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All Pet Care Hospital
1453 Sunset Point Road
Clearwater, FL 33755
Phone: (727) 442-9111
Fax: (727) 446-6670
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Mange in Dogs
“Doc, we looked online and saw pictures of mange. We’re so afraid this is contagious red mange and all our other dogs are going to get it,” said the American Pit Bull Terrier, Hailey’s mom.
Demodex & Sarcoptic Mange
You may have read many websites that describe mange and you’re more confused than ever. First, go to a veterinarian. A simple skin scrape cytology test will find demodectic mange, or demodex. Demodex is a cigar-shaped long, thin insect too small to see without a microscope. It is believed to be passed from mother to puppy during birthing. After that original transmission, it is not contagious!
Demodex: Easy to find, Difficult to treat
Sarcoptes: Hard to Find, Easy to treat
The other dog mange is sarcoptic mange, also called “red mange” in some parts of the United States. Sarcoptic mange is a fat little round insect too small to see without a microscope. It is highly contagious between warm-blooded animals. It lives deeper in the hair follicles of the skin and only comes to the surface 25% of the time when a skin scrape cytology is performed.
Any attack on the skin will irritate and change the skin. Redness, heat, pain, and swelling are the body’s hallmarks of inflammation. Whether an insect, like a flea or mite, bacteria, fungus, or yeast attacks the skin, the damage will look similar. Any of the infections can mimic each other, because they are attacking the same skin system. Tests performed by your veterinarian, along with experience, and the tenacity to look for typical signs and patterns will nail the diagnosis for you.
One last thing to remember: just because you think you know what is wrong with your puppy, the battle doe not end there. Hailey’s mom figured her skin was sore from fleas. And it was. But she did not seek help for over three weeks. During those weeks, the sore skin allowed the demodex to grow and bacteria to set in. A smaller problem grew much more complicated because of the delay.
Typical Patterns
Clown Face of Demodex
Usually, demodectic mange starts as a “clown face” look of baldness around the eyes. Sometimes even conjunctivitis for no reason at all is the first sign that the demodex is at the edge of the eyelids and bothering the puppy. That’s what happened to Hailey.
“The animal shelter gave her ointment for conjunctivitis.”
“Did she have an upper respiratory infection?” asked Doc Truli.
“What do you mean?”
“Has she had any sneezing or coughing?”
“No. not at all,” said Hailey’s mom.
That’s strange. Any time something doesn’t “fit,” Doc Truli is suspicious that we don’t have the picture. Puppies usually do not get conjunctivitis for no reason. She could have been stressed, or been in a dirty environment before the shelter. Or she could have hidden demodex on the edges of her eyelids, where we can’t perform the skin scrape test.
Any time something doesn’t “fit,” Doc Truli is suspicious that we don’t have the whole picture.
Doc Truli advised Hailey’s parents to watch for baldness or thinning of the fur. Sure enough, 1 week later, she returned with demodex lesions showing all over her face and legs.
Bald Tops of Paws and Toes
If your puppy’s toes are bald on the tops of the knuckles, get checked for mange. But what about older dogs? Juvenile demodectic mange is common. After the age of 1 1/2, it is very unusual for a dog to develop demodectic mange for the first time. This demodectic mange is called adult onset. Adult onset mange indicates a problem with your dog’s immune system. Your veterinarian can check for hypothyroidism and can evaluate your dog’s history for allergy patterns which would suppress the immune system and allow mange to grow.
Mange in Unexpected Cases
Doc saw a 5-year-old German Shepherd Dog with an open, bleeding skin infection at the base of his neck, in between the shoulder blades. The Shepherd already finished two powerful and long courses of antibiotics. Why didn’t the antibiotics work?
Proper Skin Diagnostic Tests
- Skin Scrape Cytology – find and count mites & fungus deep in the hair follicles
- Skin tape Cytology – find and count bacteria & yeast colonizing the surface of the skin
- Dermatophyte fungal culture – make sure there’s no zoonotic, contagious ringworm fungus
- Check those ears! After all, the ear canal lining is just special skin in a sunless damp hole in the head!
