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Old February 9th, 2009, 08:51 PM
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What is the corrrect dosage of Ivermectin for treatment of Demodex mange?

Hi I've read a lot of posts on here about mange and gathered a lot of good info, but I have a question about the dosage of ivermectin when treating demodex.

Our 18month old 10 pound min pin was just diagnosed with Demodex (skin scrapings were done). The vet gave us Ivomec (Ivermectin) to treat her. I am worried that eventually the dosage will be too high. Our instructions from the vet were to start her out on 1/10 cc everyday for the first week. During the 2nd week, we are to give her 2/10 cc everyday. During the 3rd week, we are to give her 3/10 cc everyday and continue until the medication is finished. Does this dosage sound too high during the 2nd and 3rd week? The vet also didn't say how long to continue the treatment. He just said to come back in May. Also, is there any kind of topical ointment that we can put on the spots with hair loss during the ivermectin treatment? Possibly Goodwinol ointment? I'm just really worried about her condition and I feel helpless. I don't want to watch her suffer so I'm searching for any valuable insight or information. I thank you all in advance...I'm a worried mom! :sad:

Oh, I should also mention that we aren't supposed to start the ivomec until March 1st since I gave her revolution on Feb. 1st.

Last edited by Bh1980; February 9th, 2009 at 10:14 PM.
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Old February 9th, 2009, 08:55 PM
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Welcome to the board, Bh1980.

I'll PM Dr Lee for you (you won't be able to PM for a while yet) and he'll be here soon to answer your questions.

How extensive are the lesions?
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Old February 9th, 2009, 10:06 PM
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Wow, thank you so much for such a fast response. The lesions aren't that bad yet. The worst one is on her side, but it isn't pussing or anything. It's just a dry white patch. She has another small patch on her back and chest. Then there are two medium patches... one on her rear foot and another under her front leg (arm pit area). I've attached pictures.

I went to the pet store tonight and bought her some immune system vitamins. I think I have her on a pretty good food and she's been on it for about a year (small breed blue buffalo which is a natural food) however, I'm open to other suggestions. She doesn't like canidae and I can't find orijen in my area. I'm just trying to do the best for her and I've read that a quality food is essential in the treatment of mange.

Again, thank you sooo much for the help. It really means a lot! I'm stressing out!
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Old February 9th, 2009, 10:21 PM
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No stressing. Uh-uh...not allowed.

Seriously, though, she'll pick up on your stress and you want to keep her as stress-free as possible. Much harder to do than to say, of course... I remember how stressed we were when Macie had her case of demodectic mange.

Check with your vet (or Dr Lee) on whether using Goodwinol is safe if the dog is on Ivermectin. We were fortunate enough with Macie that we didn't need the Ivermectin. A good diet with omega-6 supplements, along with stress reduction and daily application of Goodwinol to the lesions was enough to get her healed up.

Other than the mange spots, her coat looks beautiful! I don't suppose you have any pics of her lovely face to share?
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Old February 10th, 2009, 08:37 AM
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Ok, I'm going to try and not stress out! Never thought about her being able to tell. I always new dogs could sense stress, but I guess I just didn't think about it in my situation. Usually I'm not a very stressed out person, thankfully!

Yes, I do have pictures of her face! Way too many, some would say! Here are a few: one as a little pup, one from over the summer and one at a Halloween contest.

BTW, your dogs are beautiful. I checked out your webpage.
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Old February 10th, 2009, 09:06 AM
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Oh, Java is a doll!!!! She looks like a happy little girl! Thanks for posting the pics!

And the Pack thanks you for the compliment
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Old February 10th, 2009, 09:18 PM
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Quote:
Originally Posted by Bh1980 View Post
Our 18month old 10 pound min pin was just diagnosed with Demodex... Our instructions from the vet were to start her out on 1/10 cc everyday for the first week. During the 2nd week, we are to give her 2/10 cc everyday. During the 3rd week, we are to give her 3/10 cc everyday and continue until the medication is finished. Does this dosage sound too high during the 2nd and 3rd week? The vet also didn't say how long to continue the treatment. He just said to come back in May. Also, is there any kind of topical ointment that we can put on the spots with hair loss during the ivermectin treatment? Possibly Goodwinol ointment? ...
Good questions. I am sorry that you did not get your information answered at the office. Hopefully I can help.

Let me start with the dosing question first.

Dosing according to Plumb's Drug Handbook:
Typical dose is 400-600 mcg/kg by mouth every 24 hours.
10lbs is 4.55 kg. Thus the daily dose is 1820 to 2730 mcg.
Typical ivermectin is 10,000mcg/ml
Thus the typical dose is 0.18 to 0.27 cc by mouth every 24 hours.
Some doses can go higher so I don't have a problem with 0.3 cc by mouth every 24 hours.

Your vet is actually being very conservative with the increasing of dosing. I would typically have you start low (subtherapeutic) and increase daily, not weekly until I got you to the actual treatment dose and then maintain until clinical signs resolve. I usually start at 1/4 or 1/5 of the dose and increase to a maintenance dose at day four or five.

So I think you vet is doing just fine. I might have stopped at 0.2 or 0.25 depending upon the case but I think 0.3 is just fine. Again: I am basing this of information of a healthy 10 pound non-ivermectin sensitive pet with a confirmed dose of demodex with a typical oral ivermectin medication.

Why the scare about ivermectin? There are some pets that cannot deal with ivermectin. If they cannot, a standard dose can lead to severe neurologic signs such as blindness, disorientation, coma and death. While we think of working breeds or dogs with "white feet, don't treat" as the only dogs not being able to handle ivermectin - any dog can have this problem. It has been identified as a mutation in the MDR1 (Mult Drug Resistance) gene. Washington State University does testing for $70. Owners can obtain a test, perform an oral swab and get results fairly quickly. Here is the website: MDR Testing Information.

