Demodicosis is diagnosed by the presence of symptoms and by performing deep skin scrapings on affected areas. The mites can be seen with the aid of a microscope. The mites are present on all dogs, so alone they do not constitute a diagnosis of mange. Treatment Localized. If your dog has localized demodicosis, it is important to monitor him/her to establish whether the disease will stay localized or it will progress into the generalized form, as prognosis varies. You will be asked to bathe your dog using an antibacterial shampoo and apply a lotion on the affected area. Your pet will need additional scrapings to monitor the progression or regression of the disease every 2 to 3 weeks for 2 times.
Generalized. If your dog has juvenile onset generalized demodicosis you will be advised to neuter your dog. Demodicosis can be an expensive and frustrating disease to treat thus it is important not to contribute to its perpetuation.
Treatment is necessary when disease is generalized. It includes the treatment of secondary bacterial infections and eradication of the mites. Eradication of the mites can be accomplished by using an amitraz-based dip (Mitaban®) or by using systemic medications (milbemycin and ivermectin). Depending on the breed of your dog, your veterinarian will select the most opportune therapy. Some therapies are not FDA approved (milbemycin and ivermectin) even though they are effective.
It is very important that you closely follow the instructions of your veterinarian to minimize the likelihood of adverse effects. If the dip is used, your dog may need to be clipped to increase penetration and efficacy of this treatment. Adverse effects of the dip include excessive sedation, itchiness, tremors and coma. It is prudent to have your veterinarian dip your dog. After the dip, it is important for you to monitor for excessive sedation. If this occurs your veterinarian should be consulted, as there are medications that can help reverse this adverse effect. Also bathing will remove the residual medication present on the skin and hasten the recovery.
At home you will have to administer antibiotics for several weeks to treat secondary bacterial infection. This will take four weeks if the infection is superficial, and eight to 10 weeks if the infection is deep.
You will also have to administer oral medication (ivermectin or milbemycin) to kill the mites. The average dog will require medications for a minimum of three months. Compliance is very important not to cause resistance to the medications.
If your veterinarian chooses to use the dip as form of therapy, it is important that your dog does not get wet in between dips to maximize efficacy of the treatment. If, on the other hand, other forms of treatments are used, you may have to bathe your dog regularly with medicated antibacterial shampoos to hasten the recovery and clear the secondary bacterial infections.
If your dog is a collie, Sheltie or Australian shepherd, drugs like ivermectin should never be used because they have the potential of causing life threatening side effects in these breeds (tremors, seizures, coma and death). Other breeds may occasionally have problems with this type of medications but they are usually milder. They include difficulty walking, circling, weakness in the back legs and stumbling.