On Phoebe’s thirteenth day with us, we took her back to the vet for a variety of symptoms that popped up after the first health check – constant urination, drinking massive amounts of water, vomiting, diarrhea, and the rash on her belly.

Out the gate, the vet was almost certain that Phoebe had a urinary tract infection (UTI), but needed to send a urine sample to the lab for confirmation. If a UTI was confirmed, the next step would be to have the lab perform a smear to identify the specific bacteria that was causing the infection, thus making sure Phoebe was prescribed the best antibiotic for the job.

Since Phoebe had diarrhea, we agreed to a fecal exam. I was not surprised when the vet said Phoebe tested positive for Giardia. According to the Web site, PetMD:

“Up to 50 percent of young puppies will develop this intestinal infection, and up to 100 percent of dogs housed in kennels will develop it due to the massive exposure and closely shared living spaces.”

It can take between 7 days and 3 weeks for the symptoms of Giardia to appear.  That little adoption paper warning about potential illnesses not becoming apparent for a couple of weeks was starting playing out.  My only recommendation here is to be hypervigilant when cleaning up your rescue dog’s feces until you are sure that they are Giardia-free.

That left us with the pink rash on Phoebe’s face and belly. The vet did a skin scraping and confirmed her suspicion that Phoebe had mange.Say what?!?

Large area of pink around the muzzle; covered both sides and extended beyond the lips,
Large area of pink around the muzzle; covered both sides and extended beyond the lips,
Pinkness and the start of hair loss near the eye
Pinkness and the start of hair loss near the eye


Something about the word “mange” just makes my skin crawl. I mean, isn’t that something reserved for a disease-ridden feral dogs that lurk in allies?

Wrong! It has to do with mites and immune systems, not living conditions per se.

In short mange is caused by little mites that live on the dog (they live on other animals and humans, but for simplicity I am just referring to dogs). The mere presence of mites is not the issue, since a dog’s immune system will normally keep them under control. They become an issue when a dog’s immune system cannot keep up with them. The mites overpopulate and, depending on the specific type of mite (one is contagious; the other is not),  they either burrow into the dog’s skin or embed themselves in the hair follicles and voila! Mange is ‘born.’ Taking this a step further, mange can be limited to a few small areas (localized) or spread across the body (generalized). Phoebe was diagnosed with dermotopic mange (the non-contagious one).

Since puppies have not had a chance to build up their immune system, they become likely targets for these obnoxious mite creatures. Often, the mange will cure itself as the puppy’s immune system gets stronger. Then again, there are pups like Phoebe who simply can’t shake them.  Just like people, many things can compromise a dog’s immune system – immaturity (puppies), born sickly, stress and a poor diet come to mind. Considering Phoebe’s history it makes sense. She was living in a shelter environment (stressful) and she is young, who knows how long she was a stray, where she was, and what she got into.  If Phoebe’s immune system was the result of all of that, then the mites had a great opportunity to just take hold.

With all thee things going one, we figured we might as well send a blood sample to the lab. By the time we left the appointment, Phoebe was diagnosed with:

  • A probable Urinary Tract Infection (lab results pending)
  • Generalized dermotopic mange
  • A Bacterial skin infection, was secondary to the mange
  • Giardia

The Treatment

For the Giardia and that secondary bacterial skin infection related to the mange, she was prescribed Metronidazole twice a day for 14 days.

For the vomiting Phoebe was put on a bland diet (rice, chicken or cottage cheese), spread among four meals a day instead of two, until her tummy felt better (i.e., a few days with no barfing or diarrhea). Then I could wean her back onto her kibble. If the vomiting continued, they would show me how to give her fluids subcutaneously. She did not have any further bouts of vomit, so i lucked out there.

The mange would require several months of treatment

Ivermectin once a day, duration unknown (Ivermectin is the same medication used for heart worm prevention, so would not need her heart worm prophylactics   until the mange treatment is discontinued)

Medicated shampoo (Mal-A-Ket ) every one or two weeks. This stuff is contains chlorhexidene, ketoconazole and acetic acid, which I was not overly fond of.  Giving her a bath every two weeks was no big deal; the challenge was that we had to lather her up and let it sit for 10 minutes.

I went home feeling pretty bad that Phoebe had been dealt a really bad hand. I wanted to do whatever I could to get the manage under control as soon as possible.  A lot of sites were just duplications or slightly altered version of another. Then I stumbled upon a site that was developed by a vet  and it provided some real good information. The sentence that popped out at me, was:

“Pets weakened by Demodex may need nutritional support, a low stress environment, antibiotics and topical antibacterial and antifungal medications to help clear the mites from their skin.”

I was already set to work on Phoebe’s diet, but this put me on a  full-fledged mission to research, identify and define the best diet for Phoebe. I needed one that provided the nutrients necessary for good health AND boosted her immune system. The nutrition component is a work-in-progress that I’ll try to describe soon. I have all kinds of data in my head, but trying to describe it is as mind boggling as trying to research it in the first place.

Grand total for second vet visit: $366.53

  • Weight: 34.4 pounds (lost 2 pounds)
  • Exam: $50.00
  • Skin Scraping to Test for Mange: $22.00
  • Fecal Exam for Parasites: $32.00
  • Parvo Virus Test: $38.00
    This test was because Phoebe was a puppy with vomiting and diarrhea; “better safe than sorry” kind of test
  • Blood Work (Total Health) $150.98
  • Ivermectin Oral – Large: $40.00
  • Metronidazole 250mg Tablets: $33.55

Rescue Dog Tally (Basic Care and Health Needs): $912.52 plus the landlord’s rental deposit