Possible demodectic mange.
Age: 6-12 months
We live in Bangladesh an are unable to obtian decent vet care for my dog. I am positive she has mange and it seems to be getting worse. I have had 2 so called vets to the house to see Chica. The first gave me Amitraz Dip Concentrate along with flee and tick powder. I would soak Chica with a watered down solution of the Amitraz once a week. After the 2nd week she had a siezure which I read was a possible side effect. I called the 2nd Vet who came and said he could give Chica a shot once a week for 3 weeks and that would take care of the mange and to also brush her and apply olive oil to the spots. The mange still persists and seems to be getting worse. What can we do? Can you assist? I can send photos or do a video via Skype. Please advise.
Dr. Marie replied:
Oh, I am sorry to hear that you are having this frustrating problem with Chica. I'd love to see if I can help out as much as I can.
There are two types of mange - sarcoptic and demodectic. Usually dogs with sarcoptic mange will be the most itchy behind the elbows and the hocks and the ears. Dogs with demodex can have bald patches anywhere although the face is the most common. These patches are not itchy unless the dog has generalized demodex in which case the patches get infected. Often generalized demodex will affect the feet.
Sarcoptic mange can usually be eradicated with treatment. However, demodex sometimes needs lifelong treatment. From what you have described it sounds like they are treating for sarcoptic mange. The injection may be ivermectin which is usually good at treating sarcoptic mange.
Where I practice I use a product called Revolution
to treat sarcoptic mange and it works extremely well. It is a prescription product so I don't know if it is available in Bangladesh.
It's possible that there is something else going on as well. There could be a skin infection or allergies or even a fungal infection.
I'd love to see some pictures. I can't officially make a diagnosis online but I can give you my opinion. You can email pictures to ****@***** and I will see them. I will be heading offline shortly but will be back on later and I'll see if I can add some more information for you.
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Dr. Marie replied:
Thank you for the excellent pictures! I have posted one of them here with your question in case it may help others. Chica is a real cutie. :)
If this is mange then it looks more like demodectic mange than sarcoptic mange. Demodex is usually quite easy to diagnose with a skin scraping (all that is needed is a scalpel blade, mineral oil and a microscope - so it should be easy to get a diagnosis.)
Unfortunately if we are seeing this many patches of demodex it is likely what is called generalized demodex as opposed to localized. Generalized demodex can be a lifelong condition.
The shot that the vets are giving is likely ivermectin. Ivermectin is usually effective against demodex. However, I have not heard of giving it by injection to take care of demodex. (It will usually treat sarcoptic mange by injection but not demodectic mange.) Just to be sure I did some research for you and there are only 3 treatments for generalized demodex that are recognized to work.
The first is the amitraz dips but as you discovered they can have some toxic side effects. The second is either milbemycin or moxidectin which are found in some heartworm medicines but need to be given daily and would be extremely expensive, and the last is ivermectin given orally. The ivermectin has to be given daily in order to be effective.
It is also possible that what she has is a bacterial skin infection or even a fungal skin infection. If this were my case I would likely be giving her oral antibiotics for a few weeks as well.
I really hope she feels better soon!