PSA-PLEASE GIVE YOUR DOODLES MONTHLY HEARTWORM PREVENTION! - THE IMMITICIDE SHORTAGE & THE IMPACT ON THE RESCUE & VETERINARY COMMUNITIES

[Jacquie Yorke (DRC)]

As many of you may or may not know, there is a nationwide shortage of Immiticide the arsenic based drug and the ONLY drug approved by the FDA for treatment of heartworm in dogs.

Merial, the ONLY pharmaceutical company that manufactures Immiticide has, ( for profit margin reasons,) ceased production of the drug! They have NO immediate plans to continue production in the near future!

The entire veterinary industry as well as the entire animal welfare community are up in arms about this situation and I assure you the situation is desperate!

 

BOTTOM LINE: NO ONE HAS ANY IMMITICIDE ON HAND. Nationwide resources have been DEPLETED.

That leaves us with absolutely no way to treat heartworm positive dogs other than via the 1 year, slow-kill method with the strict administering of monthly Heart Guard preventive.

 

FYI-Heart Guard is the ONLY tested and approved method for the slow-killing of Heartworms in positive dogs.

 

Interceptor and other preventatives that use milbemycin oxime are NOT APPROVED for HW positive dogs as they can cause a HW positive dog to embolize as the adult worms die off .......That means certain death.

 

Already, many shelters across the country that HW test dogs at intake, are immediately euthanizing any and all who test positive.

 

The situation is grave ......And it is only going to get worse.

 

DRC averages between 15-25 HW cases per year and like many animal welfare organizations across the nation, we are shocked, outraged, appalled and quite frankly we are frightened by the potential impact this will have on our ability to treat HW positive doodles in our rescue program.

 

Of course the most important aspect of this posting is to encourage the masses, especially those located in the southern regions of the US where HW runs rampant, to administer monthly HW prevention to their dogs.

PLEASE!...One pill once a month....That is all that it takes.....And the cost of preventative is less than $10 a month ...... In contrast, the average cost of treatment once a dog is infected is anywhere from $700-$1400.

The treatment itself takes a physical and emotional toll on the dog as well as they must be kept calm and immobile which usually means "crated" for 5-8 weeks or face possible death from complications or embolism. And now, THERE IS NO TREATMENT AVAILABLE......

As it is, rescuers are forever having to deal with the ignorance, irresponsibility and apathy of humans when it comes to the humane care and treatment of companion animals. It's par for the course when it comes to rescue ....

But due to this situation with Merial we now have NO RESOURCES to undo what is essentially done to these animals through the irresponsibility of their owners. People's "Epic Fail" (A mistake of such monumental proportions that it requires its own term in order to successfully point out the unfathomable shortcomings of an individual or group) when it comes to providing their pets with protection from heartworm is taking a serious physical, emotional and financial toll on both the dogs and the animal welfare organizations devoted to saving them.

Remember, ONE LITTLE PILL EVERY MONTH is all that it takes to fight heartworm!

We cannot stress strongly enough just how critical it is that we all administer monthly preventative to our doodles and we all need to spread the word and educate as many dog owners as we possibly can regarding this killer.

 

Immiticide Supplies Run Dry

August 9, 2011
By: Jennifer Fiala
For The VIN News Service

The only heartworm adulticide  approved by the U.S. Food and Drug Administration (FDA) for use in canines is temporarily unavailable, with no known re-release date.

News of the Immiticide (melarsomine dihydrochloride) shortage surfaced last week with an open letter to practitioners from drugmaker Merial that warns of an outage expected to “last several weeks to months.” The letter, dated Aug. 4, asked practitioners to help conserve Merial's dwindling Immiticide supplies by ordering product only to treat dogs with severe heartworm infestation. However, the notice of the shortage caused a run on remaining stock. The company's technical services department confirmed today that Merial is "officially out" of the drug.

