[losul]

Please Dori, no offense, those were just the names Shawna asked in her post to which i was replying if they had any thoughts on the bloodwork, I think about the values, if it’s enough, etc.

Weird for me that vets never discussed yearly bloodwork with me. It might be because of my area, or I’ve been out of the loop for so long. They are always pushing the vaccines though. I’m going to try to be much more vigilant on everything going forward, no doubt. Thnx Dori.

[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.

[losul]

Thnx Shawna just saw your bloodwork reply, I guess we went to page 4 and I didn’t see. Seems like the pages were rolling by quickly. Sorry to be bombarding you with so many questions. Hope I haven’t missed others or from anyone else. I haven’t even looked much at the review boards over the last couple of days.

Those 2 items actually show within the the reference range, just at the high end of it. So I guess all that I have on it looks pretty good. I don’t know how complete it is though.

Actually and sadly i don’t have a past blood eval to go by, should it be done every year?

Yes I would appreciate Aimee, Patty, HDM and anyone else chiming in with any thoughts.

[losul]

Dori, I found this with some googling. I don’t think ivermectin shows on the list but that list isn’t all inclusive. I’ m sure you can find that ivermectin is metabolized by the same CYP3A4 enzyme in the liver, probaly other drugs in it’s class also. I pulled that up somewhere before, probably from the manufacturer’s site. I’ll look some more whenever i can get a chance. Most of the drug interactions it increases the efficacy, while there are a few it decreases it.

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

[losul]

Dori Sentinel is milbemycin? (spelling?) I would think, but don’t know for sure if it’s metabolized the same in the liver as ivermectin. I believe they’re all in the same class of drugs though.

Also didn’t see before what how were dosing. A day or so after might be O.K. I definitely wouldn’t want to give it before, at the same time or too quickly after.

• This reply was modified 10 years, 1 month ago by losul.

[losul]

My vets out of the office now until Wednesday, She said it would probably be Wednesday evening before he calls me back. They don’t really want to put me with another vet that doesn’t know the case. I guess the the X-rays, etc. , not exactly urgent immediately, but I do iwant them done.

[losul]

Don’t know why for sure Dori, maybe the law or liability, or who knows the the heck he was thinking. I’m not concerned about him getting rabies. I still have a concern that if I go elsewhere now that they may not treat him at all because his rabies shot expires today.

I was even researching that dreaded proheart6 last night, and I read that they reintroduced it with a warning oin the label to not administer within 1 month of vacinations.

• This reply was modified 10 years, 1 month ago by losul.

[losul]

Dori there may be a quick way of getting at least some minor info. google maybe how ivermectin is metabolized in the liver, half life of ivermection. Millk thistle and drug interactions, etc.

grapefruit/juice also interferes with certain drugs metabolism.

Wish I had more time to research again. and i have a horrible way of organizing my stuff.

Don’t necessary change your milk thistle protocol because of something i said though, but I would definitely suggest researching it. I thought most vets did suggest waiting a short period of time before starting.

Shawna I don’t think he ever actually coughed before that I’ve ever noticed, I think He actually did once today, I was listening and watching very closely after that application, and I think that’s what it was. A gulping or belching maybe occaisonally. He does seem like he’s been much more of a couch potato lately.

I’m going to call the vet maybe gone awhile.

[losul]

yes it’s metabolizede by a certain enzyme i forgot what the number right now P something I think. Milk thistle is known to interfere with that liver enzyme, I think it could actually cause the ivermectin to be retained in the system longer than it would otherwise. I’ll have to look back into that, when I get a chance. and also find the actual normal 1/2 life of ivermectin in the body again. I’m thinking off the top of my head it’s more than 90% gone after 2 days. I think I wouldn’t want to give milk thistle too early.

There’s also a number of other drugs it interferes with the normal metabolism.

• This reply was modified 10 years, 1 month ago by losul.

[losul]

No, he told me there was no real way of finding out, (except surgery) and that X-rays/ultrasound might not really even be able to really tell anything unless it was advanced/really advance. I asked him about the the microfilaria load, and he said something like there are a fair amount, whatever that means, but He said that was no real indicator either as to the number of worms. He did describe his state as class 1, or stage 1, can’t remembrer. But I don’t even know how he could say that for sure without appropriate diagnostic tools. Just listening to his heart and lungs, I don’t know how.

[losul]

Shawna I’m not following exactly why you think the worm load is low. I follow all else, but not sure why that?

[losul]

It looks like the combined panel tests were a group called “Young Preanesthetic Plus”

Are any of those liver values?

