[Naturella]

Hey! I think there was a threat on holistic ways to end fleas:

/forums/topic/heartworm-hookworm-tapeworm-roundworm-and-fleatick-prevention/

Also this:
/forums/topic/does-anybody-use-de/
And:
/forums/topic/anyone-in-the-market-for-food-grade-de/

So, you can look into these products: Diatomaceous Earth, or Cedarcide Best Yet. Good luck!!! 🙂

[Bobby dog]

Hi Naturella:
I recently switched to Sentinel Spectrum at the beginning of the month. I was using Iverhart Max (ivermectin/pyrantel) and Frontline plus during flea season. I also did not give heartworm meds during the winter months. The beginning of this month I took Bobby in for his 3 year Rabies, reg exam, did bloodwork to check for heartworms, and checked his stool for worms. Everything came back negative.

My Vet asked me to consider changing my HW preventative and the routine I follow for dosing it. She said there were allot more cases of tick born illnesses in our area that were previously only seen in the southern states and my HW/flea med choices were not the best anymore due to possible immunities in some parasites.

I tried Trifexis the first year I had Bobby and he still had issues with fleas. I stopped using it after 2 mos. My reasoning being that he was being exposed to a chemical for flea prevention that did not seem to work so I switched to Iverhart and tackled fleas with Front Line Plus and regular baths during flea season. Also, there were allot of reports of adverse reactions in dogs using Trifexis that scared me so the decision to discontinue it was easy.

I only bought one dose of the Sentinel to make sure Bobby was okay using it and he seems fine with it. I will now make that his HW preventative and will be administering it year round. There is a risk of illness using any HW preventative and that does scare me. I will still keep looking for other alternatives, but for now Sentinel seems to fit the bill.

The Vet Tech also gave me info on another topical for fleas Activyl. I think it may be a fairly new product. IDK My Vet did not mention anything about it during our discussion so I am not sure what her clientel has experienced with the product.

[Naturella]

Cyndi, theBCnut, Nancy – thanks so much for the invaluable advice. I also have seen that people have had issues with Trifexis, but Bruno was doing just fine on it, so I figured – no problems. Really, Sentinel was $100-cheaper and sounded similar in all-encompassness (not a word but I hope you get what I mean) – Akari, you may want to check it out on 1-800PetMeds’ website.

I would look into the garlic pills and cedarcide – interesting indeed. As far the other worms, though, what is best to be used? If Ivermectin only protects against heartworm, would just about any all-worm preventative be okay? I apologize for the possibly stupid questions, I’m just trying to learn…

Thanks to all again!

[Nancy C]

A few thoughts, as I am studying this topic as well. FYI I have given my 10 yr old golden retriever the little round garlic capsules from Whole Foods-pinkish label. One in AM and one in PM. I drop it in her food bowl. We live on a wooded lot in NC and I have NEVER seen a flea on her! I studied for 6 years for a PhD and my chair was the founding president of the American Holistic Medical Assoc, a former Harvard Neurosurgeon, BUT VERY BIG ON avoiding chemicals and pharmaceuticals whenever possible (which can be most of the time actually). He is very informed on holistic remedies, incl homeopathic, and says HE uses a product called CEDARCIDE on his several dogs for ticks and fleas. Says it’s great and it works! He lives in Missouri also in the country/ woods. It’s sold at Amazon by the quart but you can get a better deal by ordering a gallon. My container arrived yesterday and I have already sprayed it on the dogs. It has a cedar-ish fresh smell. Dr. S told me he just sprays and rubs it into the fur a couple times a week. Reviewers swear by this stuff. It’s called “BEST YET” by Cedarcide. And it is super – SAFE! My doc advisor does not put the chemicals in his dogs either. I have not asked him about heartworms but I will. Someone ELSE Who has several dogs and who I respect told me there is a product called PBG-51. The link to the site is http://www.firstchoicenaturals.com/resourcearticles/parasitesbegonefrom mypet.php. I am told that this product is not advertised for heartworms for legal reasons BUT it protects against them. I am studying that now as would like to get OFF Sentinel. I used to give my golden Sentinel only half the year. Two yrs ago my vet sat me down and nicely chewed me out saying the dog is vulnerable in NC all year around. So I promised I would keep her on it. Last thing – I am the one who has the GSD who was 18 mos in jan and wandered into big digestive troubles trying to transition him to Origen then to ACADA — several of you have helped me so much. I have discovered in this awful experience with all his loose stools and diarrhea that a flea/tick collar I bought at the vet (Solesto – made by Bayer) is probably one of the culprits for my Shepherd’s digestive disorder. The DAY after the vet’s secretary fitted Axel with the collar he had diarrhea IN the house and IN the yard. Everywhere he went the entire weekend diarrhea was falling out of him. I was going crazy. Two weeks later I realized that it was NOT the HILLS nasty WD Rx dry food he was on that caused this sudden diarrhea– geeze that stuff is like eating HAY and no way could he have the squirts on it. I had just started giving him a little Science Diet Sensitive Stomach. BUT I bought that collar as I went out the door at the vet. It HAD to be the collar. I looked on line and found that among all the LOVERS of the collar there are some detractors as well whose dogs also had bad diarrhea. So watch out about that collar!
That’s all I know for now. PS: Cedarcide gets rid of all insects, including BED BUGS!!
Nancy C

[Cyndi]

I would never use trifexis. I’ve read about alot of dog deaths because of it. I think there is a thread here on the forum & I was just reading a facebook page earlier about trifexis & all the stories of people who’s dogs have died after using it.

For heartworm I use a product called Value Heart, recommended by HDM. Its just ivermectin (sp?). For fleas I give Bailey garlic, I use diatomaceous earth on her, I also use Mercolas natural flea & tick spray, & I just recently started using Sentry natural defense flea & tick (or something like that). Bailey got a few fleas last year, but I was able to get rid of them before they got too bad.

[Carolyn P]

My dog was orphaned at 1 week of age.

I got her the initial puppy vaccinations and one rabies vaccination AFTER she got over being so sickly (she was almost 2 when she had her rabies vaccination).

I do not vaccinate my dogs and titering is $295, which I don’t do either. I **may** consider rabies only for the reason that IF by some bizarre circumstance my dog was bitten there is no cure for rabies, only euthanasia. I couldn’t live with myself knowing that I “could” have done something to prevent it. But again, it’s really unlikely they would ever be bitten by a rabid animal.

