Sarcoptic Mange in Cats

Overview of Sarcoptic Mange in Cats

Sarcoptic mange (also known as scabies) is a highly contagious parasitic disease caused by a microscopic mite called Sarcoptes scabiei that affects animals and people. These mites invade the skin of healthy cats and kittens and create a variety of skin problems. Humans exposed to infested cats commonly are affected.

Cats of all ages may be affected, but sarcoptic mange is more common in young animals. Cats living in close contact with affected dogs may develop the disease. The mite prefers to live lives on the surface of the skin, and does not survive for very long off the host.

The hallmark of the disease is intense pruritus that does not respond to symptomatic treatment; the cat scratches and chews at himself. There may also be papules (small red bumps) located on the margins of the ears, elbows, hocks (ankles), chest and abdomen. These lesions may become generalized. Other symptoms may include patchy hair loss, and crusty sores.
Symptoms are thought to be the result of a severe allergic reaction to the mite. Just a few mites can cause severe generalized pruritus (itchiness), which sometimes persists after therapy due to the allergic component of this disease. The incubation period (time until clinical symptoms become apparent) can be as long as 3 weeks after exposure.

If left untreated, chronic skin lesions develop including increased pigmentation, thickening and wrinkling of the skin, ulcerations and draining tracts. Secondary bacterial infections are common due to self-trauma.

Pruritic (itchy) papules (small red bumps) can be found on the arms, neck and waistline of affected humans. The sarcoptic mange mite of cats cannot reproduce on human skin, and lesions on humans regress spontaneously in 12 to 14 days.

What to Watch For

• Intense itching
• Presence of papules
• Patchy hair loss
• Crusty sores

Diagnosis of Sarcoptic Mange in Cats

The diagnosis of sarcoptic mange is based on three things:

• Suggestive clinical signs. The rapid onset of pruritis and the rapid progression of lesions should suggest scabies.
• Microscopic examination of skin scrapings. Mites are occasionally found on microscopic examination of skin scrapings, but failure to find the mite should not eliminate the diagnosis of scabies.
• Response to treatment. Treatment for scabies improves the condition.

Treatment of Sarcoptic Mange in Cats

Treatment should be carried out for the entire life cycle of the mite, which is 3 weeks. All animals in the household should be treated to reduce the possibility of re-infestation.

There are several ways to treat scabies.

• You may be asked to bathe your animal weekly and use an anti-parasitic lime sulfur dip (LymDip).
• An alternative treatment consists of the administration of the anti-parasitic drug ivermectin once every 2 weeks for 3 treatments. Some breeds (especially collies, shelties, and Australian shepherds) are extremely sensitive to the adverse effects of ivermectin.
• Revolution, a topical product applied monthly for flea control and heartworm prevention, also is a safe and effective treatment for sarcoptic mange.
• Treatment with antibiotics may be necessary if your cat has developed a secondary bacterial infection.
• Regular cleaning, vacuuming and washing of bedding usually are sufficient to rid the household of the mites.

Home Care

At home you may be asked to bathe your animal weekly and use an anti-parasitic lime sulfur dip (LymDip). The dip preparation is very safe, but may damage jewelry and porcelain. It produces a yellow stain on the hair coat and skin due to its sulfur content. The sulfur content also imparts a strong odor of “rotten eggs.” Gloves should be used when applying the dip.

Ideally, the dip should be applied outdoors and the animal not allowed back into the house until it is completely dry. This precaution will prevent staining of furniture and carpeting by the dip.

Mites do not survive for long in the environment. Regular cleaning, vacuuming and washing of bedding usually are sufficient to rid the household of the mites. Remember, mites can be transmitted to humans, so care must be taken when handling an infested cat.

Preventative Care

Prevention consists of avoiding contact with infected animals. Mites do not survive very long in the environment, and direct contact is necessary to become infected. All animals in the household should be treated to reduce the possibility of re-infestation.

Regular cleaning, vacuuming and washing of bedding usually are sufficient to rid the household of the mites.

In-depth Information on Sarcoptic Mange in Cats

Sarcoptic mange is a contagious parasitic skin disease of cats caused by Sarcoptes scabei. The mite is fairly host specific but can infest man and cause a transient pruritic papular eruption. In people lesions develop within 24 hours after exposure and spontaneously resolve in 12 to 14 days because the mite cannot reproduce on human skin.

The mite spends its entire life cycle on the host. The life cycle is complete in 17 to 21 days. Male mites live on the surface of the skin while females burrow into the superficial layers of the epidermis to lay eggs. Mites do not survive off the host longer than 48 hours in most conditions.

Incubation period for scabies varies from six to 30 days depending on previous exposure. If a cat has been exposed to the mite previously, clinical signs are more rapid and severe due to existent hypersensitivity.

Very few mites can cause severe clinical signs. This is most likely due to development of hypersensitivity from the host. Mite feces are the most likely source of antigenic stimulation.

Sarcoptic mange cannot be ruled out by the absence of clinical signs in other animals or people living in the same house. This is due to the limited number of parasites present in most affected animals.

