[losul]

The moxidectin component of advantage multi topical, supposedly is rapidly absorbed through the skin within 30 minutes into the subcutaneous fat layer. The flea component supposedly stays within the dermal cells and takes much longer to spread through the dermal tissues, the way I understand. They should have left the flea insecticide completely out of it. As it is, it’s another thing to be concerned about, and that I really know little about.

Evidently the moxidectin component is highly lipophilic, meaning 1. showing a marked attraction to, or solubility in, lipids.
2. having an affinity for oil or fat.

“Actual preventive products may perform differently.
Table 2 summarizes important differences in heartworm
preventives. Properties such as unique pharmacologic
behavior could result in improved efficacy. For example,
moxidectin is a highly lipophilic molecule, resulting in
higher drug concentrations and delayed elimination from
the host. Moxidectin in the Advantage Multi® for Dogs
topical formulation achieved high concentrations in plasma
(15.1 µg/L) and maintained levels at or above about 12 µg/L
for the 30-day treatment period. More importantly, consistent
administration of moxidectin (Advantage Multi® for Dogs) to
dogs for 4 or more months resulted in a continuous presence
(steady-state; approximately 36 µg/L) of moxidectin in
plasma.8 Product properties such as these may prove to be
important for effective heartworm prevention.”

See pages 8-11. See also the tables and chart. Note; this comes from Bayer Pharma’s own website, and by the Dr. Byron Blackburn, who I think has financial bias.. Regardless of any bias, I think the article still has some good information.

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

[losul]

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.

[losul]

Shawna thanks much and I’ve been reading the prior links you provided also. I’m positive doxy is going to be a part of whatever treatment we go with. I’m getting that the doxy will cause the female worms to abort and expel their babies (larvae) well before the mama ever dies, and become sterile, the females shrink some, causing a little less congestion? It helps weaken the worms, shortens their life, lessens pathology, and disrupts transmission. When the mamas do die, they should be virtually empty of the larvae that is believed to cause much irritation and reactions in the system when the large worms die? I didn’t word that very well, I know, but does that sound somewhat right?

The slow kill ivermectin/doxy treatment. Does that require extra ivermectin treatments, I think I saw somewhere every 15 days. And also concerning would be repeated rounds of the doxy? too much antibiotic treatment concerns me also.

I read that in order to be antigen detectible that there has to be at least 6 to 9 mature worms and at least 3 of those must be female. But there may be more sensitive tests used currently according to the A.H.S.. I don’t know how many he could have at the upper end. And we know that if the microfilaria test is correct that there are both males and females. We are supposed to be getting another ice/snow storm tonight and through tommorrow, they’re saying the roads are extremely slick already, but if I can get out tommorrow, I’m going to take him to the Vetco clinic (at Petco) for another HW antigen check.

The vet said I could always later change HWP’s, and with only a 30 day gap but I don’t think he meant during treatment. I think it would concern me going from moxidectin to ivermectin. I researched this before, but just going off the top of my head for now. Ivermectin has a short half life, it seems maybe 6 or 8 hours or something like that. It’s rapidly metabolized by the liver, after a day it’s mostly gone, and after a couple of days it’s nearly completely gone.

The way I understand it, the topical moxidectin builds up gradually to levels before tapering off to more constant levels (3 to 4 months.) During that period and supposedly even on the first dose it goes to work on L3, L4, and even immature L5, and supposedly it works well on those, the proponents say better than the others, and with a narrower suceptibility gap. But evidently it isn’t so effective on microfilaria (L1) until it accumulates for some reason. It seems to me that if moxi takes that much time to build up, it would also take a long time to completely leave the system, so I am surmising that it would probably be fairly easy to switch from ivermectin to moxidectin, but maybe not vice versa, because, even after a month of nothing, I think there would still be substantial moxidectin in the system, and then to be adding something else (ivermectin).

AHS guidelines about seasonal preventative usage;
“To be maximally effective, heartworm prophylaxis should be given year-round, but if seasonal treatment is chosen, administration should begin at least one month prior to the anticipated start of heartworm transmission and should continue for at least 3 months after transmission typically ceases. The latter 3-month recommendation emanates from new knowledge regarding resistant strains, which showed that extended treatment after exposure is required to prevent infection. Current data demonstrate that not all compounds and formulations necessitate this extension.” ( they may be referring to
moxidectin here?)

I think Ivermectin will cause a very rapid die-off of L1 microfilaria which is not usually desired in cases where the L1 count is moderate or high, due to risk of severe reaction, so the slower kill off of L1 could be an advantage with moxi. I think I read somewhere that is actually the only one FDA approved as a microfilaricide.

A.H.S. guidelines;
” Topical moxidectin is now FDA-approved for use in heartworm-positive dogs to eliminate microfilariae. No adverse reactions due to high microfilarial counts were observed in the
laboratory or field studies conducted for approval of this label claim.”

also they say this about other combos with doxy may have similar results as the ivermectin/doxy combo. for weakening the adults, but only going by anecdotal reports;

“Select macrocyclic lactones coupled with doxycycline individually suppress embryogenesis
and weaken adult heartworms. As mentioned previously doxycycline reduces Wolbachia levels in all stages of heartworms. Studies have shown that administration of doxycycline in combination with ivermectin provided more rapid adulticidal activity than ivermectin alone as well as more efficiently reducing Wolbachia numbers more effectively than doxycycline alone. Anecdotal reports on other macrocyclic lactones with adulticidal properties suggest similar results but no confirmatory studies have been published.”

“In cases where arsenical therapy is not possible or is contraindicated, the use of a monthly heartworm preventive along with doxycycline at 10 mg/kg BID for a 4-week period might be considered. An antigen test should be performed every 6 months and the dog not considered cleared until two consecutive negative heartworm antigen tests have been obtained. If the dog is still antigen positive after one year, repeat the doxycycline therapy. Exercise should be rigidly restricted for the duration of the treatment process.”

Shawna, Dr. Garner is a big proponent of advantage multi, and he advocates and uses a similar protocol as what my vet is recommending (excepting all the prednisone), and also as the AHS guidelines. You can see my vets protocol in my initial post. I realize now, his was the HW surgery video I watched. I EMailed him with some questions, including one about using advantage multi/doxy in a slow kill, hopefully he will find time to reply. If you get a chance could you take a look. Maybe you can tell me your opinion about using multi/doxy in either the full 3 treatment immiticide plan or the slow kill possibilty using multi/doxy. As of now I’m leaning towards the fast kill, but at the very least I need to decide quickly which monocyclic lactone (moxidectin,ivermectin, or?) to get him on. Then I can decide more from there.

Heartworm Treatment Dogs

Thnx Shawna!

[Melissaandcrew]

I just wanted to comment on Avantage. I have never used the muti nor would I due to the moxidectin. For me after the proheart issue its a drug I won’t consider. Even without the moxi, i will not use spot on flea and heartworm in one products. My concern here is how can I be sure the vector used to cause the heartworm preventative to be absorbed into the blood stream is not also carrying in the flea meds? I don’t want anything extra in the bloodstream.

I never used Advantage or any other products containg imiclopramide (spelling) either until last year when some of those products were given to me. I figured what the heck and gave them a try for one month. One week aftef using my doxie got spayed and it was the only time I feared losing a dog from the anesthesia. This dog had clear bloodwork prior to and ivs during as a “just in case”…it took her 3 days to eat/drink afterward (and a visit back to the vet in the meantime for more fluids etc) it was tbe longest spay recovery I have ever experienced. Perhaps it was coincidence but it was enough for me to toss it out. It ws d the one that did fleas and ticks only.

