Evidenzbasierte Therapie der Demodikose des Hundes

R. S. Mueller

doi:10.1055/s-0038-1623606

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2011; 39(06): 419-424
DOI: 10.1055/s-0038-1623606

Übersichtsartikel

Schattauer GmbH

Evidenzbasierte Therapie der Demodikose des Hundes

Evidence-based treatment of canine demodicosis

Authors

R. S. Mueller

¹Medizinische Kleintierklinik, Zentrum für klinische Tiermedizin, Ludwig-Maximilians-Universität München

Abstract

Zusammenfassung

Dieser Artikel gibt nach einer kurzen Übersicht über Pathogenese, klinische Symptomatik und Diagnose der Demodikose des Hundes eine Zusammenfassung der Behandlungsmöglichkeiten basierend auf publizierten Wirksamkeitsstudien. Die Krankheit beruht auf einer exzessiven Proliferation von Demodex-Milben in den Haarfollikeln, die durch genetische Faktoren, immunsuppressive Krankheiten oder Therapien hervorgerufen sein kann. Das klinische Bild manifestiert sich in Form von Alopezie, Papeln, Pusteln und Krusten. Die Diagnose erfolgt durch den Nachweis mehrerer Milben in tiefen Hautgeschabseln oder Trichogrammen. Veröffentlichten Studien zufolge sind wöchentliche Spülungen mit Amitraz in einer Konzentration von 0,05% und (bei geringbis mittelgradig ausgeprägter Symptomatik) eine wöchentliche Spot-onBehandlung mit Moxidectin zugelassene und in vielen Fällen wirksame Therapien. Bei schweren, behandlungsresistenten Fällen können als orale Medikation makrozyklische Laktone wie Milbemycinoxim (1–2 mg/kg KM täglich), Ivermectin oder Moxidectin (0,3 mg/kg KM täglich nach täglicher gradueller Dosiserhöhung ) Anwendung finden. Auch eine wöchentliche Applikation von Doramectin in einer Dosis von 0,6 mg/kg KM subkutan oder oral erwies sich in Studien als erfolgreich. Die Behandlung der in der Regel vorhandenen bakteriellen Sekundärinfektion sollte mit antibakteriellen Shampoos und gegebenenfalls oral verabreichten Antibiotika erfolgen.

Summary

This article briefly reviews pathogenesis, clinics and diagnosis of canine demodicosis and summarizes treatment options for this disease based on published evidence. The disease is caused by excessive proliferation of Demodex mites in the hair follicles that may be due to genetic factors or immunosuppressive diseases or treatments. The disease is characterized by alopecia, papules, pustules and crusts. Diagnosis is confirmed by detection of several mites in deep skin scrapings or trichograms. Based on published studies, licensed successful treatments for many patients are weekly amitraz rinses in a concentration of 0.05% and (in dogs with mild to moderate clinical signs) weekly spot-ons containing moxidectin. In severe, treatment-resistant cases, daily oral macrocyclic lactones such as milbemycin oxim (1–2 mg/kg), ivermectin or moxidectin (0.3 mg/kg after daily gradual dose increases from 0.05 mg/kg) may be used. Doramectin orally or subcutaneously at 0.6 mg/kg has also been reported as successful therapy. Secondary bacterial skin infections are common and should be treated with antimicrobial shampoos and possibly oral antibiotics.

Schlüsselwörter

Hund - Milben - Demodex - Amitraz - Ivermectin - Moxidectin - Milbemycin - Doramectin - Behandlung

Key words

Canine - mites - Demodex - amitraz - ivermectin - moxidectin - milbemycin - doramectin - therapy

Full Text

References

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