I also don’t treat for fleas/ticks and I do heartworm testing only (May and November), I don’t do heartworm medication.

I also don’t do lepto, kennel cough, etc. I don’t believe in poisoning my dogs.

I have a dog that was vaccinated for rabies twice in a 2 week period in error (no longer go to that vet). I believe he now suffers some ill effects from that.

I don’t buy into the vaccinations.

[Naturella]

Hello, all!

So, I figured I would ask – what do you all give to your dogs (if anything) for the ailments in the topic? When we got Bruno they told us that Trifexis was the most complete pill, for all them worms (treats and prevents), and kills adult fleas. Well, he was on that till March, when the vet decided that he had plateaued on weight and will probably never leave the 11-20lb segment. So they told me I can no longer buy the individual Trifexis, but only 6-month supplies at a time. So I went online (for financial reasons) and was about to get him some Trifexis, but I saw another drug, Sentinel, which claimed to also treat and prevent all the worm types and kill flea eggs (not adult fleas). It was also cheaper by like $100!!! So we got a 6-month supply of that. Bruno had his first April pill with no problems.

Well… My question is… Is it good enough? Is it really comparable/better than Trifexis? Do I need a complete pill or can I do the twice-a-year shot for Heartworm that my friend does for her dogs and not worry about fleas and such? What about topical anti-flea solutions? Do they work, are they good for the dog? My cousin was saying that he thinks it is much better to put chemistry (topical anti-flea stuff) on the dog than inside (pills that make his skin toxic to fleas), but he’s never had a dog. And what about Heartgard? My roommate uses it, but I think it’s just for Heartworm…

Basically – is there a “best” combination, and what is it, or what is it that works for y’all?

[Naturella]

This is hilariously crazy! LoL! This reminds me of the link Akari32 posted on how Purina’s reseach shows that dogs are BUILT to eat grains. Insanity…

So odd, I don’t even recall our vet discussing nutrition with us except one time, when I mentioned I feed grain free and got the “there’s still carbs in it though” lecture, which I knew, but was within limits and ok. I think I only will be seeing the vet and techs once a year for his shots, since he plateaued weight so we shop for his heartworm and other worm-and-flea medicine online now.

[theBCnut]

Those things are great! I also have the propane powered outdoor ones. But mosquitos still bite before they get sucked into the things, so that is definitely not good heartworm prevention.

[pugmomsandy]

Just because a dog is “senior” doesn’t mean it has these problems. All those problems can potentially happen at any age. I’ve fostered many dogs under 5 (even as young as 1 yr) with joint/eye/digestion/ear issues and have needed hip/knee surgeries and prescription eye and ear drops. A healthy senior can eat regular food (adult, maintenance and all life stages, puppy food). I have a 14 yr old with no active health issues. He is blind and deaf which he was already when I got him last year at 13. He is not on any medications and eats the same foods as all the other foster dogs I have. I use 3.5-4.5 star kibble and top it off with 5 star canned foods which is normally at least 43% protein. He even gets some raw food which I usually make without any plant matter. The dogs get joint supplements and vitamins, antioxidants, supergreen supplements and fish oil. My personal dogs don’t get chemical pesticides which has been linked to some cancers nor do they get unnecessary vaccines. You might want to research “over vaccination”. Try looking up Dogs4dogs dot com, b-naturals dot com, wholedogjournal dot com, dogsnaturallymagazine dot com. These are just a few of the sites pertaining to more “natural” care of dogs. If one of my dogs had late stage kidney disease, at that point I would change the diet, but I wouldn’t change the diet just because they’re a senior in general. Some things possibly connected to cancer is chemical laden commercial kibble, vaccines, the constant application of poisonous pesticides (heartworm and flea/tick meds, fertilizers), even air pollution.

http://dogs4dogs.com/

[theBCnut]

A couple things

I wouldn’t stop heartworm prevention on the other two, and I would still get rabies vac also. An undamaged liver should not have any trouble processing HW meds. I just wouldn’t add additional challenge to an already damaged liver in an already senior dog.

All the symptoms you are seeing now are completely normal under the circumstances you attributed them to, so of course you couldn’t put 2 and 2 and 2 and 2 and 2 together and get 10, however as a totality of symptoms, it does look quite suspicious.

When are you taking her back for more tests?

[NectarMom]

Cushing’s syndrome is a disease caused by long-term exposure to high levels of glucocorticosteroids, either manufactured by the body or given as medications. I do not even get Rabies vaccine for my dogs. Yes my Vet gives me a hard time and tells me that it is at my own risk to not give my dogs Rabies vaccine but I feel that my dogs are only at my house and we live in a neighborhood with other people that keep their dogs in the backyard and not running the streets. I do not walk my dogs anywhere. If we go to the Vets I carry my dogs and I personally clean and sterilize where my dogs will be set on a table for the vet to examine them. I also do not give Heartworm medication and have not for a few years now. I do believe in yearly blood work due to finding out things sooner that could possibly be fixed with my dogs. I lost one of Cancer and I learned the hard way just how important yearly blood work is. 3 Year Rabies is a very harsh injection. I won’t do it, no need in it when we do not have rabies cases here and it is just another way for vets to make money.

[theBCnut]

High protein does not cause liver problems or high liver levels, but after there is already a liver problem, the liver has a harder time dealing with as much protein. The high levels could be from something else, they could be a temporary increase due to some insult to her liver, like a toxic exposure, they could be because of some other disease process all together. You just can’t know yet. You may have to start adding carbs to her diet to reduce the protein levels, but you may need to do nothing at all, you just don’t know yet. If it turns out that she really is having liver issues, have your vet get you a recipe for a homemade diet for her. It will still be way better than anything you could buy.

She is much more likely to have come in contact with something on walks or whatever like that, than for the supplements that you gave her to have caused a problem. Unfortunately, this could be age, it could be longterm exposure to heartworm prevention, it could be from pesticides, even ones your neighbors used years ago, you may never know and liver problems can literally take a lifetime to pop up.

And yes, I do mean that most vets just feel, look, and listen to dogs at their yearly and never run blood work until there is already a known problem, so they never have normals to compare to.