[losul]

the ESINOPHILS and the HCT whatever they are, are the only ones I see that very near the top of the normal range, if I see this right.

[losul]

Shawna, i’m going to try to compose myself and call the vet back to get him in for X-rays? Woiuld you think the bloodwork already done is enough? It has ALP 23 ALT 48 TOTAL PROTEIN 7.0 BUN 27 CREATININE 1.1 GLUCOSE 91 HEMOLYSIS INDEX 1+ LIPEMIA INDEX N WBC 13.3 RBC 8.13 HGB 19.3 HCT 55.5 MCV 23.7 MCH 23.7 MCHC 34.8 NEUTROPHIL 6663 LYMPHOCYTE 4456 MONOCYTE 718 EOSINOPHIL 1450 BASOPHIL 13
T4 1.7.

I w also wondering why no urinalysis. was done

[losul]

It confirms what i’ve been thinking too. Also that his infestation may be worse than what rudimentary examination would have led the vet to believe. Could the trembling episodes have actually been a sympton? I only saw find one vague reference online to that. oh sheez

[losul]

Thnx so much Dori, for the offer I sent my reply to Shawna before I saw your posts.

OMG I feel like such a dummy.

[losul]

Dori, yes. thank you very much for that. I appreciate.

And after checking yet again, I do see the temp ranges printed right on the back of the box, not just on the interior package.. I can’t believe I missed that, even after looking distinctly for it. OMG.

[losul]

Thnx Shawna, you bring up very good points. I too would think that all or most of any infectious larvae would have already transformed into adults based upon the latest possible date(s) of infection. But I wonder if some of the migrating larvae take longer to mature than others? I can’t possibly see how Turbo could have been infected after the last heartguard was given, it got cold here early, already had some hard freezes, and I don’t think the temp again even barely hit the 50’s let alone 60 for more than a day or 2 past the date of his last HWP dose. But then I didn’t dream I would ever find a tick on his ear in early November either. Of course If I only knew then what i know now..

I think probably why the A.H.S. advised if giving seasonal to go 3 months past last possible transmission date, and 1 month before, is because of Dr. Blagburn’s studies of possible resistance to HWP’s. If one were to do that, it would be about 9 or 10 months anyway here, almost year round. it’s hard to tell what’s true, these preventatives are big moneymakers for the pharmas, and of course ivermectin has been off patent (generics) for awhile. But for me, after this is cleared, it will be necessary to err on the side of overcaution going forward.

It was explained to me that one reason they want to give the HWP first for a couple of months is because of the gap between what the HWP will kill and and what the adulticide will kill. Evidently some stages are not susceptible to either the adulticide or the HWP. The time is supposed to allow those stages that are in the gap, time to get vulnerable to the adulticide. Otherwise new adults could still move in after the older ones die.

I didn’t miss any doses, it was every 35 days, the actual dose dates are all marked on my calendars but I am trying to find more about the failure. I believe it’s most likely my failure, I can’t blame anything else. I have a case number with Merial, which they told me to have my vet call them with the case I.D. and he could then speak to their vet. All Merial would tell me is that they couldn’t guarantee it’s efficacy if refrigerated. I forget to ask or remind my vet about this the last time I talked to him.

I went ahead and applied the multi this morning after talking to them, about 4 hours ago. No reaction thus far. They assured my that if I change my mind on the HWP used, I could still do that after 30 days. I still intend to try to seek another HW test at least and/or a second opinion. I believe I might go ahead with X-rays, and I wonder why they also didn’t do a urinalysis. The extent, how long, how many, etc. it’s all questions that bear heavy on my mind, although these things may not even be able to really reveal. If I knew it were just a minor infection, it would be easier to bear and decide the course, I don’t know if he had multiple infections throughout last season, if he had minimal or any protection at all, or what.

Thnx Shawna.

• This reply was modified 10 years, 1 month ago by losul.

[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.

[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]

Melissa, I too wouldn’t yet consider the proheart as preventative (at least not until it can be proven better), after treatment, and I totally hate that the advantage multi has the flea insecticide with it, I don’t want or need that at all. The vet keeps telling me how it’s only toxic to the fleas nervous system and nothing else, but that’s kind of going in one ear and out the other with me.

I might be using the multi during and several months after Turbos treatment, not entirely sure just yet, but I will have to really think about and study it more as to giving as a future regular preventative.

Thnx for the input!

• This reply was modified 10 years, 1 month ago by losul.

[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!

[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 10 years, 1 month ago by losul.