[Shawna]

Hi losul,

I came across the information posted below while researching for a conversation I was having with HDM.. As I’ve stated before, I do think Turbo is a good candidate for the fast kill method. You are a great dog parent and his immune system is so much better than most dogs in this situation!!! Oh, you should be able to contact your local extension office and find out what type of mosquitos are common for your area. You might then be able to determine which medications best work against those particular strains.

Also, I was really happy to hear your vet was open to options :). And that he was willing to postpone the rabies vacc.. I feel more comfortable about him after learning that.

Slow kill Ivermectin treatments are being used to kill a parasite in humans called onchocerciasis.

“Most widely known for causing “river blindness,” Onchocerca volvulus infection affects an estimated 17.7 million people worldwide in 34 countries in Africa, the Middle East, South America, and Central America. An estimated 500,000 people and 270,000 people experience secondary visual impairment and blindness, respectively [1]…..

The standard treatment for onchocerciasis is ivermectin (150-µ g/kg given orally ever 6 to 12 months). Ivermectin is a highly lipophilic [49], 16-membered macrocyclic lactone from Streptomyces avermitilis [50]. Single-dose ivermectin effectively kills microfilariae by blocking postsynaptic, glutamate-gated chloride ion channels, inhibiting transmission, and paralyzing the nematode. It also appears to enhance immune responses against O. volvulus in the treated host [23].”

They go on to state that because Ivermectin doesn’t control the adult worms the patient has to be treated (in this case every 6 to 12 months) for the life of the adult worms. This is the same with heartworm in dogs other than monthly treatment in dogs versus once to twice a year with human infections. My guess is the life cycle of the O. volvulus is different than heartworms — it discusses life cycle in the article but I didn’t read it.

They very briefly talk about moxidectin for potential use to kill adult worms but as of this writing it’s not used.

“A new approach to therapy targets endosymbiotic Wolbachia bacteria. In 2000, a landmark study first showed [74] that doxycycline cleared Wolbachia bacterial endosymbionts from the endodermis and uteri of adult female worms, leading to unusually extensive worm sterility not seen in other antifilarial treatments.”

They use the “slow kill” method to treat this horrible disease in humans but are looking in to less toxic options for a fast kill (namely moxidectin).”

And we’ve both heard numerous accounts of dogs doing well on the fast kill option. Dogs not in nearly as good of health as Turbo. Trust that whatever your decision you have put your boy in the best position possible to fight this with no lasting after effects…

I wonder if prevention could be cycled in case a resistance is potentially part of the problem? Could you use an Ivermectin product for three months and then the product recommended by your vet for three months. If you decide to give the product only during mosquito season it is important to watch the weather and give the last dose one month AFTER the last possible chance of infection happening and to begin the following season one month after the weather is warm enough for infection to occur. I completely understand if you decide to give year round protection.. 🙂

[losul]

Betsy, Thnx much, all the words and support definitely helped me get through my initial shock and panic stage. I made the mistake of watching that video the other day, Dr. Turner I think, where he surgically removed 86 1 foot long worms from that poor dogs heart, and all I could think was I wanted those friggin things out of Turbo NOW.

I should have been paying more attention to all the talk a few months ago about the HW preventatives. I think it was on the off topic thread and went on for a week or two. I’m going to have to look for that discussion and read it.

I was lame to think I would just casually keep doing what I had been doing and my dog wouldn’t ever get heartworms. As much as I hate it, once Turbo is cleared I will probably have to keep him on preventative year round, on the full dosage, and maybe even checked 2X year, I can’t ever risk this happening again. There are alot of mosquitos here, I’m considered within the Mississippi valley, and part of my property is within a flood plain, actually the majority is now included in the flood plain, since they remapped after the Great Flood. Probably the mosquitos aren’t near so bad in your area.

Shawna, I hope I can manage to make the right decisions going forward. Thnx

About the Dr Byron Blaghorn that my vet mentioned. I found that yes he has an impressive bio, but I wasn’t so impressed by the study he conducted. The study was limited in size, they tested 4 different HWP’s and found that Advantage multi was the only one that had 100% efficacy against 1 certain strain of HW larvae after a single dosage. Apparently that strain has never again been found in the wild, and apparently it was not even the supposed resistant strains found in the Mississippi river delta and valley. The study was paid for by Bayer Pharma and I understand that the Dr. also received a fee from Bayer. Bayer publicized this study ALL over the place, but they didn’t publicize the fact that all 4 HWP’s had 100% efficacy after 3 doses.

I’m not sold on advantage multi. And I don’t like the included flea insecticide. I get so much conflicting information, which do I believe?
I can’t find any info on multi and doxy alone being used in a slow kill method, and not sure on it’s effectiveness at weakening/killing adult worms or it’s actual reliability to clear microfilariae. So much conflicting info. Plus I’m not sold on it’s safety. Is it better to use a drug that accumulates and builds up in the body (moxidectin) or one that does it’s job quickly and leaves the body rather quickly (such as ivermectin)?

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

[DogFoodie]

Hi Losul,

I just wanted to say again how sorry I am for all that you and Turbo are going through. I can’t imagine being in your shoes. Shawna sounded very encouraging in her earlier post, so I’ll offer all that I can, which are my prayers that Turbo’s treatment goes smoothly and that he makes a full and speedy recovery.

I also want to add that you’ve inspired me to be more consistent and vigilant with my dog’s heartworm prevention. I was bad about keeping track of when I had administered their doses, etc. I decided a short time ago to use natural products for flea prevention this year and had been previously using Trifexis for one dog and HeartGuard for the other. The Trifexis was a bad experience, so I was reluctant to use it, but it was paid for. Although we still have a foot of snow on the ground, with more on the way, I’ve already planned to have them tested the last week of March and talk to my integrative vet about her recommendations for the HW prevention products she feels are best for my dogs.

Thank you for sharing your experience. I’ll eagerly read this thread and especially your updates.

[losul]

Shawna, I assure you I am going to go over all the information you and all the others have graciously provided, and take everything into consideration. It’s been hectic and I’m an airhead, exhausted yet so wired with all the coffee and tea. So bear with me, if I can’t get back right away. I have some posts to get to on the off topic board also

I will say this much for now, I had another lengthy phone conversation with the vet and he has set my mind at ease on a number of points. Don’t worry about the rabies vaccine fore now, we have some weeks grace, if I’m still concerned he will help me in seeking an exemption.

He still will not advise the ivermectin as a slow kill at all, nada. He is however quite agreeable to trying an advantage multi/doxycycline slower kill without immiticide. The drug companies won’t and don’t exactly tell them this, nor are their actual studies showing this, (should I be repeating this?), but in his own experience and anecdotal evidence from others are that in general, the worms are cleared within 9 to 12 months in this way is what he told me. It takes longer than with the immiticide and is absolutely not without it’s own risks either though. He would not remain infective to others, nor would he be able to be re-infected. Because they have to give the advantage plus at least 2 months prior to immiticide treatment anyway, I would have that much time to decide whether to go through with the immiticide, except that they usually then give the doxy under a different schedule. They said the worst reaction they have personally expierenced to the immiticide is a welt. He told me they have on average about 2 or so HW cases/month. He is pressing for the the Advantage multi, but I don’t think it is just because his clinic sells it, I think he believes in it. He also said I could later change it to something else if need be. It’s not really priced horrible – 6 for $99.99 plus 3 “free.” I already have a “complimentary” tube.