Dori, at 14 1/2 years old, you would never want to treat her for heartworms and she would never have enough of them to have a serious case, so the first thing I would do would be to never give her another dose. BTW, when was her last dose in relation to when she had the blood work done? That alone could explain the elevated levels.

[DogFoodie]

My vet sells monthly heartworm doses. When Sam, my Golden, was a tiny puppy he worked through several weight ranges within a period of time. I guess since those rebates come through the very, my vet gets the rebates and passes the savings along up front.

[Bobby dog]

Hi Akari:
What a great Goodwill find!!!! It sounds like he is learning how to walk in his harness well. I used to work with a guy that took his cat out for a walk on a harness daily.

I love Bently and Gary together. They are sooooo cute! Bently is really a cute dog.

I don’t use the meds you mentioned above so this may be a silly question, but will your Vet sell you a months supply of flea & heartworm meds? My vet will sell heartworm and flea meds by the month if needed; it helps if you are short on funds or for any other reason. She will also sell weekly supplies of other meds that she dispenses if she is able to. Also, have you checked online to see if you can get a better price? You would just have to get your Vet to write a prescription and fax it to them. One other thing to check into is the companies that make these meds sometimes offer rebates on their websites.

[DogFoodie]

After all of the recent conversation about heartworm and preventative, I decided to have my dogs tested having been of their preventative since October. It was probably too soon with it not being six months, but they were negative and I feel better.

So, moving forward, I discussed preventative with my integrative vet and I decided on Sentinel. I had hoped to use Heartgard and Springtime Bug Off Garlic, but Sam seemed to react to the BOG and began developing a yeasty ear shortly after he started taking it, so I had to stop it and consider my alternatives.

I’m trying to recall what the recommendation was for milk thistle after Milbemycin. I tried to find it, but couldn’t. Can anyone help me with this, please?

• This reply was modified 11 years, 8 months ago by DogFoodie.

[Akari_32]

For the dogs canned food, I honestly just get what’s cheap. The Pedigree was free (3 big cans), the Purina One was on clearance at PetSmart for 70 cents each, and I have coupons for $1 off 3 cans, the alpo was 94 cents after BOGO sale and coupons (I got like 10 cans of that), the pro plan was free lol Haley needs canned mixed in her dry or she can’t eat very well, and gets upset tummy. I split a can between Haley and Dweezle, it’s not a big part of their diet, so I don’t worry about it too much. If they ate more of it, I’d be looking for better ones, but I figure it doesn’t hurt. They grew up on all the nasty stuff, as it is lol

How much are you givng for the garlic? I’d imagine it keeps mosquitoes away, too? Flea and heartworm prevention is sooooo expensive!

Oh, and expect some good stories of drugged kitty tomorrow LOL The vey said no food after 8 and no water after midnight. I don’t get off work till 8 anyways, so I gave him a big can of wellness, and that’s all he gets! He doesn’t drink, but I’ll take up the water dishes anyways.

[DogFoodie]

I think what I’ll do is stop the BOG and see what happens with his ears.

We happen to be headed to the vet this afternoon for SNAP 4DX tests and heartworm medication. I’ll talk to the vet about (gulp) combination products, just in case the BOG is the problem.

[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.

[InkedMarie]

Boone had worms once; other than that time, my dogs have never been wormed except for their heartworm preventive. They get a fecal done once a year.

[Shawna]

Hi Marie — I LOVE Dr. Falconers take on heartworm preventative/treatment (and he’s in Texas I think). There is another vet in Florida that does similar. And Dr. Martin Goldstein, per his book, treats heartworm with a glandular and several “tinctures”. Granted Goldstein is in New York but he says he has clients all over the US.

Losul — Have you ever posted a picture of Turbo? I can’t remember?

Determining when to start heartworm can be difficult but using a calendar and marking down the highs for the day (as it starts to get warmer can help).. Different researchers have found different temps and durations so going with the least makes sense. IF temperatures are below 57 degrees the larvae can not develop in the mosquito. And temps need to be high enough for long enough for the larvae to develop from L1 to L3 before the mosquito dies. It takes about 10 to 14 days at temps of 80 for the development to happen. So if temps are warm one day then 52 for five days, then a 60 degree day and a few more cool days etc, the mosquito will likely die before the larvae can develop into L3 stage. If pup is bit when larvae is at L1 or L2 stage — nothing happens. This page discusses some of the findings regarding temps http://www.acreaturecomfort.com/heartworminfo.htm

I found a, what I think to be, good alternative that should make things less complicated though. “There is more to transmission than simply the presence of mosquitoes; it must also be warm enough for a long enough time period to allow the development of microfilariae to infective L3’s within the mosquito’s body. A simple formula involves counting the degrees above 57 degrees F reached each day. Each degree is called a “heartworm development unit” and when 234 heartworm development units have accumulated within a 30-day period, conditions have been reached to allow the transmission of L3 heartworm to new hosts. A monthly heartworm pill, chewable, or topical must be given at the end of a month in which 234-heartworm development units has accumulated.

When 30 days pass and 234 heartworm development have not accumulated, mosquitoes will be dying from the cold before any microfilariae they carry can develop to the infective stage. Monthly heartworm preventive needs not be given after a month under these conditions.” http://www.marvistavet.com/html/body_heartworm_prevention.html

Hope that helps.. 🙂

[InkedMarie]

I just got this link in email this morning, haven’t even read it but hope something in it helps

http://vitalanimal.com/heartworm-cured/

[Melissaandcrew]

The only time I have seen stool affected is with coccidian and giardia. Most of the rescues that come in that have had worms have had fine stool, but I would guess that depends on the dog. If you are giving any heartworm preventatives, you are deworming monthly. For most dogs, that should be sufficient, imo.

[Melissaandcrew]

Fecal floats are never 100 percent as they are looking for eggs.and they may not be present at that time.

I have fecals done sporadically depending when a dog is at the vets. I deworm all the dogs here once a yr with droncit and then one cycle of strongid. But we have a lot of strange dogs coming and going frim the property so its more just in case. Btw…the heartworm preventatives deworm monthly when given.

[Shawna]

That’s wonderful that the Vetco vet was able to give you some more useful information!! I agree, would have been nice to know earlier.

