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Ivermectin FactsSide effects include: ataxia, Most side effects are reversible Not for use in collies, Shetland Duration of treatment is Do not mix ivermectin with |
April 1, 2004
Demodicosis: Clinical Review
& Current Treatment Options
Clinical Findings
Demodicosis
can present as localized or generalized disease and can be squamous
or pustular. Localized disease occurs commonly on the face, head,
and distal forelimbs. Five or fewer lesions can be classified
as localized disease. Localized lesions may wax and wane over
several months. Approximately 10% of localized disease will progress
to the generalized form of the disease. Dogs with six lesions,
pododemodicosis or one major body region affected can be classified
with generalized disease. Most dogs with demodicosis are non-pruritic.
Squamous demodicosis can present as diffuse erythematous scaling
dermatitis with follicular plugging and follicular casts along
the hair shafts. Large areas of prominent hyperpigmentation with
comedones and erythema with or without alopecia
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may also be seen.
Pustular demodicosis occurs as a result of secondary pyoderma and/or
furunculosis associated with the demodicosis. Dogs with pododemodicosis may exhibit interdigital nodules, draining tracts and severe digital edema and swelling. Footpad hyperkeratosis may be seen in dogs with pododemodicosis. Dogs with generalized deep pustular demodicosis may be depressed, lethargic |
and febrile. Generalized lymphadenopathy can also occur. In a small number of cases, pruritic ceruminous otitis associated with demodex may be the sole clinical finding or may be present concurrently with localized or generalized disease. The diagnosis is made by identifying mites from deep skin scrape samples, and some dogs may require sedationto obtain adequate samples. In rare cases a skin biopsy may be required to make the diagnosis. | |
Treatment Options |
Key Points
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| Presently the only product approved by the FDA for the treatment of demodicosis in dogs is a 19.9% amitraz solution (Mitaban®). Mitaban® is currently unavailable due to the lack of a FDA product inspection facility. An off-label alternative to Mitaban® | ||
| is the large animal preparation Taktic EC®. Taktic® is 12.5 % amitraz. To achieve the 250 ppm concentration, use 16.8 ml in 2 gallons of water. Dogs should be clipped short and bathed with a benzoyl peroxide shampoo prior to dipping. Dips should be applied every 7-14 days. Additional non-approved treatments include ivermectin and milbemycin. |
One percent ivermectin is used at a dose of 400-600 mcg/kg orally once daily. The target dose should be gradually reached by starting with a dose of 100 mcg/kg and increasing by 100 mcg/kg until the target dose is reached. Alternatively, milbemycin oxime (Interceptor®) is dosed orally at 2 mg/kg once |
daily. Treatment duration is 2-4 months. Side effects are uncommon and typically reversible and may include ataxia, trembling and stupor. Milbemycin oxime should be used with caution in collies and puppies younger than 12 weeks of age. Milbemycin and ivermectin both appear effective in 80-85% of dogs with generalized demodicosis. |
Pustular
demodicosis of the face and head
copyright
2004 Southeast Veterinary Specialists