He gave me the name of a supposedly renowned expert in field who is very much a proponent of advantage multi, and I think he said he wrote some papers on it for The American Heartworm Sociey. Dr Byron Blagburn. I haven’t had time to look for anything about this yet, just some general info;

http://www.vetmed.auburn.edu/faculty/pathobiology-faculty/blagburn#.UxEimfldXeU

He also said I could wait until Monday to start the Advant if I was concerned about some possible kind of reaction while their clinic was closed. He said the only reaction they have persomnally seen is some itching after application at the site, that quickly subsides in about 10 or so minutes.

He was not opposed to taking X-rays, and thought if not neccesary it could still be a good ideal, it was just that most people don’t and want to keep expenses to a minimum. They have a professional radiologist look at them, he only comes in once a month, but they could be sent to him (extra charge of course) for faster results.

This vet is not the senior vets ( which are a married couple) at this office, he was a 2000 graduate. But the vet office and their vets came highly recommended to me by several people. He might not have extensive expierience, but so far, I do like him. Very easy to talk to and get along with, seems like a vet that continues to seek an share knowledge and wants to grow that knowledge. Yet I am still thconsidering about that 2nd opinion or at least another HW test elsewhere. I called some and couldn’t get an appointment before mid-week. I found out Vetco – those traveling clinics that usually appear once a week in Petco stores can do a HW test Sunday at Petco, but not exactly crazy about going that route. There wouldn’t be any second opinion there. Yet I might just do it to confirm and it would get done and with results Sunday.

The baffling trembling episodes are still very troubling to me, but no reoccurences.

Melissa, Thanks so much for the support, your input and your expieriences I have calmed some finally now and I am going to take a day to think things over. I’m going to try and shut my eyes soon 🙂

Patty, I think going by the records I showed him, he said the infection likely couldn’t bhave been more than a 1 1/2 years ago, but not sure on I recall correctly. Thank you Patty, I really appreciate the kind words.

[theBCnut]

Hi Losul

I just want to point out that since you have only had Turbo for 1.5 years, he could have already had the heartworm infection, but it wasn’t far enough along to be detected before you got him.

I hope everything goes smoothly for Turbo. I don’t know what I would do in your shoes myself. Sorry you are having to go through this.

[Melissaandcrew]

Hi losul-

So sorry to hear that you and Turbo are going through this-Take two deep breaths and breathe…While you want to make a decision sooner than later, nothing is going to change in the next few days, so consider all your options : )

Its been years since we have had to treat a heartworm positive dog in our rescue, but we have used the Immitricide protocol since it was first released as an option. For us, we have never had any type of reactions or losses.

I prefer the Immitricide as while it has its risks, I want those suckers gone before they can continue to burrow and cause more damage. The only time I would consider slow kill(for me) is if the dog was old, compromised or otherwise ill-and then I would consider it.

Whatever you decide, be certain and take some time to think it through so that you are comfortable and not second guessing yourself.

We are all here for you and will keep both of you in our thoughts and prayers .

Melissa

[Shawna]

I just posted this to HDM on the regular site but thought you might not see it..

“The doxy makes the worms sterile so resistance shouldn’t be an issue with any worms picked up from the doxy treated dog. One of the benefits of giving doxy is that it makes the dog no longer infective to other dogs.

From heartwormsociety.org “Microfilariae from dogs treated with doxycycline that were ingested by mosquitoes developed into third-stage larvae that appeared to be normal in appearance and motility, but these larvae were not able to develop into adult worms, thus reducing the risk of selecting for resistant sub-populations.” http://www.heartwormsociety.or…

I see advantages to the fast kill as well as slow kill methods. I personally would use the slow kill with SP Canine Cardiac Support and herbs mentioned in Dr. Goldsteins book for heartworm treatment plus. But I understand Losul’s desire to get the worms out as soon as possible too… And Turbo seems to be a good candidate for the fast kill method when doxy and heatguard (or another form) are used first to lessen the risks of immiticide treatment.

I’d give raw eggs to keep glutathione levels up. Cardiac support by giving an organ supplement or giving organic heart. I like Standard Process because it has anti-inflammatory factors that work specific to the organ being used for as well as “food” for the specific organ. Anti-inflamatories like turmeric. I personally would give small amounts of garlic and use probiotics regularly. etc etc etc Chlorella is an excellent detoxer.

Edit — been a HORRIBLY busy at work last few days.. I’ve missed much of what has been discussed :(..”

Another thing to consider is that although nobody wants to get that diagnosis, it is really not as bad as some try to make it. You caught it early. Even before symptoms appeared. He has every chance of doing well no matter which way you go. After re-reading your post I do see where your vet is recommending doxy and heartworm before the immiticide. That makes me feel more comfortable with his recommendation!!! 🙂

Here’s a link that may not provide new info but hopefully will take a little of the scare out of the diagnosis.. This is naturopathic vet Dr. Jeannie Thomason’s site http://www.thewholedog.org/heartworm.html

PS — I found several folks that had dogs with a minor infection like Turbo’s. One said her dog was free of heartworm nine months after starting the slow kill method. Some of the results you are hearing from could be from immune compromised dogs as well. Turbo is way ahead of the pack in that regards. That is also why I would be less freaked about the fast kill method for him!!! You’re a good puppy parent and Turbo has every chance of having no complications because of it.

I’ve always read to use ivermectin when doing slow kill. I’d do more research before choosing slow kill and anything but ivermectin. A quick google search says this about moxidectin “Ivermectin is the medication most commonly used to kill the microfilaria (larval stage.) There are other medications that will kill them (such as milbemycin) but ivermectin kills more slowly. When too many microfilaria die at once, it can cause shock and collapse for the dog. Thus, ivermectin is preferred because of the slower kill rate. Other products like selamectin and moxidectin do not kill the microfilaria efficiently enough to clear them reliably. Fortunately, ivermectin is available in several monthly heartworm preventive medications. Examples are Heartgard ®, Tri-Heart® and others.” http://vetmedicine.about.com/od/diseasesandconditions/a/CW-HeartwormTreatments.htm

Of course, one comment on vetmedicine site is not enough to base something like this on but do research more before deciding. I’ll try to check it out too.

Did you ask him his reasoning for recommending the rabies vacc at this time? Is it that he is not aware of the problems, disagrees that problems could arise, thinks they are overstated or what? Does your state allow exemptions? Why not put it off?

Here’s data from several people that have actually USED the slow kill method and cleared heartworm. And likely these are dogs that are nowhere near as healthy as Turbo however I don’t know that. Just a guess. http://www.chronofhorse.com/forum/showthread.php?365271-Slow-Kill-Heartworm-treatment

It’s also the method that most rescue use around here. And again I would try to get Dave’s Hounds input. BUT, when it really comes down to it you will do what you think is best for Turbo and EVERYONE here that is truly your friend will support your decision because we all know that you are the one that has to live with that decision not us… We all will support you no matter what your choice. And as stated before, I think Turbo is a good candidate for the immiticide option as he is young, healthy and has the right person in his corner!!!!!!

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

[Shawna]

Hi Losul,

SOOOO sorry to hear about Turbo’s issues :(…

Here is what Dr. Becker says about heartworm treatment (and no, what your vet recommended is not the slow kill method).
“As it turns out, low-dose ivermectin therapy in dogs with no sensitivity to the drug, in combination with the antibiotic doxycycline, can be an extremely effective, inexpensive option for treating heartworm infection.

The cost was about 50-75 percent cheaper than Immiticide and all four cases of infection cleared beautifully.

The only time I’ll consider using Immiticide in the future (once it becomes available), is when I have an ivermectin-sensitive patient.” http://healthypets.mercola.com/sites/healthypets/archive/2011/11/22/cheaper-safer-therapy-for-heartworm.aspx

Dave’s Hounds has been using the slow kill treatment with his older, adopted Hound Dog and things, last reported, seem to be going well. Might be worth talking with him!!!!

