disease.Mike Richards, DVM
Q: Our Pit Bull puppy, who is currently 18 weeks old, was diagnosed with Demodicosis mange around April 10th. On that visit, our vet showed us under the microscope the mite and told us that she needed to be dipped with Mitaban. He aslo gave her a steriod shot of cortisone and prescribed two medications (Cephalexin 250mg & Hydroxine). Two days later, we noticed that she was scratching her self raw on the chest and seemed to be itchy all over.
We took her to an emergency clinic and the vet we saw said that she was going to get a lot worse than before she starts to get better.
We have just taken our puppy in for her second dipping and our vet said that she still has the same number of mites as when we first brought her in. Two days later, she started scratching herself raw on her chest again and seems to be itching all over...is this normal? Our vet also gave us a higher dosage of Cephalexin 500mg...do you think this will help? Is there anything we can possibly do at home to help; like an ointment or lotion? We are very concerned because she seems to be getting a lot worse.
Something else I am wondering is, if she is having an allergic reation to the Cephalexin, were can I look for a rash if she has mange? We noticed that she has small bumps, like pimples on her chest. Could this be a possible allergic reaction?
Any help or information you can provide will be greatly appreciated.
Thank you,
David & Linda
A: David and Linda-
It sometimes takes three or four dips with Mitaban to see a lot of improvement and it takes at least six or eight dips to cure the condition in most dogs. It is usually not considered to be a good idea to use cortisones in a dog with demodecosis because they suppress the immune response to the mites even further than it is naturally suppressed in dogs susceptible to this problem. I don't know how much effect that has on resistance to treatment but it may have some. In general antibiotics will control the itching within a few days as it is usually from the presence of a bacterial skin infection. If this is not the case by now, it would be a good idea to ask your vet about referral to a veterinary dermatologist for a second opinion on the case. It is not likely that your vet is wrong about the demodectic mange but it is entirely possible that there are two problems present at the same time.
Just in case there is some confusion it is usually considered to be OK to use corticosteroids to control the intense itching when treating for sarcoptic mange, which is a completely different problem than demodecosis.
A soothing bath, such as an oatmeal shampoo bath or a tar and sulfer shampoo bath might help with the itching. Antihistamines help a few dogs and aspirin is even helpful in some cases. Let your vet know the itching continues and if it is severe, definitely consider asking about referral to a veterinary dermatologist if that is possible in the area in which you live.
Mike Richards, DVM
Extreme itchiness - Demodex or Allergy
Q: Dear Dr. Mike,
I have an adorable female Boston Terrier "Ruthie", who at around 5 months of age, was diagnosed with demodex mites. Her ears smelled bad and she was scratching and biting her ears and legs to the point of bleeding. The vet (vet #1) suggested mitaban dips which seemed to not be very successful. Several scrapings were done thereafter and the mite was never found again, however she continued to itch. Eventually sores occurred on her belly and became infected and smelled awful. He put her on antibiotics and again, the dips. Again, there was a very temporary period when she seemed to not itch so badly, however the itching did come back. I had read about a treatment called "milbemycin" and he tried that for 4 weeks, but there was no improvement. He said that the condition was probably made worse by allergies and eventually gave her an injection of steroids. Finally, there really seemed to be an immediate improvement...... for about a week or two, then back to the itching. In the meantime, we moved about 50 miles away and changed vets. By this time, the dog was almost 1 year old. The new vet (vet #2) said that she should stay on antibiotics, take steroid pills and discontinue the dips since they had not proved to be very beneficial. She still itched. He also said, emphatically, that the demodex mites would not cause the terrible itching that she was experiencing and that more than likely she was having allergies. When I saw no improvement, I called a friend and she recommended her vet highly, so I called him. He (vet #3) considered all that had been done to her and did four scrapings and did not detect demodex. He told me that the best approach to treatment of allergies was to do some testing similar to that which is used in humans. She would have to have a large area shaved and have the allergens injected, however, she would have to be off of the steroids for at least 30 days to do this test. He said that there was a blood test that could be done to identify allergies, but he felt that the first test he mentioned was much better. We tried to wean her off of the steroids (Prednisolone 5mg.) and when we would get down to 1/2 pill every day, she would begin to itch. I would add Children's chewable Benadryl, 1 pill two or three times a day. If we could get her down to 1/2 pill of Pred every other day, or less, she would scratch herself bloody. It looks like we will never be able to keep her off of the "Pred" for the needed 30 days to perform the prescribed test. I was also giving her a liquid antiobiotic (it looked very much like the stuff I used to give my children). By mistake, the antibiotic was left down in Florida while we were down there on vacation, and I didn't get anymore when we returned. That was my oversight. She didn't get any better, it was the same old story. I called the vets office, and expressed my concern to his office girl and asked of the vet wanted to see Ruthie. She said the doctor wasn't in that day but she would tell his associate (vet #4) about my concerns, when she returned to the phone, she said that the vet said that the demodex could indeed cause extreme itching and that I should start the mitaban dips again. I continued the steroids, benadryl, and gave her 4 dips (one every other week)....no real improvement. Again, when I would try to wean her off the steroids, she would start to itch. Now vet #3 is trying the treatment for sarcoptic mange. He gave her a shot and gave her a lime sulphur dip. Should I ask for more antibiotics also?
