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EV ACVD Study > Demodex Consensus Statement > Flashcards

Demodex Consensus Statement Flashcards

1
Q

Most likely cause of generalized demodicosis in young dogs

A

Temporary immune alteration

Usually CELL-MEDIATED deficiency

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2
Q

Most likely cause of generalized demodicosis in older dogs

A

Immunosuppressive conditions, treatments

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3
Q

Which demodex species can infect healthy cats

A

Demodex gatoi

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4
Q

T or F: a single gene mutation is responsible for juvenile generalized demodicosis

A

False. It is genetic, but likely multiple genes

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5
Q

Which is longer: Demodex canis or Demodex injai

A

Injai is longer!

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6
Q

Which is longer: Demodex cati or Demodex gatoi

A

Cati. Demodex gatoi is short

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7
Q

Which breeds are predisposed to Demodex injai

A

Terriers. Excessively greasy

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8
Q

Clinical sign of Demodex gatoi

A

Truncal pruritus

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9
Q

Best diagnostic for demodex

A

Deep skin scrape

But can do trichograms, tape strips, examine exudate too!

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10
Q

T or F: if you find a single mite on a deep skin scrape, that is confirmatory of clinically relevant demodicosis

A

False. But more than 1 does confirm clinical relevance

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11
Q

T or F: A dam or sire may be breed again if one of their puppies has generalized demodicosis

A

False. Dogs with generalized demodicosis and their parents should not be bred.

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12
Q

Monitoring protocol for a dog with generalized demodicosis

A

Skin scraping q1month until 2 negative scrapings

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13
Q

How long should treatment continue for demodicosis

A

At least 4 weeks past 2nd negative monthly skin scrape

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14
Q

Topical treatment protocol for dogs with demodicosis

A

Amitraz 0.025-0,05% weekly.

Clip long haired animals

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15
Q

Oral ivermectin, moxidectin, milbemyxin oxime protocol for demodicosis in dogs

A

Ivermectin 0.3-0.6mg/kg PO q24h

Moxidectin 0.3-0.5 mg/kg PO q24h

**START AT LOWER DOSE AND TAPER UP- in case sensitivity to macrocyclic lactones (toxicity)

Milbemycin oxime 1-2 mg/kg PO q24h

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16
Q

SC doramectin protocol for demodicosis in dogs

A

0.6 mg/kg SC q1w

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17
Q

T or F: Topical moxidectin/imidacloprid should be considered for mild-moderate cases of
canine demodicosis

A

True

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18
Q

Topical treatments for cats with demodicosis

A

2% Lime sulfur dip weekly

Amitraz bath 0.0125% weekly

OR

Weekly moxidectin/imidacloprid spot on

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19
Q

T or F: demodex is a commensal of many mammals

A

True.

Transmitted from dam to puppies within first days of life

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20
Q

What type of immunity is deficient in dogs with juvenile demodicosis?

A

Cell mediated!
*Low CD4 T cells
*Low TNFa (proinflam)
*Increased IL-2, IL-5, IL-6, IL18, IL-10, TGF-b (immunosuppressive)

Normal humoral response

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21
Q

Are MHC class II molecules upregulated or downregulated on keratinocytes of dogs with demodex

A

Upregulated

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22
Q

Which TLR is increased in dogs with demodicosis

A

TLR2– recognizes chitin

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23
Q

T or F: Most dogs with juvenile generalized demodicosis have recurrence once it is treated

A

FALSE. Recurrence is very uncommon

Likely a TEMPORARY immune aberration to allow mites to overpopulate

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24
Q

Diseases/drugs in adult dogs that predispose them demodicosis

A

*Leishmaniosis
*HAC
*Hypothyroidism
*Neoplasia
*Babesiosis
*Ehrlichiosis
*Glucocorticoids
*Chemotherapy

