Demodectic Mange

Mange mites are microscopic bugs that live in the skin of your pet. Demodex mange mites live in the hair follicles of your pet. They can be present in small numbers in normal pets and the immune system keeps them in check. In pets with stressed immune systems, the mites may be able to multiply and thereby cause clinical disease. Generally, we see this disease in immature dogs, dogs with depressed immune systems as a result of disease, hormonal disorders or drug therapy and sometimes in old dogs whose immune systems have deteriorated naturally.

What are the symptoms of Demodectic mange?
As the demodex mites multiply in the hair follicles, inflammation occurs that results in the loss of the hair from the follicle. Generally, this is not an itchy disease and the owners simply notice areas of thinned hair or missing hair. Frequently, we will see it first appear around the eyes and ears, but it can occur anywhere on the body. Some pets only get it in a few areas, where others have most of the body affected.

How do we diagnose Demodex infestation?
This diagnosis is made by observing the mites or their eggs under the microscope after obtaining a sample from a deep skin scraping. The process of skin scraping may cause a slight bit of bleeding at the site but is not dangerous. Sometimes, we may not be able to find the mites despite multiple scrapings. In some cases, we have to take a piece of skin (biopsy) and send it to the lab for histopathology.

Is demodex contagious to other pets or to people? Demodectic mange mites do not spread to people under any circumstance and to other pets under normal conditions. The one exception is that the mother may pass the mites to the offspring during and around birth. Therefore, one may see a few puppies in the same litter develop the symptoms of mange.

How do we treat mange: Currently, we treat mange with the topical dip called "Mitaban". This drug has been approved for this purpose and is effective in approximately 75-80% of the cases. The dip must be applied to the pet after a medicated bath with a shampoo that opens the follicles on the coat. The dip is a potent drug and may cause the following side effects:
Drowsiness
Wobbly gait
Loss of Appetite
Vomiting
Weakness
Collapse
Due to the strong nature of this medication, we have dips should be applied at the hospital and the pet observed for the better part of the day before being sent home.

Most dogs need from 5 to 8 dips given at 1-week intervals in order to clear the disease. We usually will recheck the pet after 4 dips with a skin scraping to see if the mites are still present. Once it is determined that the mites are gone, 2 more dips are given to be certain they are all dead. In addition to the Mitaban dips, the pet's immune system is addressed:.

1. Fortify the immune system by feeding high quality food (typically Hill's P/D diet) along with daily vitamins.

2. Add a food supplement called Derm Caps which provides the essential fatty acids needed to help the skin heal.

3. Administer antibiotics for a period of 2 to 6 weeks v if the pet has a concurrent bacterial infection in the skin.

4. For older pets that develop this disease: run tests to evaluate their metabolic function (kidneys, liver, white cells etc) along with their thyroid function and sometimes their adrenal function.

How successful is the treatment: Fortunately, 90% of the pets that develop demodex mange as puppies will improve and get over the disease with treatment and aging. As they grow, their immune system matures and can deal with the mange mites provided we support them with the drugs above. For older pets that contract this disease, the prognosis is quite variable. If the underlying problem that is depressing the immune system is found and reversed, there is a much better chance of helping them than simply try to treat the mites themselves. For the pets that do not respond to the initial treatment, often times they are changed to alternative treatments with oral drugs typically containing the drug Ivermectin. This drug is not approved in the dog for this purpose, but is it known to be safe and frequently efficacious.