Thanks Cyndi 🙂 I found some more of him that I put on disk but forgot the cd at home. His new owner changed his name from Biscuit to Yoda. Not sure where Biscuit came from but he needed to be a Taz or Turbo or something more like that. 🙂

From what I’ve read, Ivermectin is still quite effective beyond the 30 days. I had the following printed out and in my pile of papers to read at home. Was cleaning in an attempt to find Kipee and Tumbleweeds birth dates. Anyhoo, the data dated 2013 reads
“For Heartgard-30 (Merial, Duluth, GA), the target was simply heartworm prevention. According to the original new animal drug application (NADA), 1 “of the 83 dogs treated at monthly intervals in natural infection trials, or treated 30 days after induced infection, with doses of ivermectin at 3.0 mcg/kg or greater, only 2 dogs developed infections. [Author’s note: The 2 dogs that were positive were dogs that had each received 3.0 mcg/kg on day 30 after having been infected with approximately 50 L3.] Even when the treatment interval was extended to 45 or 60 days following infection, only 2 of 88 dogs given ivermectin at 6.0 mcg/kg or more developed infections.” 1 Dogs receiving 6 mcg/kg at 45 and 60 days were negative at necropsy. Thus, the minimum effective dose of 6.0 mcg/kg monthly was chosen.”

Here’s what they say about Advantage Multi
“For Advantage Multi for Dogs (Bayer Animal Health, Shawnee Mission, KS), 6 the dosage was chosen based on an established minimum effective dose for moxidectin against intestinal nematodes. It was shown, however, that 2.5 mg moxidectin/kg protected all 44 dogs treated 33 to 34 days after inoculation and 12 dogs treated 45 days after inoculation.” http://www.wvc.org/images/session_notes_2013/2013_S3D.pdf

Treating every 35 days with Heartgard, as you did, should have been more than sufficient unless the worms were already there or a resistant strain.

• This reply was modified 11 years, 9 months ago by Shawna.
• This reply was modified 11 years, 9 months ago by Shawna.

[losul]

Hi Shawna, did you already post some “monster” pics? Somehow I either missed or am not getting them.

What you say, was also what i had always thought before, and is logical. Now I’m unsure about some things. It’s hard to determine exactly when the season starts, when larva could be developing in mosquitos, etc., at least for me anyway, maybe that’s why they are saying to start a month before now, to be on the safer side? , And not entirely sure that it’s always as effective 30 or so days post infection?

I had Turbo HW tested again yesterday (Sunday) at Vetco. They used the IDEXX snap antigen test, and again he tested positive. The Vet there showed me the results on the device, and explained and compared them with what was shown in the IDEXX brochure. It indicated low antigen levels, and in that vet’s opinion probable low adult worm load. The positive control turned a solid dark blue as it always should. The low antigen indicator turned a blue with about half the density of the control. The high antigen indicator was nearly altogether unoticeable, until the vet pointed it just out a very slight blue tinge. Otherwise I didn’t even see it. In the IDEXX literature it definitely looked most like the pic for the low antigen levels. Scroll down to “interpreting test results”.

http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/snap/heartworm/snap-heartworm-pkg-insert.pdf

From there it was reccommended to see regular vet. Vetco doesn’t look for microfilaria.

My vet didn’t show me the results of his test, and didn’t say anything about high/low level antigens. I don’t know what kind of test he used. He just said he was positive on antigens, and they then looked for microfilaria and confirmed. It could have been really helpful to me to know the level from the start. I have an appointment for X-rays Wednesday. I still haven’t determined an exact course of treatment yet, again I hate to use any more harsh chemicals, steroids, and drugs than actually needed for his best interest.

• This reply was modified 11 years, 9 months ago by losul.

[losul]

Hi weezer. Milk thistle had nothing to do at all, nada, with making my dog more susceptible to heartworms. I feel that other completely unrelated things I did/neglected to do, were to likely to blame.

I myself take milk thistle sometimes, I always have some on hand, but I’ve actually rarely given it to my dog, and not with any consistency, but that’s mainly because I forget, otherwise I wouldn’t have been afraid to give him a low dose regimen after oral ivermectin, as long as there is a reasonable time lapse after administration, but never concurrently with, immediately after, or in high doses.

I think you misunderstood. There’s only a very few drugs, where milk thistle is thought to decrease the efficacy, most of the drug interactions and most of the concerns are that milk thistle actually increase the efficacy of ( has the effect of increasing dosage) and slowing elimination times. It becomes even more of a concern with dogs might be dose sensitive, as those with the MDR-1 genetic defect.

Weezer BTW, I know I probably seem over reactive and emotional some times, LOL. But I assure you that I am all male. 🙂

• This reply was modified 11 years, 9 months ago by losul.

[weezerweeks]

So would u give the milk thistle after the 3rd day or just not give it? He had heartworms when I got him and I don’t want to go through that again!!

[weezerweeks]

I have to give my yorkie his Heartgard the 22nd and was planning on giving him milk thistle the day after for a week but after reading about losul and her dogs heartworm problems and the discussion about milk thistle causing it not to be effective I don’t know what to do. Should I give it or not. Would love t hear from HDM.and anyone else. Thanks

[Shawna]

I’ll get some more picks of my little monster posted here shortly.. I recently transferred all pics from my laptop to an SD card for storage (replaced the laptop).

Also wanted to mention — with ivermectin/heartgard, dosing should start one month AFTER heartworm season begins. Since heartgard doesn’t build up in the system and kills L3 and L4 stages, if there has been no bite there can be no L3/L4 to kill. And it would have been impossible for the L1 stage larvae to show up on the test if you had been using. That could have made knowing the stage/class harder??

[losul]

Hi Patty, Thank you for the info, very helpful. and also good to know about the liver values.