Related Symptoms or Ailments

• The primary lesion is the pruritic erythematous papule, which is an itchy, red, raised skin bump. Later, these papules become associated with thick yellow-gray scale/crusts, especially on the ear. Sarcoptic mange has predilection for areas with sparse hair.
• Lesions are characteristically present at the edges of the pinnae, elbows, hocks and ventral chest and abdomen. It can become generalized.
• Secondary alopecia, skin thickening (lichenification) and hyperpigmentation can result from self-trauma. Excoriations are commonly seen. Erythema can become generalized.

Besides the classic presentation of scabies, there are two rarer syndromes:

• The first one is called “Scabies incognito” and is seen in well-groomed cats. No skin lesions are seen in these cats but intense pruritus is present.
• The second syndrome is called “Norwegian scabies” and is seen in young kittens, elderly patients or immunosuppressed cats. In these cases pruritus is mild to non-existent but severe crusting and large numbers of mites are present. This presentation is probably caused by a lack of hypersensitivity reaction, which usually is the one that keeps the number of mites limited.

Diagnosis In-depth

The diagnosis of sarcoptic mange is made on the basis of suggestive history, compatible clinical signs, microscopic examination of skin scrapings and response to therapy. Response to therapy sometimes is used as a diagnostic test because the sarcoptic mange mites can be very difficult to find on skin scrapings.

Your veterinarian will probably recommend the following:

• Superficial skin scrapings. Most skin scrapings are positive for the sarcoptic mange mite in less than 50 percent of cases. Skin scrapings should be superficial and cover a broad expanse of skin. The best areas to scrape are the ear margins and elbows. Avoid areas of skin that the animal has mutilated. Areas with thick crusts are suitable areas.
• Fecal flotation. Mites may observed during microscopic examination of feces for parasites because the mites may be swallowed when the cat chews on its skin.
• Potassium hydroxide digestion of hair, crusts, and scales collected in large quantity. The material is digested in potassium hydroxide and centrifuged. This material is examined microscopically for mites and their eggs.
• Skin biopsy. Occasionally mites may be seen on microscopic examination of skin biopsy specimens, but this method is not a very sensitive. Papules are the best lesions to biopsy.

Treatment In-depth

All extremely pruritic cats with typical clinical symptoms should be treated. Cats with non-seasonal pruritus that is poorly responsive to treatment with cortisone-like drugs (glucocorticoids) should be treated for sarcoptic mange to rule out this possibility.

All animals in the household should be treated. Various treatments may be used to eradicate sarcoptic mange mite infestation. They include:

• Lime sulfur (LymDip®) 2 to 4 percent: mix 4 to 6 ounces per gallon of water and apply once every 5 to 7 days for a total of 6 treatments. Lime sulfur is the treatment of choice for kittens less than 4 weeks old and animals that cannot be treated with ivermectin. Hair may need to be clipped if too long to ensure good contact of the product with the skin. A keratolytic or antibacterial (OxyDex) shampoo may be needed prior to the dip.
• Ivermectin (Ivomec®) at 200 micrograms/kg (0.2 mg/kg) by mouth given twice at two week intervals or given four times at weekly intervals. In most cats, pruritus is reduce by at least 50 percent 7 to 10 days after the first treatment and it gradually disappears within four weeks.
• Milbemycin (Interceptor®) at a dosage of 0.5 to 1 milligrams per pound of body weight once weekly for 4 weeks also is an effective treatment for sarcoptic mange. Milbemycin should be used with caution in ivermectin-sensitive breeds due to the potential of similar adverse effects.
• Amitraz (Mitaban®) also is an effective treatment for sarcoptic mange. It is not approved for this use however. To treat sarcoptic mange with amitraz, the drug is applied at the same concentration used for the treatment of demodectic mange (1 vial in 2 gallons of water) and administered as 3 to 4 dips given at 2 week intervals.

Amitraz should be used at 25 to 50 percent strength in toy breeds due to increased risk for toxicity in smaller breeds. Sedation is the most common adverse effect of amitraz. Amitraz should not be used in geriatric or sick animals and in those with diabetes mellitus because amitraz may cause a temporarily high blood sugar level.

• Selamectin (Revolution®) is an avermectin type drug that also can be used as treatment for sarcoptic mange. Selamectin is rapidly and completely absorbed through the skin and is safe for use in ivermectin-sensitive breeds. One treatment is sufficient to eradicate infestation. However, in severe cases a second application may be necessary.
• Bedding should be washed at high temperature or discarded. Vacuuming is recommended to eliminate possible reinfestation.
• Secondary bacterial skin infections are common and may require antibiotic therapy. Superficial bacterial infections often are treated for 4 weeks with antibiotics whereas deep infections may require treatment for 8 to 10 weeks.

Follow-up

Prevention is done by avoiding contact with infected animals. Mites do not survive for very long in the environment, thus direct contact is necessary to become infected.

Therapy needs to cover the mite life cycle (three weeks). With appropriate therapy, there should be complete resolution of itching and skin lesions.