Comparison of Efficacy, Side Effects, and Cost of Isoxasolines and Ivermectin Against Generalized Canine Demodicosis

Abstract

Demodex canis mites are found in the normal skin microbiota of most dogs, but can result in canine demodicosis if the number of mites dramatically increases due to underlying disease, immunosurpression, genetic defect, stress, or breed association. Treating generalized Demodectic mange often requires high owner compliance over a potentially long period of time, especially when using ivermectin. Recent studies have revealed that a class of insecticides known as isoxasolines provide a better alternative for treatment of generalized demodicosis, specifically afoxolaner (NexGard®), fluralaner (Bravecto™), and sarolaner (Simparica™). This review compares the efficacy, side effects, and cost of isoxasolines to ivermectin in efforts to aid owners and veterinarians in choosing an effective, yet safe and lost-cost treatment option. Although additional studies are needed, fluralaner appears to be highly efficacious and the safest and cheapest treatment option for generalized canine demodicosis, while ivermectin appeared to be the least preferred treatment option presently, a major factor being toxicity.