I've been itching to tell this story for some time:

“Dr. Orzeck,” said the veterinary technician as she handed me the client’s file, “if you don’t mind, I’m gonna let you handle this one by yourself. This mange stuff gives me the creeps.” During the entire ten months as a practicing newly-graduated veterinarian, I’d only seen her act this way once before. And as it turned out, it would be because of the very same disease.

Upon entering the exam room on that dreadfully hot and humid August day, I was greeted by a cheerful, young, All-American family of four. There was Dad, slightly overweight (I can hear it out there now: “Hey Doc, be careful! You ain’t no Slim Jim yourself”), dressed in flip flops, baggy shorts, and an orange muscle T-shirt that was just a little too small to cover his entire belly. There was Ma, who wore shorts that matched her husband’s, and a white NASCAR tank top, under which she was braless (this being braless is part of the story, so don’t anybody think I intentionally was looking. I honestly did my best to avert my gaze.) Standing on their left side and holding a half-gallon-size cup of Mountain Dew bought from the local Seven-Eleven mini-mart, was young Junior, who looked to be about ten years old, and was the spitting image of Dad, right down to the orange muscle shirt, protruding belly, and baggy shorts. Standing to their left was little Daughter, who was maybe six years old and a miniature version of older brother. She also clutched a quart-sized container of Pepsi.

Sitting on the floor, scratching and chewing and mutilating himself ceaselessly, and looking like one big yellow walking scab, was an eight month old Pit Bull pup named Otis.

Besides my immediate concern for the poor beast on the floor ripping his skin off, the other problem I noticed was that on all of the bare arms and legs of the family standing before me, were nasty-looking, red, tiny, blotches, some of which were scabbed over, but most of which were raw and oozing. They, too, were scratching themselves non-stop.

“Doc,” said the dad, “poor Otis just won’t stop itchin’ himself. He’s driving us crazy. I sure hope you can do something!”

“Sir,” I asked, “how long has he been itching himself raw like this? And even more important,” as I pointed towards his arms, “how long has your family had those sores on all of your bodies?”

“Geez Doc, I’m glad you asked. We don’t know what it is. We’ve been treating ourselves with poison ivy lotion, udder balm, Neosporin, and anything we could think of for the past two months; but nothing’s working.”  Motioning to his wife to come closer to the exam table, he had her turn around so that she faced away from me. Then, pulling her blouse up all the way to the bottom of her neck, he said, “if you think our legs and arms are bad, just look at Ma’s back.”

And sure enough, in the area of where the bra straps would have normally gone across her back and up over her shoulders, were red welts that she had scratched into one continuous bright red sore. “Doc, its like that in the front, too. Do you wanna see?”

Because I’m just an innocent and humble old farm boy from upstate New York who still embarrasses quite easily, I quickly told him it wouldn’t be necessary. I got the point. I then told him that even though I wasn’t a physician, I’d seen several times before the lesions he and his family had, and that I had a pretty good idea of what everyone’s problem was.
After performing a simple skin scraping on Otis, I had the answer: he (Otis) and his family all had mange, specifically Sarcoptic mange.

Sarcoptic mange! Yuck!!! The very word sends creepy crawling shivers up the backs of many people. I’m getting the “itchies” just sitting here typing the word!!! Mange, specifically sarcoptic mange (there are a couple of other varieties), is nothing more than an infection by a tiny mite called Sarcoptic scabiei. These mites are so small, you could put a hundred of them on the head of a pin. I see probably fifty or more cases of the disease in dogs every year. The hallmark sign of the disease is intense, skin-ripping, non-stop, puritis (itching.) It is easily confused with fleas and/or allergies. In humans, this disease is called Scabies. (As an interesting aside, the word scabies comes from the Latin word “to scratch” (scabere). The disease occurs world wide.

Our dogs, and rarely cats, catch the disease by coming into intimate contact with another animal who has the disease. In just about every case of mange I see here in upstate New York, there is a history of the pet having contact with a fox in the previous six months. Humans catch the disease by a similar exposure or they get it from their infected pet. (Horses, cattle and pigs also can have mange.)

We are lucky in this modern age to have very effective and safe treatments for this disease. I use a drug originally made for fleas and heart worm prevention called Revolution™ to kill the mites internally. (It is important that a dog or cat be tested and is negative for heartworm disease before using Revolution.) In my practice, I also give a cortisone shot to provide the misfortunate animal with some relief from their relentless itching. Less commonly used, but widely available worldwide, are lime sulfur dips.
My two-legged clients I send to see their family physician. A very comprehensive article on human scabies and treatment can be found at http://en.wikipedia.org/wiki/Scabies

Thank you.

Doctor Oz

Copyright © 2007 by Richard Orzeck, DVM
The information in this article is based upon the author’s personal experience and his best interpretation of veterinary data at the time of writing. It is not intended to render veterinary advice or service. Specific needs and questions concerning your pet’s health should always be addressed by his or her best friend, your local veterinarian.


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