All the regional Vetco clinic’s at Petcos in my area have canceled operations today due to hazardous driving conditions, so a 2nd HW antigen testing is out of the picture for today. We are expecting more sleet/ice/snow later today/tonight still. They will be at some of the Petco locations again next Sunday.
The thing to do upon diagnosis of HW is to immediately start (if not already on) a HWP, ivermectin, milbemycin, moxidectin to arrest maturation of some of the larval stages, and possible resulting further damages. The worst thing to do is nothing, and yet it has been almost 5 days now, and I still have done nothing. He hasn’t been on an HWP since Oct 18(heartguard+).
My turmoil has been;
1) the still unexplained trembling episodes last weekend.
2) the shock finding that he is heartworm positive
3) the fear that I wouldn’t be able to get treatment without a current rabies vaccination, it expires tomorrow, the vet was originally pressing to go forward with the vac.
4) I have a brand new vet, which i know/knew little about, wanting to put him on advantage multi (moxidectin) a drug that I knew very little to nothing about, and advising not to use the others, that I knew a little about.
5) The fear that once starting on moxidectin, I wouldn’t be able to change to different one throughout his treatment protocol. I think that may still be the case.
6) The fear that once given moxidectin it would alter any further HW testing results for a second opinion. This was largely unfounded, and especially for the antigen testing. The antigen remains for several months after adult worms clear. The moxidectin would affect the microfilaria testing probably some, but one dose of moxidectin will not likely clear so many of the L1, whereas Ivermectin, or the others would induce a much more rapid and sudden kill of L1.
7) I still don’t know the number of adult worms ( never will), whether more are still maturing, they likely are, and I don’t know if the heartguard lost any, all, or most efficacy by my refrigerating it for the entire season last year., and how much protection if any he had.
I don’t want everyone to think I’m totally Nutzo, (I am, I just don’t want everyone to think that 🙂 I can’t tell how horrible I feel about still not starting some kind of treatment still after five days, knowing the situation may likely be growing worse with each day’s postponement. Unless I find out something different in the interim, and provided my vets office can be open and road conditions are where I can get out (in case of a bad reaction) My intent is to go ahead and apply the advantage multi to my dog tommorrow morning, and then take things from there. I just cannot sit on my hands any longer.