A skin scrape cytology test revealed demodex mange mites mixed with the infection. Mange mites and bacteria work together to alter the pH acid-base balance of the skin and they release enzymes to make each other happier. So, if you treat the bacteria and not the mange, then the problem never cures. Once the Shepherd received treatment for both the infection and the mites, his sores went away and he felt comfortable again!
Demodectic Mange Treatment
Demodex is considered a normal commensal on dog skin. This means that some demodex is natural and does not cause disease. Anything that is natural, but growing out of control, is far trickier to control than an unnatural, foreign invasion infecting the skin – like sarcoptic mange.
Demodex takes a minimum of 6 weeks and a maximum of up to a year or longer to control, or cure.
Treatments for Demodectic Mange
- Treat bacterial infections
- prescription medicated shampoo
- systemic antibiotics
- Support nutrition and healing
- Good quality dog food
- Omega 3 Fatty Acids & Vitamin E (ask for Vet Rx)
- Kill demodex
- Only FDA approved treatment: Mitaban dips
- “Off-label” treatments:
- Oral daily ivermectin
- Promeris topical drops
- daily milbemycin (Interceptor brand) tablets
Hailey’s system did not take well to the prescription FDA-approved Mitaban dips. She experienced lethargy, vomiting, and some diarrhea. She switched to Promeris topical dewormer and felt much better. So far, she is 2 weeks into treatment and you can see in the slide show, her fur is starting to fill in!
More Reading About Dog Skin Diseases
VirtuaVet’s: Gigantic, red, bald, angry, sore Hot spot
VirtuaVet discusses Allergic skin disease
Obese Chihuahuas Live Shorter Lives
(Not just Chihuahuas, all dogs!)
Every day Doc Truli hears someone say, “He’s so cute fat like that!” Is this some form of reverse Anorexia by Proxy? Do people think a dog or cat or child is cuter fatter because they have a body dysmorphia projecting onto the pet or the child? Sure seems like it!
Then there are the people that judge every dog they see on a walk,”Oh, look at that, what a shame. He’s just too thin!” They are rarely right!
Fact is, thinner dogs live 2-4 years longer than their calorie glutting fat friends.
Which Chihuahua is Normal?
Surprise! 1 is obese and two are normal. The obese Chihuahua is 50% overweight. He weighs 16 pounds and he should be 8 pounds. He eats 100% extra calories each day. Probably in canned food, or treats and semi-soft chews that are unregulated. Imagine this: most treats are about 30 calories each and an eight-pound chihuahua should eat maybe 250-300 calories per 24-hour day (depending on athleticism.) So 10 treats is already enough calories. Unfortunately they are “empty calories.” All calorie and no nutrition.
Does this help you rethink why your dog might be fat?
Doc Truli Was a Puppy Pusher
Years ago, yours Truli was puppy pusher. Yes, Doc Truli admits, she worked in a pet store that was also a veterinary clinic, grooming parlor, and boarding facility. She also worked in Lancaster County, Pennsylvania. Arguable, the puppy-mill capital of the American East. Doc has an insider’s perspective. read more…
How Can You Get a Fat Cat to Eat Better Food and Less Food, Especially in a Multi-Cat Household?
Is It Bad for a Cat to be Fat?
Ralph was obese. The 24-pound striped tabby cat tipped the scales. His blubber overflowed the bucket scale, and we weighed him on the dog scale.
50% of pet cats and dogs are obese in the United States, following the lead of their humans. This fat shaves 2-4 years off of the cats’ lifespans. Arthritis, intervertebral disc disease, asthma, heart disease, diabetes, and pancreatitis abound in the US feline population. read more…
Doc Truli at Dogtoberfest, Dunedin, FL, USA 2010
All Pet Care Hospital and Doc Truli contributed to the Suncoast Animal League Third Annual Dogtoberfest Charity Event 2010 in Highlander Park, Dunedin, FL, USA. Surprisingly, Doc Truli was the only veterinarian on hand at the event to answer pet questions! Our “Ask the Doc” table located next to the food, was a hit! At least 3,000 people attended the event, and I’ll tell you how I know that in a minute.
Let’s Stump the Doc
Many people stopped by to meet Doc Truli or to chat, but a few people actively attempted to “stump the Doc.”
