island rehabber
07-24-2013, 06:21 AM
This paper from the NY State Dept of Environmental Conservation presents a clear overview of what is mange and how do we treat it:

The Mange Mite
Mange in wildlife, domestic animals and humans (called scabies) is caused by a tissue-burrowing arthropod called a mite. In the US, the three main types of mite are Sarcoptes scabiei (Sarcoptic Mange), Notoedres centrifera (Notoedric Mange) and mites from the genus Demodex (Demodectic Mange). It is thought that within an individual mite species, there are different strains that have a preference for certain groups of animals and are best suited to live off them. Regardless of the mites preference, there is still a possibility for infection to spread to humans (The mites won’t reproduce but can cause a reaction and painful itching).
The mites will burrow into the skin of the animal (where they feed and reproduce) and cause a buildup of antigenic material. This includes molted exoskeletons, eggs, feces and dead mites. Antigenic materials stimulate the production of antibodies and cause an immune reaction. The end result is extreme itchiness, loss of hair/fur, the appearance of scaly skin and scabs and blisters. Prolonged infection can lead to weight loss, inability to thermo-regulate and possibly death (usually caused by a secondary infection).
Visit www.portal.state.pa.us/portal/server.pt/document/1208918/ (http://www.portal.state.pa.us/portal/server.pt/document/1208918/mange_pdf)mange_pdf to read a guide on mange by the Pennsylvania Game Commission.
Due to their microscopic size, detection of the mites sometimes can be difficult. Performing a deep skin scraping and analyzing it under a microscope may allow you to see them. However, the signs of mange can be present after the mites are gone so a skin scrape may not always be accurate. An enzyme-linked immunosorbent assay (ELISA) may also be performed to confirm the presence of the mites (Unfortunately it is not very effective). ELISA’s check for the presence of antigenic material by testing samples from the animal and seeing if they can bind with laboratory generated antibodies (antigens bind to antibodies). If the antibody finds the antigen in the sample, it causes a color change (caused by an enzyme attached to the antibody). The color change provides a visual confirmation that the antigen exists.
An informative paper titled “Sarcoptic Mange in Wildlife” can be read at http://www.oie.int/doc/ged/d521.pdf which goes into more details of the symptoms and diagnoses of mange.
Administration of Ivermectin, a broad spectrum anti-parasitic, is one of the most commonly used drugs in the treatment of mange. Unfortunately the drug will only kill adult mites and leave their eggs unharmed. It takes about 10 to 14 days for an egg to hatch into an adult. Ivermectin must be given again at least two weeks later to kill the newly hatched mites and prevent reinfection of the animal (If possible a third dose two weeks later is suggested).
Another option is Revolution or Stronghold (salamectin) which are antihelminthics commonly used for dogs. These drugs are placed on the skin of the animal (usually on their backs, below the neck) and may need to be reapplied depending on the severity of the infection. If you would like to pursue this option, a prescription written by your vet is required to purchase the drugs.
Be aware that after giving these drugs, the animal may appear to get worse. The massive die-off of the mites may cause a severe immune reaction from the animal’s body. It is also possible that the skin damage caused by the mites and immune response may make it easier for bacteria to invade. It is suggested to also give broad-spectrum antibiotics in severe cases of mange to prevent or cure any possible secondary infections.
In addition to the treatments we have suggested, online searches often bring up many other treatments for mange. These include using natural products such as lemon juice and honey or chemicals such as a lime-sulfur dip. Be aware that methods may not work and may even harm the animal. Please discuss these treatments with your vet before using them.
The prognosis of the animal greatly depends on the severity of the mite infestation. Small localized areas of hair loss can usually be cured by killing the mites (Ivermectin/Revolution/Stronghold). It is also possible that these minor cases may be taken care of by the animals own immune system. More severe cases are usually accompanied by secondary skin infections. If left untreated the animal may be unable to properly thermo-regulate leading to lethargy, weight loss and muscle atrophy. Organ damage may also develop in some animals. At this point, the animal will need supportive care in addition to removal of the mites. You should be prepared to provide heat therapy (heating pad, heating blanket), fluid therapy and nutritional support while the animal recovers. Make sure to isolate the animal to prevent spread of the mites to your other patients.