Accepted Answer

Ok, Claire!

With what you are describing, I am very suspicious your Pug may have Demodex mange mites.

This is a type of mange mite that is fairly common in pups and young dogs. Usually one just sees little areas of hair loss, the skin doesn't look angry or ulcerated (just as you have described).

Here are some links:

http://www.peteducation.com/article.cfm?cls=1&cat=1352&articleid=729

http://www.petplace.com/dogs/demodicosis-red-mange-in-dogs/page1.aspx

http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=630

Have a look at the links and see if they look like what you are seeing.

If they are, your vet will be able to confirm this suspicion by doing a skin scraping. We can easily find the mites on a skin scraping and see them on a microscope slide.

The treatment is fairly straight forward.

Nowadays, most vets just use ivermectin by mouth or by injection daily.

Or if this is just isolated to one spot, it is possible that your vet may suggest applying Lindane cream to the area three times daily to see if there is improvement. This is not nearly as effective, however.

Your veterinarian has prescribed Advocate (which is also called Advantage Multi in North America). It contains Imidacloprid and Moxidectin. It was released first in Australia. There it already failed for demodex treatment.Studies are on-going in Europe to check efficacy of this drug for eliminating Demodex. However, so far many dogs did get worse instead of better when used once a month. So, now they are studying using it every 2 weeks. It seems to work better that way, but still many dogs with Demodex treated with Advocate do not clear the infection.

Here is more:

http://www.bayeranimal.com.au/default.aspx?Page=50&ItemId=38

So, I personally still use Ivermectin to treat Demodex as it is cheap, safe and effective.

Here is more about it:

http://www.petplace.com/drug-library/ivermectin-ivomec-heartgard/page1.aspx

 

In terms of additional things that you can do, I usually suggest the following for patients that I see:

1. Benzoyl peroxide shampoo and a soothing conditioner.

The idea here is that you can flush the Demodex mites out of the hair follicles. Keep in mind that traction on the hairs during shampooing could increase the hair loss initially. This may make it look like the shampoo is making the problem worse initially, but it is not. It is just removing hairs that were already damaged by the mites.

2. Vitamin E

This has been used for years to help dogs with Demodex. There are differing opinions on how useful it is, but it certainly does no harm and may be beneficial. It has to be given quite frequently (5 times a day) at one capsule of 200 IU per dose. It is usually continued for about 8 weeks.

3. Probiotics

Your veterinarian could supply you with a one month treatment of FortiFlora.

Here is more about it: http://www.dogbuffs.com/?p=80

This has been shown in clinical studies to have positive effects on immune function!! It could just give your dog the boost he needs.

Another probiotic that you could use is Culturelle, which is widely available in the USA. Here is a link to this product:

www.culturelle.com

4. Plant sterols/sterolins

This is something that is strongly recommended by my veterinary colleagues who practice alternative medicine. They swear by it! In the U.S. you can get a good product called Moducare from health food stores, and from one direct-to-doctors nutraceutical suppliers. You can also find it from lots of internet sites.

Moducare is a plant sterol, and if you do a medline search on "plant sterol" or "sterolin", you will find some data. It is believed to enhance immune system balance, which is what seems to be off in dogs with Demodex.

More here: http://www.moducare.com/

It is suggested that you keep the dog on this product for at least 3 months.

5. Acupuncture

This has been reported to improve immune function in dogs. Your vet could refer you to a veterinarian trained in this modality.

I hope that this has been helpful! If it has, please hit the "Accept" button and leave feedback.

If you have more questions, just reply and I will try to help.


The above is given for information only. Although I am a licensed veterinarian, I cannot legally prescribe medicines or diagnose your pet's condition without performing a physical exam. If you have concerns about your pet I would strongly advise contacting your regular veterinarian.

Good luck with your puppy!
Fiona

Expert:	Dr.Fiona
Pos. Feedback:	99.9 %
Accepts:
Answered:	11/4/2009

Dog Veterinarian

15 years experience as a companion animal veterinarian in British Columbia, California and Ontario