CANINE DEMODICOSIS AND ITS MANAGEMENT

Canine demodicosis is a common disease encountered in small animal practice. It is a difficult

disease to cure and cases are often seen by referral dermatologist, either due to a failure to
diagnose the disease or because of difficulty in management. Localised demodicosis in young dogs is
very common and 90% of these will cure spontaneously. Generalised demodicosis can be divided
into juvenile onset (before the first year of age) and adult onset (after 2 years). A further subdivision
of generalised cases is demodectic pododermatitis. These may result as a failure of complete cure of
a generalised cases or present as foot lesions alone. Generalised cases in particular may be very
difficult to cure, especially the adult onset group. In these it will be necessary to identify an
underlying cause and treat it if success is to follow. In approximately half the cases it is not possible
to identify an underlying cause and in these continuous treatment is required with a guarded
outlook.
DEMODEX MITES

Three Demodex mites have been described in the dog. Demodex canis is the commonest. Demodex
injai is a slightly longer mite. Both mites are inhabitants of the hair follicle. A third mite inhabitants
the outer layers of the skin and is shorter than the other two. It is often called Demodex cornei due
to its location.

CLINICAL SIGNS
There are variable clinical signs. Localised alopecia in short haired young dogs is suggestive. The
generalised cases may show alopecia, pustules, comedones, and in early cases erythema which may
be mistaken for allergic disease. In chronic cases the colouration becomes blue grey. In time the
entire body may be affected. In early stages it is the head and feet which are primarily affected.

DIAGNOSIS

Deep skin scrapings

Hair plucks
Tape strip preparations (for D. cornei)
Examination of pustule contents
Biopsy (mainly chronic demodectic pododermatitis)

TREATMENT OPTIONS
A. LICENSED PRODUCTS (UK)
Amitraz
This is the oldest licensed product. It is a monoamine oxidase inhibitor which affects the
neurological system of the mite. In the UK it is formulated as a 5% dip which is applied
weekly . In the United States the label is for half this strength applied every two weeks.
Using the UK system the success rate is approximately 90%. This depends on good
compliance. It is also advisable to clip long haired dogs before application of the product
Amitraz is also available as a spot-on in combination with metaflumizone. The advantage
with this treatment is that the veterinarian can apply the product thus eliminating
compliance problems. In the authors clinic it is applied every two weeks which is off label.
A series of cases of drug induced Pemphigus foliaceus apparently caused after application of
the product has been seen in the United States which has lead to the withdrawal of the
product recently. This has not been seen in Europe and for the moment there are no plans
to discontinue its use.
Moxidectin
Moxidectin is available as a spot-on product in combination with Imidacloprid. It causes
paralysis and death of the mite. It is licensed for weekly use. Preliminary reports suggest that
it is not very effective in advanced cases.
B. UNLICENSED PRODUCTS
Ivermectin. The drug is given orally once a day at a dose of 0.6 mg/kg. Certain breeds show
side effects. These are Collies and other herding breeds. This is caused by an MDR1 gene
defect which renders such dogs unable to pump drugs which cross the blood brain barrier
out of the brain. The signs are vomiting, lethargy, inappetance, and ataxia. There is a blood
test available to detect this gene defect. Alternatively it is also possible to begin with a low
dose of 0.1 mg/kg and build up over a week or so to the full therapeutic dose if no side
effects occur. Ivermectin is effective in more than 90% of cases.

Milbemycin. This drug is given at a dose of 2mg/kg and is often used with Ivermectin
failures. Adverse effects are much rarer than is the case with Ivermectin and dogs which will
not tolerate this drug can usually be treated with Milbemycin. This treatment is expensive
Doramectin is similar to Ivermectin and there is a report of successful treatment with this
drug
Selamectin. Recently a report suggests that daily dosing orally with Selamectin is effective.

TREATMENT OF RESISTANT CASES

Griffin recommends combination therapy in cases which have failed to respond to one or both
agents mentioned above. He combines Ivermectin 450-600 mcg/kg twice weekly orally with amitraz
every two weeks either as spot on or dip.

REASONS FOR TREATMENT FAILURE

Owner induced(poor compliance) This includes improper use of the medication, not applying
the spot on to the skin, infrequent application of the product, premature discontinuation of
the product, not shaving the dog if the dip is used
Veterinarian induced. This includes no or late diagnosis due to failure to skin scrape of
failure to perform adequate deep scrapings, failure to treat secondary infection with long
term antibiotics, and stopping the treatment too soon. In addition some of the dogs will be
pruritic due to secondary infection. The use of glucocorticoids in these cases is
contraindicated as it favours the multiplication of mites and worsening of the secondary
pyoderma.
A concurrent disease which has not been diagnosed, for example hypothyroidism
hyperadrenocorticism, internal parasites.

FURTHER READING
Griffin treatment of Canine Generalised demodicosis British Veterinary Study Group November 2011
29-35 November 2011
Mueller R.S Treatment protocols for demodicosis: an evidence based review. Veterinary
Dermatology 15. 75-89 2004