It's been almost a week, and so far I don't detect any real improvement in the itching. It is somewhat under control at the moment because she is taking 2.5 mg of the Pred daily and the benadryl as needed. She is scheduled for 3 more dips. Basically, it seems that the only thing that relieves her itching at all is the steroid and I am very concerned about long term effects it will have on her. I really have to consider her quality of life, but I can't help but believe that there must be answer to her problem out there somewhere. What do you think? PLEASE HELP ME AND MY BELOVED RUTHIE.
Jill
A: Jill-
Vet #3 (this sounds like the dating game), has proposed a direction for testing that most closely follows what I like to do in these cases. You have several alternatives for dealing with this situation while attempting to come to some conclusions about what is causing the itching. In addition, I tend to agree with the assessment that demodecosis does not normally produce itching of this degree of magnitude except through secondary bacterial infection which should be at least partially controllable with antibiotics. There are exceptions to every rule and I have seen an occasional intensely itchy dog with demodex. Since Mitaban also kills sarcoptic mange in most instances it is possible that there is a dual infection in some dogs. I would consider switching to a hypoallergenic diet, such as the new one Purina has come out with, Hill's i/d, one of the Innovative Diets foods or a homemade diet suggested by your veterinarian. If food allergy is contributing to the problem, removing the offending food may produce a significant reduction in clinical signs in two to four weeks, or possibly slightly longer. You can continue prednisone until it is apparent that there is a reduction in itching, if necessary. Another alternative is to ask for referral to a veterinary dermatologist. Specialists often see the odd presentations of normal diseases and the normal presentations of unusual diseases more than general practitioners. Often they can make a significant difference in cases that have been difficult for general practitioners. If this is an option in your area it would be worth considering. Skin biopsies have been helpful for us, even when we had to leave a dog on cortisones, which do have some effect on the biopsy but often not enough to make it worthless. I agree that the blood test is probably not as accurate as the skin testing for allergies but it can be done while the dog is on prednisone, so you might consider trying it, even though you have to be a little cautious about interpreting the results.
I have to admit that I was taken back just a little by the use of prednisone in a dog that has a previous diagnosis of demodectic mange that may have been generalized. Often, corticosteroids make it possible for the Demodex mites to really cause problems but if this happens they should be easy to find on skin scrapings. Since they aren't, it is probably OK.
Mike Richards, DVM
Q: If one breeds a dog that has had a case of demodectic mange to another dog that has had demodectic mange (both localized), is there more of a chance for generalized demodex to occur?