“After mailing the Dear Doctor letter we experienced an unprecedented surge in Immiticide orders and depleted inventory much more rapidly than anticipated,” explains Natasha Mahanes, a Merial spokeswoman.

Immiticide availability has been shaky since early last year, when Merial, the animal health arm of Sanofi, reported that its U.S. supplier could no longer obtain the product’s active ingredient, and the FDA was hesitant to allow Merial’s overseas supplier to fill American orders. As a result, Merial stopped allowing veterinarians to simply order and stock the drug in an effort to conserve U.S. supplies and implemented a “restricted distribution program.” Translation: Veterinarians treating only severe cases of heartworm disease could access the drug on a case-by-case basis with approval from the company.

In an email exchange with the VIN News Service, Mahanes noted that Merial’s latest Immiticide supply problems are not tied to the troubles of 2010. Rather, it is “a new and separate manufacturing challenge," she writes.

“This situation is related to technical issues providing finished product to us. The finished product is made by a manufacturing company in the U.S.," she explains. "… We are working diligently to mitigate this situation, and there is a possibility that an alternate source of supply may be identified."

That’s encouraging news for veterinarians such as Dr. Skip Fix, a practitioner in Houston. With two boxes of Immiticide left in his clinic, Fix is pondering how best to ration it.

“At this moment I have a 50-pound dog that I’m going to treat,” he says. “There are five bottles to a box, and he’s going to need two-and-a half of them. We’re trying to find out from the shelter near us if they need the remainder for a small dog so we can use every last drop of this.

“This shortage could take a month, it could take forever,” Fix adds. “I usually have a couple heartworm cases going every week, so it is a concern."

Once his in-house supply runs dry, Fix plans on turning to a heartworm preventative and doxycyline to manage infestation — a protocol supported by the American Heartworm Society, slated soon to release updated guidance for practitioners on treating heartworm-positive dogs without Immiticide.

Dr. Tom Nelson, a past president of the American Heartworm Society and a practitioner at the Animal Medical Center in Anniston, Ala., notes that the use of doxycyline in combination with heartworm preventive has been shown to reduce pathology, the number of adult worms and the infective potential of microfilaria in canine patients.

"The shortage of Immiticide is unfortunate, but we're going to have to deal with it," he says.

Treating heartworm is tricky business. An infected dog, for example, must not vigorously exercise because an increase in heart rate raises the risk that fragments of dead worms in its blood vessels could cause thromboembolism — the formation of an embolism, in this case of dead worms — to the lungs, which usually presents as acute dyspnea. The condition is treatable with steroids but may prove fatal. Nelson notes that Immiticide quickly kills worms, thereby shortening the time that a dog's exercise must be restricted.

Slow-kill therapies, such as the use of heartworm preventatives, potentially allow for greater opportunity in which worms might block blood vessels, leading to worsened pulmonary pathology.

"Exercise should be restricted during the duration of the treatment. We're normally talking about 12 to 18 months," Nelson says.

Heartworm heartbreak: Medicine shortage forces vets to choose between dogs

9:29 AM, Aug 24, 2011

Dr. Duffy Jones is at the other end of the leash from a black lab.

"This is Zappo," he said from the Peachtree Hills Veterinary clinic. In response to raised eyebrows, he added, "Atlanta Lab Rescue gets creative with their names."

Zappo nudges the camera and thumps his tail. Like most labs, he's all heart. But his heart is a little too big. Dr. Jones points to cloudy white spots on an X-ray. Zappo is infected with heartworms.

(Click here to read more about Heartworm from the American Heartworm Society.)

"Of all of the diseases we see, this one is the most preventable," Dr. Jones said. "That's why it's so frustrating."

Mosquitoes carry the parasites easily in warm areas like Georgia. It can be fatal to your dog.

Dr. Jones will use his last two boxes of Immiticide to treat Zappo and another rescue lab. The next heartworm infected dog that comes into his Peachtree Hills office will not get the medicine he needs.

