An update on the therapy of canine demodicosis

Canine demodicosis, a disease caused by a proliferation of Demodex mites, typically leads to alopecia, comedones, follicular papules and pustules, scaling, and crusting. It may be treated with either amitraz rinses or macrocyclic lactones. Amitraz rinse is approved for application every 2 weeks at a concentration of 0.025%. Higher concentrations and more frequent applications increase the success rate but also increase the risk for adverse effects. Ivermectin is used at 0.3 to 0.6 mg/kg/d PO and moxidectin at 0.2 to 0.5 mg/kg/d PO. Both drugs may cause adverse neurologic effects in sensitive dogs. Milbemycin oxime at 1 to 2 mg/kg/d PO is a safer treatment option. A weekly spot-on combination of 2.5% moxidectin and 10% imidacloprid is recommended for milder forms of the disease.