Scabies & Miscbrown

8/6/2019 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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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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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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****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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MoxidectinMoxidectin


Bew

are in sensitive breedsBew

are in sensitive breedsAdvantage Multi (Bayer)Advantage Multi (Bayer)

DoramectinDoramectin


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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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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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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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 ?

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