[aimee]

I read Dr Falconers report on the case of Mr Piggy, whom was diagnosed a year earlier with heartworms, and was being treated with a “slow kill” protocol. A critical evaluation leaves multiple questions.

The drugs used and the frequency given are not described except to say “had been trying her vet’s slow kill protocol with an antibiotic for six months” Did Mr Piggy have any drugs for first 6 months after the initial diagnosis 1 year ago? Additionally, I don’t know of any slow kill protocols that use antibiotics only and for a 6 month duration no less. All protocols I know involve using a monthly or more frequent dose of ivermectin or similar drug along with pulsed doxycycline. This leaves the reader to wonder what drugs did Mr Piggy receive and when did he receive them.

He reports “it didn’t work. He was still showing worms on his test” The test is not described. The only test I know that “shows worms” is an ultrasound. I’m guessing he is saying that worms are present because antigen was detected in his blood. Is that valid?? Antigen can be present long after the worms have died which is why testing isn’t done for 6 months after adulticide is given. Did Mr Piggy even have heartworms when presented to Dr Falconer?

Two months later he reports, “Bingo: Negative Heartworm Test this remedy hit the mark…..Mr. Piggy is… negative for heartworm!” Is it correct to say a dog is “negative for heartworm” based on an antigen test? I would argue that that is an incorrect statement. All we can say is no antigen was detected or the test result is below detectable limits.

Is it practical to conclude that heartworms died while Mr Piggy was in Dr falconers care? It is commonly reported to take 4-6 months after heartworm death for antigen to decrease to the point that it isn’t detectible on an antigen test. Mr Piggy’s test went from detectible to non detectible in 2 months times suggesting that the heartworm death preceded Dr Falconers care.

When looking at this critically what do we really know? Mr Piggy may or may not have had heartworms when coming to Dr Falconer and he may or may not have had heartworms when he left.

I think it is just as likely actually more likely that Mr Piggy was antigen positive and heartworm negative when he first came to Dr Falconer and over the course of several months the antigen level fell below detectable limits.