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Dr. Joey
Dr. Joey, Board Certified
Category: Dog Veterinary
Satisfied Customers: 4695
Experience:  15 yrs in practice, specialist canine/feline medicine
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My puppy has mange. Our vet has her on meds and baths

Customer Question

my puppy has mange. Our vet has her on meds and baths for other a month and her hair is falling out continually. What options are left?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Joey replied 1 year ago.
Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.
I assume she has demodex mange. And I do hope your veterinarian told you this could take months to clear up. Rarely do we have miraculous recovery within 4 weeks. I often feel my clients 12-18 weeks, but if we get an earlier recovery then that is spectacular. As well int he first 3 weeks everything is going to look far worse before it gets better. AS the mites die, then hair follicle they lived in releases its hair. That means in the healing process a lot of hair falls out. Sounds like she is on all the right starting medications!
So, if she is at 4 weeks on medications then she needs a recheck for a repeated skin scraping to have your vet see if mites are still present and if so in what density and if they are alive. If yes to everything, then she needs her dose of ivermectin adjusted, if possible. If not and we feel this is not working, then a change of medication may be indicated. Usually we have to go to compounded milbemycin orally which is very expensive. I do not find topical Advantage Multi to be that effective in resistant cases, although there are some that advocate this; that is purely my clinical experience.
I so much wish I had an easy miracle cure for you. This is a frustrating problem that take a long time to clear and usually several dosage adjustments, depending on where your vet started her with the ivermectin. There are no topicals over-the-counter that will be useful for this other than using a good clensing shampoo (but sounds as if your vet is doing the baths). Never use any topical corticosteroids (like hydrocortisone) because this can make the mites tough to treat for 4-8 months.
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