Mary Straus at Dog Aware website has some fantastic information on heartworm and the slow kill method. Doxy basically makes the worms sterile which prevents the existing ones from reproducing. Since your vet says stage 1 there assumably aren’t an overload of them. Steralizing the ones that are there would be a good idea. Doxy also makes it so Turbo can’t infect any other dogs. Doxy also kills the bacteria that hitches a ride w/ the heartworm. It is thought that the bacteria, called wolbachia, die off is what causes a lot of the dangers with the fast kill method. As well as clogging due to mass die off of the worms. You can pulse the doxy and ivermectin for a few months and then do the immiticide or you can stay on the doxy/ivermectin long term from my understanding.

“These studies clearly indicate that treatment with a combination of weekly ivermectin and daily doxycycline given intermittently will sterilize the heartworms, prevent the dog from being infectious to other dogs, speed up the death of the worms prior to (or in place of) Immiticide treatment, limit inflammation and damage caused by the worms’ presence, and reduce the chance of serious adverse reaction from Immiticide treatment.” http://dogaware.com/articles/newsheartworm.html

And more on dogaware http://dogaware.com/articles/wdjheartwormtreatment.html

He’s young and strong enough that he could probably handle the immiticide but if the slow kill is just as effective without as many complications…….. At the very least, do a round of doxy and ivermectin BEFORE the immiticide.

I can not believe the vet would recommend a rabies shot knowing that Turbo has heartworm AND wanting to do the immiticide treatment??? That’s just asking for trouble in my opinion. Just my opinion though….

I did not know that heartguard should not be refrigerated? Thanks for mentioning that in your post!

I would also consider giving, or continuing, supportive care such as giving high quality probiotics, anti-inflammatories etc. I would also suggest looking into a product called Canine Cardiac Support by Standard Process. Here’s a brief primer on it but more can be found (or even call the company) http://www.animalrehabstlouis.com/wp-content/uploads/2012/10/cardiac_support.pdf

I have no suggestions or ideas for the trembling… 🙁

I personally would get a second opinion before starting heartworm treatment be it slow or fast kill. I would simply need that piece of mind. I wouldn’t tell the new clinic that he had already been found positive either..

[pugmomsandy]

The pugs get one immiticide shot on one day and another on the following day. Then they spend maybe 2 days more at the vet. None have been lame. A few have a “welp/welt?” but sometimes the non heartworm ones get that from the other vaccinations they got. The pugs I’ve had post heartworm treatment have been fat to almost emaciated, young and old, post URI or other ailment and they all received a full round of vacc’s as well. Half will be symptomatic afterwards – they have a cough/gag and that’s all for a few days to maybe 2 weeks. I’ve only had 4 out of 228 pugs die from probable pulmonary embolism. One was necropsied and he had a very bad case of worms. He was full of 12-18 inch worms, so he was severe. Some of the vets that do half-way slow-kill give doxy for a month prior to immiticide and then another month of doxy and then the second immiticide and that’s it. The rescue won’t do the non-immiticide slow kill. Takes too long and people are afraid to adopt a dog with heartworm.

[weezerweeks]

I have been through the heartworm treatment with my yorkie so I know what ur going through. The second injection Bailey had made him paralyzed in his back but my vet gave him some kind of narcotic and he was okay. The hardest part for me was the confinement for 30 days. Every time we went out had to put him on leash where he couldn’t exert much energy but we made it and u will too. I will be thinking about and praying for u and Turbo!

[aimee]

I respect immiticide.. I can’t lie the drug scares me a bit. It is painful and is injected deep into the back muscles. When injected into legs it causes lameness. Rarely it has caused sterile abscesses and if it leaks and migrates and gets to the spinal cord very very rare cases of paralysis have been reported. I’ve heard of dogs having “allergic” ie anaphylactic reactions again very rare. As far as organ toxicity …it is a lot safer than what used to be used. Still knowing all that it is what I’d choose for my own dog if ever faced with a heartworm positive dog.

P.S. Means a lot to me that you hoped I would be one of the ones to reply.

[aimee]

Hi losul,

First I’m so sorry for what you and your dog are going through. I myself have nightmares that I get that dreaded call in which I’m told my dog has heartworms. I know that giving less of the pill and less frequently than recommended is likely playing heavily on your mind. In actuality we don’t know what role that played as sometimes dogs on full prevention protocols come up positive too.

I’m sure this is scarey. I’ll try an answer your questions to the best of my ability.

Do you need a second opinion? If you want to look further, have a different type of test done vs a different vet who may be using the same brand test. There can be false positives on a heartworm test, but they are rare.

The fact that they saw microfilaria kinda clinches the diagnosis. There are other microfilaria that can be seen in blood, Dipetalonema comes to mind and a parasitologist can likely identify them for you. The sample may need to be sent to a university vet school. But really the chance you have both a false positive and a different type of microfilaria seems unlikely …I think you would be grasping at straws …

Should you consider slow kill? I’ll give you my opinion for what it is worth, I wouldn’t. I can’t put my hand on it at this moment. Will look for it if you want but as I remember in dogs treated with slow kill considerable ongoing lung damage occurred UNLESS the dogs were on complete exercise restriction for the entire duration. Your dog is young, I’m guessing active, and would be difficult to keep continually crated for nearly a year plus(?) of his life. There also is some speculation that slow kill may be contributing to resistance. Unless your dog is clear of microfilaria during a slow kill treatment ( meaning your dog has microfilaria because of your dosing and not strain) your dog will be infecting others with a resistant strain and spreading resistance.

Should you use moxidectin? So far as I know of only one study that compared efficacy head to head and moxidectin was more effective when given as a single dose. Time will tell if that holds: one study one strain. The moxidectin treated dogs didn’t develop heartworm with only one dose post exposure whereas dogs given 1 dose ivermectin or milbemycin did develop worms. Dogs given 3 monthly doses of milbemycin post exposure were also clear. As I recall this test was done with a strain thought to have resistance.

Moxidectin is also the drug in Pro Heart injections. Is a continuous yet decreasing amount of moxidectin as effective as monthly peak doses? I don’t have any answers for you, I think though it has failed whereas the monthly topical has not due to higher blood concentrations with monthly pulse doses.

I’ve noted on Trifexis (milbemycin) commercials it states to give for 3 months post exposure whereas Sentinal Spectum (milbemycin) has upped that to 6 monthly doses post exposure. For now my dogs get milbemycin, same day each month year round. If I lived in heartworm land… southern states where resistance is being seen I’d choose moxidectin. Likely if my vet was saying moxidectin topical I’d go with it trusting that he/she understands the local strains. I don’t mess around with heartworm prevention.

The preventatives I can think of are ivermectin ( heartgard and others), selamectin( Revolution) milbemycin( sentinal, trifexis,) moxidectin( advantage multi, proheart) diethylcarbamazine (daily still available???)

Should you vaccinate? This is beyond my ability to answer. I think your vet is the best person to answer this one.

Trembling/ fearful…. two things come to mind: pain and fear unrelated to pain. Fears can be to unusual scents, sounds (electrical equipment, ultrasonic, rodents etc ) Pain… any lip licking swallowing drooling that might help you pinpoint it?
.
Again I’m so sorry you are going through this…your vet is the best one to help you through this. The American Heartworm Society guidelines are written as they are for a reason…. If it was me I’d make use of them: 3 injections and doxy. Best of luck

[losul]

Now I’m really confused. I thought the slow kill method was done without using immiticide at all, just the ivermectin or? and doxycycline. According to this site, it seems the slow kill method is what my vet was originally reccomending and still is, the 1 immiticide treatment followed one month later by a double (2 day) immiticide treatment, and includes alll the other drugs also? I guess what Sandy describes (1 two day treatment) is a faster kill method then?

http://heartwormtreatment-fordogs.com/slow-kill-heartworm-treatment-for-dogs/

I think it was Dave’s Hounds who awhile back was using some other kind of slow kill method on his rescue dog?

