Ivermectin is our last resort. If we get them early, usually Goodwinol salve and Sulfur Shampoo is all we need. But since we are ‘experienced’ we usually get the really bad cases including when they turn into skin infections. but the Ivermectin works when nothing else will. It also makes them extra thirsty so keep the water dish high. Good luck!!!
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So it’s a pill? If so, then does it need to be IN something? And it needs to be ‘stinky’? Sounds like a challenge. (PS: We say our animals never die; they just run up large vet bills. And our vet said he should have named an expensive piece of equipment after us. But problems like this can defy everything at times.)
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No,it’s a really thick bitter liquid. That us why it’s okay to thin it out with a tasty liquid. It’s the pure form of the active ingredient in Heartworm medication. This type of stress/environmental mange is brought about by malnutrition and weakened immune system (Shelter Puppies are especially prone to this) and this ingredient wipes out all the mites on the animal (healthy creatures co-exist with them just fine) so that the skin has a chance to heal and then hair grows back. It’s kinda like accutane for acne. It’s REALLY effective, but that is because the hope is you’ll never need to use it again.
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Thank so much for this explanation. I also have a lot of medical (human) background so particularly appreciate this. Any ideas of how to catch this little bugger?
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Sadly not. Even the scabbiest puppy will come up to me if it means I’ll share the baked chicken I carry around… 
I’m guessing you are working with a rescue? If not, the folks at Kitty Bungalow has really helped our block feral problem. You can reach out to see if there is another approach to trap. The good news is that once he starts on the ivromectin regime… it will do its work. The only reason you would want to contain him is to keep his wounds dressed/dry/clean.
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I’m just weighing in on the OP. I might try sleeping in the yard night after night. Maybe s/he would get used to me and I could grab that baby. Tough time.
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Three weeks into the treatment and he’s looking great!
Fur coming back in (he’s all fuzzy in spots!), only a couple of visible scabs, and he’s decided that since I’m offering mackerel it’s okay for me to be within a couple feet of him - no sudden movements, though.
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Aw, that’s just the very best news. Are y’all somewhere where he could be maintained in a semi-feral state? You know, like not getting hit by cars, harassed by people. Congratulations. PS: Is this an organization that accepts donations?
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We’re in the middle of Pasadena, Cath, on a major thoroughfare, but it’s a long block with deep lots. Since he was neutered he’s been staying within a couple lots of our place.
I would love to get him into a barn cat program, but there are waiting lists.
If we can get him to the point of being touched/handled, then we might have better luck with placement - we’re working on it. (Since he’s at least five years old he’d likely have difficulty adapting to being a house cat, though that would be the optimal outcome.)
And yes, The Cat Posse accepts (loves!) donations.
This is the group that helped with the initial trapping (for his neutering) and one of the volunteers cared for him post-surgery and provided transport, too (due to the neuro issues I no longer drive).
They were also instrumental in getting this kitten trapped for us (he stayed with us and has taken over the household):
They’re good people doing good things.
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I just made a donation and I hope others will also. Feral animals have been caused by humans and we need to help. Thanks again for the work you do. Cath
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Hurrah! That stuff is vile but it works!! The bones and oil in the mackerel are also super good for him! 
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From the other morning, @catholiver:
He’s had a couple of traumatic days as some young male peacocks have been hanging around, eating his kibble, screaming at whatever peacocks scream about, drinking from and then dumping over the bird baths, etc. So he’s been hunkering down under bushes and such.
Peacocks:
Sleeping in the sun:
His skin is better, but he’s still having flareups, so working with vet to figure out long-term approach to care.
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I know that there are infections that can be treated and the symptoms resolved but the infection is then “subclinical” no symptoms but then return. Thanks again for your work. Oh, and the smelly food…to keep this on-topic. Right???
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Such a beautiful boy!
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A rather good update.
The best thing about 2020 (possibly the only really great thing, personally), for us, was the gradual socialization of this fine feline (named Marcel).
No idea why, but last April he started (oh-so-slowly) becoming more relaxed around humans.
By September he was open to ear scritches and would come running at mealtime.
By early November he was willing to come into an enclosed laundry room, so long as the door to the outside was open.
And by the end of December he was willing to venture into the house.
As of this morning, he has been an Indoor Cat for almost 96 hours! He’s looked out the door a couple of times but hasn’t chosen to venture forth. That is a relief as we now have a pack of coyotes in the neighborhood and they are decimating local wildlife and eating outdoor cats. (This sucks but I accept that it’s a reality of living in an urban ecosystem.)
Anyway. We’re still working on getting the other cats to accept Marcel (the females are fine with his presence, the males are stressed) - no fights, thankfully!
Oh, and he’s still getting bitter oral meds as his skin is a mess and they are being hidden in mushed anchovies. 
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What a wonderful thread!
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That’s a great outcome. Here’s hoping the other boys eventually warm up to him.
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This big guy - Ulysses - is our next Trap/Neuter/Release project. Hard to see from the photos, but he’s quite large: at least 15 pounds and a very long, well-muscled body. Looks like a wild cat.
So we will start with pungent fish and see how it goes!
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He looks great! Nice clear eyes and great undercoat! Good luck!! His size, he’d make a great working cat!
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