Looking back at records and thinking clearer now, you could be right, I think there could be a window of chance he could have been infected prior to adoption. I have records from the shelter where I adopted, they are pretty sketchy, but I believe he was there twice and I think briefly at another shelter, which I have no records for. The records from them that I have go back to Dec., 2011, but on 8/24/2012, they show exam, heartworm negative, pyrental, mchip. 8/31/2012 HWP given. This was the only time on the shelters records where HWP was given. There was a prior HW test done on 12/09/2011, but no mention of HWP between then and 8/24/12. Seems kind of strange now that the first HWP given to him at the shelter was suddenly 5 days before we adopted. We adopted on 9/5/1012. The adoption came with a complimentary exam and fecal from the shelter’s attending veterinarian which we used on 9/12. They sold us numerous things including 12 doses of heartguard +. I didn’t like the vet, very absent-minded to put it lightly, I had to keep reminding her we still needed the fecal, and she even seemed afraid to touch Turbo, barely did. I’m pretty sure I finished 2012 with 2 more (2/3) doses. I think after 2012 season was done was when i refrigerated it. I was giving him 2/3 of the chew and then putting the leftover 1/3 in a baggie, and using with an additional 1/3 the next time, that remaining 2/3 was used for the next dose, etc.

About this same time last year he had a HW check with his rabies vaccination, before we later resumed with HWP. I didn’t even know until recently, that if giving seasonally, it should be started 1 month before the season starts. I was under the impression until recently, that the weather had to stay above 57 degress for like 10 consequtitive days, and then I thought there was a 30 day window of time after that. And I remembered with past dogs, we’d get a 6 dose supply and it would last the season.

I’ll likely never know 100%, but for me, there’s just too much I did wrong. At the very least, i should have been throwing away the leftover 1/3’s, reading the package thoroughly, and I should have gotten myself better informed. I’m pretty sure this experience wouldn’t ever happen in most cases, given a more proper protocol than what I did.

Yes i think too Xrays first, and then I’ll take it from there whether to get ultrasound also, and hopefully help determine a more exact course of action. I might have to wait for awhile for results on that. They have a pro radiologist come in to read them, but generally only comes in once a month, sometimes more often. I could get a quicker result, but with additional cost. The timing of this going on with other circumstances currently at hand, unfortunately, I’m going to have to at least be mindful of the ongoing/upcoming expenses.

THNX again Patty.

Shawna:
I knew you fostered BT’s, but I had no idea that you had a mix of the same sort as Turbo! I would luv to see pics of your little “turd”. Getting pics on my computer and then figuring out what to do with them from there, has long been on my “to do” list. I’m so technology deficient, I’m such a procrastinator, and I’ve so many things backed already up on that list, but I intend to get around to it.

That’s so funny the way you describe the “monster”. Turbo is the quirkiest dog I’ve ever met. He very oftentimes tries to communicate things, and many times still, I’m left scratching my head as to exactly what it is.. And sometimes his manners are such that I wonder if he wasn’t one that was taken too quickly from his Mama and siblings, before learning proper manners, and the consequences of not using good manners. I can see where he has been probably been misunderstood for much of his prior life. The first couple days we had him, i was second guessing myself some, and we nearly didn’t even take him to start with. But within a few days, I knew he was right for us. I could go on and on, but I absolutely must get busy this weekend, and the days following, doing things that are already so backed up.

Thnx again Shawna.

Turbo has noticeably been drinking more water and urinating more, this past week. I always thought he never drank enough, and I’ve always added some water to his kibble portions. I don’t think I’d ever seen him pee for more than 10 or 15 seconds at a time at the most, but the other day I think he must have peed for 45 seconds straight, and that was midday. I guess the advantage multi could cause that. Still no more trembling episodes and still haven’t a clue about what happened with that. might be a few days before I can write again.

[Shawna]

Hi Patty,

Dori actually contacted them and was told this
“Hi losul and Shawna, I just spoke with tech support at Merial makers of Heartgard and was told that the ENTIRE dose must be given. You cannot split in half because they can not guarantee it’s efficacy. It is suggested that you not do that.”

Of course they would not suggest splitting doses for reasons other than efficacy. I just remember reading somewhere that to use a compounding pharmacy versus splitting the drug if pup is at the low end of dosing..

I did a quick google search and Mary Straus agrees with you and with Dori. “The issue of splitting heartworm pills comes up frequently. I have spoken to representatives from Merial (maker of Heartgard) and Novartis (maker of Interceptor). Both said that the active ingredients are mixed into their products before the pills are formed, and therefore should be evenly distributed (though they cannot guarantee this). However, both manufacturers advise against pill splitting.”

So maybe not splitting is just a precautionary recommendation. In which case it is unlikely the splitting would have been an issue.

[theBCnut]

If Turbo was tested within 6 months of getting him and this is the first time since then that he was tested, I would strongly suspect that he already had heartworms but was not far enough along to test positive. Many, many times a year, we got dogs in that had come from the shelter and had tested negative, but 8 months later they turned out to be positive after all.

I corresponded with someone who claimed to work at the plant where Heartgard was made. They said that the ivermectin and the meat paste carrier are mixed in a vat then pressed into molds of the appropriate size. That tells me that other than not giving enough or allowing air to spoil the meds, splitting should not be a problem. Example, if I have a 35 lb dog and a 15 lb dog, I should be able to split a chew for a 60 lb dog into thirds and give one dog 1/3 and the other dog 2/3 and it should be fine as long as I can split them accurately. I should not save some for the next month though, because the drugs could oxidize. The vet and the company make more if I have to buy a pack of the appropriate size for each and since it is a prescription drug, the laws don’t allow sharing anyways, but trimming off excess should not make the whole dose ineffective. My dogs weigh 42 lbs and usually I have to buy drugs for 60 lbs. Trimming off 1/4 should still leave enough drug for a 45 lb dog, but if it is a drug that comes in sealed pods/blister packs, I assume that it should be kept away from oxygen until use.

[Shawna]

Patty — I very much appreciate your natural and holistic approach combined with your schooling and hands on experience!!!!

Losul — I agree with Patty.. This infection could be quite old, even predating you adopting Turbo. Prior to this, have you had Turbo heartworm tested since getting him? Even if he got them under your watch — I think blaming yourself is a stretch.. How many of us didn’t know about the potential issues with refrigeration? I certainly didn’t. And many people read that you split the dose and no mention of problems. Even when I mentioned it, I wasn’t 100% certain. Just a vague memory.. And if heartworm in your area are ivermectin resistant, well you certainly can’t blame yourself for that!!