But now I find this describing a slow kill method as what I had thought it was ivermectin, or ivermectin + doxycycline to sterilize the female worms. This site doesn’t recommend that at all, the same as my vet really doesn’t.

http://vetmedicine.about.com/od/diseasesandconditions/a/CW-HeartwormSlowKillversusImmiticide.htm

[losul]

I just found this about advantage multi. So maybe it is a good/safer product? Also compares some of the others.

“Advantage Multi

Moxidectin is a remarkable substance that is both safe and effective as a heartworm prevention. Advantage Multi is a topical solution for application to the pet’s skin once a month.

It is the only heartworm prevention that may be given to heartworm positive dogs.
It is the only heartworm prevention that is effective against all strains of heartworms identified.
It is the only heartworm preventative that kills early L5 or young adult heartworms.
Advantage Multi is a combined product of Moxidectin which prevents heartworms and controls intestinal worms (hookworms, roundworms and whipworms) combined with imidacloprid which kills adult fleas. I recommend Advantage Multi as the best Heartworm Prevention Available today. It has a broader range of effectiveness against the life stages of heartworms and is also effective against more species of intestinal parasites as well. It is safer than other products in the same category and can be given to puppies at 7 weeks of age and to heartworm positive animals. There is a new concern that heartworms are developing resistance to heartworm preventions. See this article that compares Advantage Multi to all the other common heartworm preventions.”

Heartworm Prevention Dogs

Also found info on heartworms, treatments, etc. here;

http://www.heartwormsociety.org/pdf/2014-AHS-Canine-Guidelines.pdf

[JeffreyT]

Yes, the theBCnut, you have a point about treating the actual heartworm. It is a higher dose of heartworm meds plus an antibiotic. But my precautions (flea/tick spray, not going out dawn/dusk, etc) should ensure I will not have to make that choice.

Marty Goldstein DVM (and many holistic vets) believes heartworms are less of an epidemic than the disease causing toxicity of heartworm meds. I lost a dog to cancer and swore that I’d do everything possible to avoid repeating that nightmare.

If I chose to do meds I’d probably do the low dose Safeheart medication.

[losul]

I just discovered Tuesday evening that our dog Turbo has heartworm infection. It came as a huge shock, as i thought I was being meticulous with his care and his diet. Almost as bad, I am probably to blame for it, and I am sickened and upset by this. I was using
Heartguard+ chewables. I was trying to minimize his toxin exposure, so I didn’t give year round, just for the approximately 7 months mosquito season, and every 35 days instead of 30. Also, because Turbo is 34 pounds and I had the box for 26-50lbs, I was only giving him 2/3 of the chew. Lastly I was keeping the HG in the refrigerator, and now I found out that HG isn’t supposed to be refrigerated and they can’t guarantee the efficacy when refrigerated. I just called them and reported the case to them, telling them all the truth about the situation.

I don’t want to write our life story, sorry about the lengthy post, I’m just trying to get all the info out, so I can hopefully get some good advice to help me make the best decisions. Turbo is approximately 32 months old, 34 pounds, a boston terrier mix, we think maybe mixed with staffordshire or pit, but almost certainly mixed with some kind of bully type. We adopted him from our County’s Animal control about 1.5 years ago. He spent somewhere around 1/2 of the first 14 months of his life in 2 different sessions at the County shelter, and evidently 1 session at a City shelter. It was the first dog we have had in about 7 years, after having had many previously, for most of my life. We were out of the loop on most things dog, so I got very studied up on it, wanting to do things as right as possible, before we even started looking for another dog. I knew the type ( boston terrier or mix) I wanted and knew that I would put him on a raw diet before we even got him, and so be it, within 3 or 4 weeks we had him on about a 60% raw, 40% commercial diet, with no problems ever, except some gas for awhile.

Turbo is very handsome, charming, and playful, but can be rude, stubborn, very assertive, sometimes defiant. We love him the way he is, he’s always been a joy, and no real problems at all, except some assertion/agression (not fearful aggression) towards certain dogs, usually only the largest dogs or bully types. He’s completely different (quirks) than any other dog we’ve ever had, but for us, he’s really a perfect fit, and is always well behaved in the house.

We’ve been in search of a great dog Vet since we got Turbo. Tuesday’s visit was the 4th different vet. I had set up an appointment ahead of time for his upcoming rabies shot, and to test the waters with a new (and hopefully permanent) vet. In the meantime Turbo had a really strange and scary issue that happened Saturday evening and lasting into Sunday. An hour or so after he had his Saturday evening meal, and totally not typical, he began “hiding” in a corner of the house, or he would go to either the basement door or the back door. We take him through the basement into the garage when we go in the car. He goes out the back door into our yard. He also started very visibly trembling, looking very sheepish, and scared. He would not take a treat at all, so totally untypical of him. Once outside, he did not want to come back in at all, wanting to lay on a chair on the deck instead, even though it was quite cold and he doesn’t like cold for long. We’d make him come back in only to do the same again. Sitting in the corner at the end of the hall or at the basement door or the back door. He acted like he just wanted to be out of the house and maybe even away from us, seemed afraid of me for no reason, and the trembling hard, very scary. So not typical, Turbo has NEVER been fearful of anything that I know of, but he just did NOT want to be in the house at all. I eventually took him for a short car ride, and he seemed to have perked up some. So we got back into the house just a little bit reluctantly. He then took a treat fairly eagerly, but after taking a second one, he suddenly just dropped it and ran away to the corner again. The trembling and strange behavior again too. We nearly took him to the emergency clinic. It later subsided though, and eventually he went to bed right beside me, where I watched him the rest of the night. He seemed to sleep well. Next day, just a little more of the same scary stuff, and then he ate his typical raw morning meal. Soon after eating he started acting better throughout the day (Sunday). He never vomited nor had diarrhea nor showed any obvious pain through the whole ordeal.

Baffled, I spent most of Sunday researching the trembling symptoms. Nothing seemed really to fit at all, but I was concerned about problems like kidney/liver. I contemplated all sorts of things such as Lyme or tickborne illness ( he had a tick on his ear that I didn’t catch right away, it was November and we had already had several hard freezes. The tick left a pea sized nodule that lasted about two months. Friday evening he chewed on a cow hoove awhile until I took it away from him, because he had broken off a rather large sharp shard. Saturday morning he had his typical raw meal, but his evening meal was not quite as typical. Usually he gets 2/3 cup kibble matched with 1/3 of a can food, or 3/4 cup kibble and an egg, or sardines. This time I gave him less than 1/2 cup kibble + about 4 ounces of canned salmon + 1 egg cooked in coco oil, and i added about 1/2 t of nutritional yeast. i think I’ve added a very small amount of yeast to his raw mix before, but not completely sure. So thoughts of a bad reaction to the yeast also came into play, along with thoughts of too much fat at once. Even the thought of a ghost in the house came up.

Monday morning I called the vets office an\d told them I thought we needed to put the rabies shot on hold, and instead get him checked and do some blood work to get to the bottom of this. Tues evening: I explained everything to the techs and the vet as best I could, even that I home prepped over 1/2 of his diet. He asked me what I was feeding him and I told him him briefly, just didn’t come out and say”raw”, but I think he knew it. He didn’t ask if raw and seemed satisfied with what I was feeding and supplementing. This
vet spent alot of time with us, well over an hour, didn’t admonish for anything, wasn’t arrogant in the least, didn’t “push” anything , and so far I think I like him O.K. He examined Turbo and was pleased with his apparent health. So he didn’t push any lab work at all. I still elected to go with an outside lab wellness blood work, along with an in house tick borne illness and heartworm check.