VinceA: Vince-
If both dogs had demodecosis that was local only and which they recovered fully from, without
treatment, then there probably isn't an increased likelihood of generalized demodectic mange in the
puppies, based on my understanding of the disease. It would be best to check out their siblings and
parents for cases of generalized demodecosis before breeding, though. If either dog was treated with
amitraz (Mitaban Rx) or other treatment generally successful at eliminating generalized demodecosis it
is not possible to say whether or not their localized mange would have become generalized. It is quite
common for owners to insist on treatment of localized mange and for vets to go along with the demand,
to be sure to determine whether this happened, too. If one of the dogs was treated my best recommendation
is to avoid this breeding.Mike Richards, DVM
Q: Dr. Mike, have a one year old Croatian sheepdog. In the past six months she has had 3 ear infections which were treated with Amoxicillin and Panorex. She also had demodectic mange, for this she was given Goodwinol ointment. The ointment did not work, so she was given three mitaban dips every two weeks. The dips seem to have worked so far, her fur is growing back. I was informed that both of these problems can recur. When I asked my veteranarian if there was anything I could do to prevent ear infections, she responded with,"The dog is young and she might have them for the rest of her life." She also could not tell me what was causing the ear infections. I know that my veteranarian can't predict the future, but I do want the best care for my dog, but it can become very expensive with chronic problems. My question is, is it appropriate to ask my veteranarian for a consultation to discuss my concerns so that I can be informed and prepared for what can be done in the future. Or do I continue to bring my dog in for every ear infection and deal with it as a case by case basis?
A: shr- As long as you understand that your vet can only give you an educated opinion about the longterm prognosis of the problems you are seeing I think it is very appropriate to schedule an office visit to discuss these concerns. If your vet feels uncomfortable with this sort of prognosticating it may be worth asking for a referral to a veterinary dermatologist. Most are good about filling owners in on the long term prospects for diseases under their care.
It is possible that the ear infections could be a symptom of the demodecosis. Demodex will sometimes cause otitis. Overall, the chances of clearing up generalized demodecosis with persistant treatment is probably between 50 and 80% somewhere. It can be difficult to do and it is relatively expensive but the odds are good enough that I feel comfortable advising most clients to try for a cure.
Mike Richards DVM
Controlling chronic demodecosis
Q: Dear Dr. Mike, We have a three year old mix Border collie that has had severe Mange almost its entire life. Our vet has not been able find a cure for it. We have tried Mitaban, Ivomec, and various othe dips, etc. Do you have any additional ideas we could try? We will try anything! Thanks! Sandy
A: Sandy- There is some indication that long term use of antibiotics is helpful in controlling chronic cases of demodecosis. I am not sure how this works but perhaps relieving the skin of some of the immunologic burden allows it to fight the demodecosis better. Or perhaps a lot of the clinical signs are actually due to secondary bacterial infection. I may be necessary to use antibiotics for months in order to help. The only other medication I can think of for direct control of the mites that you did not mention was milbemycin (Interceptor Rx). This is an expensive option and not always effective, either, but it is another alternative. Some vets are increasing the concentration of amitraz (Mitaban Rx) used but I have not been willing to do this yet as we see some problems with toxicity at the recommended dosages. I do think continuous long term antibiotic usage may be beneficial even when the mites can not be eliminated.
Mike Richards, DVM
Q: We have a 4 year old chow mix we got from the SPCA. Our vet looked at his skin (specifically his right elbow, right inner thigh and a spot on his back) and told us that it looked to be a classic case of demodectic mites. He scraped off a sample and looked at it under the microscope and told us that he did not find any mites but he doesn't scrape to deep. He gave us an antibiotic and cream to help with the problem. My wife has been reading up on the subject at the local library and is very concerned (to the point of tears) that our beloved animal will die. I have read on the internet several opinions on the subject and found one doctor who seems to believe it is no big deal and others who believe it is. Well is it? Also, without really testing the area again can our doctor be sure it is mites? What else could it be? Do you have any advice on the subject? We will probably take him to a dermatologist in the Dallas area soon to make sure he has mites or to find out what it is that he has. Any advice? Thanks Russ
A: Russ-Going to the dermatologist is the best course of action. If Demodex mites are causing the clinical symptoms it is a big deal in a four year old dog but at least 50% of the cases of chronic generalized demodecosis will respond to treatment satisfactorily and another 30 to 40% of the dogs will respond well enough that the condition can be controlled with chronic use of medications. Demodex is usually pretty easy to find on skin scrapings so I suspect it may not be the problem but once in a while (particularly in shar peis) it can be difficult to find. Sarcoptic mange may also be present. This mange is usually easier to treat and is much harder to find on skin scrapings. Lots of times we have just treated for it hoping to figure out whether it was the problem by the response to treatment. This works often enough that we keep on trying! The dermatologist will be able to give you a better idea which of these problems is present -- or what the problem is if neither mite is likely.
