Expert: Dr. Louis N. Gotthelf - 3/22/2008

Question
I am treating a couple of pups for demodectic mange.  This service was very helpful
in giving directions on how to proceed.  The pups are looking really good.  I am
almost finished with the duration of their treatment.  

They presented with demodectic at around 2 mos.  This involved a whole litter of 8
pups from a mom rescued.   The mother dog does appear to have some type of skin
disorder.  There is a type of hair loss.  LIke she has thin hair all over but not
baldness.  Her skin looks pretty good.  There are a couple of areas that look slightly
flakey or irritated but nothing serious.  No itching, no infection.   

On the pups It began as a localized form but within three weeks it was spreading.  I
initially thought it might be Sarcoptic mange, the areas on head were raw and
bloody and pups were scratching I was told this is symptomatic for Sarcoptic
mange and treated accordingly but it continued to spread.  I began treating for
demodectic at the time for the second sarcoptic dosing.  After a few days I was
seeing improvement and felt I was dealing with demodectic maybe both I don't
know.

  At that time It seemed  apparent to me  that all of the pups were developing the
generalized form of demodectic mange.   After two weeks there was great
improvement on the two pups in my care but still enough of the demodectic
remained to cause me concern.  I extended the treatment an additional two weeks
after recieving advice to do so.  

I only have two of the pups in my foster care.   They are neutered and have all other
vet work done.   I am trying to place the pups as soon as I know they are good to
go.   I am trying to figure out what I need to do for follow up if anything.     I am
reading some conflicting info regarding scrapings.  Some info recommends
scraping 1 month following the clearing up of all indication of demodectic.   Some
info challenges this saying even dogs that don't have a problem may show
demodectic mange mites in a scraping.  The thinking being that most, possibly all
dogs that nursed have them present on their skin but most dogs do not develop a
problem with it.    

Could you shed some light on this?
Would it be possible to see if it redevelops before taking action?
What are the pros and cons to waiting to see if it redevelops?
Could we follow up with a ivermectin dosing for a couple weeks at the end of the
month?


The treatment was ivermectin.  Based on a dose of 1 cc per 50 pounds.  Take pups
weight divided by 50 pounds gives the amount of a 1cc syringe that I use.  They
have been treated for nearly four weeks.  

Thanks Terri

Answer
Many puppies will self cure as they get to 9-12 months.  Their immunity kicks in and then they are fine.  SOme dogs require lifelong periodic treatment to keep the numbers of mites down so there are not any symptoms. The problem is their decreased function of the immume system, which we cannot measure.