Demodicosis, or demodectic mange, is caused by an overpopulation of the Demodex mite. Demodex mites are naturally present in the hair follicles of dogs, as they are passed from mother to puppy during nursing and cuddling in the first few weeks of life. Most dogs live their entire lives without incurring any problems from the mites, but some dogs may have stress or immune system issues that allow the mite population to flourish. This can cause dry, scaly, severely itchy skin, which is known as mange. There are many treatment options of varying cost and effectiveness.
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Ivermectin
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Ivermectin is an anti-parasitic drug that is effective against a wide range of parasites, including the Demodex mite. Although it is not FDA approved to treat demodectic mange, it is the treatment of choice because not only is it inexpensive, but a relatively short series of injections tends to clear the condition quickly. Many herding breeds are predisposed toward an ivermectin sensitivity that can be potentially dangerous, so these dogs must rely on an alternate mode of treatment.
Amitraz
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Amitraz is the main ingredient in Mitaban dip, the traditional mange treatment. It is a topical medication, applied to the entire body with a sponge, almost like a bath. The medication is allowed to air-dry on the skin, which ensures sufficient contact time and deep penetration into the follicles. According to Mar Vista Animal Medical Center, Mitaban dips can be up to 80 percent effective when used weekly at double strength, but this may not be safe for very small or very young dogs.
Milbemycin Oxime
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Milbemycin oxime is the active ingredient in Interceptor monthly heartworm preventative, which has been used successfully to treat demodectic mange. It is a pill that can be given orally at home instead of an injection, and it isn't messy like a dip. The only disadvantage is that it can be prohibitively expensive---these pills are sold in packs of six, and mange treatment involves giving a pill every single day for several months.
Benzoyl Peroxide
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Benzoyl peroxide is a popular treatment choice for localized mange, where only a small area needs to be treated instead of the whole body. A benzoyl peroxide gel applied to the affected area daily can show dramatic improvement, especially when combined with frequent bathing with a benzoyl peroxide shampoo. In fact, dogs being treated with Mitaban dips are usually bathed with a benzoyl peroxide shampoo beforehand to help open the pores for more effective treatment.
Rotenone
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Rotenone, sold as Goodwinol ointment, is the traditional treatment for localized demodectic mange. Applied to the affected area once or twice daily, it can produce satisfactory results in many cases. It is an inexpensive treatment choice, and is often the starting point for treatment, especially in ivermectin-sensitive dogs.
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