Mike Richards, DVM
Golden with demodex and other problems
Q: Hi! My name is Maricarmen, I have a female Golden Retriever and she has 8 months, since she was 4 months she's been diagnosed with hypothyroidism, and malabsorbtion, and anemia. She was first diagnosed with anemia caused by parasites. Then her anemia was cured, her blood level was O.K. now, but then she was diagnosed with malabsorbtion and hypothyroidism. Her hypothyroidism was controlled with a pill but she is still having trouble digesting her food. A month and a half ago she was diagnosed with mange, I don't really remember what kind of mange she has but the veterinarian prescribed Mitaban, and an ointment. I really want to know what you think about her case and what you recommend to me. She has all these troubles but she is a very hyperactive dog. Her mange started in her left paw, with red patches and abrasions , her skin is gray (because of the problems with anemia she had , when she was two - three months her skin wasn't this gray), so she also has like black and white patches. Her hair is falling but I don't know if it is because the heat here in Puerto Rico, or because of the Dip of Mitaban. We have given her 5 Dips ( weekly) and the condition is worst. What can I do is there a better medicine for her? Please write soon we are very worried.
A: Maricarmen- Mitaban is the only approved medication for Demodectic mange. It is not unusual for dogs to look worse after dipping with Mitoban. As it kills the mites and they die in the hair follicles there is often additional hairloss. Antibiotic therapy for secondary infections is very very important in the success of therapy for demdecosis. If your dog is not on antibiotics it would probably help a great deal to add them.
It is highly unusual for a dog to be hypothyroid at this age. It is not unusual for dogs to test "low" on thyroid hormone when they have significant illness of any type, so this may be a misleading lab value in some cases. It usually does not hurt to supplement thyroid hormone but this is worth rechecking.
If the Mitaban (Rx) doesn't work, alternative medications are ivermectin and milbemycin. Neither of these are approved for this use but both have been recommended in the literature.
Mike Richards, DVM
Q: Dr. Mike, Our puppy is about 5 1/2 months old, weighs about 39 pounds, she is part Collie, Husky, Golden Lab, and maybe Shepherd. (A very pretty dog we adopted from the SPCA at age six weeks). When we took her to get spayed the vet said she had mites. Because Teisha had just been spayed she said she could not have the rinses. She prescribed Interceptor flavor tabs. (milbemycin oxime) We gave her weekly doses of that for 4 weeks and she looks much worse. Now she has started getting pustules forming on her tummy, she also has swelling around her mouth. Is there any other way to treat this? Can I apply the rinses at home? It sounds like it will be quite costly to have the rinse applied by the vet... Also what causes the mites? The vet told us it was from stress. Our dog is very well cared for and much loved by my husband, myself and two sons. She is an outside dog. We spend a lot of time with her and take her for walks. She was occasionally tied up in the back yard when she was smaller, but now is loose in a fenced yard. I felt that calling it stress made it sound like she wasn't taken care of or something... What can you tell me about mites and the treatment? Thanks for your help. Debbie
A: Debbie- We dispense amitraz (Mitaban Rx) for clients to use at home. It is important to follow the directions on the package insert and from your veterinarian if you apply this medication yourself. It may work even though milbemycin (Interceptor Rx) did not. There should be no problems relating to the spay surgery at this time with using the dip.
"Stress" is an often misunderstood term. We tend to think of stress as a bad thing and assume that it must have a bad cause. This isn't necessarily true. There can be good stresses. If you don't think so, think back to your wedding day! Stress can be anything that makes your dog's body react to hormonal influences, good or bad. It is very hard to determine what might worry a dog or what might make a dog happy enough to cause "good" stress.
