Veterinary World 2011, Vol.4 (1):41-44 REVIEW An Update on Therapeutic Management of Canine Demodicosis b

Canine demodicosis is a common noncontagious parasitic dermatosis caused by different spp of Demodex mites including Demodex canis, Demodex injai and D. cornei. Generalized demodicosis can be one of the most frustrating skin diseases, one will ever treat. Conventional and newer miticidal therapies are available to veterinarian to treat this frustrating skin disease. All recognized Demodex mites in dogs appear to respond similarly to mite targeted therapy. Treatment for canine demodicosis includes amitraz, ivermectin, milbemicin oxime, moxidectin, and doramectin. The use of any glucocorticoid-containing products is contraindicated and could favour disease generalization. Conventional treatments will often appear to work however, but it relies heavily on a highly toxic method of treatment. Using natural remedies for mange, on the other hand, can enhance the dog’s immune system, so that the body can fight off the mange mite infection by itself.


Introduction
Therapeutic approach

Treatment of localized canine demodicosis
Canine demodicosis is a common noncontagious Juvenile-onset localized demodicosis resolve parasitic dermatosis caused by overpopulation of the spontaneously within one or two months in most dogs.host-specific follicular mites of various Demodex Thus, miticidal therapy is not required unless the species.Dogs have three recognized species of disease generalizes.By not treating localized cases Demodex mite; clinically majority of cases of canine with miticidal therapies, dogs developing generalized demodicosis are caused by Demodex canis.The disease can be identified and eliminated from breeding Demodex canis mite is part of the normal cutaneous programs given the genetic basis for this disease.flora of dogs.This mite is limited to the hair follicle Furthermore, mite-specific therapy has potential side and, rarely, the sebaceous gland.Number of mites is effects and presents an unnecessary risk in patient with kept low by a dog's immune system.The newly potentially self curing disease.observed species of Demodex mites have led to the Localized demodectic lesions may benefit from identification of additional patterns of clinical disease.Demodex injai, the large body Demodex species mite, topical antimicrobial agents such as mupirocin, is larger in all life stage than Demodex canis (Desch benzoyl peroxide, chlorhexidine, or ethyl lactate when and Hillier, 2003).These mites tend to reside within secondary pyoderma is present.The use of any glucocorticoid-containing products is contraindicated the sebaceous glands.Cases of the D. injai infection and could favour disease generalization.A clinical are associated primarily with dorsal seborrhea dermatitis (Bensignor et al., 2006).A newly identified examination with skin scraping two to four weeks after short bodied Demodex species mite has been initial diagnosis is indicated to monitor for disease tentatively named Demodex cornei.Unlike the other resolution and progression.

Treatment of generalized canine demodicosis canine Demodex species mites, D. cornei can reside in
Generalized demodicosis can be one of the most the most superficial layer of the epidermis.It is 50 % frustrating skin diseases, one will ever treat.Premature shorter than the other form of D. canis (Tamura et al., treatment cessation by owners is a central reason for 2001).The clinical signs and treatment of D. cornei so treatment failure.Since clinical signs often improve far appear to be similar to those of D. canis.
before parasitological cure, owners should understand Conventional and newer miticidal therapies are the need for regularly scheduled follow-up visit to available to veterinarian to treat this frustrating skin ensure a successful outcome.disease.
Antibiotic therapy for pyoderma use macrocyclic lactones instead of extralabel amitraz.Superficial staphylococcal pyoderma is treated Amitraz collars are not recommended for treating empirically by using a beta-lactamase-stable demodicosis (Mueller, 2004).antibiotic for a minimum period of four weeks.Amitraz dips are not without risk to dogs and Adjunctive topical therapy with an antibacterial their handlers.Many patients experience mild shampoo may hasten clinical resolution.Common toxicosis seen as excessive lethargy for one or two antibacterial shampoo ingredients include benzoyl days after dipping (Gortel, 2006).More overt signs of peroxide, chlorhexidine, and ethyl lactate.Benzoyl toxicosis are similar to those of seen with use of peroxide-based shampoo are often recommended alpha2-adrenergic agonists, including sedation, because of their keratolytic and supposed follicular hypothermia, bradycardia, and hyperglycemia flushing activity (Scott et al., 2001).Antibiotics (Hugnet et al., 2001).Hyperglycemia is a potential should only be recommended on the basis of cultural concern in diabetic dogs as well as in clients.The use and antibiotic sensitivity test.
of alpha2-adrenergic antagonists can reverse signs of

