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My dog's mange returned worse, losing weight & tired. What's next?

Updated on September 23rd, 2025

Pet's info: Dog | German Shepherd | Male | unneutered | 3 years and 5 months old

My dog's skin has been turning black and has pink spots all over. I've taken him to 5 different vets in the past year and all have said something different until the last vet diagnosed him with mange and got treatment for it. Once treatment ended, he was doing way better but it came back again but worse. Now, he's losing a lot of weight, scratching himself and gets tired by only walking around. What can I do now?

2 Answers

Most Helpful Answer

Answered By Andrea M. Brodie, DVM

Veterinarian

Published on October 14th, 2018

Sometimes it takes more than one round of treatment to treat mites. If your dog has demodectic mange your veterinarian will have to look at the underlying cause of the repeated outbreak as demodextic mange usually lies dormant until the dog has a compromised immune system. If it is sarcoptes mange then your dog may have reinfected himself. Your veterinarian can prescribe Bravecto, a chew that covers fleas, ticks and all types of mange, even demodectic mange.

1Pet Parents found this answer helpful

Related Answers from Veterinarians

Answered By Lotus Altholtz
Veterinarian, Board-Certified Lab Animal Medicine Specialist
Published on January 31st, 2019
Clinical symptoms of demodex can be resolved, however this type of mange is treated with antibiotics as it is a parasite and not a bacteria. Most dogs do have a small # of this type of mite living in their hair follicles but do not have the hair loss, itchiness and scaly skin typical of pets showing clinical symptoms because they have healthy, mature immune systems. Usually dogs that have recurring symptoms of mange have immune systems that are compromised for a variety of reasons (a young or old age, concurrent illness are some possible reasons). One easy way to prevent clinical symptoms from returning is to keep Willow on a monthly oral flea/tick preventive such as prescription NexGard (given once a month year round), Bravecto (given every 12 weeks) or Simparica (given once a month year round) that is also recommended by veterinary dermatology specialists because they are very effective in treating mange. Oral NexGard, Simparica or Bravecto year round is much easier than the older traditional treatment which often involved daily dosing of oral ivermectin in cherry syrup for 45 days. After dosing with one of these products, use of an anti-itch shampoo twice weekly such as Douxo Calm Dog and Cat Shampoo (available on Chewy.com) with phytosphingosine to help restore the skin barrier is very helpful to improve comfort/reduce itch. Having a full physical exam and screening bloodwork to rule out concomitant medical issues that could be compromising Willow’s immune system is recommmended as well. Good luck!
1Pet Parents found this answer helpful

Smart Picks for Smart Questions

Related Questions

My dog's demodex keeps returning. What are my treatment options?

Mara needs the medications to treat the mites. Some dogs do need lifetime treatment. The good news is that many dogs will respond to the new oral flea and tick medications such as Nexgard and bravecto which may clear or keep demodex in check. Mara should also be spayed- demodex has a genetic component so she should not have puppies but beyond this each heat cycle stresses her immune system and makes an outbreak more likely. Grain free is not necessary, while it shouldn't hurt her it is a marketing gimmick by food companies and not based on medical research. Please schedule her a veterinary visit asap to get her treated, the skin infections that accompany demodex are severely painful. http://www.veterinarypartner.com/Content.plx?P=A

Updated on September 23rd, 2025

My dog's mange isn't improving after weeks of treatment. What now?

You need to have him examined again and treated for any concurrent skin infections which may be fungal or bacterial. Follow up with your veterinarian to discuss skin cytology and testing for ringworm.

Updated on September 23rd, 2025

My dog has Demodex mange. What's the next step after shampoo?

Very good information. Yes you are correct that topical shampoo with Benzoyl peroxide is a great addition to therapy to rid the mites. The next step would be to get her an oral treatment, which in my opinion the best and easiest way to treat Demodexx is to give her Bravecto or Nexgard. These are flea/tick preventatives, however they are also labeled for Demodexx treatment and can be given once very 1-2 months to treat Demodexx. The other way to treat Demodexx, which in my opinion is a lot more time consuming and costly, is daily Ivermectin 1%. Both these treatments will require a veterinary prescription first, so it is best to get Nu'u seen by a veterinarian if she hasn't already. It is also important to get repeat skin scrapes every 2-3 weeks during treatment to monitor her progression and also this helps you determine when she can go off her medication.

Updated on September 23rd, 2025

Why is my dog's demodex mange worse after treatment? Secondary infection?

They can get a secondary infection from demodex and it usually gets worse before it gets better. The mites live in the hair follicle, so as the treatment works and the mites due, more hair falls out. Around week four after treatment is stated is usually as bad as it gets then things start to improve from there. A good bath in a shampoo with benzoyl peroxide helps flush the mites out but can be drying if done more than once a week. If there are scabs with a discharge it is best to get rechecked

Updated on September 23rd, 2025

My puppy won't stop itching; what's causing this persistent skin issue?

The only way to definitively diagnose mange (Demodex) is by skin scrapings which should be repeated every 2-3 weeks during treatment until 2 negative skin scrapings are found. Make sure that the flea and tick medication prescribed will also treat mites (milbemycin or moxidectin) and keep in mind that the dosage frequency is different for mite treatment than it is for flea preventative. Treatment needs to continue for 1-2 months after there is a negative skin scraping. Steroids are usually contraindicated in treatment of Demodex. Demodex mites are not contagious to other animals so your other dogs may not be affected.

Updated on September 23rd, 2025

Why is my dog's skin red and itchy after demodex mange treatment?

It isn't uncommon for dogs going through mange therapy to initially get itchier as the mites die and cause inflammation. However secondary infections are also very common with mange. It is common for a dog to be on antibiotics and perhaps an anti-itch medication in addition while being treated for the mange. You could call the veterinarian that prescribed the mange treatment to discuss antibiotics and/or medication to help with his itching. Sometimes a topical shampoo helps but often oral medications are needed.

Updated on September 23rd, 2025

Health & Wellness

My dog's Demodex is gone. Why is his skin dark and flaky now?

You didn't mentioned how long ago you started the treatment and how bad was the infection, Demodex can take between a few weeks to several months to clear up completly, it is important to renew the treatment as long as the skin seems to be affected. eventually the skin will recover but it will take some time, i usually recommend Bravecto for treatment.

Updated on September 23rd, 2025

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