Despite this, I don't know how much stress really has to do with demodicosis in many cases. In generalized demodecosis there is a genetic defect that leads to an inability on the part of the dog's immune system to fight off this mite in most cases. In demodicosis that is not generalized there may be a role played by stress or by some other factor that leads to suppression of the immune system.
Good luck with this.
Mike Richards, DVM
Q: Hi Dr. Mike, I hope you can help me out again. This time it's a bitch with what has been diagnosed as demodectic mange. The vets told the owner that this type of mange can only be contracted from the mother and that that bitch (mother) should not be bred again as the other pups will also have it. The young bitch was diagnosed when she was a little over one year old. The owners have gone through quite an expense with regular dips of Mita-Ban and 100-day treatment with Ivermectin, etc - with no remission. None of the other pups in the same litter developed anything like this. They are all a little over two years old now and I am in touch with all of the owners. The mother no longer belongs to me (I had co-owned her) and she was bred again just before we heard about this occurrance of the mange. None of the pups in this new litter (they are now one year old) have the problem either. To me, this demodectic mange is not clearly attributable to the mother. Is there any other way of contracting this demodectic mange? Thanks so much. Carla
A: Carla- You didn't mention the breed of the affected puppy -- in some breeds the heritability of demodecosis is pretty well established but in other breeds there is more of a question mark. When it is very important to establish heritability it is generally best not to treat the puppy until the infection is clearly generalized. Many puppies develop localized demodecosis lesions (confined to the head or a couple of areas on the body) and eventually outgrow it as their immune system strengthens. When a puppy does not outgrow the mange or when it spreads to several sites on the body it is most likely to be generalized demodex and is therefore more likely to be an inherited condition thought to occur from a deficiency of a specific type of T-cell. It is tough to make a decision to spay a good bitch or to neuter the sire, or both, when generalized demodecosis appears in a small percentage of puppies in a litter. This definitely could be, is even likely to be, genetic. The mite is present on most dogs but does not cause disease -- so the inherited component in this case is the susceptibility to hairloss and secondary skin infections as a result of overgrowth of the mite population -- NOT the infection with the mites, itself.
The breeds with a known tendency to develop demodecosis include the shar pei, West Highland white terrier, Scottish terrier, English bulldog, Boston terrier, great Dane, Weimaraner, Airedale, Malamute and Afghan. If your dog is one of these breeds, it would be wise to be even more suspicious of an inherited component to this disease.
There are systemic conditions which seem to bring on relapses or new occurrences of demodecosis. Cushing's disease is the most notable but this is present primarily in older dogs. Liver disease seems to be able to predispose dogs to demodecosis and is also more common in older dogs. Any condition causing sufficient immunosuppression can lead to problems with demodicosis so it is always a good idea to look carefully for an underlying cause, especially in a older dog suddenly showing signs of Demodex infestation.
To the best of my knowledge there is no way to prove that demodecosis is occurring due to an inherited tendency in an individual dog, or to disprove this. If the condition is not treated and resolves on its own, that is a good sign that an inherited immunodeficiency is not present but there is no way to tell that in this puppy except that it doesn't sound very plausible with the history given. If the pup had responded well to medications it would be more arguable that the condition was not likely to be genetic.
So that's the best I can do. Even though only one puppy is affected, you have to seriously consider the possibility of a genetic disorder in the puppy. The decision on breeding or not breeding, considering the rest of the information, such as the low incidence in the two litters, is not mine to make. My sentiments lie with not taking any chances but I am like many veterinarians --- convinced that there are too many dogs in the world as it is and sure that highly selective breeding is best. Many dog breeders have an entirely different outlook on this situation, understandably.
Mike Richards, DVM
Q: My friend has a 10-1/2 year old golden...who was diagnosed with demodex....isn't that a puppy problem? I thought it only happens in puppies....
A: Sonja- Demodecosis is most commonly seen in young puppies between the ages of 3 months and a year. It can occur later in life in dogs that have severe immune compromise for some reason. When it does occur in an older dog, a really good search should be made for some disease that could be causing it. Cushing's disease, liver failure and cancer are possible causes of this in an older dog. I am sure there are others. It may be able to occur just due to a decrease in immune competency with age but I'd still recommend looking hard for another problem.
