demodex

Re: demodex

Simon Tai — Thu, 01 May 2014 17:00:45 GMT

As Martin , says you need to make sure that there is no underlying immunosuppressive disorder ( I would do full bloods, T4:TSH and a urinary creatinine:cortisol ratio to rule out HAC).

Ivermectin has worked in the past and there's no reason to suggest that it might not in the future. In relapsing cases of generalised demodicosis, once resolved and negative skin scrapes for 2 months post resolution, I have reduced the dose of ivermectin at 600ug/kg p/o to twice weekly with some success.

I have had little success with Advocate at the weekly, fortnightly or monthly regime myself.

Re: demodex

Martin Atkinson — Thu, 01 May 2014 16:42:56 GMT

If you're sure there is no other issue (have you ruled out HAC for example) then another way to treat it is with Milbemycin 2mg/kg daily until resolution. This is expensive of course using Milbemax but there are versions of it on its own without the praziquantal which are cheaper. I believe Interceptor (Novartis) is such a product and is widely use in Europe but you will need an import licence - maybe contact Novartis.

Re: demodex

Francisco Gomez — Thu, 01 May 2014 16:28:32 GMT

[quote user="Utlendigur"]

or even weekly to start with (off licence) but even then I don't think many people have faith in it

[/quote]

I think now weekly treatments are licensed! http://www.noahcompendium.co.uk/Bayer_plc/Advocate_Spot-on_Solution/-38248.html

Aggghhh!! datasheets are changing more often than the updates on my iphone!

'Advocate can be applied once a week and for a prolonged time. In all cases it is essential that the treatment should be continued until skin scrapings are negative on at least 2 consecutive monthly occasions.'

Re: demodex

Anonymous — Thu, 01 May 2014 15:58:08 GMT

thanks for the reply,

no steroid use previously. the demodicosis has been present since probably about a year of age, it wasnt diagnosed until about 2 years of age.

There aren't overt signs of pyoderma at present, no pus redness just scaling. He has had bloods and biopsies previously which came up as nowt other than folliculitis and mites present on the biopsies and bloods were generally normal. That was 3 years ago and since I have seen him I havent gone further but as you suggest immunosuppression is a possibility. it was a juvenile onset but persistent demodicosis. otherwise he is clinically normal.

Re: demodex

Utlendigur — Thu, 01 May 2014 15:38:59 GMT

[quote user="Martin Atkinson"]I have to say that you need to be looking further than just controlling the mites. An adult dog of a breed not pre-disposed to Demodex with such a serious recurring problem would alarm me and it is likely there is some immuno-suppressive illness going on. Time to start looking deeper.[/quote]

Any history of corticosteroids being given recently or when problem first started?

Advocate often has to be used more frequently than monthly eg every 2weeks or even weekly to start with (off licence) but even then I don't think many people have faith in it

Also if there is any pyoderma it's worth treating that as it can exacerbate the demodex.

Re: demodex

Martin Atkinson — Thu, 01 May 2014 15:30:46 GMT

I have to say that you need to be looking further than just controlling the mites. An adult dog of a breed not pre-disposed to Demodex with such a serious recurring problem would alarm me and it is likely there is some immuno-suppressive illness going on. Time to start looking deeper.

However if it is really just uncomplicated Demodex then you could offer to bathe the dog with Aludex in-house and charge appropriately, I fail to see how this would worsen the owner's asthma though.