Expert: Jana Connell RVT, CVT - 11/6/2011

Question
does ivomec liquid or the shot form work better for the treatment of sarcoptic mange. What should I dip my dog in? The vet is treating him with ivomec liquid by mouth and atarax. Its been 4 weeks. He never stops itching. Thank you

Answer
You might want to read these articles on sarcoptic mange in dogs:

http://www.peteducation.com/article.cfm?c=2+1589&aid=764

and this one:

http://www.petplace.com/article-printer-friendly.aspx?id=82

These articles will tell you much more than I can. However, it may take more than one treatment to rid your dog of these mites. The intense itching is caused by an allergic reaction to the mites themselves. Antihistamines really don't help much. Make sure he has sarcoptic and not demodex mange.

Be patient and don't skip any treatments. Amitraz is the treatment of choice along with Ivermection. Atarax is only an antihistamine and it probably won't help much.

# Ivermectin at a dosage of 300 micrograms/kg (0.3 mg/kg) given orally twice at 2-week intervals or given 4 times at weekly intervals can be used in some animals to treat sarcoptic mange. Treatment of sarcoptic mange with ivermectin represents an "off-label" use of the drug. Ivermectin should not be used in collies, shelties, Australian shepherds, Old English Sheep dogs. Ivermectin has been reported to cause life-threatening nervous system toxicity in these breeds.

In most dogs with sarcoptic mange, pruritus is reduced by at least 50 percent 7 to 10 days after the first treatment and pruritus gradually disappears within 4 weeks.

# Milbemycin (Interceptor®) at a dosage of 0.5 to 1 milligrams per pound of body weight once weekly for 4 weeks also is an effective treatment for sarcoptic mange. Milbemycin should be used with caution in ivermectin-sensitive breeds due to the potential of similar adverse effects.

# Amitraz (Mitaban®) also is an effective treatment for sarcoptic mange. It is not approved for this use however. To treat sarcoptic mange with amitraz, the drug is applied at the same concentration used for the treatment of demodectic mange (1 vial in 2 gallons of water) and administered as 3 to 4 dips given at 2 week intervals.

Amitraz should be used at 25 to 50 percent strength in toy breeds due to increased risk for toxicity in smaller breeds. Sedation is the most common adverse effect of amitraz. Amitraz should not be used in geriatric or sick animals and in those with diabetes mellitus because amitraz may cause a temporarily high blood sugar level.

# Selamectin (Revolution®) is an avermectin type drug that also can be used as treatment for sarcoptic mange. Selamectin is rapidly and completely absorbed through the skin and is safe for use in ivermectin-sensitive breeds. One treatment is sufficient to eradicate infestation. However, in severe cases a second application may be necessary.

# Bedding should be washed at high temperature or discarded. Vacuuming is recommended to eliminate possible reinfestation.

# Secondary bacterial skin infections are common and may require antibiotic therapy. Superficial bacterial infections often are treated for 4 weeks with antibiotics whereas deep infections may require treatment for 8 to 10 weeks.


Hope this helps some!