DEMODECOSIS TREATMENT : PARASITE INFECTION

IVERMECTIN
Ivermectin is inexpensive relative to Milbemycin and involves no labor intensive bathing. It DOES, however, taste terrible if given orally (it may be necessary for the owner to learn how to give ivermectin as an injectable treatment.) There is, unfortunately, an important occasional problem that keeps other treatment options listed: drug sensitivity. Some individual dogs are sensitive to ivermectin and can die if subjected to a typical therapeutic dose for demodicosis.
Sensitivity to ivermectin may not be predictably limited to “collie breeds” and thus it is often prudent to use a lower test dose before initiating the relatively high doses of ivermectin needed to treat demodicosis. Not all individuals of collie heritage are sensitive to ivermectin and a test is now available through Washington State University to determine whether an individual should be able to safely take ivermectin or not. An alternative to testing is to use a low test dose for a period of time and watch for mild side effects. If there is any question about your pet’s potential sensitivity to ivermectin, your veterinarian will instruct you. There is a range of ivermectin doses used in the treatment of demodicosis and it seems that higher doses do clear infection faster than lower doses. This means that if a lower dose has been ineffective, a higher dose may still work. This does not mean that a pet owner should experament with ivermectin doses on their own as there is some potential for lethal toxicity if this drug is not used appropriately.

AMITRAZ (MITABAN)
Unless the animal is largely bald or has a short coat, complete clipping will be required for maximal contact with the dip.Dip should be preceded by a benzoyl peroxide bath to help clear up skin infections and open the hair follicles so the dip can penetrate to the mites. Shampoo must sit on the pet at least 10 minutes before rinsing. CAUTION: this type of shampoo can stain jewelry and clothing.
Dip is applied by sponge. Gloves should be worn while applying dip. The dip dries on the dog's fur and should not be rinsed off. The dog should not get wet between dips.Dipping occasionally yields mild sedation as a side effect. Very small dogs may become highly sedated and require an antidote but this is unusual. For your convenience, dipping and bathing may be performed at the hospital thus allowing for veterinary supervision in the event of side effects.
Dipping/bathing is recommended every two weeks according to the FDA approved label on the bottle of dip. Most universities are finding that the cure rate jumps from 25% to 80% when dip is used at double strength and applied weekly. No toxic effects have been seen using the dip in this way and this is our current recommendation when opting for dips except in very small dogs and puppies.Dipping is a fair alternative for ivermectin in collie breeds and in ivermectin sensitive individuals.

BUT REMEMBER AMITRAZ DIPPING SHOULD NOT BE USED IN TOY BREEDS OR IN YOUNG (UNDER 4 MONTHS OF AGE) PUPPIES.

NOTE: Amitraz is a drug of the monoamine oxidase inhibitor class. People who are taking selected serotonin reuptake inhibitors (such as Prozac®) could have a bad reaction to the use of amitraz if they administer dips to pets. Human diabetics should also avoid administering amitraz dips.

INTERCEPTOR®
Interceptor (active ingredient: Milbemycin oxime) is normally marketed as a monthly heartworm preventive; when it is used on a daily basis, it is effective against generalized demodicosis. This discovery was welcomed by the veterinary profession as finally demodicosis can be treated without labor intensive dipping or concern about ivermectin sensitivity. The downside to this treatment is expense as Interceptor is typically sold in 6 dose packages and it is not uncommon for several months of treatment to be needed. Sometimes it is possible to obtain discounted product that is short-dated (meaning it will expire before six months have passed). This product cannot be sold for heartworm prevention if it will expire before it is used up but for daily use against Demodex mites it would be fine and used well before its expiration date

PREVENTION
Physiological stress is an important factor determining the degree of severity of demodectic mange and the following steps should be taken to reduce stress:Females should be spayed as soon as the disease is controlled. Coming into heat, hormone fluxes, and pregnancy are very stressful. Also, predisposition to demodicosis is hereditary and should not be passed on.The dog should be fed a reputable brand of dog food so as to avoid any nutritionally related problems.Keep the pet parasite-free. Worms are irritants that the pet need not deal with and fleas may exacerbate the itchiness and skin infection.Keep up the pet's vaccinations.The mites themselves cause suppression of the immune system so the pet needs every advantage to stay healthy.