scabies & miscbrown
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Scabies andScabies andMiscellaneousMiscellaneous
ParasitesParasites
Tina Brown, MS, DVMTina Brown, MS, DVM
Louisiana State UniversityLouisiana State University
VMED 5365VMED 5365
March 1, 2007March 1, 2007
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SarcopticSarcoptic MangeMange
The parasiteThe parasite Sarcoptes scabeiSarcoptes scabeivar.var. caniscanis
PRURITICPRURITIC, nonseasonal,, nonseasonal,transmissibletransmissible
Host specific but can infest man,Host specific but can infest man,cats, ferrets, and foxescats, ferrets, and foxes
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Sarcoptes scabei var. canisSarcoptes scabei var. canis
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Life CycleLife Cycle
Entire life cycle on host (17Entire life cycle on host (17--21 days)21 days)
Can live off host in correct environmentCan live off host in correct environment
Female mite burrows into superficialFemale mite burrows into superficial
layers of the epidermis to lay eggslayers of the epidermis to lay eggs Male mites live on skin surfaceMale mites live on skin surface
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TransmissionTransmission
Highly contagiousHighly contagious!!
50% exposed dogs50% exposed dogs
will be infectedwill be infected30% of cases,30% of cases,
exposure unknownexposure unknown
Mites prefer skinMites prefer skinwith little hairwith little hair
Ears, Elbows,Ears, Elbows,Hocks,Hocks, AbdomenAbdomen
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ZoonosisZoonosis
24 hours to 21 days24 hours to 21 daysafter exposureafter exposure
Papules on arms,Papules on arms,
neck, beltlineneck, beltline
Regress spontaneouslyRegress spontaneously.. 12 to 14 days after.. 12 to 14 days after
contact is terminatedcontact is terminated
Severe pruritusSevere pruritus
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Clinical SignsClinical Signs
Dogs and humans may haveDogs and humans may havehypersensitivity reaction to mitehypersensitivity reaction to mite
A few mites can cause generalized pruritusA few mites can cause generalized pruritus
3 most pruritic skin diseases in dogs3 most pruritic skin diseases in dogs1. Scabies1. Scabies
2. Flea allergy2. Flea allergy
3. Food allergy3. Food allergy
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Clinical SignsClinical Signs
Dogs of all agesDogs of all ages
Erythematous papulesErythematous papules+/+/-- lymphadenopathylymphadenopathy
Occult scabiesOccult scabies--no lesions, only pruritusno lesions, only pruritus
Suspect in ALL cases of spontaneousSuspect in ALL cases of spontaneousprurituspruritus
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Clinical Presentation:Clinical Presentation: EAR
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Clinical Presentation:Clinical Presentation: HOCKS
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Clinical Presentation:Clinical Presentation: ELBOWSELBOWS
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DiagnosisDiagnosis
MultipleMultiple broadbroad superficialsuperficial skin scrapingsskin scrapings
ScrapeScrape pinnaepinnae, elbows, hocks, elbows, hocks
Not areas
of excoriati
onN
ot areas
of excoriati
on
Only positive in 20% casesOnly positive in 20% cases
PinnaPinna--Pedal Reflex
Pedal Reflex
Sensitivity as high as 90%Sensitivity as high as 90%
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DiagnosisDiagnosis
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DiagnosisDiagnosis
Fecal sampleFecal sample
HistopathologyHistopathology
biopsy papulesbiopsy papules
mites rarely foundmites rarely found
Serum antibodySerum antibodytesttest
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DiagnosisDiagnosis
Response to treatment is diagnosticResponse to treatment is diagnostictest!!test!!
If you suspect it treat itIf you suspect it treat itRemember occult scabiesRemember occult scabies
Commonly misdiagnosed as allergyCommonly misdiagnosed as allergyAtopyAtopy
Flea allergyFlea allergyFood allergyFood allergy
Contact dermatitisContact dermatitis
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TreatmentTreatment
Treat all in contactTreat all in contactanimalsanimals
Environmental cleanupEnvironmental cleanupCorticosteroids forCorticosteroids for
prurituspruritus
Prednisone 1mg/kg sidPrednisone 1mg/kg sidfor 3for 3--7d7d
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TreatmentTreatment--topicalstopicals
Lyme sulfurLyme sulfur
Every 5Every 5--7 days for 4 to 6 treatments7 days for 4 to 6 treatments
Amitraz (MitabanAmitraz (Mitaban))Fipronil (Frontline)SprayFipronil (Frontline)Spray
Topical (pourTopical (pour--on) Ivermectinon) Ivermectin
0.5mg/kg q14d0.5mg/kg q14d
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Treatment: Systemic drugsTreatment: Systemic drugs
Ivermectin (IvomecIvermectin (Ivomec 1%)1%) Very effectiveVery effective
Extra label useExtra label use
Beware in sensitive breedsBeware in sensitive breedsCheck heartworm microfilaria statusCheck heartworm microfilaria status
prior to treatment!prior to treatment!
