You're petting your cat and feel a rough, bald patch. Or maybe they won't stop scratching, day and night. A quick search points to "mange." But what is mange in cats, really? It's not a single disease, but a skin condition caused by microscopic mites. Think of it as an unwelcome insect infestation on your cat's skin, leading to intense itching, hair loss, and misery. Left unchecked, it can spiral into severe skin infections. The good news? It's treatable. This guide cuts through the confusion, explaining exactly what you're dealing with, how to spot it, and the steps to take for your cat's recovery.

It All Starts with a Mite: The Two Main Types of Feline Mange

Mange is a blanket term. To treat it effectively, you need to know which mite you're fighting. The two primary types behave very differently.

Sarcoptic Mange (Feline Scabies): The Intense Itcher

Caused by Sarcoptes scabiei mites. These are the nightmare tenants. They burrow into the top layer of your cat's skin to lay eggs. This tunneling causes an intense, relentless allergic reaction—the signature symptom is severe itching that seems disproportionate to the visible lesions. It's highly contagious to other pets and can even cause a temporary itchy rash in humans (called "sarcoptic mange in cats zoonotic"). Cats often pick it up from contact with infected wildlife (like foxes) or other pets.

Demodectic Mange (Demodex): The Opportunistic Resident

Caused by Demodex cati or Demodex gatoi mites. Here's where it gets interesting. Most healthy cats have a few of these mites living harmlessly in their hair follicles—they're normal residents. Problems erupt when something disrupts the balance. Demodex gatoi is contagious between cats and causes itching. Demodex cati is usually a sign of an underlying problem. It's not typically itchy unless a secondary infection sets in.

What triggers an overgrowth? A compromised immune system is the big one. This could be due to stress (like a move), poor nutrition, an untreated chronic illness (like diabetes or FIV), or even certain medications like long-term steroids. I've seen cases flare up after a cat underwent major surgery—the physical stress was enough to tip the scales.

How to Spot the Symptoms of Mange in Your Cat

The signs can be subtle at first. Don't wait for a Hollywood-style bald, crusty cat. Early detection makes treatment easier.

• Relentless Scratching and Grooming: This is your biggest clue. It's not a casual scratch behind the ear. It's frantic, focused, and frequent. You might see them chewing at their flanks or hind legs.
• Patchy Hair Loss (Alopecia): It often starts in classic spots. For sarcoptic mange, look at the thin-skinned areas: the edges of the ears (they can look "tattered"), elbows, ankles (hocks), and belly. Demodectic mange often shows up around the eyes, chin, and head first.
• Skin Changes: The skin itself becomes angry. Look for redness (inflammation), papules (small red bumps), and thick, grayish-yellow crusts. With constant trauma from scratching, the skin can become thickened and leathery (lichenification).
• Secondary Infections: This is the dangerous complication. Broken skin is an open door for bacteria. You might notice pustules, oozing, a foul smell, or hot spots. The cat may become lethargic or run a fever.

I remember a case, a rescue named Barnaby. His foster thought he just had "dry skin" because they only saw mild dandruff on his back. But he was over-grooming his belly bald when no one was looking. A vet visit revealed a thriving Demodex population. The dandruff was actually scale from the mites.

Getting a Diagnosis: What Your Vet Will Do (and Why Skimping Fails)

You cannot diagnose mange at home. Period. Skin conditions like allergies, ringworm, and bacterial infections can look identical. Guessing and using over-the-counter products can make things worse and waste precious time.

Your veterinarian's process is methodical:

1. Deep Skin Scraping: This is the gold standard. The vet uses a scalpel blade to gently scrape the skin's surface (often at the edge of a lesion) until it oozes a tiny bit of capillary blood. They view the collected material under a microscope. Seeing the mites, their eggs, or feces confirms the diagnosis. Sarcoptic mites can be elusive; multiple scrapings or a failure to find them despite classic symptoms may lead to a "presumptive diagnosis."
2. Fungal Culture: Often done simultaneously to rule out ringworm, a common mimic.
3. General Health Check: Especially for demodectic mange, your vet will likely recommend blood work (a CBC and chemistry panel) to screen for underlying conditions like diabetes, kidney disease, or feline leukemia virus (FeLV) that could be impairing the immune system.

