When hwp were first licensed one dose after exposure would prevent infection. I think Heartgard and Sentinal are licensed that way. But we aren’t in Kansas anymore or maybe we never were : ) One dose post exposure isn’t always doing it. (Bayer tried to capitalize on this as one dose of topical Moxi prevented infection but one dose of ivermectin and milbemycin didn’t for the MP3 strain.) However, repeated doses of the preventatives DID prevent infection against those strains. When Trifexis was licensed it was licensed as 3 doses post exposure. I think this is because 1 dose didn’t meet FDA requirements but 3 doses did. Now the most recent HWP licensed, Sentinal Spectrum, is licensed as last dose 6 months post exposure.
I see this as different than resistance, I believe with the true “resistant” strains it doesn’t matter how many doses are administered, infection occurs. Hmm… I look at this kind of like the “slow kill” adult, one dose doesn’t do it but repeated doses does. This is why I do and will continue to give my dogs HWP for a min. of three months after the last possible exposure to heartworms. Giving doses multiple months post exposure isn’t about selling more preventative, it is about preventing more infections! Resistance of bacteria to antibiotics isn’t always all or none either. The bacteria may be resistant at dosage X but not at dosage Y
It is currently thought that the adulticide may not be as effective against young adult vs older adults which is why I think the current treatment protocol is to treat with prev for several months before the immiticide is given.
The Alkp and Alt are liver enzymes. Like Shawna it doesn’t surprise me to see a high end Eos count. I don’t know though that it has any predictive value.