Mike Richards, DVM
Q: On Wednesday, March 26th, my girlfriend and I adopted a chocolate lab/????? mix named Daisy from the Humane Society here in Austin. She was spayed on Tuesday and has just been a sweetheart the past couple of days. We took her yesterday to the vet and had a skin scraping on her head. Sure enough, Demodex mites in a little bald spot. I've been told that this is not contagious to any animal but my roomates want proof and won't let her live with us until they have it. Right now the dog is staying with my girlfriend . This is turning into a big problem and causing a lot of tension in my home. Could you please e-mail me or post a short note explaining what Demodectic Mange is and why it is not dangerous to my roomates. Also, if you have any recommended reading on the subject so I can show them documented proof I would appreciate it very much. Daisy, my girlfriend, and I thank you in advance and look forward to your reply.
A: You'll have to tell your friends that they don't watch enough good TV. Every now and then on channels like the Discovery Channel, there are specials that show the little parasites that live on human beings all the time. The mite that lives in human being's eyebrows is a Demodex mite. Many species have these mites living on their bodies all the time, including humans and dogs. Normally, there is a balance between the parasites ability to reproduce and the host's ability to kill the mites. A few mites live to keep the species going and the host never even knows it.
Unfortunately, an occasional dog does not have the proper set of T-cells to kill the mites. This gives the mites an advantage and they propagate excessively, over-running hair follicles all over the dog's body instead of just around its eyes. The result is hairloss, easily infected skin and the typical appearance of demodicosis (Demodectic mange infestation).
Since almost all dogs already have these mites and since it takes very intimate contact to spread them from dog to dog, this problem is not considered to be a contagious disease. Demodex from dogs does not infect people - nor do Demodex mites from people infect dogs.
Most dogs with only one or two spots of Demodex will outgrow it as their immune system gets stronger with age or decrease in stress. This happens about 80% of the time. The dogs that can not outgrow the problem can be difficult to treat but most of the time this mite can be controlled with persistant effort.
Good luck with this.
Mike Richards, DVM
p.s. -- do your room-mates know about dust mites? Life is full of little microscopic organisms :)
Q: Dear Dr. Mike, I have an 8 week old weimaraner puppy who I noticed lately has hair missing around his eyes. He doesn't seem to be itchy. I took him to my regular vet and she did skin scrapings on a few areas but didn't find any mites. She still suspects he has Demodectic mange. She said she usually treats this type of mange with Ivermectin but since she didn't actually see the mites and he is so young she gave me some antibiotics to give him and told me to keep an eyer on it. Is this contagious? Does this mean his immune system is not what it should be? He was shipped from Indiana when he was only 61/2 weeks old and we got him the next day, maybe the stress from such big changes so young made him more susepitble? Any information you can give me would be greatly appreciated. Sincerely
A: I think that I might be suspicious of Demodectic mange, too -- except that it would be very very unusual in a puppy this young. The mange mite has a 20- 35 days lifecycle, which means that it is very hard for it to cause clinical disease in a puppy that is younger than about 12 weeks of age because it takes a while for the population of mites to grow to sufficient numbers to cause disease. Demodex mites are not contagious. Virtually all dogs have them living in the skin around their eyes. They are passed from mother to puppies and are contagious in that sense but the disease demodicosis occurs only in dogs in which an immune system deficiency allows the mite population to overgrow its normal boundaries and cause disease. I do think that the right thing to do is use the antibiotics, then wait and see what happens at this time. If the eyelids become inflamed or any signs of itchiness or other irritation develop or the hairloss spreads to any other area, take the puppy back to your vet for a re-exam. Hopefully this is just a minor problem associated with all the stress the pup has been through.
Mike Richards, DVM
See Photo - Beagle with Demodex
Q: my dog has been diagnosed to have demodox canis. I am trying to locate a picture of the parasite to show my fiancee what exactly our dog has. do you have a picture that can be sent or have an idea where i might be able to find one? thank you very much .
A: Push
and find the nasty thing. Hope you like him. Michal
Last edited 08/01/05