[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.

[losul]

Shawna, thnx so much for your info and reply. I just now saw it and will definitely read the links ASAP.

All I can say right now is the vet seems to really be against using ivermectin at all as he thinks they may well have ivermectin resistance, even if I try a true slow kill method. He said it could actually take years with the ivermectin, if it ever even would completely killed them, and the the meantime, damage could occur or continue to occur. I think, but not sure, he was talking about using moxidectin with doxycycline and without immiticide as a slow kill method over the phone and he seemed kind of amenable to, although he still would not really reccomend ithat, it was the full protocol he was reccomending. Did you see what that was in my initial post? He also told me several serious disadvantages to attempting this slow kill that are really worrisome. I have been seeing all kinds of resistance stories now, and even some vets calling the ivermectin slow kill “no kill”.

Geez. I wish I could get my mind together, and type faster also. It took me virtually all day yesterday to write my initial post.

I was really leaning towards another vet’s opinion , and I should have already done it, but this point, it’s late Friday and I’m afraid to continue anymore postponement, i feel very pressed, exhausted, and I’m about to go nuts.

I didn’t think the rabies shot was at all a good idea right now either, and it kind of really bothers me that he is still encouraging going ahead with it.

I don’t think the Heartguard box says anything about temperature on it, I can’t find anything, but on the back at the top right of the foil package it says store at 68 degrees to 77F, excursions between 59 and 86 degress fahrenheit are permitted. I didn’t realize that until the other day, and never even thought about it before the other day. The vet didn’t even know. I don’t have my glasses on me, and hard to read, but I’m pretty sure that is the ranges. When I called Merial, they simply would say that they can’t guarantee efficacy when refrigerated. Maybe they don’t test it for efficacy when kept at lower temps, I don’t know.

I’m still awaiting a call back from the vet, I suspect he won’t call call back until the EOD. I’m going to have to try back again soon.

Thnx again so much Shawna, I’m going to read now your links.

[losul]

Dori, I saw that Cyndi was very kind to post a message/request to Shawna on the off topic message board on my behalf. Shawna is indeed amazing. Thnx Cyndi, and thnx again Dori.

Sandy thank you so much for the feedback, very helpful. 228 pugs wow, that’s such an amazing and honorable feat to rescue/foster that many dogs. Right now I am leaning towards the entire protocol with the immiticide, and the advantage multi immediately, doxy, etc. as my vet first desribed. The immiticide would happen beginning 2 months from now. I want these damned things out of him ASAP, but as safely and reliably as possible also. I am now awaiting a return call from him.

InkedMarie, thank you very much for your thoughts also, it means alot to me.

[losul]

Dori, i would never mind anyone’s prayers and thoughts. I very much welcome them. Thank you very much.

Turbo is inside over 90% of the time, but is free to go out whenever he wants. I have about 2 acres of our property covered with a radio/underground fence. Ordinarily mosquito’s are a really big problem right here in my localized area, and property. the last two warm seasons and summers though we had extreme drought, except in the Spring of last year, and mosquitos were not even all that noticeable the last couple of years, compared to years past The back of the adjoining property to us, was evidently used to keep livestock or horses at some time in the past, but since we’ve been here, the area is completely overgrown with woods and brush. There are large areas of low lying shallow pools, ponds, wallowing ponds or whatever back there, where water sits and stagnates during a wet season. Really it’s a big swampy area during rains or a wet season. In years past, as soon as dusk or even before dusk would start, we couldn’t even stand to be working in our garden. I’ve always wanted to do something about it, but the property owner was very much a recluse, and enstranged to us. She has since passed away several months ago, and nit certain who owns the property now (relatives). We couldn’t use any kind of mosquito dunks in it, because of close vicinity to the creek at the back of property and the creek often overflows into that area. I’m going to have to look into getting a backhoe, and either cut a drainage trench from the pools to the creek or try to fill in the areas with dirt.

I too am VERY much hoping for Shawna’s input soon. I will keep updated when I can. Thnx Dori.

• This reply was modified 10 years, 1 month ago by losul.

[losul]

Cyndi, it’s not matter that no advice offered, what you have offered is very helpful and means alot to me thnx. Weezer, it helps much to have support from someone who has been there, and your prayers also means very much to me. Thnx

[losul]

Aimee. Thnx so much for your replies in detail.

What i am reading this morning is confirming much of what you are telling me.

The vet wants him on the Advantage multi for 2 months first before the 1st immiticide treatment. I already have a tube, just not applied yet. I’m going to call him with a few more questions this morning.