Skipping the vet and going straight for a "mange shampoo" you saw online is like trying to fix a leaking pipe with duct tape. You might cover the symptom briefly, but you haven't addressed the leak—or even confirmed it's a pipe and not an electrical wire.

The Treatment Roadmap: From Medication to Home Care

Treatment is multi-pronged. It's not just about killing mites; it's about healing skin, preventing reinfection, and supporting overall health.

Prescription Medications Are the Backbone

Forget old-fashioned, toxic dips. Modern treatment is safer and more effective.

• Topical "Spot-on" Treatments: Products like Revolution Plus (selamectin/sarolaner) or Bravecto Plus (fluralaner/moxidectin) are often first-line. Applied to the skin between the shoulder blades, they kill mites and prevent reinfection for a month or longer. They're convenient and less stressful than oral meds for many cats.
• Oral Medications: Isoxazoline class drugs (like fluralaner in Bravecto, sarolaner in Simparica) are highly effective. They're given as a chewable tablet. Your vet will choose based on your cat's health profile and lifestyle.
• Injections: In some persistent cases, ivermectin injections may be used, but this is off-label for cats and requires careful dosing by your vet.

Treatment must continue for the full lifecycle of the mite. Your vet will prescribe a schedule, often for 4-8 weeks. Do not stop early because the itching stopped. Eggs may still be hatching.

The Crucial Home & Environmental Care Most Guides Miss

Medication kills mites on the cat. But what about in the environment? This step is critical for sarcoptic mange and a good practice for all cases.

• Wash Everything: All bedding, blankets, and removable couch covers your cat uses should be washed weekly in the hottest water safe for the fabric. Dry on high heat.
• Vacuum Like a Pro: Vacuum carpets, upholstery, and cat trees thoroughly. Immediately seal and dispose of the vacuum bag or empty the canister outside.
• Disinfect Surfaces: Hard surfaces can be wiped with a diluted bleach solution (1:32) or a disinfectant recommended by your vet. Let it sit for 10 minutes before wiping.
• Isolate if Possible: In multi-pet homes, isolating the infected cat during initial treatment can prevent spread. Treat all in-contact pets as your vet advises, even if they show no symptoms.

Supporting Skin Healing and Immune Health

If the skin is infected, your vet will prescribe antibiotics or antifungal meds. An Elizabethan collar (cone) is often non-negotiable to prevent self-trauma.

For demodectic cases, supporting the immune system is key. This means ensuring a high-quality, balanced diet (ask your vet for recommendations), minimizing stress with pheromone diffusers (like Feliway), and managing any diagnosed chronic illnesses.

Practical Prevention Tips for Multi-Pet Homes

Prevention is about vigilance and good habits.

• Routine Parasite Prevention: Many broad-spectrum monthly preventatives (the same ones that treat fleas, heartworm, and intestinal worms) also prevent sarcoptic mange. This is your strongest shield. Discuss the best option with your vet.
• Quarantine New Animals: Always have a new cat or dog examined by a vet before introducing them to your resident pets. A two-week quarantine period is wise.
• Limit High-Risk Exposure: If your cat goes outdoors, be aware they can contract sarcoptic mites from wildlife environments. Keeping them indoors or in a secure catio significantly reduces risk.
• Maintain Overall Health: A well-fed, low-stress, and healthy cat has a robust immune system better able to keep normal mite populations (like Demodex) in check.

Understanding what mange in cats truly is—a mite infestation with distinct types—empowers you to act swiftly. The path from that first worrying itch to a healthy, comfortable cat involves a partnership with your veterinarian, a commitment to the full treatment plan, and some diligent home care. By focusing on the specific mite, addressing any underlying triggers (especially for demodectic cases), and not cutting corners, you can resolve this uncomfortable condition and get your feline friend back to their happy, scratch-free self.