Difference between revisions of "Demodicosis"

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Also known as: '''''Demodecosis — Red Mange'''''
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==Description==
 
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An inflammatory parasitic disease of dogs and cats caused by [[Demodex]]. The mites are host-specific and can occur in dogs, cats, cattle, sheep, goats, pigs and horses. There has to be increased numbers of immature mites to classify as an infestation. The mite is transmitted from dam to offspring during nursing. The mites live in hair follicles and infestation may lead to secondary bacterial infection and furunculosis.  
==Introduction==
 
An inflammatory parasitic disease of dogs and cats caused by ''[[Demodex]]''. The mites are host-specific and can occur in dogs, cats, cattle, sheep, goats, pigs and horses. There has to be an increased number of immature mites to classify as an infestation. The mite is transmitted from dam to offspring during nursing. The mites live in hair follicles and infestation may lead to secondary bacterial infection and furunculosis.  
 
  
 
==Signalment==
 
==Signalment==
 
Commonly affects the dog and more rarely the cat.  
 
Commonly affects the dog and more rarely the cat.  
  
'''Breed predilections''':
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'''Breed predilections'''
Demodicosis is usually a disease of short haired dogs and is more common in pedigree breeds. Within [[Canine Breeds - WikiNormals|dog breeds]], the Staffordshire bull terrier, German Shepherd dog, Old English sheepdog, Collies and Dalmatians are at risk. Additionally within [[Feline Breeds - WikiNormals|cat breeds]] it has been reported that there is an increased incidence in Siamese and Burmese cats.
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Demodicosis is usually a disease of short haired dogs and is more common in pedigree breeds. Within [[Canine Breeds - WikiNormals|dog breeds]], the Staffordshire bull terrier, German Shepherd dog, Old English Sheepdog, Collies and dalmations are at risk. Additionally it has been reported that there is an increased incidence in Siamese and Burmese cats.
  
'''Age predilections''':
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'''Age predilections'''
Often animals less than 12 months of age are affected although adult onset is recognised.  
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Often animals less than 12 months of age of affected although adult onset is recognised.
 +
 
 +
 
 +
==Diagnosis==
 +
History and clinical signs will often indicate demodicosis. Following hair plucks and skin scrapings [[Demodex| Demodex]] mites can be identified microscopically.
 +
In all cases of adult onset demodicosis a detailed history and medical investigation must be undertaken.  
  
 
==Clinical Signs==
 
==Clinical Signs==
 
Crusting, hair loss, grey hyperpigmentation and plugged follicles are typical findings in animals suffering from demodicosis.
 
Crusting, hair loss, grey hyperpigmentation and plugged follicles are typical findings in animals suffering from demodicosis.
  
===Dogs===
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Dogs:
May be localised or generalised.
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May be localised or generalised in the dog.
  
 
'''Localised demodicosis:'''  Typically seen in dogs 3-6 months of age and 90% of cases will heal spontaneously.  Signs are of a mild non- pruritic alopecia in some cases erythema and a fine scale.  Lesions are most commonly found on the head particularly around the periocular region and the forelimbs.
 
'''Localised demodicosis:'''  Typically seen in dogs 3-6 months of age and 90% of cases will heal spontaneously.  Signs are of a mild non- pruritic alopecia in some cases erythema and a fine scale.  Lesions are most commonly found on the head particularly around the periocular region and the forelimbs.
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'''Generalised demodicosis:'''
 
'''Generalised demodicosis:'''
 
Most commonly occurs in dogs between 3-12 months of age.  Can be widespread from the beginning and lesions can range from multiple poorly circumscribed areas of erythema, alopecia and scale  to generalised pustules often  resulting in rupture of the hair follicle (furunculosis).
 