The trembling thing, I can not imagine at all, what he would have been fearful of, even though at the time he even acted fearful of me. He’s just not a fearful dog. Very bold if anything. He didn’t do lip licking, swallowing or drooling. It just totally baffles me.

Thnx again Aimee.

• This reply was modified 10 years, 1 month ago by losul. Reason: changed reply to replies

[losul]

Just want to add, the money and effort to keep him restricted is not really a consideration, I just want to do what is best for Turbo.

The more I read, the more see that my vet’s original recomended protocol may be the best for him at this point?

Is the immiticide treatment in itself very damaging as a poison?

What a horrible situation.

Edit: Aimee, I posted the above before I saw you reply, I was really hoping you would be one to reply, THNX. I’m going to read it now

• This reply was modified 10 years, 1 month ago by losul.

[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

[losul]

Thnx Sandy, they get just the 1 (double) immiticide treatment? Are those fosters symptomatic, coughing, underweight, tire easily or anything like that? and do they take doxycycline and preventatives before/after also?

[losul]

Aleksandra.

There’s a thread on the forum here that talks about BRB.

/forums/topic/blue-ridge-beef/

BTW, congratulations!

[losul]

I don’t use many supplements at all, not on any kind of regular basis anyway. The vetri-science probiotic chew was one that I have used though. Still have about 1/4 a bag or so after over a year.

One reason i chose that brand at the time was because they have or had the National Animal Supplement Council seal and logo on them. But i don’t know, maybe that was a just a false sense of security.

[losul]

Hello Scott. I think it’s mostly a matter of personal preference. If you’re confident as to the quality of the product you use for yourself, and your dog swallows the pills readily, I see no problem, and more economical to use something you are also using. Just keep a tab on the freshness. You might open one of the gelcaps occasionally and taste it.

For me, it’s handy to keep a bottle of the IP in the refrigerator door, all I have to do is open the refrigerator and give a pump right into dog bowl, without even removing the bottle.

The IP contains 727 mg EPA and 498 mg DHA per teaspoon. 2 pumps equals 1 teaspoon. Directions call for 2 pumps for dogs 50 pounds or under, 3 pumps for 50 to 100 pounds, and 5 pumps for over 100 pounds. I usually only give my 35 lb dog one pump daily, though, he also gets some sardines, salmon and poultry eggs sometimes.

The IP is labeled for pet use only, even though it is claimed to be pharmaceutical grade. My dog graciously shares it with us anyway. I buy the large 33 ounce bottle, (about 24 bucks) it’s only a buck or two more than the half size (on Amazon). Freshly opened, the oil has very little taste to it, I have to say though, that even after adding additional tocopherols to it myself, after maybe 4 months the taste starts becoming noticeably stronger and a few weeks beyond that, the taste starts to become repulsive. So I throw out the remaining few ounces and replace.

I think you could probably double or more the gelcap dosage if you wanted to for your dog, if he’s not obtaining too much EPA DHA from other sources.

• This reply was modified 10 years, 3 months ago by losul.
• This reply was modified 10 years, 3 months ago by losul.

[losul]

The best way I’ve ever found to get a reluctant dog to take a pill is to open their mouth, then holding open with one hand, drop the pill as far back in the mouth/throat as far as you can go with the other hand, usually poking the pill back even farther with your finger, then close their mouths and hold and stroke the throat downwards gently. Then give a treat if you want for being a good boy/girl.

It’s always worked for me.

[losul]

ESCGuy, thnx for the update. I don’t know whether it’s denatured/condemned meat or not. I’m just going by what others have said about charcoal in it. Does it have charcoal in it or not? I can’t see any other reason for charcoal to be in it, can you?

Here’s what the owner of MyPetCarnivore has to say about it, as they are often approached by peddlers of denatured meat;

https://www.mypetcarnivore.com/index.php?option=com_content&view=article&id=125:the-hidden-dangers-of-denatured-meat&catid=21:holistic-living-for-you-a-your-pet-carnivore&Itemid=144

• This reply was modified 10 years, 3 months ago by losul.

[losul]

ECS guy, your dealer is only telling you a part truth. The sole reason that certain meat leaving a USDA plant is denatured with charcoal, is because that meat has been condemned for human consumption, and denaturing severely lessens the chance that that condemned meat could ever make it’s way into the human food supply chain.