Why step up incrementally? For dogs that are not suspected of having a problem with ivermectin, this is a relatively safe and effective way of 'testing' your pet. If they have a problem with ivermectin, then they will show clinical signs at the lower dose. The 0.1cc dose is not enough to treat demodex in a 10 lb dog but enough to typically show clinical signs if they are sensitive. If we started at a dose that would treat the demodex at 0.3cc and the pet had ivermectin problems - we would be a dose that could lead to serious life threatening problems.

How long to treat? Textbook is to perform weekly skin scrapings and continue treatment until there have been two negative scrapings. This is often very expensive for owners. It is common to continue until clinical signs have resolved and possible scrape at that time. Typical treatment courses will last 2 to 4 months.

Goodwinol Ointment? For single local spots of demodex, goodwinol is my treatment of choice. If we see generalized demodex (more than one spot), then ivermectin is currently the 'treatment of choice'. Goodwinol ointment at the same time will not necessarily increase response time.

Additional ointments or supplements? I do recommend Omega 3 fatty acids (fish oils) for demodex cases. (alright, I admit, I think I recommend this for many, many pets... ) I also think conditioning sprays, creams and shampoos can help with dryness.

Final note: Thanks hazelpackrun for the tip on this thread.

I hope this helps.
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Old February 11th, 2009, 12:21 PM
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Red face Thank You!

Dr. Lee, thank you so much for your response. I feel better now. I will start the ivermectin March 1st and hopefully we will get good results.

Hazelrunpack, thank you for help also! I really appreciate you PMing Dr. Lee for me!

Hopefully, I can report some good news soon!
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Old February 11th, 2009, 01:56 PM
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We'll be waiting for a good report! And more pics, of course!

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Old May 9th, 2009, 11:26 PM
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Thank you! The mange is gone!

HazelRunPack & Dr. Lee, Just wanted to say thank you again for your help and advice regarding Java's demodex mange. It's been 2 months and I'm happy to say that I think the demodex is gone! Java shows no signs of having it. No itching, no hair loss, nothing. I haven't had her retested, but I'm almost positive its gone. I did not give her the Ivomec. I just didn't feel comfortable. I started giving her immune system vitamins and fish oil with her wet food. We also gave her a bath twice a week for 10 minutes with Virbac Pyoben Shampoo from the vet. Every few days I also applied NuStock. Don't know if that worked, but I passed the tube on to a friend and it's working on scars/hot spots for her german shep. So THANK YOU for your help!! I just hope it doesn't come back!
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Old May 9th, 2009, 11:41 PM
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That is awesome!! YAY! I bet your pupper is much happier!!! I am SO happy that we have never had mange in any animal.. my parents cat had ear mites but we have not had it! fingers crossed..

I have a friend that treats her dog's ear mites with the ivomec horse de wormer... serious..
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Old May 10th, 2009, 02:40 PM
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That's great news, Bh1980!! Thanks for the update!

As I understand it, once the immune system gets strong enough to fight off an initial bout of demodex mange, it's unlikely to be a problem again. So that Java is out of the woods and will have no further trouble!

Ummmm...got any more pictures? yep...my name is hazel and I'm addicted to pictures
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Old May 12th, 2009, 04:07 PM
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Of course I have more pictures! I think 98% of the pictures on my computer are of my furkids! Here are a few.

Thank you again for all your help!
~ Brittany
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Old November 15th, 2009, 05:29 PM
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Hello!

I have an 8 1/2 months old pitbull puppy with dmodex, My vet had been giving him an ivermectin shot once a week whilst I bathed him once a week in some medecated shampoo along with tactic dip.

I was informed my a 3rd party that i'd save alot of money by getting and issueing the ivomec myself considering I was paying like $3o a visit and that I have five other dogs and I have to constantly but heart gaurd, I was also told that I could just use the ivomec as a substatute to the heart gaurd.

So firstly I want to know how much and how often I should give the demodex puppy the ivomeec. judging by the earlier case here it would seem like roughly 0.3 ml for every 10 lbs. My problem in going threw with that is what is on the ivomec box, 1cc to 110 lbs for a cow! My dog is 45 lbs so 0.3 x 4.5 is over a cc. can dogs take ivomec better than bing meaty live stock or im I doing something wrong?

lastly, What should the monthly dosage be for my other dogs?
95 lbs
55 lbs
40 lbs
65 lbs

weights rounded to closest five from last weighings.

ps. sorry for crappy spellingz.
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Old October 22nd, 2012, 09:21 PM
fez757 fez757 is offline
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do you have to dilute ivomec 1percent to give this treatment
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Old October 22nd, 2012, 11:38 PM
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We're not vets here for the most part, fez757. I strongly suggest you speak to a vet about the proper dosage for your dog and to make sure you have the proper form of Ivomec. A vet will also be able to give you information on the risks of the medication--some breeds of dogs tend to be sensitive to ivermectin, and administration of the drug can lead to death in affected individuals.
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Old April 16th, 2013, 12:51 PM
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WOW! Sad to say the dog I was talking about had so many problems other than demodex that I had to put him to sleep. I'm here hitting up google once again because demodex has struck me a 3rd time...............funny I'm not an expert by now. I had no intention on asking any questions because obviously I did not get a response the last time I asked. but scrolling through the comments I saw my name and I was like I dont believe it. I don't even remember signing up for this forum. I realize the vet that commented here answered the dosage question but I'm too slow to follow all the different measurement terms. and in 4 years my math hasn't gotten any better....................well, until 2017 I guess Bye yall!
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