I had a foster puppy that was 1/2 Boston Terrier and also definitely had some bully in him.. Everyone who saw him thought pitty, especially Staffordshire. He came to me, with his mommy, when he was only 4 days old. His eyes were still shut.. He was such a little monster, so head strong and SO smart. He was the only foster dog that escaped the 4×4 enclosure I made for them (2×4’s and plastic chicken wire). In the enclosure I had an open crate, water bowl, potty pad, blanket etc. Came home one afternoon to find him terrorizing the other dogs in my bedroom with a little hole large enough for his little body in the plastic wire.. Little turd!!! I don’t have any good pics of the little guy with me but I’m going to post a not so good one on the blog here in a sec. Full grown my little guy is about 30 pounds too.. Weird huh…

[theBCnut]

Hi Losul

Several things
The bloodwork is exactly where I would expect it to be and the most important thing is those liver enzymes. He should have no problem with treatment, since his liver function is normal.

I can’t find the thread that I’m looking for on another site, but the consensus was that you should wait 3 days after ivermectin to start milk thistle, no opinion on others because it was specifically a thread about using ivermectin that turned into a thread about using milk thistle.

The heartworm infection still could have occured before you got Turbo depending on when the heartworm tests actually took place and what kind of tests they were.

The load should be light because you/your vet are seeing no other signs. Ultrasound would certainly be more diagnostic as far as being able to see the worms and whether they are causing a heart murmur(if your vet didn’t hear one), enlarging of one side of the heart, filling the pulmonary artery, etc. only if they have high quality, up to date equipment and are good at interpreting what they see.

If the xray looks normal, then I probably wouldn’t do an ultrasound, and I would assume a light load of worms. But if the xray showed any changes, I would want the ultrasound too.

[losul]

Hello again Dori.

I wouldn’t EVER want to discourage milk thistle use in totality. I really do believe in it’s potent powers to protect and even help heal the liver. But it’s also because of these potent powers I think awareness/caution is warranted, and especially in regards to possible interactions with other drugs/botanicals, and under certain other circumstances.

I think the last time I looked into this, was well over a year ago. The bookmarks I had on it died with my last computer. It’s hard to get detailed and reliable info from anywhere but the manufacturers, as to actual expected half lives, exactly how the drugs are metabolized, etc. and am having difficulty getting that reliable info again. It’s also hard to get reliable studies on various herbs and supplements,

Going by other resources I think it can be established that ivermectin is primarily metabolized by CYP3A4 in the liver, and as far as I’m concerned, for me, there is enough evidence that milk thistle does inhibit CYP3A4, even though there are few studies as to exactly what extent, dosage rates, potency hard to be determined etc. on milk thistle or almost other botanicals/herb. Most sites I’ve seen, classify milk thistle as a CYP3A4 inhibitor of undefined potency, which would be usually be the case in unregulated and essentially non-standardized supplements. That study referenced in the link i posted the other day, implies relatively high inhibiting potency for milk thistle.

http://www.hcvadvocate.org/hepatitis/hepC/mthistle.html

Not sure exactly how milbemycin, moxidectin, is metabolized, but I would have to assume it’s much the same way as ivermectin, as they are all in the same class of drugs. Apparently ivermectin has a longer longer half life in dogs than i recalled, and milbemycin a little longer than ivermectin. But these, when given in oral dosages, are at least predictable as to their peak plasma concentrations, especially when given without a meal, it’s within hours. Because of the slowed release method of topical moxidectin, peak concentration times for that cannot reliably be determined, I’ve read anywhere between 8 to 21 days after dosage. I would have liked to have incorporated milk thistle into Turbo’s regimen at some point, but as of now, I don’t see how i can confidently do that using moxidectin, and what i don’t know yet about moxidectin. Because all these HWP’s are in the same class of drugs, for now I have to assume they are metablized much in the same way as ivermectin.

If a medication has an expected half life of 24 hours, it doesn’t mean the medication will be cleared in 48 hours. It means that every 24 hours the remaining plasma concentration should be expected to be divided by 2.

I suspect that most advice for milk thistle is for very low dosage, only once a day, and after a reasonably safe time period, at least a day or two after HWP administration? Given in that way, I wouldn’t think there would be significant alterations in elimination time or efficacy, However, I wouldn’t listen to any advice that says to give it before, concurrently with, or immediately after any HWP. Nor any loading up on dosage of it. Additional precautions should be dogs with the defective/suspected defective MDR1 gene, which are already much more susceptible to these drugs crossing the blood/brain barrier, dogs on certain other drugs, or are being given high doses of ivermectin, or the others.

“Dogs with defects in the P-glycoprotein gene (MDR1) can be severely poisoned by ivermectin.”
“Since drugs that inhibit CYP3A4 enzymes often also inhibit P-glycoprotein transport, the risk of increased absorption past the blood-brain barrier exists when ivermectin is administered along with other CYP3A4 inhibitors. These drugs include statins, HIV protease inhibitors, many calcium channel blockers, and glucocorticoids such as dexamethasone, lidocaine, and the benzodiazepines.[21]”

http://en.wikipedia.org/wiki/Ivermectin

Note: I think ivermectin and other like drugs given in the low dosages as given normally for heartworm protection, are usually considered safe for dogs with the defective MDR1 gene, unless other factors come into play.

The only time I would ever consider loading up on milk thistle for a dog is if poisonous mushroom ingestion is strongly suspected or in acute aflatoxin poisoning. In which case, high dosages could save the dogs liver and it’s life.

[losul]

Yeah, I guess he should. But the blood testing is what I picked out with his help before we even had any diagnosis of anything. I was looking for something causing his trembling. So I had the outside lab work, and the tickborne illness and heartworm check. After the HW came back positive, he never suggested doing any different outside lab bloodwork, and it remained the same as it was.

edit: That stuff is alot more liquid than i thought it would be, and the wet spot has spread farther than i thought it would, maybe 4 or 5 inches in diameter It’s still slightly damp., although I saw a little “dust” around the circumference. I guess it should completely dry soon. No apparent irritations or anything. Still really wish they’d have left the insecticide out of it.

• This reply was modified 11 years, 9 months ago by losul.

[aimee]

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.

[losul]

Dori, yes I found the same thing, most sites heartworm sites discuss x-rays, ultrasound and even urinalysis, to determine extent. Thats why I couldn’t understand my vet not recomending them and had to call him back on those things. He can’t possibly judge with any certainty just by listening to heart and lungs, and his being asymptomatic. I thought that at the very least x-rays and bloodwork were essential in determining stage. And that’s why I worry that there could be more than it first appears.

