By: Stacey Sheeketski, RPNC Volunteer and Foster
Demodex, or red mange, is a non-contagious form of mange found in dogs and cats. It is caused by live mites that the immune system is unable to control. All puppies have it; most are able to fight it off within the first 6-8 weeks. According to Pets.WebMD.com (http://pets.webmd.com/dogs/demodectic-mange-dogs), around 10% of puppies are unable to keep the disease from spreading. The site also states that 30-50% of dogs under one year of age will recover spontaneously without treatment. Generalized Demodex presents as patches of missing fur on the head, legs, and trunk and sometimes the skin will appear red and be itchy (see Figure 1). In moderate to severe cases, the skin is infected and smells horrible, has open sores, and is extremely irritated and itchy (see figure 2). There are several treatment options, depending on which vet or website you go to, ranging from topical ointments to toxic dips. In our experience, the best treatment (and preventative) is a combination of quality food, medication, and optional supplements.
Figure 1 Mild Demodex case
Figure 2 Severe Demodex case
Demodex is diagnosed with a skin scraping and identification of live mites under a microscope. Along with antibiotics, a common medication used to treat Demodex is Ivermectin, basically a high dose of Heartguard Plus (http://www.1800petmeds.com/education/mange-treatment-dog-cat-9.htm), used for 2-3 months. The recovery is slow, but noticeable after the first couple weeks of treatment. Ivermectin is available in liquid form, which is easily added to the dog’s dinner. It does smell, so adding some canned food or cottage cheese may help picky eaters. The dosage for a 10 pound dog is to start with 1/10 cc every day for a week, then increase the dose to 2/10 cc for a week, then 3/10 cc the third week. For those unable to get to a veterinarian, Ivermectin is available on this site, as are antibiotics: http://www.revivalanimal.com/store/Search.aspx?SearchTerms=ivomec&ajax=. For mild cases, Advantage Multi can be used as treatment every two weeks.
In general, the best processed diet for dogs is high protein, grain-free kibble. This applies even more for dogs with Demodex. Demodectic mites live on systemic yeast, which lives on yeast and sugars (carbs). By eliminating carbs from your dog’s diet, the mites have nothing to feed off of and die. Affordable, quality kibble is Taste of the Wild, found at feed stores, and Nature’s Domain, found at Costco. Wild Calling, found at Petsmart and other pet supply stores, offers a quality high protein, grain-free canned food that can be mixed with the kibble to mask the scent of the Ivermectin. You can also wet the kibble and microwave for a few seconds to bring out the smell of the food.
There is little to no data to confirm the use of supplements as helpful in treating Demodectic mange. As it is an auto-immune issue, boosting the immune system and treating from the inside out is the best. I choose to give fish oil and Vitamin E supplements. Other people add Vitamin C and other immune system boosters. An oatmeal bath twice weekly seems to soothe the affected areas (recipe below). Some people also give probiotics or mix plain yogurt with food, although you might want to watch the yogurt, as that feeds yeast.
¼ cup coconut milk
1/3 cup Dr. Bronner’s or other chemical-free soap
¼ cup oats
Mix together and massage onto affected areas or use as soap for a complete bath. Store in an air-tight container, keeps up to 4 weeks. This makes a good dog soap, with or without the oatmeal, for general bathing as well.
Although it has been used for years, we discourage the use of mitaban (basically a chemical dip). Some vets still use this course of treatment, but it has the worst side effects (including transient sedation, anorexia, personality change, bloat, and fatality) and hasn’t been proven to be more effective than other treatments. The fact that the warnings on the label advise you to wear rubber gloves, not inhale the fumes, wash hands thoroughly after, and not touch pets after use is enough for me to never use it on my dog. It is toxic to cats and is recommended for use in dogs over 4 months old. (http://www.drugs.com/vet/mitaban.html)
An old wives tale is to treat demodectic mange with motor oil. Not only is this inaccurate, it is extremely damaging to the dog. According to DogSkinTreatments.com, “When a dog absorbs the oil through the skin, it penetrates the body and affects the internal system as well. Obviously, this causes a whole new host of problems, such as drastic changes in the blood pressure, as well as severe kidney and liver damage.” After licking themselves and biting at irritated skin, as dogs, do, consumption of the motor oil can cause vomiting, bringing the motor oil into the lungs, causing pneumonia. Motor oil of today has a different chemical makeup than 50 years ago, when sulfur was present enough to kill the mites. (http://dogskintreatments.com/does-motor-oil-really-help-against-demodectic-mange/)
There are many topical treatments on the market that say they will cure demodectic mange. As with other treatments, there is no data to show that one is more successful than another. Sometimes one treatment isn’t effective, so another is tried. Sometimes people add supplements and others don’t. Some dogs respond to one treatment over another and some dogs heal faster than others.
Demodex is a pain, but easily conquered. The recovery can take months and some dogs always struggle with it. Many shelters will euthanize a dog that comes in with Demodex due to the time it takes to treat and a lack of resources to provide quality food, frequent chemical-free baths, and supplements. Quality grain-free food and staying active are the dog’s best defenses to heal from and prevent Demodex.