Miticidal therapy
toxicosis and can be used before dipping in patients All recognized Demodex mites in dogs appear to with a history of adverse effects.Atipamesole (50µg/ respond similarly to mite targeted therapy.Treatment kg intramuscularly) can reverse the signs of toxicosis failure is rarely due to resistant mites.More frequent within 10 minutes (Hugnet et al., 2001).Avoid of treatment failure in canine demodicosis include antidepressants and MAO inhibitors, such as poor pyoderma control, premature discontinuation of selegiline, in dogs receiving amitraz.Animal handlers therapy, unsuccessful control of underling conditions, administering amitraz should wear protective clothing and the use of concomitant glucocorticoids.However, and apply in a well ventilated area.Personnel should if a patient dose not responds to the initial miticide, one be aware of potential risk for drug interactions.Those should switch to another treatment option (Mueller, with respiratory problems or diabetes should not use 2004).
amitraz (Avsarogullari et al., 2006).A new spot-on According to reports of earlier workers formulation containing metaflumizone and amitraz treatment for canine demodicosis includes, amitraz, can be used as a topical treatment for generalized ivermectin, milbemicin oxime, moxidectin, and demodicosis in dogs older than 1 year of age (Fourie et doramectin (Mueller, 2004;Dimri et al., 2009).Earlier al., 2007).workers found evidence that ronnel, lufenuron, and Macrocyclic lactones levamisol should not be used to treated canine Macrocyclic lactones include the avermectins (Mueller, 2004).Because of the safer therapeutic (ivermectin and doramectin) and milbemycins options available, organophosphates should not be (milbemicin oxime and moxidectin).This class of used to treat demodicosis.
drugs selectively binds to glutamate-gated and Amitraz gamma-aminobutyric acid (GABA)-gated chloride Topical amitraz is FDA-approved for treating cannels in the mite's nervous system, resulting in cell generalized demodicosis in dogs older than 4 months hyper polarization, mite paralysis, finally death. of age.Amitraz, a miticide and insecticide, is a Macrocyclic lactones do not readily cross mammalian monoamine oxidase inhibitor (MAOI), prostaglandin blood-brain barrier (Macdonald and Gledhill, 2007).synthesis inhibitor, and an alpha2-adrenergic agonist Safety in mammals is due to the lack of glutamate (Mueller, 2004).Amitraz liquid concentrate is to be gated chloride channels in the peripheral nervous used as a 0.025% (250ppm) dips every two weeks for system and restriction of GABA to a central nervous three to six topical treatments until no live mites are found.All dogs cannot be cured with amitraz system.Ivermectin administered as per the label protocol.Consequently, For generalized demodicosis, the injectable investigators have found greater cure rates by using form of ivermectin should be given orally at a dose of various regimens of increased dip concentrations or 300 to 600µg/kg/day (Mueller, 2004).The aqueous frequencies.Overall, topical amitraz at 0.025% to formulation may be more palatable than are propylene 0.05% every seven to 14 days is recommended.
glycol-based products.Adverse events are sporadic Pododemodicosis and demodectic otitis can be and include lethargy, edematous wheels, mydriasis, treated with an extra label mixture of amitraz and muscle tremors, and ataxia.The main concern is mineral oil (1:9), although this mixture may irritate the development of signs attributed to sever neurootic epithelium in some individuals.If label protocol toxicosis including depression, stupor, coma, ataxia, proves to be ineffective, it may be more acceptable to mydriasis, tremors, emesis, drooling and seizures; milbemycin oxime administration are similar to those death can also result.Blindness has also been reported of ivermectin and include depression, stupor, coma, in dogs (Kenny et al., 2008).
ataxia, and seizures.The major limitation of this drug The better identify ivermectin-sensitive dogs, is expense.