[Shawna]

I haven’t used traditional heartworm preventatives for the past 19 years, am not now and probably never will. Even after knowing losul’s experience. I have a fantastic holistic vet, access to another AMAZING holistic vet, a dad that is a trained herbalist, products in my pantry that fight worms (including heartworms) along with a father that can help with dosing if I were to need it etc etc.. But I do understand why folks would chose the traditional preventatives.!!

[Shawna]

Hmmm Losul, I think I’d want the x-ray or ultrasound for sure then.. As Patty said, even if it shows nothing it tells you something. I know I have been told that they can determine the extent of the infection but I don’t recall how.

I found the below, regarding staging, on Dogaware
“Heartworm infection is divided into four or five stages (depending on the model used), based on the severity of the infestation and the age and health of the dog.

Stage 1 (mild) consists of young, healthy dogs with no symptoms and minimal changes evident on X-rays.

Moderate (stage 2) infection will show heartworm disease that is evident on X-rays, but symptoms are minimal, mostly coughing. Stage 3 is a severe infection, with weight loss, coughing, difficulty breathing, more damage visible on X-rays, along with liver and/or kidney damage.

Stage 4 and 5 are considered critical, with the dog often collapsing in shock. These dogs will not survive ordinary heartworm treatment, and must have the worms surgically removed if they are to have any hope of survival.”

Has he coughed at all? I did a QUICK google search and didn’t see anything linking shaking with heartworm disease. I did see “tremors” so googled “tremors heartworm”. All I got from that is side effects of preventatives.. May just be coincidental??

• This reply was modified 11 years, 9 months ago by Shawna.

[Shawna]

Dori,

Losul mentioned some time ago that milk thistle given too early after a heartworm preventative may interfere with the preventative (either by increasing or decreasing efficacy). Neither of which we would want to happen… I don’t think we ever decided when would be the optimal time to give the milk thistle — two days after, a week after etc? It would also depend, I’m sure, on what product is used and how it works.

[Shawna]

Just saw your bloodwork question. Eosinophils are white blood cells (part of the immune system) that help fight of parasitic infections (like worms). They can also be seen with allergies/intolerances. I’m not surprised to see them high and I would think that the fact that they are not above normal, in an otherwise healthy dog, is a very good sign.. Aimee, Patty, HDM or anyone else have any thoughts on that comment?

Higher HTC shows increased production of red blood cells but I’m not sure how that would pertain to heartworm infection, if at all? First I would check past blood evals to make sure this isn’t his normal and not elevated at all.

As far as other blood work or a urinalysis —- sorry, no help there… 🙁

[Shawna]

I’m not sure I’m following losul.. It takes six months, per those sites, for heartworm larvae to mature to adult worms and make offspring. So if heartworm babies, microfilariae, were detected in the blood than he’s had the infection for at least six months now.

I agree that he couldn’t have been infected after the last heartworm dose was given. It would have happened several months before then or there couldn’t be detectable microfilariea.

I’m also not sure that giving extra doses of a drug that heartworm are “resistant” to is going to improve the outcome? Either they are resistant or they aren’t. Giving antibiotic resistant bacteria extra doses of the antibiotic they are resistant to doesn’t improve resistance. Not sure why it would in heartworm either? Seems to me like a ploy to sell more preventative.

You wrote “New adults could still move in after the old ones die”… That is true but NOT in the winter when mosquitos aren’t active. Heartgard kills the L1, L3 and L4 stage heartworms but not L5. The adulticide kills the L5 (and maybe late stage L4?). But L1 microfilariea swimming around in the blood CAN’T become adult worms without first being sucked up by a mosquito where they transform from L1 to L3. The only way for Turbo to get new adult worms is if he gets bit by L3 carrying mosquitos— which won’t be happening now. They would give heartgard or another product that kills L1-L4 in advance to assure that all L3 and L4 maturing larvae are killed and the adulticide to kill the adults. The circulating L1 are not a threat to Turbo unless they are first transformed by a mosquito but they too would be killed by the preventative. If I’m not being clear — at this very moment in time, he can’t get any new adult worms unless he is bitten by a mosquito carrying stage L3 larvae. And that would be RARE to happen in cold temps. All you have to worry about is the small load he has right now… Again, this is one of the reasons why I think Turbo is a good candidate for fast kill. We know the worm load is low and will be when the adulticide is administered AND Turbo is in very good health…

• This reply was modified 11 years, 9 months ago by Shawna.

[Dori]

I don’t use Heartgard so I’m not sure weather it says it on the box or not. If it doesn’t, it certainly should as they were so adamant not to refrigerate unless they expect the Vet to tell you but, really, it would be their responsibility. As i said, I don’t use the product so maybe it is on the box in tiny print. I use Sentinel and after Losul’s tragic story with Turbo I will be doing year round treatment. I live in Atlanta and the weather is always a little dicey here in this part of Georgia. Yesterday it reached 76 degrees in the afternoon and today’s high will be 46. I was only treating during the hotter months but now I’m a bit freaked out about putting their health in the hands of my ability to predict the weather or keep track of it moment to moment. From what you said in some earlier post, I think it was you, the treatment for Heartworms seems more toxic and scary if not the same as giving year round Sentinel. My guys are too small (as are yours I believe) to withstand treatment if they actually got heart worms. My biggest is 8 lbs. and healthy, yes, but she was 14 years old last September so she’s not a great candidate for major heart worm infestation or the treatment for even low infestation. I don’t like the idea and of course will worry about giving them the Sentinel year round but I will do that. Actually I gave the a dose the morning after I read Losul’s original post on this Forum. I do give Milk Thistle for seven days after the dose.

[Dori]

This is from the Heartgard website as to administration. Shawna, I believe you are correct in that the entire pill must be given. From what I’m reading the site says that you should continue to give Heargard for one (1) month not 3 after heart worm season ends.

