Page 544 - Cote clinical veterinary advisor dogs and cats 4th

244 Demodicosis

• Dehydration replacement volume (mL) Recommended Monitoring • Consider colloidal therapy (plasma, albumin,
= % dehydration as a decimal (e.g., 10% is Body weight, respiratory rate, urine output, hetastarch) if hypoalbuminemia is present.
VetBooks.ir • Adjustment of fluid rate and frequent, close skin turgor, blood pressure, PCV/total solids, Technician Tips
heart rate, pulse quality, capillary refill time,
0.1) × body weight in kg × 1000
monitoring of respiratory rate and comfort
BUN, creatinine
• Assessing hydration status by skin turgor
if heart disease, renal disease, or systemic
or cachectic patients (false impression of
hypertension is present PROGNOSIS & OUTCOME alone can be misleading, especially in elderly
• Electrolyte replacement dehydration).
○ Do not supplement potassium at a rate • Dehydration can be addressed by fluid • The conjunctival mucous membranes are
of > 0.5 mEq/kg/h (p. 516). administration. often most reliable (barring ocular disease)
○ Do not raise or lower serum sodium at a • Prognosis depends on cause. because oral mucous membranes are prone
rate of > 1 mEq/L/h (pp. 498 and 518). to drying (open-mouth breathing/panting
PEARLS & CONSIDERATIONS in dogs) or coating with mucus (vomiting).
Nutrition/Diet
If vomiting absent, access to water for oral Comments Client Education
intake recommended • Urine output and change in body weight are Anorexic animals or those with vomiting and
among the easiest and most accurate ways diarrhea (especially very young or very old)
Drug Interactions to gauge the level of hydration. can become dehydrated quickly and should be
Do not add sodium bicarbonate to calcium- • Absent vomiting, oral rehydration (naso- examined by a veterinarian as soon as possible.
containing fluids (precipitation reaction). esophageal tube) is ideal for animal with
marked heart disease. SUGGESTED READING
Possible Complications • Subcutaneous fluids are poorly absorbed from Rudloff E, et al: Fluid resuscitation and the trauma
• Overhydration/volume overload: increased animals with marked dehydration. patient. Vet Clin North Am Small Anim Pract
respiratory rate, chemosis, serous nasal • For severe dehydration (>8%), recheck 38(3):645-652, 2008.
discharge, subcutaneous and distal limb electrolyte (sodium, potassium, chloride, AUTHOR: Adam J. Reiss, DVM, DACVECC
edema, pulmonary edema, pleural or and phosphorus) imbalances and acid-base EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
peritoneal effusion, hemodilution, cerebral status frequently (every 4-8 hours) during the
edema, peripheral edema first 24 hours of therapy to ensure treatment
○ Monitor more closely if heart or kidney goals are being achieved.
disease

Demodicosis Client Education
Sheet

BASIC INFORMATION CONTAGION AND ZOONOSIS ○ Adult-onset generalized demodicosis often
Demodex mites are host specific, and demodico- appears at > 4 years of age.
Definition sis is not typically contagious for immunocom- • Other
An inflammatory skin disease associated with petent animals. However, D. gatoi is contagious ○ Demodex injai: a much longer follicular
excessive proliferation of Demodex mites. to healthy, in-contact cats. mite than D. canis, present in low
numbers. Associated with pruritus and
Synonym GEOGRAPHY AND SEASONALITY greasy skin and haircoat on the dorsal
Demodectic mange D. gatoi is common in the southeastern United trunk and face (over-represented in terrier
States but apparently rare worldwide. breeds).
Epidemiology ○ A short-bodied Demodex mite sometimes
SPECIES, AGE, SEX ASSOCIATED DISORDERS found on skin scrapings is likely a mor-
• Canine demodicosis caused by Demodex canis Canine generalized demodicosis is very phologic variant of D. canis.
is most common in young dogs. frequently complicated by pyoderma, which Feline:
• Feline demodicosis can affect cats of any can be deep and severe. • Demodex cati: rare, often associated with
age; Demodex gatoi has a highly regional Clinical Presentation immunosuppression in adult cats
distribution. • D. gatoi: regionally common, pruritic, con-
DISEASE FORMS/SUBTYPES tagious. Very different condition from that
GENETICS, BREED PREDISPOSITION Canine: caused by other canine and feline Demodex
• Dogs with juvenile-onset generalized demodi- • Localized (D. canis): one to several small areas mites
cosis and their first-degree relatives should not of alopecia, often on the face and forelegs, • A third unnamed species of mite has been
be bred. A hereditary predisposition exists. typically starting at 3-6 months of age reported in cats.
• Purebred dogs are predisposed, with short- • Generalized (D. canis): affects an entire
coated breeds overrepresented (e.g., pit body region, completely involves two or HISTORY, CHIEF COMPLAINT
bull–type dogs). more paws, or presents with more than six • Chief complaint in canine demodicosis is
lesions. Usually more severe skin lesions and hair loss, with variable pruritus and other
RISK FACTORS secondary pyoderma and multiple lesions skin lesions. Pruritus is common if pyoderma
• Juvenile onset: most likely results from present at onset. Classification of localized is present.
temporary immunodeficiency versus generalized requires clinical judgment. • Pruritus is a major feature of D. gatoi
• Adult onset: often immunosuppressive ○ Juvenile-onset generalized demodicosis infestation in cats and frequently of D. injai
diseases or treatments begins at < 18 months of age. infestation in dogs.

www.ExpertConsult.com