Puppy with Demodex Mange

Question
Hello Jana, I have a 5 month old male pit bull mix puppy. I have had him since he was 8 weeks. He is up to date on his vet care and heartworm and flea treatments. He was diagnosed with demodectic mange when he was around 3 months. He has around 10 spots but they are not infected or completely bald. The vet wants to wait and see what happens in hopes of his immune system taking over. He is due for his last shots on the 12th in just a few days. I was considering starting treatment for the mange as it does not seem to be getting better and I do not want him to become bald before we start treating. However, I would rather not start with the dips. I know Ivermectin is a treatment even though it is not approved and is risky in that it can present allergic reactions I would rather start with the Ivermectin with low doses to make sure he does not have a reaction. Is it logical to start with the Ivermectin rather than the dips? Can the demodectic mange be treated with the Ivermectin alone if it works and there are not reactions? In other words, does it make sense for me to ask my vet to start with the Ivermectin first and see what happens with that rather than the dips? Also, I have one other concern. The last time he was at the vet for his shots which was around 3 weeks ago, he had his anal glads expressed and had about 2 oz of dark liquid come out. I asked the vet to express these glads because my puppy was biting and looking at his bottom as if it bothered him and would even sometimes yelp very loudly and become scared while focusing on his bottom area. I will definately follow up with this with my vet but I had some questions maybe you can help me with. For a puppy with demodectic mange, is it possible that it itches him in his bottom area and thats why he is frustrated with it? Could he have a genetic anal glad problem? One other question, I will have him fixed once he has had his shots but if he has the mange on his private areas would this cause him to yelp and become scared in reverence to his bottom? I have looked him over and he does have a few very small spots on his private area but its not major spots. Any insight would be great. Sometimes he becomes so scared after looking at his bottom I am starting to get worried why he is doing this. Thanks.

Answer
Elizabeth,
I am not a vet, but in my 28 yrs of being a technician and working with 7 vets and my own research, I have NEVER heard of anyone 'waiting' to treat demodectic mange. The whole point of treatment is to stop it from spreading and becoming systemic. Once that happens your chances of successfully curing this dog go way, way down.

Demodectic mange is a result of a low immune system. The dog wouldn't have it if his immune system was up to par right now. It might not be for another 6 months. Are you going to wait to treat it then? He will be completely covered with it by then.

You need to start treatment now. You can use spot treatments on each area but it sounds like he has already passed that point of treatment.
There are collars that can treat it such as Preventic collars. There is a daily heartworm medicine that can treat it, Sentinel or just the Interceptor pills. Sentinel is Interceptor combined with flea control.

The dips are the same ingredient as the Preventic collars. Ivermectin is used also but some dogs do react to Ivermectin- usually the working class of dogs such as border collies, collies and dogs of that nature.

Ivermectin in generally safe for most dogs in proper doses.

His anal glands bothering him is not related to the mange at all. Mange itches but it doesn't hurt them. What you are describing sounds like a dog with impacted anal glands. There isn't a genetic issue with them. Some dogs are just have more problems expressing them when they have a bowel movement. Sometimes this is helped with more fiber in the diet, sometimes not.

If this were my dog I would start treatment tomorrow. Don't wait any longer. Most dogs become less susceptible to mange as they get older due to their immune systems being stronger, but you shouldn't wait for that to happen to a dog that already has it.

Do some reading online about Ivermectin and then decide what you want to treat with. The dips make them a bit sleepy but they work well. What ever you decide, get started on it.

Let me know how it goes and how he does.