I was floored when they came back and said he was both pos on the antigen and microfiliae HW tests. He was negative on the tickborne. He explained the clinic’s HW protocol; 1) monthly HW preventative for 2 months prior to treatment, and continuing throughout treatment and beyond. 2)Doxycycline. for 2 weeks prior to treatment.3) first immiticide treatment (injection); dexamethasone injection, tramadol injection. Hospital overnight, strict confinement until returning for next treatment.4) doxycycline again for 2 weeks prior to immiticide treatment. 5) 2nd immiticide treatment. ( 2 injections 24 hours apart), dexamethasone and tramadol injections given daily with each treatment. Hospitalized for 3 days and 2 nights. strict confinement at home 30 days 6) Heartworm check 6 months afdter last immiticide injection to confirm elimination of heartworms.

He also explained the clinic’s preferred HW preventative – Advantage multi – a topical application, (imidacloprid for fleas which Turbo does not have + moxidectin, the HW preventative, which is supposedly absorbed through the skin). I didn’t even realize they had a topical for HW. I told him I would rather not use an insecticide for fleas that he didn’t need. He said alternatives (such as heartguard) could be used but may not be as effective, in his opinion. I then mentioned that I recalled hearing about a “slow kill” method. He seemed a little stunned, and said that that method was actually more dangerous, wasn’t as reliable and it could take much longer if it even worked. I again expressed my concern about all the toxins, especially the arsenic/immiticide.

He didn’t think the trembling episode was HW related at all, although he didn’t offer any real explanation for it. Also he thought it would be fine for him to go ahead and get the rabies vaccination, or I could wait for the outside lab’s bloodwork results in a day or 2. I told him we would definitely wait.
—–

Here’s where I need advice;

Do you think I should get another HW test from another vet along with a second opinion?

Should I consider a slow kill method vs the clinic’s protocol?

Should I use heartguard or another ivermection based HWP vs the advantage multi, moxidectin based? Is their any other moxidectin based without other insecticides included? Is there another one more effective than the others? Are there any other HWP’s using some different drug altogether?

Should I continue to put on hold the rabies vaccination? if I put off more than a few more days, then he will be past due again, will probably only be able to get the 1 yr vs the 3 yr, and would have to be re-vaccinated again in a year.

Does anyone have anyone input about what could cause the trembling episode?

Any other opinions/advice?

———–

Update: The vet called with the bloodwork results. Everything looked “perfectly normal” he especially stressed the liver and kidney values, the blood cell and platelet counts and values, thyroid, and some other things I don’t recall now, I don’t have a copy yet. What a big relief on that much. I had some more questions to ask, such as should he have X-rays, ultrasound, etc. He could, but didn’t think neccesary nor did he advise it. I asked about the microfilariae count, he said a fair amount? Somewhere I had read about the 3 classes of HW infections. I asked what “class” his condition would be, he replied definitely class 1, which I saw described somewhere (going by memory)as asymptomatic to mild, no radiologic signs, nor signs of anemia. He still encouraged going ahead with the rabies vacination, and strongly urged getting started on the advantage multi soon. But he seemed much more amenable now to a slow kill method, maybe along with doxycycline, before I even asked again, even seemed to kind of go along with it, though he still didn’t recomend it, he still recomended their protocol. He also expressed concern that these worms may be resistant to ivermectin, and it could take a very long time to kill them using it. So he again really encouraged using their Advantage multi. I guess this multi is a new thing.

——-

Any advice/opinions would be very much appreciated, as I’m feeling lost and very worried over this. I think my questions still remain the same after getting the blood work results.

[weezerweeks]

You are so right Patty my vet used the arsenic but first we had to take antibiotic and prednisone a month but the worst part was keeping him calm for a month while the heartworms were dying and traveling.thank goodness we just had the 2 shots 24 hours apart but did not have to go back in a month for the second one.my vet says he has had less problems with Heartgard than any other heart preventive.

[theBCnut]

I think it is funny that some people don’t give prevention because it is so toxic, but they say they would treat their dog if it came up positive because that isn’t as toxic. Treatment is way harder on a dog than prevention. One method uses arsenic and the vet is literally balancing how much to give to poison the worms but not kill the dog. The other method uses exactly the same thing as heartworm prevention in either the same dose or a higher one. I use heartworm prevention for my dogs, but if I decided not to, I would not treat a positive dog, since if I’m doing all the things to keep mosquitos off of him anyways, he could never have more than just a very few worms, which would never cause an issue.

I don’t think a monthly dose of Sentinel is much different in toxicity than Ivermectin, it does have something for fleas in it too, but my understanding is that it is one of the less noxious ones. It’s definitely better than Trifexis.

[weezerweeks]

Dachassett I also live in Ga and my vet recommends heartworm treatment all year. We have mosquitoes all year in Vidalia,where I live and my yorkie is a rescue who had heartworms so this is the only medicine I give him. The heartworm treatment he went through was terrible but thank God we made it!

[theBCnut]

When I was working, the only breed of dog that ever came in due to toxic reactions to normal products were Yorkies. We always warned new Yorkie owners that they are as sensitive as cats to toxic substances, so I wouldn’t doubt that it could be the heartworm prevention.

[JeffreyT]

Yes, I’d get the dog to the vet immediately.

After reading Scared Poopless by Jan Rasmusen we decided not to give heartworm meds because they are basically poisons meant to kill the heartworm/larvae.
http://www.dogs4dogs.com/blog/2009/05/13/heartworm-medication-safety/

For prevention we always apply natural flea/tick spray like Mercolas, and test twice a year for heartworm to get it early when it’s not dangerous and treatment is easy. From what I’ve read, it’s not as easy to get heartworm as vets make it out to be.

How is he doing?

[SpanielMom]

I have two English cockers and they did well losing weight on grain free food + raw as a topper. Took me a few weeks to introduce them to raw because cockers tend to have a little more sensitive tummies in my experience, but it has been the best thing on earth to keep weight steady. My cockers have done well on the nutrisource brand as well – grain free nutrisource and also the PureVita – 28% and 24% protein, respectively. I like the grain free nutrisource because it is pretty easy on the pocket as long as your dog has no sensitivity to chicken.

Also – my cockers are not very active either right now because I also have a dog recovering from heartworm who has to be on cage rest and I don’t think it’s fair to take the others out to play and leave her there. 🙁 poor thing. My cockers have done fine on low activity (past 5 months so far) since I started adding a little raw. And I definitely agree with Melissaandcrew, just cut back on the kibble a bit if someone is looking chunky. 🙂

[InkedMarie]

Rambunctious: I have heard the same thing. I’ve also heard that places repackage the meds & use expired ones. For this reason, I buy only from my vet. Heartworm isn’t something I am willing to chance. A former vet price matched for me, when I asked.

[Melissaandcrew]

My vet rxd it for my 40 pound ish dog as 1/8teaspoon every 12 hours. A fecal flotation is a test to find the eggs in the stool. Not always 100 percent accurate. I just recently did every one with panacur and she did a not get a bit of an issue from it. Interceptor never bothered her but the ivermectin based heartworm preventatives do. We would deal with it for the day. I did find that it is not as much of an issue once the food issue was dealt with

Now we just mske sure to give her natures variety raw on the day of treatment and for the day following..no more major issues. When at her worst she would lose weight despite being fed high volumes of food which made it worse. Her weight now is petfect with out fluctuating.

