The term scabies is somewhat colloquial and refers to a mite infection with any of the mites in Sarcoptidae family. Many veterinary dermatologists never see this condition in their entire careers; in the United States, notoedric mange is considered rare with regional hot beds of infection.

How is Diagnosis Confirmed?

A scraping of the crusty skin can be examined under the microscope. Mites and/or their eggs are generally not difficult to detect if they are present; still, their absence does not rule out notoedric mange. Sometimes a trial course of treatment is needed to fully rule out the infection. The mite is highly inflammatory, hence the intense itching. 

Consider that when one cat at home is diagnosed with this condition, all cats at that home may require treatment.

Treatment

There are several options for the treatment of this condition.

Isoxazoline Class Flea Control Products 

At present, there are three products labeled for feline use: Fluralaner (Bravecto®), Lotilaner (Credelio®) and Saralaner (Revolution Plus®). These medications are the newest insecticides for cats and have become popular for killing fleas and ticks but they are also effective against mites such Notoedres cati. None of these products is actually approved for use against Notoedres cati; because of the rarity of Notoedres it is unlikely that any company will pursue official approval. A single dose should be effective and regular use of these products for flea control should be preventive.

Selamectin (Revolution® and Revolution Plus®) 

This topical medication was designed for flea, heartworm, and intestinal parasite control. In dogs, it is approved for control of sarcoptic mange mites but due to the rarity of Notoedres cati, as noted above, the manufacturer is unlikely to pursue the expensive process of gaining FDA approval for Notoedric mange. Still, selamectin, is effective against Notoedres cati and regular use of it for flea control seems to be preventive. 

Moxidectin (Advantage Multi® and similar brands) 

This product is another monthly topical flea preventive similar to the other ones listed. As with the others, regular use is preventive. Advantage Multi is used against fleas, ear mites, heartworm, roundworms, and hookworms. 

Ivermectin

Usually given as an injection, this medication was one of the first treatments used against Notoedres cati. It is still used today. Treatment is typically weekly or every 2 weeks for a month and recovery is prompt. Doses approved for heartworm prevention in cats are not high enough to treat Notoedric mange; different dosing is needed.

Dipping 

In the past, a series of six or seven lime sulfur baths or amitraz dips were used to control this infection. While this certainly works, the cat’s general dislike of bathing created need for something more convenient. Furthermore, lime sulfur has an extremely objectionable smell and will discolor fur. Amitraz tends to produce sedation in some patients and headaches in some humans. Not surprisingly, this method is rarely used nowadays. 

This is Pete before and after he was treated with one dose of ivermectin.

In some cases, the tendency to develop demodectic mange runs in families.

Signs of demodicosis can include hair loss, reddened skin, scabbing, crusting and sometimes itching.

Localized demodicosis involves only small areas of skin on a dog. Generalized demodicosis involves most of a dog’s body or paws. Skin infections from mite damage are common. Sometimes, these skin infections become life-threatening, and cause swelling and fever.

Any skin infection needs to be treated with a topical medication or antibiotic. For localized demodicosis, most dogs resolve on their own and don’t need to be treated with an anti-mite medication. Instead, dogs with localized demodicosis are observed for spreading or worsening of mites. For dogs with generalized demodicosis, treatment requires an anti-mite medication such as one of the following below. Continue any anti-mite treatment until no mites are found on two consecutive skin scrapings.

Dips are usually applied either weekly or every two weeks according to the veterinarian’s prescription. Dips are usually applied by grooming technicians in the veterinarian’s hospital.

Occasionally, another form of amitraz (Taktic®) is chosen. Different dilution instructions are required for Taktic®.

Ivermectin

Ivermectin is available as a liquid deworming agent (Ivomec® and generics) and as a monthly heartworm preventative pill. For canine demodicosis, the liquid form is given by mouth once a day. Side effects can include the following: lethargy, vomiting, diarrhea, and neurologic signs. Many veterinarians will gradually increase the dose of ivermectin to monitor for side effects. Side effects are more common in herding breed dogs (e.g. Collies, Border collies, and Old English sheepdogs). A genetic test is also available to determine if a dog may be sensitive to ivermectin.

Milbemycin oxime

Milbemycin is available as a monthly heartworm preventive pill (Interceptor®) for dogs. For canine demodicosis, the pill is given by mouth once a day.  Side effects can include the following: lethargy, vomiting, diarrhea, and neurologic signs.

Moxidectin

Moxidectin is available as a liquid deworming agent and as a monthly topical heartworm preventative (Advantage Multi®). For canine demodicosis, usually the topical form is applied to the skin once a week.  Side effects can include the following: lethargy, vomiting, diarrhea, and neurologic signs.

The Isoxazoline Flea/Tick Products (Bravecto®, Nexgard®, and Simparica®)
These medications are available as oral flea and tick control pills for dogs. For canine demodicosis, the dose varies based on the specific product.

Many veterinarians will neuter dogs with generalized demodicosis as soon as the disease is under control. This is in the best interest of the dog since breeding and heat cycles can cause disease recurrence. Additionally, veterinarians recommend neutering dogs with juvenile-onset, generalized demodicosis because this disease likely has a genetic basis.  

Animals with localized demodicosis have a good prognosis with proper care. As the severity of the disease increases, the prognosis worsens. Some dogs with generalized demodicosis must have regular treatment for the rest of their lives while others may be cured after a variable number of months of treatment. In all cases it is important to keep your pet as healthy and stress free as possible, including a good nutritional diet, regular checkups, routine deworming and heartworm prevention.