With demodex, as with any other health issues displayed on these pages, it is best to get the opinion of your veterinarian and this is not a substitute for getting medical advice from a professional. This is just a lay person's discussion of demodex from someone who had a whole litter of pugs come down with it (no fun!).
There are two types of demodex or demodectic mange--JUVENILE (LOCALIZED) DEMODEX and GENERALIZED DEMODEX.
Demodectic mange is a parasitic skin disorder caused by the demodex mite. Most dogs and humans have this mite deep in their hair follicles, but it usually does not cause a problem. If a mange condition materializes, it is due to the immune system not being able to keep the mite in check.
In puppies, the mites are generally acquired from the dam while nursing. The juvenile form is characterized by a few localized areas of hair loss which vary in size, but are generally about the size of a quarter. The lesions are usually on the head, neck, and front legs, but can occur anywhere on the body. The lesions generally develop between 2 and 12 months of age when the immune system is not yet fully mature, but can occur anytime, even in elderly dogs with no previous history of demodex if age or illness compromise the immune system in some way.
Juvenile (localized) demodex can be brought on as a result of the dogs immune systems inability to cope with the stress of teething, diet change, stressors in the the home environment, coming into heat, change of home, change of routine, early weaning from the dam, early or overly zealous vaccination program, and so on. If left on its own, juvenile (localized) demodex will usually start to clear up on it's own and hair growth will begin within 4 to 6 weeks. Essential fatty acid supplements help during this stage of regrowth, or a dog food that had a good efa source in it's formulation. See this website for more information on such a food:
FLINT RIVER RANCH PET FOODS.
How do you test a dog to see if your pup or dog had demodex? Only a deep skin scraping by your veterinarian will determine for sure, and the test can easily give false negatives in the early stages. It is important when demodex is even suspected that NO steroids be given!!! This will only lower the immune system and make it extremely hard to eradicate. Demodex can in rare cases become life threatening, so mismanagement of the dog's care can bring on dire consequences.
Many vets adopt a wait and see attitude toward localized demodex which is a good thing. If the hair begins to grow back on it's own with no interference, the immune system has kicked in on it's own. I would recommend Dr. Pitcairn's Complete Guide to Natural Health for Dogs & Cats for good general information on things you can do to help support and improve the immune system naturally while you are waiting to see if the demodex will clear up or become generalized. Some of my puppies were greatly helped by the information in this book and some had to be treated pretty aggressively at the vet's office. Each dog is an individual in that regard.
If I could just make a few suggestions from the book and my own experience, it would be to make sure your pup gets plenty of rest and intermittently plenty of exercise and sunshine. ALWAYS KEEP YOUR PUP AS STRESS FREE AS POSSIBLE. Spay your female before she goes into heat. Get Dr. Pitcairn's book and learn how to give your pup the best nutritional support as possible. Lemon juice can be dabbed on the sores to help dry them up and heal them. Goodwinol ointment (in conjunction with the dips) is rarely prescribed anymore because there is no evidence that it does any good whatsoever, and as I mentioned, I found the lemon juice to work better and it was less messy.
Generalized demodex is more serious and may cover large parts or most of the body. Large patchy areas of hair loss occur. The skin is red, rough, and may be covered with an exudate due to secondary bacterial or fungus infections which complicate the disease. Skin infections may further complicate matters as well.
Due to the weak immune system of the affected dog, generalized demodex can come back possibly every year or so, and will need to be treated each time. With the new aggressive approaches to the disease, this may not happen as frequently as it did in the past. If this does occur however, your vet should do a thyroid test and test for other chronic diseases that might keep compromising the immune system of the dog in question.
Some dogs have a hard time with the dip if they are allergic to it, and besides it's pretty toxic. Be sure your vet is first bathing in a benzol peroxide shampoo to open up the pores or the dip will have little effect. More stubborn cases or with allergic dogs, an Ivermectin or Mylbemycin Oxime treatment might be just the thing that is in order. These heartworm meds are generally given monthly to prevent heartworm, but can be given in large doses daily (expensive but worth it) to eradicate the mite. The exact dosage can only be prescribed by your veterinarian. Since you will be buying a lot of it, you can have your veterinarian write you a prescription and call it into Foster and Smith. Even with the shipping, if you get all the medicine shipped at once you save a bundle.
The most common reaction to this more aggressive form of treatment is that the mites come to the surface in vast numbers as they die off and it might get extremely itchy and uncomfortable for a few days, accompanied by massive hair loss. An anti-histimine is sometimes in order to control the itching. Within a few days though, you will generally see a marked improvement and it is important to keep giving the medication daily until there are 2 clear skin scrapings at the vet, because as in antibiotic treatments, you don't want to get a "super mite" that becomes immune to the treatment. Another note is that Selsun Blue shampoo may help with any secondary staph infection (blackened skin) that may accompany generalized demodex. It seems that the blackened skin causes problems with hair regrowth.
Founder, Pug Rescue of NW Arkansas