May 9, 2026
Canine Sarcoptic Mange
Intense pruritus, papules, and crusting on ear margins and elbows — the pinnal-pedal reflex clinches it.
If the ear scratch reflex is positive, treat for scabies.
3yo FS mixed 18kg. EXTREME itch x3 wks, not sleeping. Papules + crusting on ear margins, elbows, hocks, ventral abdomen. Pinnal-pedal reflex is strongly positive bilat. Skin scrape was negative but I'm thinking sarcoptes. Treat empirically?
🔬SARCOPTIC MANGE — TREAT EMPIRICALLY — Classic distribution + pinnal-pedal reflex positive = treat for scabies. Skin scrapes are only 20–50% sensitive — false negatives are the norm.
Why Empirical Treatment Is Correct
- Skin scrapes are 20–50% sensitive — negative scrape does NOT rule out sarcoptes
- Pinnal-pedal reflex ~82% specific + classic distribution (ear margins, elbows, hocks, ventral abdomen)
- Response to therapy is the best diagnostic test — if you suspect it, treat it
Treatment Options (Pick One)
- Fluralaner (Bravecto) 25–56 mg/kg PO once — single dose curative in most cases; easiest option
- Sarolaner (Simparica) or Afoxolaner (NexGard) PO monthly x 2 doses — all isoxazolines are excellent
- Ivermectin 0.2–0.4 mg/kg PO q7d x 4 weeks — avoid in MDR1-mutant breeds (Collies, Shelties, Aussies)
- Selamectin (Revolution) topical q2wk x 3 doses — alternative for ivermectin-sensitive breeds
Symptomatic Relief + Monitoring
- Prednisone 0.5–1 mg/kg PO q24h x 5–7 days — break itch cycle | Cephalexin 22 mg/kg q12h x 14–21 days if pyoderma
- Expect improvement within 2 weeks; full resolution 4–6 weeks — if no response by 4 weeks, reconsider Dx
⚠️ Environmental + In-Contact Animals
- Treat ALL in-contact dogs — even if asymptomatic; they may be carriers
- Wash bedding in hot water + dry on high heat — mites survive off-host 2–3 days
- Zoonotic! Transient papular rash in humans — self-limiting once the dog source is treated
Your dog almost certainly has scabies — burrowing mites causing intense itching. The scrape was negative, but that's common. One dose of Bravecto usually cures it. All dogs in the household need treatment; humans can get a temporary rash that resolves once the dog is treated.
Sources
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