one report recommended initially dosing ivermectin at
Moxidectin given orally at 400µg/kg/day may be 50 µg/kg/day and then incrementally increasing the effective in treating generalized demodicosis.dose by 50µg/kg during the first days of treatment Moxidectin can be used at a lower dose and then until the target dose is achieved (Mueller and Bettenay, gradually increased to 400µg/kg/day similar to 1999).Another way to gradually increase the dose of ivermectin (Wagner and Wendlberger, 2000).ivermectin is to calculate the target dose and Doramectin is another avermectin, can be used at corresponding volume, and then give 25% (day 0-2), 600µg/kg/week subcutaneous injection (Dimri et al., 50% (day 3-5), 75% (day 6-8) and 100% (day 9+).The 2009; Johnston, 2003).This drug should not be used in pour-on formulation of ivermectin is not effective in ivermectin sensitive breeds of dogs.treating generalized demodicosis (Mueller, 2004).

Signs of ivermectin toxicosis can occur
Conventional treatments will often appear to inspective to any breed but are most common in work however, but it relies heavily on a highly toxic ivermectin sensitive breeds such as collies and other method of treatment.Using natural remedies for herding breeds (Hopper et al., 2002).There is no safe mange, on the other hand, can enhance the dog's specific antidote for ivermectin toxicosis.Initially immune system, so that the body can fight off the following an oral exposure the focus should be on mange mite infection by itself.Natural remedies such ivermectin removal; activated charcoal and saline as nutritious foods, herbs and other supplements can cathartic can be used.Symptomatic and Supportive be used to treat the skin problem topically.Lots of raw care can help the majority of intoxicated animals.
dark leafy vegetables like broccoli, watercress should Treatment could be prolonged (days to weeks), be added to diet which help in quick recovery from intravenous fluids, pads, turning affected animals to demodectic mange.Raw foods increase the prevent pressure sores and treat possible bradycardia.
antioxidents as these are crucial at this time for the Picrotoxin has been proposed as a specific antidote.
immune system.Because antioxidants minimize There are some reports of using picrotoxin to treat damage to cells, they are useful whenever disease is ivermectin toxicosis.It is generally titrated to effect.
present and immune support is needed.Adding dietary Picrotoxin is a potent GABA antagonist that causes an supplements is also important to help relieve the dog's increase in the excitability of neurons in the CNS itch and improve his skin conditions.Fish oil provides which leads to convulsions.Seizures caused by omega-3 fatty acids and can be very effective in easing picrotoxin administration may be treated with an itch.Other sources of omega-3 fatty acids include barbituates.Picrotoxin has a narrow margin of safety flaxseed oil and pumpkin seed.and is not the best treatment for ivermectin toxicosis.
We have demonstrated the efficacy of Jatropha Physostigmine has been shown to have some effect in curcas oil against canine demodicosis.Jatropha curcas the comatose animals.This may be due to an increased oil along with Withania somnifera root extract concentration of acetylcholine in affected neurons.revealed higher efficacy against demodectic mange The comatose animal may exhibit a transient increase (Singh and Dimri, 2010).Powdered garlic, and in metal alertness.This may be beneficial to the goldenseal, mixed in olive oil, can be applied to areas veterinarian by: confirming the diagnosis of of skin infested with Demodex mange.Garlic contains ivermectin toxicosis, possibly treating the more severe sulphur compounds which mites dislike.Diluted cases and giving the owners hope for their comatose garlic oil can therefore be used topically to the affected dog.
areas.Since garlic is antibacterial as well, applying

Milbemycin oxime
garlic oil to the affected areas will have the added Oral milbemycin oxime is recommended at a benefit of minimizing bacterial infection.If dog is dose rate of 1.5 to 2mg/kg/ day, although the dose sensitive to garlic, licorice can be used instead.High ranges of 0.5 to 3.1 mg/kg/day have been used (Holm, quality natural food, processed food or those high in 2003).Cure rate vary are better with higher dose.
sugars should be avoided.Mites feed on the yeast Ivermectin-sensitive breeds generally tolerate living in the body, and systemic yeast feed on milbemycin oxime at the dose outlined above nutritional yeast and sugars (carbohydrates).By (Tranquilli et al., 1991).Side effects of daily Metaflumizone plus amitraz for the treatment of eliminating these things, the mites will starve to death.