ADMINISTRATION: Remove only one chewable at a time from the foil-backed blister card. Return the card with the remaining chewables to its box to protect the product from light. Because most dogs find HEARTGARD Plus palatable, the product can be offered to the dog by hand. Alternatively, it may be added intact to a small amount of dog food.The chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole.
Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended.
HEARTGARD Plus should be given at monthly intervals during the period of the year when mosquitoes (vectors), potentially carrying infective heartworm larvae, are active. The initial dose must be given within a month (30 days) after the dog’s first exposure to mosquitoes. The final dose must be given within a month (30 days) after the dog’s last exposure to mosquitoes.
When replacing another heartworm preventive product in a heartworm disease preventive program, the first dose of HEARTGARD Plus must be given within a month (30 days) of the last dose of the former medication.
If the interval between doses exceeds a month (30 days), the efficacy of ivermectin can be reduced. Therefore, for optimal performance, the chewable must be given once a month on or about the same day of the month. If treatment is delayed, whether by a few days or many, immediate treatment with HEARTGARD Plus and resumption of the recommended dosing regimen will minimize the opportunity for the development of adult heartworms.

[Shawna]

Oops, forgot this..

IF refrigerating the product does cause issues, that could be another reason it failed.

And

Heatguard kills L3 and L4 stage larvae. I’m not sure why one would need to continue giving it up to three months after heartworm season ended. If giving every 30 to 45 days it should kill any L3 and L4 still maturing under the skin??

[Shawna]

Hey Losul,

You may have already made your decision on what to do and what product to use but either way I think it is important for you to know the heartworm life cycle.

Microfilaraie circulating in the bloodstream, from my understanding, CAN NOT become adult worms without first going through L1 to L3 changes IN A mosquito. With this in mind, I don’t see how the worm burden can increase during these frigid winter months. Check with your vet to make sure about this but here’s some data.

FDA — “Microfilariae cannot become infective larvae without first passing through a mosquito. When the infected mosquito bites another dog, the mosquito spreads the infective larvae to the dog through the bite wound. In the newly infected dog, it takes between six and seven months for the infective larvae to mature into adult heartworms.” http://www.fda.gov/animalveterinary/resourcesforyou/animalhealthliteracy/ucm188470.htm

From what this and others are saying — Turbo has had this infection for at least six or seven months but maybe longer for there to be detectable L1 microfilariae in the blood.

American Heartworm Society — “Microfilariae cannot mature into adult heartworms without first passing through a mosquito.” http://www.heartwormsociety.org/pet-owner-resources/heartworm.html#lifecycle

Trifexis website — “Microfilariae are actually microscopic larvae. They live in the blood of most heartworm-infected dogs. Microfilariae are ingested by a mosquito that feeds on an infected animal, where they molt twice over a period of about 2 weeks and develop into infective larvae…. An infected dog will typically be carrying microfilariae within 6 to 7 months after first being infected by the initial mosquito bite. And the cycle continues.” http://www.trifexis.com/about-parasites/about-heartworms/heartworm-lifecycle.aspx

There hasn’t been enough time for the infection to have been caused by not giving the preventative in November and after — the infection had to have happened before that. Which also means that the heartguard you were using wasn’t working (unless you missed giving – which I doubt). I also thought I read that heartguard should not be divided into multiple doses as the medication is not uniform throughout the product. Someone please correct me if that is incorrect.

If the above mention of splitting is correct, you could have given one dose with medication in it. The very next day Turbo could have been bitten by a mosquito. The next month you could have given the non-medicated portion and then again when splitting the next month non-medicated could have been given. By the time the next dose carrying medication is given the larvae could have developed to L5 stage (young adult) where heartgard (and others) are ineffective. OR, the mosquito’s in your area are ivermectin resistant.

• This reply was modified 11 years, 9 months ago by Shawna.
• This reply was modified 11 years, 9 months ago by Shawna.

[losul]

Melissa, I don’t have any doubt that it’s (supposedly gradually) released into the bloodstream, where it slowly builds up plasma concentrations. If the vet wanted to use a 6 month injection of this, (and as far as i know it would Never be done on a HW pos dog) I would have already immediately looked elsewhere. Speculation, but I think it would be very hard to formulate a timed release product for prevention that would give a relatively even plasma concentration for an entire 6 month period. There’s also the issue of injecting it properly. I would imagine it would have to be very carefully injected into storage fat, and if not done properly, the potential for really big problems, which I think they proheart6 had. I doubt I would ever trust a 6 month injection of this, not for prevention or otherwise, not ever.

Speculation again, but i would think 1 month topical doses would have a much higher margin of safety. Absorbed through the skin, wouldn’t the drug have to meet the subcutaneous -below skin fat layer before ever reaching the bloodstream or at least without an excessive amount getting in the bloodstream right off the bat? Supposedly it only builds up slowly for the first 3 or 4 months (3 or 4 applications) before the plasma concentrations level off and stop building up even with additional applications. Bayer says this the big advantage. On page 11 on the right, there is a chart that shows supposed plasma concentrations over time.

I don’t even really want to dwell too much about shortcomings of proheart6, I’m not even considering it and I think I know some of it’s problems, but in table 2 on page 10, it says this about it “At the end of the 6-month dosing interval, residual drug concentrations are negligible12”

http://www.bayerdvm.com/show.aspx/canine-heartworm-disease-blagburn

Intuition at first tells me I would rather have a drug that gets in, and more importantly gets out fast. Bayer claims the slow and more continual and evened out plasma concentrations is the big advantage to this vs. a big plasma spike and rapid exit such as ivermectin dosing, and then there is very real risk of anaphylactic shock from using ivermectin in a HW pos dog, because of the very sudden and too rapid die off of microfilaria. I don’t know, I really wish I had more answers and more time. I can’t really argue for this drug, sadly, I just don’t have anywhere near all the answers.

[losul]

I found this article which mostly describes and talks about MOX use in horses and certain worms, and describes the drugs chemistry, etc. It also mentions many other uses in many different species, including the Onchocerca volvus thing that Shawna was talking about, and the brief, so far, Proheart 6 month thing for heartworm in dogs. Interesting.

Note: the 2 authors of this paper are affilliated with Fort Dodge Animal Health.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2751841/

I’m wondering if Wyeth/Fort Dodge owns the rights to Moxidectrin, and maybe only licenses the drug to Bayer (advantage multi) in a topical formulation and with an included insecticide, so that it couldn’t compete directly with their so far, troublesome 6 month injection for HWP in dogs.