The denatured meat could be condemned because it’s 3D or 4D, contaminated with pathogens, excessive or forbidden steroids, hormones, antibiotics, other contaminants, etc. It’s not denatured because it’s going to make pet or animal feed, it’s denatured so it CAN’T be used for human food. Pet food manufacturers are free to use meat that leaves the plant and is sold as passed for human consumption, but some of them use the failed, condemned and denatured, meat-much, much, cheaper.

Also those pet food manufacturer’s that claim the meat comes from a USDA inspected facility really means nothing. Both USDA passed and condemned (failed) meat comes from and leaves USDA inspected facilties.

• This reply was modified 10 years, 4 months ago by losul.

[losul]

crazy4cats, That’s great news! and I’m hoping right along with you. I know what a nightmare that can be as we had a real nightmare experience with giardia and our previous dog many years ago.

[losul]

Hello all, I’ve been reading a lot of good things about berberine lately for healing treatment of colitis, IBD, other GI disorders etc. Here is one study.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311435/

[losul]

Kms. Before you even mentioned metronidazole, I had already guessed that it had begun there. Do you mind me asking why specifically he prescribed metro? Giardia, clostridium, just a shot in the dark for diarrhea?

[losul]

Kms.
I’m really sorry I can’t answer many of your questions and I’m not qualified to give medical advice. I don’t know specifically what your vet prescribed the SMZ TMP for, if it was even for anything specific. It may not be effective against clostridium? I would ask questions of your vet, before carrying on.

c. difficile and c. perfingens are often culprits in humans. I think c. perfingens more often in dogs.

SMZ TMP (usage in humans) http://www.webmd.com/drugs/drug-64007-SMZ-TMP+DS+Oral.aspx?drugid=64007&drugname=SMZ-TMP+DS+Oral

“This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a resistant bacteria. This condition may occur while receiving treatment or even weeks to months after treatment has stopped. Do not use anti-diarrhea products or narcotic pain medications if you have the following symptoms because these products may make them worse. Tell your doctor immediately if you develop: persistent diarrhea, abdominal or stomach pain/cramping, or blood/mucus in your stool.”

“Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection (oral or vaginal fungal infection). Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge or other new symptoms.”

About the kaolin (pro-pectin)

Kaolin Interactions

Kaolin pectin may decrease the absorption of drugs that chelate with aluminum salts (eg, digoxin, clindamycin, lincomycin). Until more information is available, avoid taking kaolin with drugs that chelate with aluminum. It may also decrease the absorption of trimethoprim and quinidine.

http://www.drugs.com/npp/kaolin.html

It looks like as long as you separate the doses enough, it may be O.K.

Trimethoprim (Proloprim) interacts with KAOLIN
Kaolin might decrease the absorption and decrease the effectiveness of trimethoprim (Proloprim), an antibiotic. To avoid a potential interaction, separate trimethoprim (Proloprim) and kaolin doses by at least two hours.

http://www.webmd.com/vitamins-supplements/ingredientmono-44-KAOLIN.aspx?activeIngredientId=44&activeIngredientName=KAOLIN

The questions about the probiotics and enzymes- I don’t know, but me, I would be leery of using the enzymes at least for the time being.

By lightly cooked meat, I meant cooked only enough to kill pathogens that may be present. The rice cooked per package directions should be fine.

[losul]

Ah the security of a backup generator. One takes for granted the convenience of electricity, until one does without for even a short time. 10 days I couldn’t even imagine.

[losul]

canigivemydog-cool site and bookmarked it. I got a good laugh out of the can i give my dog viagra?

unh unh my dog isn’t getting any of mine, lol.

[losul]

Patty, yes, the addition of fiber at this point would probably only serve to slow transit time down, to absorb water, retain toxins longer, and then the body would probably have to work even harder, and lose even more water in it’s attempts to flush it out. Just my thoughts.

I don’t have any experience with oil of oregano. Is it safe for dogs?

[losul]

*to late to edit, but I meant to say go with plain cooked enriched white rice. The way I said it sounds like I meant- look for unenriched.

• This reply was modified 10 years, 4 months ago by losul.

[losul]

Actually, the diarrhea can be a defense mechanism to attempt to flush out the toxins. If it were me, for now, I would remove all extra forms of fiber, including pumpkin, and anything else that could slow the transit time through the digestive tract, so the toxins aren’t retained any longer than necessary.

Probably, amongst other things, the outside lab is testing for the various toxins that some clostridium species create under certain conditions.

For now, and temporarily, I would just go with lightly cooked beef, chicken, and plain white rice (most white rice sold in the U.S. is enriched with vitamins). I wouldn’t use any whole grains or anything else hard to digest.

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