Most commonly occurs in dogs between 3-12 months of age.  Can be widespread from the beginning and lesions can range from multiple poorly circumscribed areas of erythema, alopecia and scale  to generalised pustules often  resulting in rupture of the hair follicle (furunculosis).
A lymphadenopathy and pyrexia are also common features. Pododemodicosis can occur with the generalised form and can persist after other lesions have resolved or appear in isolation. This manifests as erythema and secondary infection of the feet.   
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A lymphadenopathy and pyrexia are also common features of generalised demodicosis. Pododemodicosis can occur with the generalised form and can persist after other lesions have resolved or appear in isolation. This manifests as erythema and secondary infection of the feet.   
  
'''Adult Onset Demodicosis:''' Can present as generalised disease or focal alopecia . Onset in adulthood is often associated with internal disease such as ([[Hyperadrenocorticism|hyperadrenocorticism]], immunosuppression or neoplasia. Long term use of glucocorticoids in the West Highland white terrier has been associated with adult onset demodicosis.
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'''Adult Onset Demodicosis:''' Can present as generalised disease or focal alopecia . Onset in adulthood is often associated with internal disease including ([[Adrenal Glands - Pathology#Adrenal Hyperfunction|hyperadrenocorticism]] and [[Thyroid Gland -Pathology#Hypothyroidism|hypothyroidism]]), immunosuppression or neoplasia. Long term use of glucocorticoids in the West Highland white terrier has been associated with adult onset demodicosis.
  
===Cats===
 
Often multifocal alopecia particularly of the eyelids, periocular region, head and neck. Erythema scale and crust may be present with varying degrees of pruritus. Otodemodicosis which manifests as an erythematous ceruminous otitis has also been reported in the cat.
 
 
   
 
   
===Cattle===
 
Pea-sized nodules are present over the body. Each nodule contains several thousand mites. Affects hide quality and is economically important in Australia.
 
 
===Goat===
 
 
The disease is becoming more common in goats and it is similar to that in cattle.
 
 
===Horse, Pig, Sheep===
 
  
Demodicosis is rare in these species.
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==Laboratory Tests==
 
 
===Small Mammals===
 
[[Mites - Gerbils#Demodecosis|'''Gerbils''']]: Alopecia, scaliness and ulceration of the tail and hindlimbs. Normally in undernourished, debilitated, old, young or pregnant animals. Caused by ''Demodex merioni''.<br>
 
[[Mites - Hamsters#Demodicosis|'''Hamsters''']]: Moderate to severe alopecia that appears dry and scaly. Normally in animals over 1.5 years of age that are undernourished, immunosupressed or suffering from concurrent disease. Caused by ''Demodex criceti'' and ''Demodex aurati''.
 
 
 
==Diagnosis==
 
 
 
History and clinical signs will often indicate demodicosis. In all cases of adult onset demodicosis, a detailed history and medical investigation must be undertaken to identify an underlying systemic disease.
 
 
 
===Microscopic Exam===
 
Microscopic examination of deep skin scraping reveals the cigar-shaped adult [[Demodex| ''Demodex'']] mites (eight legs), larval forms (six legs) and lemon-shaped eggs in high numbers. Hair plucks can also demonstrate mites microscopically. As mites are often residents in normal skin, detecting mites on a skin scrape may not always provide a definitive diagnosis - results should be combined with the entire clinical picture. The absence of mites on multiple skin scrapes may allow you to rule out the disease. 
 
 
 
===Laboratory Tests===
 
 
Haematology and Biochemistry may be useful in identifying an underlying cause in adult onset demodicosis.
 
Haematology and Biochemistry may be useful in identifying an underlying cause in adult onset demodicosis.
 
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==Biopsy==
===Biopsy===
 
 
Cutaneous biopsy may be necessary if lesions are chronic, granulomatous or fibrotic.
 
Cutaneous biopsy may be necessary if lesions are chronic, granulomatous or fibrotic.
  
