What are the options for treating feral cats with mange?

Last updated: 2019-07-19
Author: Dr. Erica Schumacher
Document type: FAQs
Topics: Infectious Disease, Community Cat Resources
Species: Feline

A dedicated TNR advocate struggles to find help for the feral cats and kittens coming in with mange. With felines often too sick for surgery, the search for a suitable treatment has been frustrating. Dr. Schumacher explores the problem and explains why there are no easy answers.


I am deeply involved in our county TNR effort. This county is approximately 750 square miles and has nearly 390,000 residents, meaning that we also probably have nearly 100,000 free roaming cats. My organization gathers grants to support local TNR efforts and in the last year we have begun to see an extraordinary number of cats/kittens overwhelmed with mange--mites so numerous, that some of the afflicted cats cannot open their eyes. Kittens are dying and adult cats cannot see to find food. When trapped for TNR, they are often declined by our surgical partners because they are not healthy enough to withstand the necessary anesthesia.

My local research has been a dead end because any suitable treatment suggested includes being able to medicate them with a topical agent twice before we catch them again for TNR. Ninety percent of these cats are hard to catch once, much less three times, so I'm in desperate search for another method of treatment. Are there any food additive treatments that you are aware of, even off-label medications, that might help us? Or are there any environmental treatments, such as spreading powdered sulphur in their colony resting areas that might discourage the mites?

Please let me know of any other avenues of research that I could pursue. 

Thanks so much for your help. 



Hello and thank you for your dedication to improve the lives of cats in your community! Mange in cats in humid southern climates is often caused by the mite Notoedres cati. Infection with these mites can result in the severity of disease you have seen. It is certainly heartbreaking to see the devastating effects of mange on animals, especially those that don’t allow you to touch them for treatment!

Unfortunately, we don’t have any easy answers. Treating feral cats for mange presents numerous challenges: 

  1. As you have found, treatment options are limited. There are no FDA-approved treatments for mange in cats, and while off-label options do exist, many require repeated administration. 
  2. Topical treatment is often not possible unless under anesthesia for spay/neuter. 
  3. Oral treatment is ideal but risks under or over-dosing or treating the wrong cat in a free-roaming area. 
  4. The legality of treating unowned cats may differ depending on the state (i.e. is a veterinarian-client-patient relationship required for each individual cat or is it legal to treat a “herd” of cats?).

There have been some recent advances in ectoparasiticide options and one in particular stands out as the most feasible option for treatment of feral cats. The isoxazoline compound fluralaner (Bravecto®) is available in a topical form for cats and both topical and chewable forms for dogs; a single dose lasts for 12 weeks. Although it is off-label use, it has been shown to be effective at treating both dogs and cats for Sarcoptic mange (caused by Sarcoptes scabeii, a mite similar but not identical to Notoedres cati). Some veterinarians have reported success in treating cats with Notoedric mange using the chewable form in only one dose. Again, this is off-label use. Laws regarding off-label use of medications vary by state and use must be under the direction of a veterinarian.

In the circumstance of a feral kitten with severe mange, it may be reasonable to give it a dose of topical Bravecto and then house short-term until healthy enough for surgery. This is not a solution recommended for every cat or every organization, however. Housing a feral cat in captivity is extremely stressful and not many organizations are equipped to do so in even a relatively humane manner (large outdoor enclosures with ability to avoid humans during cleaning and feeding times).

Unfortunately, environmental treatment is not likely to help. The mites don’t live long in the environment; they really need a host to survive. In order to eliminate the mites, the host cats themselves must be treated.

Again, there are no easy answers. Increasing our TNR efforts to minimize the number of kittens born and treating cats as they come through for surgery may be the best solution we have at this time.

Thank you again for your question and for the work that you do!


University of Wisconsin Shelter Medicine Program

Erica Schumacher, DVM
Outreach Veterinarian 
Shelter Medicine Program
University of Wisconsin – School of Veterinary Medicine



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Fourie JJ, Liebenberg JE, Horak IG, Taenzler J, Heckeroth AR, Frénais R; Efficacy of orally administered fluralaner (Bravecto™) or topically applied imidacloprid/moxidectin (Advocate®) against generalized demodicosis in dogs; Parasit Vectors. 2015 Mar 28;8:187. doi: 10.1186/s13071-015-0775-8. 

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