“My vet said my dog’s cruciate ligament is ruptured and he must have surgery, what do you think?”
The second knee is likely to go in the next year.
“I can’t get rid of fleas, is there anything new on the market?”
Comfortis pill for dogs, labelled organic
“How do I keep my Chihuahua from getting carsick?”
Ginger root. ”What’s that?” Dramamine II “Harrumph, I don’t like drugs.” “Acupressure point on the inside of the front leg just above the wrist. “Are you crazy?” Okay, what answer were you looking for?
“What do you think this lump is? My vet tested it yesterday, but the results aren’t back yet?”
Don’t know. Glad you got it tested. Wait and see!
“Do you take care of Chinchillas, too?”
Yep.
Doc Truli’s favorite question that usually stumps dog parents?
“What kind of food do you feed your dog?” An uncomfortable silence follows. The color of the bag and the word “natural” come up. But that’s usually about it! How embarrassing. Happens (almost) every time! read more…
Diagnosing an Allergic Pet Takes Medicine and Sleuthing
Work with your veterinarian to figure out your pet’s allergies. If more than one pet in your household is allergic, do not become discouraged, about 50% of American pets are allergic. It is probably not a poisonous horrible thing you did to your pets, it’s probably just that they are related by family, breed, or they are all in the affected 50%!
If it seems like your veterinarian wants to run a million tests, this checklist can help you keep track of the tests, and maybe reassure you that all the investigation is needed!
“I check the general health of a patient first, because back health or a disease and make allergies worse,” says Doc Truli. ”Then we ‘control the controllable’ with a food elimination diet, and give nutritional supplements to see if the allergy resolves. Then we go into excluding common skin diseases and then finally, allergy testing and treatment.”
Pet Allergy Investigation Checklist
- Thorough, thoughtful physical examination
- Perfect flea prevention and treatment if present (If you can do this yourself, you may save a vet visit! 50% of pet dermatology specialist appointments turn out to be a flea problem!)
- Most allergic pets have secondary skin infections that need to be treated so we can see what the condition is like when only the allergy is present
- skin scrape cytology for mites (mange)
- skin tape cytology for lice and yeast and bacterial counts
- ear cytology for concomitant otitis (very common with skin problems)
- CBC, Chemistry, Thyroid screening test, fecal parasite exam, heartworm test, for cats feline leukemia and feline aids test
- Try Omega 3′s and Vitamin E
- Allergy Elimination Diet (8-12 weeks). See VirtuaVet’s Detailed article on how to perform the food trial at home.
- Lyme-sulfur dips in case of hidden mange or infections tests did not identify (tests are not perfect).
- Skin surgical biopsy (usually tiny samples, can be done in non-sedated patient… usually.)
- allergy blood serum tests and/or allergy skin testing (usually does require sedation, shaving the sides, and a dermatologist to correctly interpret the results.)
Your veterinarian will help you treat any secondary yeast, mite, or bacterial infections. Your pet may need anti-itching oral or topical medication for comfort while the investigation takes the necessary months to complete. If you discover another condition, such as hypothyroidism, get it treated. Sometimes the body just needs some balancing in order to handle the allergies itself.
Next time on VirtuaVet: Are Common House Product Scents setting off your pet’s allergies?
Q: Why can’t I just use an anti histamine?
A: Only 10% of cats or dogs respond to antihistamines.
Some Pets Suffer In Spite of Your Best Efforts
Doc Truli came across a scientific report that might explain why some pets are still itchy and miserable after all of your best efforts.
Maybe you have tried the allergy diet trial. Maybe you cook for your pet. Maybe your cat is ripping her fur out and still itchy after seeing the dermatologist several times. Maybe you’ve done the gammit of allergy investigation and treatment. Maybe your veterinary behavior specialist has tried 3 or 4 drugs on your pet thinking that he or she is “crazy.” Maybe your dog only feels okay if he takes daily prednisone, and you cannot fathom why he’s still allergic. read more…





































