[weezerweeks]

I think I remember you saying you use milk thistle for a week after heartworm preventive. I want to detox my yorkie but I need to know where to get it,the kind you use, and what dosage. He weighs 7 lbs. thanks

[weezerweeks]

Yes bad heartworm area, I live in South Ga. Plus my yorkie is a rescue and he had heartworms when I got him and it was a terrible treatment. Heartworm is the only preventive I use!

[JASTECH]

I would use 250mg 1xD for a week to clear out the ivermectin from that little Yorkie. Is their a heartworm issue in your area? I ask this because most Vets will try to get all dogs on preventative in the Attic. I have not ever given my yard heart guard which the Vets out here say is needed yet they don’t have statistics of k9’s with heart worm.

[weezerweeks]

I am interested in giving my 7lb. Yorkie milk thistle for a week after His heartworm preventive,Heartgard plus, what is the dosage I should give him and what are the names and places I can get it. Thanks

[theBCnut]

Joet, I don’t like pure balance at all, but it doesn’t cause heartworms or pneumonia. This was written by someone who didn’t take care of their dogs and wants to blame it on someone else.

[joet]

TO–ASANDY–FROM JOE T–

dont understand how the advisor rates this 5 star—
12.5 can is $1.00—called them—-
confused me—how could a 5 star food ==$$$$2.39—-over $3—normal price,
blue–wellness-merrick-etc–and all are great—

how eventhough its a big chain store sell a 5 star for a buck–so i investigared–heres 1 of the results–and also—-dont buy it—-
here it is–;;;;;;;;;

From Missy: “Two of my pets died this weekend. One was kidney failure but he also had heartworms. The little one that was healthy before Jan.14, 2007 died from pneumonia, both dogs ate Ol’Roy dog foods. When I first took the little one to vet cause she had trouble raising & walking they thought she had back problems. It wasn’t until she had difficulty breathing that they did blood work right after the recall. Could her death be caused from the poison? Her symptoms varied from fever, bloody lose stool, excessive drinking and urination, weight loss, and pneumonia. She was sick from Jan.14 – March 25,2007. All the symptoms took place over this period of time! Could it have been caused by the poison?”

thats only qon–also biscut recalls and other things—–

again A 5 STAR FOR A BUCK—NO WAY

[theBCnut]

Trifexis is really hard on some dogs.

[nationalguard88]

Thanks Patty. I’ve used Heartguard plus in the past. My vet recommends trifexis, but I’ve read horrible things about it, and I don’t need the flea protection. I use other things for that.

[pugmomsandy]

My dogs and house smell like essential oils most of the year – Halo Herbal Dip or plain eucalyptus for the mosquitoes.

[Susan]

Yes-I won’t stop giving mine HW medicine either, but good to know can at least back off the 30 day routine. My mother has rescued a few dogs that were heartworm positive and it was sad.
Thanks for the info!

[theBCnut]

All monthly heartworm preventions kill the larva in the first 3 stages of their life. All of these stages take a little more than 45 days for the larva to pass through them. The makers of heartworm prevention originally chose to promote them as “monthly” because they felt that it would be easier for people to remember. And before cellphones that was probably true. We got calls all the time from people who had forgotten to give their HW prevention and were in a panic. Now, I just plug into my cellphone a reminder for HW P. HW comes from mosquitos. I live in FL and we have mosquito season all year long, so HW are prevalent and I would never do without, but I have been using it every 45 days since it first came out. I’ve read one person who only uses it every 90 days, but that amounts to being the slowest that the larve can move through the stages and is far too risky for me.

[Susan]

Pattyvaughn-
I have always thought heartworm prevention needed to be a 30 day regimen. I give mine Heartguard and very seldom miss a dose. Please enlighten me so I can back off on the dosage. Here in south central Texas fleas and ticks can be a real problem, also. We have few freezes and sandy soil can add to the problem. My vet is very pro heartworm prevention and has always insisted once a month is necessary.
Thanks!

[theBCnut]

There are natural alternatives, but they require giving them 3 times a day. I give the monthly every 45 days and if you live where it actually freezes, you can stop giving it over the winter. I try to give Ivermectin and not give the ones with extra wormers, flea treatments, etc. I save those for when the big guns are really needed. For a week after you give heartworm prevention, you can give milk thistle to help the liver detox.

[nationalguard88]

Wondering how people feel about giving these prescription drugs to their dogs? Any alternatives that are safer? Thanks.

[FreeholdHound]

This is a copy (couldn’t get the link) of report that was posted on a Greyhound FB page earlier.

ATLANTA —

Grieving animal lovers across the country are coming forward blaming a popular pet drug for killing their dogs. Channel 2 Action News has uncovered several cases in Metro Atlanta.

“It’s like a piece of your heart is being torn out,” said dog owner Beth Timms from Gainesville.

Her dog, Gizmo, died after taking Trifexis. The once-a-month pill made by Elanco is a combination pill for heartworm, parasites and flea prevention. Elanco is the animal health division of pharmaceutical giant Eli Lilly.

Gizmo was a healthy 12-year-old mixed-breed. Shortly after taking Trifexis for the first time, she suffered lethargy, vertigo, seizures and a 106-degree temperature.

“We had to let her go. We had to have her put to sleep,” Timms said. “I killed my dog.”

Timms emailed consumer investigator Jim Strickland after finding a Facebook page titled “Trifexis Kills Dogs.”

Owners from all over the country have posted on the page, blaming the drug for their dogs’ deaths.

The Facebook page led Strickland to a home in Sandy Springs, where a dog bowl still sits empty in the corner. The dog who once used it was a puppy named Bishop.

“He died. For no reason, no warning,” said Bishop’s owner Jenny Schmitt.

Bishop was a 16-week-old Vizsla, which is a Hungarian hunting dog. He was one of seven in a litter born in June from an American Kennel Club Grand Champion.

Three of Bishop’s litter mates are thriving in Florida. A fourth is a healthy puppy living Buckhead. None of them has ever had Trifexis.

Bishop and the other two litter mates, named Tucker and Jade, each received their one and only dose of Trifexis in September. Bishop and Jade died within three weeks. Tucker died in six days. Veterinarians ruled they all died of heart inflammation.

“I think Eli Lillly and Elanco need to ask the broader question, ‘Does this drug even need to be on the market?'” Schmitt said.

Elanco is headquartered outside of Indianapolis. Strickland went there to speak with one of Elanco’s top veterinarians. Dr. Stephen Connell insisted Trfiexis is safe. He said he gives it to his own dogs.

Connell said Elanco has dispensed 50 million doses since Trifexis hit the market less than three years ago.

“We don’t like the fact that it has killed any dogs. But with any pharmaceutical product, we understand that the very rare sensitivities, allergic events — those types of things are going to happen,” Connell said.

Elanco’s spokesman later said Connell didn’t mean to say the company doesn’t like that Trifexis killed any dogs, but rather the company doesn’t like hearing reports of any deaths.

Strickland got the numbers on reports about Trifexis made to the Food and Drug Administration. The latest figures are as of April 2013.

Pet owners have filed 2200 reports of the drug causing their dogs to vomit. There are 600 cases of lethargy, and 31 reports of dog deaths. That’s about one per month since the drug hit the market.

The warning on the Trifexis box states mild side effects. Connell admitted to Strickland that the company has gotten reports of dogs suffering seizures, but Elanco has found no link to any dog deaths.

A University of Georgia Veterinary School pathology report on Bishop’s death stated a bacterial infection likely caused the dog’s heart failure. It ruled his symptoms were not typical of drug toxicity.

Trifexis contains two drugs, spinosad and milbemycin.