 +
==Pathology==
 
==Treatment==
 
==Treatment==
Localised demodicosis in young dogs will often resolve spontaneously.
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==Prognosis==
 +
==References==
  
In cases of generalised demodicosis: Amitraz (Aludex, Intervet/Schering-Plough Animal Health) should be used as a dip weekly until there is a resolution of clinical signs and skin scrapes are negative for the mite. The mites are not easily accessible to acaricides due to their deep location in the skin and to aid amitraz penetration, clipping a dog's coat and washing with benzoyl peroxide shampoo prior to application is recommended.  Side effects of this treatment include lethargy, anorexia, depression, vomiting and diarrhoea.
 
  
A spot on treatment containing imidacloprid and moxidectin (Advocate, Bayer) is also licenced to treat demodicosis. An alternative licensed product is an amitraz and metaflumizone spot on (Promeris Duo, Pfizer AH).
 
  
Any secondary pyoderma present on the animal must also be treated with appropriate antibiotics.
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*Squamous demodecosis
If the amitraz and imidacloprid-moxidecin combinations are ineffective or not tolerated ivermectin or milbemycin can be given daily. This treatment is off-licence and requires informed owner consent as well as monitoring of the animal for signs of neurological side effects.
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**Less serious
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**Dry reaction
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**Alopecia, desquamation and skin thickening
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**Absent to mild pruritus
  
==Prognosis==
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*Follicular/pustular demodecosis
Prognosis is good for localised cases. Generalised demodicosis is often managed medically however many cases are controlled rather than cured. Owners must be educated about the disease and be advised not to breed from animals with the generalised form.
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**More serious
Adult-onset dogs are often refractory to treatment.
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**Skin invasion by ''staphylococci''
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**Skin becomes wrinkled, thickened and contains pustules which ooze serum, blood or pus
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**Affected animals may be seriously disfigured
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**Severe pruritus is associated with secondary infection
  
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*Immune factors are important in determining the severity and occurrence of demodecosis
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**Familial susceptibility
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**Immunosuppression
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**Immunosuppressant therapy
  
{{Learning
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==Diagnosis==
|Vetstream = [https://www.vetstream.com/canis/Content/Bug/bug00050 Demodecosis in dogs]<br>[https://www.vetstream.com/canis/Content/Disease/dis02358.asp Demodectic mange in dogs]<br>[https://www.vetstream.com/canis/Content/Technique/teq00593.asp Skin scraping]
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*Liquid paraffin applied to a skin fold
|flashcards = [[Cytology Q&A 18]]
 
|literature search = [http://www.cabdirect.org/search.html?q=%28title%3A%28Demodicosis%29+OR+title%3A%28Demodex%29+OR+title%3A%28demodecosis%29%29+AND+od%3A%28Dogs%29 Demodicosis in dogs]
 
 
 
[http://www.cabdirect.org/search.html?q=%28title%3A%28Demodicosis%29+OR+title%3A%28Demodex%29+OR+title%3A%28demodecosis%29%29+AND+od%3A%28cats%29 Demodicosis in cats]
 
  
[http://www.cabdirect.org/search.html?q=%28title%3A%28Demodicosis%29+OR+title%3A%28Demodex%29+OR+title%3A%28demodecosis%29%29+AND+od%3A%28horses%29 Demodicosis in horses]
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*Deep skin scraping
  
[http://www.cabdirect.org/search.html?q=%28title%3A%28Demodicosis%29+OR+title%3A%28Demodex%29+OR+title%3A%28demodecosis%29%29+AND+od%3A%28cattle%29 Demodicosis in cattle]
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==Control==
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*Not easily accessible to acaricides due to their deep location in the skin
  
[http://www.cabdirect.org/search.html?q=%28title%3A%28Demodicosis%29+OR+title%3A%28Demodex%29+OR+title%3A%28demodecosis%29%29+AND+od%3A%28sheep%29 Demodicosis in sheep]
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*Repeat treatments needed
  
[http://www.cabdirect.org/search.html?q=%28title%3A%28Demodicosis%29+OR+title%3A%28Demodex%29+OR+title%3A%28demodecosis%29%29+AND+od%3A%28goats%29 Demodicosis in goats]
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*Recovery may take several months
  