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25
Diseases in adults cats that predispose them to demodicosis
*FIV *Xanthoma *Diabetes mellitus Localized form with BISC
26
Breeds predisposed to generalized demodicosis
*American Staffordshire terrier *Staffordshire bull terrier *Chinese Shar Pei *French bulldog
27
Breeds predisposed to juvenile onset demodicosis
*English bull dog *Pit bull *Sealyham terrier
28
Which DLA haplotypes (encode for MHC) are associated with generalized demodicosis in mastiffs and boxers?
FH2002 FH2975 FH2054
29
Is Demodex cornei it's own species?
No. It is a short version of D canis (or dying ones!)
30
Are D injai females or males longer?
Males are longer than females
31
T or F: there is a third, unnamed species of demodex mites in cats (other than D gatoi, D felis)
True. It has a longer gnathosoma and short opisthosoma than D cati.
32
Where in the USA is Demodex gatoi common
Southeast USA Very regional
33
T or F: Short D canis (aka Demodex cornei) is more pruritic than D canis
True Also, pruritic if 2' bacterial infection
34
Clinical lesions of Demodex injai
Marked greasiness of dorsal trunk
35
Where in the skin does Demodex gatoi live
Stratum corneum (like sarcoptes) NOT hair follicle
36
How to perform a trichogram for demodex
Pluck hairs from 1 cm^2 (50-100 hairs) in direction of growth. Put on mineral oil w/cover slip.
37
In intact female dogs, what can trigger recurrences of demodicosis
Estrus
38
T or F: systemic antibiotics should only be used for SEVERE bacterial pyoderma 2' to demodicosis
True! Topical benzoyl peroxide shampoo was enough to clear mild/moderate cases, as long as ivermectin was administered for demodex
39
MOA of amitraz leave-on rinse
Monoamine oxidase inhibitor Alpha 2-adrenergic agonist Inhibits prostaglandin synthesis
40
AE of topical metaflumizone+ amitraz; topical fipronil + amitraz spot on products
Pemphigus foliaceus-like drug eruption
41
How to perform amitraz leave-on rinse
-Clip hair short -Apply with sponge; allow to dry without rinsing -Do not get wet BETWEEN weekly baths, so amitraz stays on the skin -Do not ingest
42
AEs of Amitraz
*Depression, sleepiness *Ataxia *Pruritus, urticaria, edema *Skin irritation *Polydipsia, polyphagia *Hypotension, bradycardia, hyperglucemia *Vomiting, diarrhea
43
Reversal to amitraz toxicity
Yohimbine, atipamezole
44
Which humans need to avoid contact with amitraz
Diabetic humans
45
Which dogs are predisposed to amitraz toxicity
Small breeds: Pomeranians, Chihuahuas CHIHUAHUAS ARE ON THE LABEL
46
Which medications should be avoided with amitraz
Other sedating agents (bc Amitraz is alpha-2 agonist) Synergistic toxicity
47
What percent of dogs with amitraz monotherapy for their demodicosis do not achieve cytologic cure
20% -- combo with other meds
48
T or F: Ivermectin is labeled for treatment of demodicosis in dogs but not cats
False. Only approved treatment for demodicosis in dogs is Amitraz
49
What is the most effective route to administer ivermectin (for tx demodex)
PO daily >>> SC q1w, pour on 3x/w
50
AEs of ivermectin
Neurotoxicity!! Early: Mydriasis, temporary blindness Lethargy Vomiting Ataxia, tremors Late: Seizures, coma, respiratory failure, death
51
What is the first clinical sign of ivermectin toxicity
Mydriasis Mydriasis is also the last sign to resolve of ivermectin toxicity
52
What is the antidote for ivermectin toxicity
None Charcoal, IV lipids (Flumazenil in rats, Physostigmine helps CNS short term but AEs)
53
Which breeds are sensitive to ivermectin? Mutation?
Collies Australian shepherd dogs Shetland sheepdogs English sheepdogs ABCB1 gene (formerly mdr1); autosomal recessive--> nonfunctional P-glucoprotein = ATP-dependent transmembrane transporter protein, esp at the blood-brain barrier. Cannot transport drugs OUT of the CNS
54
What medications should be avoided with ivermectin
Other substrates of P-glycoprotein efflux transporter ie: ketoconazole, cyclosporine, glucocorticoids -- ALSO Spinosad products ---> inhibitor of P-gp!
55
56
Which medication is safer than ivermectin in ABCA1 dogs (though still titrate dose up!
Moxidectin
57
What is the best tolerated method of moxidectin/imidacloprid administration
Topical q1w
58
Isoxazoline MOA
Bind to ligand-gated chloride channels (GABA receptors). Block Cl ions across cell membrane of pre and postsynaptic cleft. = Prolonged hyperexcitation --> death
59
How is fluralaner excreted
Unchanged in feces by hepatic elimination
60
How is afloxolaner excreted
Biliary excretion of unchanged afoxolaner Biliary and renal clearance of afoxalaner metabolites
61
At what age can afoxolaner, surolaner be administered to puppies?
8 weeks
62
T or F: inactivated Parapox virus suis subcutaneously with amitraz leave on may be benefitical. Immunostimulant
True
63
Which oral isoxazoline has been successful in treating a CAT with demodicosis
Fluralaner

EV ACVD Study (52 decks)

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