“The spinosad is from the United States. The milbemycin is sourced from China” said Connell.

He added their Chinese supplier has had multiple inspections and is a non-issue.

He also addressed the deaths of the puppies.

“It is our opinion that there are other factors involved in this case,” Connel said.

Bishop’s owner doesn’t believe that.

“The three puppies that all died within the same week, all had Trifexis, all around the same time,” Schmitt said. “It’s a heck of a coincidence.”

[VegetarianDog]

I have two vegetarian dogs, both relatively healthy. One has food allergies to animal protein and now that she’s solidly in her teens she has a bit of arthritis and some hearing loss. The other is blind from glaucoma she had before I adopted her and has had reflux for at least a couple years longer than we’ve had her (I was a humane society employee and my shelter had fostered her through heartworm treatments for a couple months with another employee when she first arrived there, then adopted her out to a home that we had to confiscate her from a year and a half or so later. Then I fell in love with her while working on rehabilitating her and wound up adopting her, so we know what she was like the first time she came through the shelter, but still have no idea about the first several years of her life). Aside from those specific issues, they’re in excellent health. When we first adopted our allergic girl, we tried all the atypical meat and carb sourced foods out there (duck and potato, venison and pea, etc). She reacted to everything, even plain fish. Her allergies are bad enough that when my brother was letting her lick out his empty individual serving yogurt cup, the teeny tiny amount of gelatin the yogurt he had contained was enough to cause her to have a flare up. Because of that, we switched to a vegetarian diet as soon as we found one that worked for her. She still craves meat 9 years later, but she just can’t have it even with twice daily antihistamines. An accidental mouthful of cat food is enough to cause a $300 vet trip for anibiitics, special shampoo, powerful antihistamjnes, and steroids and land her in an ecollar for a month because when she has a flare up, she’ll scratch and chew every inch of herself bald and keep right on chewing and scratching, crying as she’s doing it because she’s already gone through the skin. For us, vegetarian food is not a choice, it’s a necessity. Our other dog is vegetarian as well because the allergic dog will eat meat-poop if she can (thank god for top entry kitty litterboxes since cats are obligate carnivores) and flare up from that and even though we try to clean up as soon as poop happens, missing even one piece a month isn’t a risk we can take.

It would be amazing if there were more spaces where people with vegetarian or vegan dogs could go to exchange information about which of the vegetarian options are healthiest. You either won’t change their minds about the ethics or it’s a medical requirement for their dog, so isn’t it better to quit judging people and help them make the best possible choice within the parameters they’re working with?

• This reply was modified 12 years, 1 month ago by VegetarianDog. Reason: Edited for clarity

[pugmomsandy]

I rescue and the group only does immiticide back to back. Rarely they do the immiticide 30 days apart. If it were my dogs, I think I would opt for slow kill. Has your vet staged the heartworm disease? In the early stages with a small amount of worms, it’s less stressful on the dog, but still dangerous none the less. I’ve had 4 dogs in 4 years die from complications of heartworm treatment (pulmonary embolism). One is at the vet right now with complications. If you use topical flea/tick/mosquito meds, you can still also use essential oils like Sentry Natural Defense and Halo Herbal Dip.

http://healthypets.mercola.com/sites/healthypets/archive/2011/11/22/cheaper-safer-therapy-for-heartworm.aspx

[Dolly]

Hi BeachDog,

My pup had to have heartworm treatment after I took over her care at about the age of 10. My vet gave the injections a month apart, as she said this was the new ‘safer’ way to treat heartworm. As the previous post, she was given antibiotics and steroids, my vet gave me this as an option, and said it could help keep recovery smooth. It is a long, terrifying, two months, but it was what worked for me. My vet also suggested trying to treat with just a preventative and hoping the worms would die before they did to much damage, but I didn’t want to risk the long term damage the worms could do. I think this is a personal choice you should make on your own, weighing the risks. For a preventative I use heartguard. In my research and expeirience, heartguard and revolution are both very effective. Revolution has extra preventative for fleas/ticks/other parasites. I live in the north, so I like to use heartguard so I can only use flea and tick medicine when neccesarry. Good luck!

[weezerweeks]

My yorkie rescue had heart worms. My vet put her on an antibiotic for a month and prednisone. Then he gave her an injection on morning and the second injection the next morning. He was still on prednisone. I had to keep him quiet for a month especially while the worms are dying and traveling. No running, I walked him out on a lease where he couldn’t run. He didn’t have to have another injection a month later because he didn’t have the big ones or small(can’t remember which) He is fine now but I keep him on heart worm preventive year round because I live in South Ga and we have mosquitoes year round. Good luck!

[Beach Dog]

Hello. I live on an island in the Caribbean, and have a 4 year old, 75lb, female mutt. Two days ago she was diagnosed positive for heartworm…and yes, I cried. Luckily, she is in the early stages with no obvious symptoms of coughing, weight loss etc. I sought the advice of different vets and have been presented with 3 options. (1.) Do the 2 day adulticide treatment. (2.) Do a split treatment, where one dosage is injected and then a second and final dosage is given 3weeks after. (3.) Give her heartworm ‘preventative’ medicine over the next year, and assess if that reduces the quantity of adult worms present. While I make my decision, we started her on the “Pet Life Endolav Plus” pills. (She had not been given any heartworm pills prior).The pills were also given to my other dog, which is a 5 month old male mastiff. So my questions are:

1. Which option is the safest, while being most effective (I’ve gotten different responses from different vets).

2. For those living in climates where mosquitoes thrive all year round, what are the best heartworm preventative medicines and also methods? (I’ve noticed comments on this forum that advise against topical bug repellents, but mosquitoes are rampant here.)

3. Is there anything I can do to help prep my dog for treatment? Whether through addition of vitamins or a special diet? She currently doesn’t take any supplements. She was rescued as a puppy, and for the past 3 years has been fed Alpo/Pedigree/Beneful along with occasional cooked meals of rice and meat. I wasn’t aware this was potentially bad until recently, and have luckily found someone on island that distributes Sportsmix, ProPac and Earthborn Holistic Primitive. I went with the propac because it had lower calcium levels, which is seemingly better for the puppy. (Getting foods rated higher than 2 star here is challenging). I’ve started cooking meats and muscles to add to the kibble, and when I have the time on the weekend I cook full meals, including organs. (Still experimenting, as this is still new to me, having only just ditched the supermarket brands a month ago).

Grateful for any advice. She’s honestly the sweetest dog we’ve ever owned, and I badly want her to survive this. I would hate to have rescued her, only to have this as her fate. I also want to ensure that the 5 month old remains healthy.

[theBCnut]

Skip the furminator, they can really irritate the skin on all dogs, but especially on thin coated breeds. You need to adjust the dose on the trifexis or he won’t be protected from heartworms. You can add about 1/2 teaspoon of coconut oil to his food for the itchy skin. If he continues to be itchy all over then I would suspect allergies.

[InkedMarie]

What is BCP ear packing ointment? Ive never heard of that. He’s done with his latest round of Momentax (spelled wrong) and has clean ears. Only eating Zeal and just Bug Off Garlic Granules for supplement. Want to see what goes on. I typed up every food and supplement I can remember, wondering if the Mercola enzymes, CVS vitamin C or Dr Langers probiotics are causing the problem or if it’s not diet related.

I am taking Gemma to the vets on Monday for another UA (recheck), will ask if they have it and can I buy it. I am trying hard to not take Boone in to the vet again. Not to cry poverty but having Gemma to the vets twice in two weeks, once for being bound up and then for a UTI has depleted my vet envelope and she has a recheck, heartworm check and rabies if everything is fine, on Monday.