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Treatment: Systemic drugsTreatment: Systemic drugs
Milbemycin (InterceptorMilbemycin (Interceptor ))Safe in ivermectin sensitive breedsSafe in ivermectin sensitive breeds
33--4x more expensive than Ivermectin4x more expensive than IvermectinAs effective as IvermectinAs effective as Ivermectin
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Treatment: Systemic drugsTreatment: Systemic drugs
****SelamectinSelamectin ( Revolution( Revolution TMTM ))
Topical avermectinTopical avermectin
Systemically absorbedSystemically absorbed
Safe in ivermectin sensitive breedsSafe in ivermectin sensitive breeds
95.2% effective after 1 dose and95.2% effective after 1 dose and
100% effective after 2 doses according to100% effective after 2 doses according to
Pfizer!Pfizer!
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Treatment: Systemic drugsTreatment: Systemic drugs
MoxidectinMoxidectin
Extra label useExtra label use
Bew
are in sensitive breedsBew
are in sensitive breedsAdvantage Multi (Bayer)Advantage Multi (Bayer)
DoramectinDoramectin
Extra label useExtra label use
Beware in sensitive breedsBeware in sensitive breeds
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ConclusionsConclusions
Expect to see significant reduction inExpect to see significant reduction inpruritus after twoweeks of treatmentpruritus after twoweeks of treatment
FAQFAQHow long do you isolate from other pets?How long do you isolate from other pets?
??Pfizer suggest 30 days??Pfizer suggest 30 days
Can cats get scabies?Can cats get scabies?
Yes, treat all in contact petsYes, treat all in contact pets
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ScabiesScabies--take home pointstake home points
VERYVERY pruriticpruritic/papular/papular
DdxDdx--flea allergy and food allergyflea allergy and food allergy
Ear pinna, elb
ows, h
ocks
Ear pinna, elb
ows, h
ocks
Best diagnosis=Best diagnosis= response to therapyresponse to therapy
Treatment optionsTreatment options--considerconsider breedbreed
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Miscellaneous ParasitesMiscellaneous Parasites
NotoedresNotoedres
CheyletiellosisCheyletiellosis
Otodectic mangeOtodectic mangeChiggersChiggers
Cat fur miteCat fur mite
PediculosisPediculosis
CuterebriasisCuterebriasis
MyiasisMyiasis
Fly strikeFly strike
TicksTicks
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Notoedric Mange (feline scabies)Notoedric Mange (feline scabies)
Highly contagiousHighly contagious parasitic diseaseparasitic disease
Poor offPoor off--host survivalhost survival
FamilyFamily SarcoptidaeSarcoptidaeCan affect dogs, foxes, rabbits, &Can affect dogs, foxes, rabbits, &
humanshumans
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Clinical SignsClinical Signs
Head MangeHead Mange
Intense pruritusIntense pruritus
Papules, scales, crusts, alopecia,Papules, scales, crusts, alopecia,excoriationsexcoriations
Pinnae, head, neckPinnae, head, neck
May spread to feet and perineumMay spread to feet and perineum
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DiagnosisDiagnosis
SuperficialSuperficial skin scrapingsskin scrapings are usuallyare usuallypositivepositive
Distributi
onof lesi
ons and intensity
Distributi
onof lesi
ons and intensity
of pruritus are highly suggestiveof pruritus are highly suggestive
Pinnae, head, neckPinnae, head, neck
Fecal examination may reveal mitesFecal examination may reveal mites
HistopathologyHistopathology
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Notoedres catiNotoedres cati
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TreatmentTreatment
Lime sulfur dipsLime sulfur dips
Use E collar for catsUse E collar for cats
Amitraz (MitabanAmitraz (Mitaban) dips) dips Ivermectin (IvomecIvermectin (Ivomec 1%)1%)
Treat all in contact animalsTreat all in contact animals
Corticosteroids for pruritusCorticosteroids for pruritus
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CheyletiellosisCheyletiellosis -- WalkingWalking
DandruffD
andruffLive on the skin surfaceLive on the skin surface
Produce a mild dermatitisProduce a mild dermatitis
Mites can surviveo
ff the ho
st fo
r 10Mites can surviveo
ff the ho
st fo
r 10to 14 daysto 14 days
Highly contagiousHighly contagious
