Demodectic Mange - Ivermectin or Mitaban Dip?

When a puppy is just 1-2 days old, many of them will have already been exposed to demodex canis, a mite that lives in hair follicles. It's considered normal, humans carry them as well, just a different variety. It only becomes a problem when the immune system isn't functioning correctly, and these microscopic critters start taking over, causing a condition called demodectic mange. While there are dogs that may develop demodectic mange from stress or poor diet, many dogs just have a genetic predisposition for a weak immune system, resulting in a constant battle with demodectic mange. A good friend just wrote that her dog has demodectic mange, and was wondering what treatment is the best, Ivermectin or Mitaban Dip? Wow, that's a tough choice to make, as both of these drugs have possible side effects...

While Ivermectin is used commonly to treat dogs with demodectic mange, the FDA only approves Ivermectin to be used as a heartworm preventative in dogs. For this reason, the use of Ivermectin to treat dogs with demodectic mange is considered "off label" usage. Therefore, to learn about possible adverse reactions and side effects of Ivermectin in dogs, you can view the Ivermectin Heartguard product warning label.(PDF) One thing to keep in mind, is that a higher dosage of Ivermectin is given to treat dogs with demodectic mange, than is used as a heartworm preventative. Here is the adverse reactions listed on the label:

ADVERSE REACTIONS: The following adverse reactions have been reported following the use of HEARTGARD: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation. SAFETY: HEARTGARD has shown a wide margin of safety at the recommended dose level in dogs (See PRECAUTIONS for exceptions) including pregnant or breeding bitches, stud dogs and puppies aged 6 or more weeks. ln clinical trials, many commonly used flea collars, dips, shampoos, anthelmintics, antibiotics, vaccines, and steroid preparations have been administered with HEARTGARD Chewables in a heartworm disease preventive program. Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions, which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, stupor, coma and death. HEARTGARD demonstrated no signs of toxicity at 10 times the recommended dose (60 mcg/kg) in sensitive Collies. Results of these trials support the safety of HEARTGARD products in dogs, including Collies, when used as recommended.

Since Ivermectin is given in a higher dosage to treat demodectic mange, it's considered a safer option to test Collies for sensitivity, before Ivermectin treatment. Ivermectin seems to be the drug of choice for many veterinarians treating demodectic mange, and on the plus side it doesn't require clipping hair or weekly baths.


What about Mitabin Dip to treat demodectic mange?

Mitaban Dip is approved by the FDA to treat demodectic mange, but it has some side effects to be aware of as well. Mitaban Dip Product Warning Label (PDF)

ADVERSE REACTIONS AND SIDE EFFECTS
Ingestion of MITABAN may increase the risk of adverse effects. Therefore, appropriate care should be exercised both during and immediately after MITABAN application to minimize the opportunity for exposure by the oral route. The most frequently observed adverse reaction in the clinical studies was transient sedation, which occurred in approximately 8% of the generalized demodicosis patients. This effect was observed within 2 to 6 hours post treatment, and usually dissipated within 24 to 72 hours. In approximately 40% of the affected generalized demodicosis patients, the effect dissipated in less than 24 hours. Sedation often was less apparent when additional MITABAN (amitraz) treatments were applied, however in approximately 35% of the generalized demodicosis patients sleepiness was observed after each treatment. Transient pruritus, which clinical investigators considered to be an indirect effect due to an inflammatory reaction associated with dead mites, occurred in less than 3% of the generalized demodicosis patients. This effect usually occurred and dissipated within 24-48 hours post treatment. Other observations noted by the clinical investigators and/or clients were a low incidence (less than 1%) of convulsions, ataxia, hyperexcitability, personality change, hypothermia, appetite stimulation, bloat, polyuria, vomition, diarrhea, anorexia, edema, erythema and other varying degrees of skin irritation. Three fatalities were recorded.

An additional pre-caution with the Mitaban Dip is that it can NEVER be used in small dogs, or dogs under four months of age. This is purely ancidotal, but I've read some scary stories about this dip at 1800PetMeds. JellyBean was treated with Mitaban dip for demodectic mange and had to be rushed to the emergency clinic. Then Dotson, who suffered from demodectic mange as well, could not even stand and involuntarily defecated, after he had the Mitaban dip.

There are three different types of demodectic mange, they are localized, generalized, and demodectic pododermatitis. With localized demodectic mange, that means the mange is in one small area, usually on the face. With localized demodectic mange, treatment is not normally necessary, as it clears up on its own.

However, most veterinarians will say that a dog cannot recover from generalized demodectic mange or demodectic pododermatitis without medical treatment. Generalized demodectic mange is easy to identify, because that means the mange has spread all over the body. With the demodectic pododermatitis, it is exclusively on the paws, and is considered very difficult to cure. One thing all types of demodectic mange have in common, is that they are all influenced heavily by stress. No matter what type of mange your dog is suffering from, start with nutrition, and buy the healthiest dog food you can possibly find. You can also reduce stress by...

- Giving your dog a natural supplement designed to strengthen the immune system.
- Make sure your dog is not exposed to extreme hot or cold.
- Isolation can cause stress, so it's important to spend extra time with your dog.
- Get plenty of exercise and play.
- Studies prove dog massages reduce stress.:)

Demodectic Mange - Ivermectin or Mitaban Dip?
Either way, it's a tough choice. While both of these drugs present risks, it would also be dangerous to allow a case of generalized demodectic mange to advance unchecked. Whichever drug or treatment you decide on, strengthening the immune system may be the key to prevent future reoccurances.

If any one has a story about how they effectively treated demodectic mange, please write to tell us about it!