Veterinary Medicine - August 2008 - (Page 453)

Demodicosis PEER-REVIEWED peroxide, chlorhexidine, and ethyl lactate. Benzoyl peroxide-based shampoos are often recommended because of their keratolytic and supposed follicular ushing activity.9 TABLE 1 Treatment Summary for Generalized Demodicosis in Dogs • Bathe the dog one or two times a week with an antibacterial shampoo containing ingredients such as benzoyl peroxide, chlorhexidine, or ethyl lactate. Miticidal therapy All recognized Demodex mites in dogs appear to respond similarly to mite-targeted therapy. Treatment failure is rarely due to resistant mites. More frequent causes of treatment failure in canine demodicosis include poor pyoderma control, premature discontinuation of therapy, unsuccessful control of underlying conditions, and the use of concomitant glucocorticoids (Table 3). However, if a patient does not respond to the initial miticide, switch to another treatment option.10 According to a review of treatment protocols for canine demodicosis, amitraz, ivermectin, milbemycin oxime, moxidectin, and doramectin are all recommended for treating canine demodicosis.10 This same review found evidence that ronnel, lufenuron, and levamisole should not be used to treat canine demodicosis. Improper study design factors including patient selection, age of onset strati cation, de nition of cure, time to cure, and follow-up time were major limiting factors in evaluating the ef cacy of some treatments. Thus, there was insuf cient evidence for or against the use of many other treatments. Because of the safer therapeutic options • Control concurrent secondary pyoderma with a beta-lactamase-stable antibiotic (e.g. cephalexin) for a minimum of four weeks. Consider antibiotic selection based on bacterial culture and antimicrobial sensitivity testing, especially with deep pyoderma. • Select miticidal therapy after reviewing indications, dosages, administration regimens, and adverse effects. Do not use ivermectin, moxidectin, or doramectin in ivermectin-sensitive dogs, such as herding dog breeds. Avoid spinosad use in dogs receiving extralabel high doses of ivermectin, other avermectins, or milbemycins. • Perform four to six skin scrapes from the same body areas every two to four weeks, recording mite life stage and mite number. Compare ﬁndings of previous visits to determine whether the current miticidal dosage is effective. • Continue miticidal therapy until you obtain two consecutive negative results on skin scrapings taken two to four weeks apart. • Identify and treat any underlying potentially predisposing conditions in cases of adult-onset demodicosis. available, organophosphates should not be used to treat demodicosis. Amitraz. Topical amitraz is FDAapproved for treating generalized demodicosis in dogs older than 4 months of age. Amitraz, a miticide and insecticide, is a monoamine oxidase inhibitor (MAOI), prostaglandin synthesis inhibitor, and an alpha2-adrenergic agonist.10 Per the product label, amitraz liquid concentrate (Mitaban—P zer Animal Health) is to be used as a 0.025% (250 ppm) dip every two weeks for three to six topical treatments until no live mites are found. Not all dogs can be cured with amitraz administered per the label protocol. Consequently, investigators have found greater cure rates by using various regimens of increased dip concentrations or

Table of Contents Feed for the Digital Edition of Veterinary Medicine - August 2008

Veterinary Medicine - August 2008 Contents Editors' Note Leading Off ClinQuiz Idea Exchange Practical Matters Diagnosing and Treating Canine Copper-Associated Hepatopathies Canine and Feline Demodicosis CE Form Advertiser Index Product Preview Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - August 2008

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