Affects cats, dogs, rabbits andAffects cats, dogs, rabbits and
exposed humansexposed humans
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Clinical SignsClinical Signs
Dorsally orientedDorsally orienteddry scaling withdry scaling with
little or no prurituslittle or no pruritus
Increasing scaleIncreasing scale
and pruritus asand pruritus asdisease progressesdisease progresses
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DiagnosisDiagnosis--CheyletiellaCheyletiella
Identification of the mite or its eggIdentification of the mite or its egg
Direct examination with a magnifyingDirect examination with a magnifyingglassglass
Multiple superficial skin scrapesMultiple superficial skin scrapes
Scotch tape impressions of dorsumScotch tape impressions of dorsum
Flea combFlea comb
Response to treatmentResponse to treatment
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TreatmentTreatment
Treat all in contact animals andTreat all in contact animals andenvironmentenvironment
Easy t
otreat
Easy t
otreatLimeLime sulfursulfur
Selamectin (Revolution)Selamectin (Revolution)
Fipronil sprayFipronil spray
IvermectinIvermectin
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Otodectic MangeOtodectic Mange -- Ear MitesEar Mites
Otodectes cynotisOtodectes cynotis Lives in external ear canalLives in external ear canal
Does not survive in theDoes not survive in theenvironmentenvironment
ContagiousContagious diseasedisease Affects dogs, cats, andAffects dogs, cats, and
ferrets as 1ferrets as 1 hostshosts
Rarely in exposed humansRarely in exposed humans
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Clinical SignsClinical Signs
Otitis externaOtitis externa
Ectopic infestationsEctopic infestations occur whenoccur whenmites colonize the skinmites colonize the skin
often cause n
odisease
often cause n
odisease
some animals have a pruritic dermatitissome animals have a pruritic dermatitis
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DiagnosisDiagnosis
Direct otoscopic examinationDirect otoscopic examination
Microscopic examination ofwaxMicroscopic examination ofwax
Skin scrapingsSkin scrapingsScotch tape impressionsScotch tape impressions
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TreatmentTreatment
Treat all in contactTreat all in contactanimalsanimals
Clean ears toClean ears toremove debrisremove debris
Miticidal earMiticidal earpreparationspreparations
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TrombiculaTrombicula
Diagnosis based onDiagnosis based onhistory, macroscopichistory, macroscopic
evidenceof parasiteevidenceof parasiteand skin scrapesand skin scrapes
Treatment withTreatment with
parasiticidal dips orparasiticidal dips ortopical otictopical oticparasiticideparasiticide
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Cat Fur MiteCat Fur Mite
Salt and Pepper appearance to dullSalt and Pepper appearance to dulland dirty coatand dirty coat
Not highly contagiousNot highly contagious
Scrape, tape prepScrape, tape prep
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PediculosisPediculosis -- LiceLice
Spread by direct contact or bySpread by direct contact or bycontaminated brushes or beddingcontaminated brushes or bedding
Eggs attached to hairs of the hostEggs attached to hairs of the host
= nits= nits
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PediculosisPediculosis
Can be veryCan be verypruriticpruritic
Diagnosis tapeDiagnosis tapeprepprep
Treat all inTreat all in
contact animalscontact animals
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CuterebriasisCuterebriasis
CuterebraCuterebra fly eggsfly eggs
Skin lesions localized to the head,Skin lesions localized to the head,
neck,or trunkneck,or trunk
When larvae enlargeWhen larvae enlarge nodule withnodule withfistulafistula
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Misc parasitesMisc parasites--take home pointstake home points
NotoedresNotoedres (feline mange)(feline mange)
Very pruriticVery pruritic
Scrapes diagnosticScrapes diagnostic
CheyletiellaCheyletiella (walking dandruff)(walking dandruff)
Scrape, tape prep, direct examScrape, tape prep, direct exam
OtodectesOtodectes
Ectopic infestations head and neckEctopic infestations head and neck
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Questions ?Questions ?