[http://www.cabdirect.org/search.html?q=%28title%3A%28Demodicosis%29+OR+title%3A%28Demodex%29+OR+title%3A%28demodecosis%29%29+AND+od%3A%28pigs%29 Demodicosis in pigs]
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*To aid [[Ectoparasiticides|acaricide]] penetration, clipping a dog's coat and washing is recommended
}}
 
  
==References==
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===From Pathology===
  
Forsythe, P (2007) '''Collection and interpretation of clinical samples for dermatological analysis''' ''In Practice 2007 29: 158-16''
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*[[Demodex|''Demodex'']] are normal inhabitants of hair follicles and sebaceous glands
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*Have to have increased number of immature mites to classify as infestation
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*Host-specific
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*Occurs in dogs, cattle, sheep, goats, pigs, horses and cats
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*Transmits during nursing from dam to offspring
 +
*''Demodex canis'' in dogs:
 +
**Generalised or localised
 +
**Mainly young dogs affected or adults with other disease ([[Adrenal Glands - Pathology#Adrenal Hyperfunction|hyperadrenocorticism]], [[Thyroid Gland - Pathology#Hypothyroidism|hypothyroidism]])
 +
**Often inherited in pure bred
 +
**Grossly:
 +
***Localised: scaly, erythematous, macular, alopecic areas; usually face or front legs
 +
***Generalised: large, coalescing lesions, patches, erythema, alopecia, scales, crusts
 +
**Microscopically:
 +
***Localised: lymphoplasmacytic perifolliculitis with hyperkeratinisation, sebaceous adenitis, low pigment, intraluminal mites
 +
***Generalised: perifolliculitis and follicular hyperkeratosis, follicular pluggingf, bacterial proliferation, bacterial neutrophilic folliculitis
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****May cause folliculat rupture -> furunculosis, cellulitis, lymphadenitis and septicaemia
  
Henfrey, J I (1990) '''Canine Demodecosis''' ''In Practice 1990 12: 187-19''
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<big>
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'''[[Demodicosis - Dog|Dogs]]'''
  
Tilley, L.P, Smith, F.W.K. (2004) '''The 5-minute veterinary consult, canine and feline.''' (3rd edition). Lippincott Williams and Wilkins.
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'''[[Demodicosis - Cat|Cats]]'''
  
4th year BvetMed Dermatology Notes. RVC 2008
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'''[[Demodicosis - Cattle|Cattle]]'''
  
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'''[[Demodicosis - Goat|Goats]]'''
  
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'''[[Demodicosis - Pig|Pigs]]
  
{{review}}
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'''[[Demodicosis - Sheep|Sheep]]
  
{{OpenPages}}
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'''[[Demodicosis - Horse|Horses]]'''
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</big>
  
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[[Category:Demodicosis]]
  
[[Category:Expert_Review - Small Animal]][[Category:Dermatological Diseases - Dog]][[Category:Dermatological Diseases - Cat]]
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[[Category:To_Do_-_Caz]]
[[Category:Dermatological Diseases - Cattle]][[Category:Dermatological Diseases - Sheep]][[Category:Dermatological Diseases - Pig]][[Category:Dermatological Diseases - Goat]]
 
[[Category:Dermatological Diseases - Horse]]
 
[[Category:Integumentary System - Mite Infections]]
 

Revision as of 15:35, 8 July 2010



Description

An inflammatory parasitic disease of dogs and cats caused by Demodex. The mites are host-specific and can occur in dogs, cats, cattle, sheep, goats, pigs and horses. There has to be increased numbers of immature mites to classify as an infestation. The mite is transmitted from dam to offspring during nursing. The mites live in hair follicles and infestation may lead to secondary bacterial infection and furunculosis.

Signalment

Commonly affects the dog and more rarely the cat.

Breed predilections Demodicosis is usually a disease of short haired dogs and is more common in pedigree breeds. Within dog breeds, the Staffordshire bull terrier, German Shepherd dog, Old English Sheepdog, Collies and dalmations are at risk. Additionally it has been reported that there is an increased incidence in Siamese and Burmese cats.

