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Old January 21st, 2009, 01:18 AM
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Dr Lee Dr Lee is offline
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Quote:
Originally Posted by Anon1023 View Post
He's about 14 months old, so still a puppy. We took him to my vet the day we got him and was told that his case was more serious than we were led to believe and could potentially be worse than just the mange, although the mange is bad enough. He has a generalized case and it is very serious and very painful. He's been put on Ivermectin, antibiotics and has a medicated shampoo. But every day he is bleeding from somewhere and we can't even pick him up. He can barely move, although he does eat and go out.
Most cases will positively respond to ivermectin. The medicated shampoo and the antibiotics treat the secondary symptoms. If the clinical signs are worsening and not improving then rechecking with your veterinarian is important. There are several options. Typically the canine dose is 300-600 mcg/kg PO q24h x 60 days past negative skin scrape. Thus is the pet is on the low end of the dose, then a slow and progressive increase from 300mcg toward 600mcg/kg might be helpful (ASK YOUR VET. DO NOT INCREASE THE IVERMECTIN YOURSELF - your pet might already be at the higher dose).

There are also other medications that treat demodex: Interceptor(Milbemycin), Amitraz (Mitaban), etc... Sometimes one pet will respond better to one demodectic medication than another. Again - ask your veterinarian. FWIW - Ivermectin is typically the first choice medication and what I typically will start with (assuming the pet is not a collie, etc...)

Sometimes the primary demodectic infection is resolving but the secondary bacterial infection is taking over. Thus repeating the skin scrape, impression smear cytology and culture might be useful testing to rule out a severe secondary antibiotic resistant bacterial infection. (or even a fungal infection).

Also as already stated, this is a disease of the immune system. For this reason, the cases of adult onset demodecosis aggressive diagnostic testing is recommended to rule out underlying diseases that affect the immune system. Thus it is not implausible for juvenile demodecosis that is severe and/or non-responsive to medications, might have underlying disease. Thus basis work up of blood tests, urinalysis and radiographs (plus or minus some other tests - ultrasound, bile acids, etc...) might be very useful.

Also, in any difficult demodecosis case - a dermatologist consult and evaluation is always recommended. However due to your initial statement, I figured you were looking for some other options. I hope this helps.
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Christopher A. Lee, DVM, MPH, Diplomate ACVPM
Preventive Medicine Specialist With a Focus on Immunology and Infectious Disease
myvetzone.com
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