Age predilections Often animals less than 12 months of age of affected although adult onset is recognised.


Diagnosis

History and clinical signs will often indicate demodicosis. Following hair plucks and skin scrapings Demodex mites can be identified microscopically. In all cases of adult onset demodicosis a detailed history and medical investigation must be undertaken.

Clinical Signs

Crusting, hair loss, grey hyperpigmentation and plugged follicles are typical findings in animals suffering from demodicosis.

Dogs: May be localised or generalised in the dog.

Localised demodicosis: Typically seen in dogs 3-6 months of age and 90% of cases will heal spontaneously. Signs are of a mild non- pruritic alopecia in some cases erythema and a fine scale. Lesions are most commonly found on the head particularly around the periocular region and the forelimbs.

Generalised demodicosis: Most commonly occurs in dogs between 3-12 months of age. Can be widespread from the beginning and lesions can range from multiple poorly circumscribed areas of erythema, alopecia and scale to generalised pustules often resulting in rupture of the hair follicle (furunculosis). A lymphadenopathy and pyrexia are also common features of generalised demodicosis. Pododemodicosis can occur with the generalised form and can persist after other lesions have resolved or appear in isolation. This manifests as erythema and secondary infection of the feet.

Adult Onset Demodicosis: Can present as generalised disease or focal alopecia . Onset in adulthood is often associated with internal disease including (hyperadrenocorticism and hypothyroidism), immunosuppression or neoplasia. Long term use of glucocorticoids in the West Highland white terrier has been associated with adult onset demodicosis.


Laboratory Tests

Haematology and Biochemistry may be useful in identifying an underlying cause in adult onset demodicosis.

Biopsy

Cutaneous biopsy may be necessary if lesions are chronic, granulomatous or fibrotic.

Pathology

Treatment

Prognosis

References

  • Squamous demodecosis
    • Less serious
    • Dry reaction
    • Alopecia, desquamation and skin thickening
    • Absent to mild pruritus
  • Follicular/pustular demodecosis
    • More serious
    • Skin invasion by staphylococci
    • Skin becomes wrinkled, thickened and contains pustules which ooze serum, blood or pus
    • Affected animals may be seriously disfigured
    • Severe pruritus is associated with secondary infection
  • Immune factors are important in determining the severity and occurrence of demodecosis
    • Familial susceptibility
    • Immunosuppression
    • Immunosuppressant therapy

Diagnosis

  • Liquid paraffin applied to a skin fold
  • Deep skin scraping

Control

  • Not easily accessible to acaricides due to their deep location in the skin
  • Repeat treatments needed
  • Recovery may take several months
  • To aid acaricide penetration, clipping a dog's coat and washing is recommended

From Pathology

  • Demodex are normal inhabitants of hair follicles and sebaceous glands
  • Have to have increased number of immature mites to classify as infestation
  • Host-specific
  • Occurs in dogs, cattle, sheep, goats, pigs, horses and cats
  • Transmits during nursing from dam to offspring
  • Demodex canis in dogs:
    • Generalised or localised
    • Mainly young dogs affected or adults with other disease (hyperadrenocorticism, hypothyroidism)
    • Often inherited in pure bred
    • Grossly:
      • Localised: scaly, erythematous, macular, alopecic areas; usually face or front legs
      • Generalised: large, coalescing lesions, patches, erythema, alopecia, scales, crusts
    • Microscopically:
      • Localised: lymphoplasmacytic perifolliculitis with hyperkeratinisation, sebaceous adenitis, low pigment, intraluminal mites
      • Generalised: perifolliculitis and follicular hyperkeratosis, follicular pluggingf, bacterial proliferation, bacterial neutrophilic folliculitis
        • May cause folliculat rupture -> furunculosis, cellulitis, lymphadenitis and septicaemia

Dogs

Cats

Cattle

Goats

Pigs

Sheep

Horses