"This is going to be hard for all of us," Jones said. "For us, the frustration [is] that we can't help these dogs."

Merial, a pharmaceutical company owned by Sanofi, is the only FDA-approved company to make Immiticide, the treatment for heartworm-infected dogs. Earlier this month, they sent letters to vets nationwide saying a technical issue caused a supply disruption.

They're out.

In a letter to 11Alive News, a Merial spokesman wrote: "As a result of this new supply interruption, we have depleted our inventory of IMMITICIDE and anticipate that the outage will last from several weeks to months... Merial and the IMMITICIDE manufacturer fully understand the critical need for the product and regret this outage. We are working together to return to full supply as quickly as possible."

At the Atlanta Humane Society, Dr. Gloria Dorsey is forced to make difficult choices.

"It's like triage." She said. "We have to select very carefully which individuals might be better candidates for treatment. Unfortunately, the rest go on the back burner while we wait for more medicine to be produced."

Lilly and Rosie were rescued from a hoarding house in Alabama. Winn Dixie was surrendered. They are lucky: they're being treated with Immiticide. But the clinic is on a limited supply, and no one knows when production will get back online.

There's a simple way to protect your dog: preventative medicine. Monthly heartworm preventative medicine costs less than $10 a month. But, a new map released by the American Heartworm Society shows the number of cases has gone up in between 2007 and 2010.

The spread is due, in part, to pet-owners cutting corners, saving money, not protecting their dogs. Now, with the only cure in short supply, vets are forced to put infected dogs in a "holding pattern." They keep them as inactive as possible since higher heart rates spread heartworms faster. Anti-inflammatories treat the symptoms. Vets like Dr. Jones say they're hoping to keep them alive and undamaged for weeks or months until production resumes.

"It's very concerning to all of us in the veterinary community," Jones said.

 

nationwide shortage of medication used to kill heartworms in dogs is "not catastrophic,"

The Atlanta Journal-Constitution

A nationwide shortage of medication used to kill heartworms in dogs is "not catastrophic," say animal health professionals.

 

Duluth-based Merial, distributor of Immiticide, the only FDA-approved drug available to treat adult heartworms in dogs, sent letters earlier this month to veterinarians informing them of the depletion of inventory. The news was not unexpected; the company warned of production problems as far back as December 2009.

 

Merial spokesman Steve Dickinson said "technical issues" have halted the production of Immiticide by a third-party supplier. The company is "trying as hard as [it] can" to resume production or find an alternative supplier, he said.

 

Dickinson said one of the problems is that the active ingredient in Immiticide, melarsomine, is difficult to manufacture. Melarsomine, a derivative of arsenic, is effective at killing adult heartworms -- a parasitic roundworm transmitted by mosquitoes -- that infest animal arteries and can cause death.

 

Currently, Merial has no Immiticide to sell to veterinarians, said Dickinson. He did not know when production would resume, saying only that the problem could last several weeks or months.

 

Those in the animal health care field say that while the lack of Immiticide is a problem, it's no cause for panic.

 

Scott Zimmerman, a manager at Dearborn Animal Hospital in Decatur, said pets on routine heartworm preventative medication are at a very low risk of contracting heartworm disease.

 

But, dogs with adult heartworms can't "currently be treated with the best medicine," said Zimmerman.

 

The lack of Immiticide "is not a death sentence," said Becky Cross, founder of Atlanta Lab Rescue.

 

Cross said roughly half of the 350 animals her group find homes for each year must be treated for heartworms, which can cost upwards of $800.

 

"A lot of shelters that test for heartworms will just put animals to sleep," said Cross, who estimated more than half of the $120,000 Atlanta Lab Rescue spent on vet bills in 2010 was for heartworm treatments. "Lots of rescue groups won’t take heartworm-positive dogs"

 

Atlanta Lab Rescue will begin using a cheaper but less effective "slow kill" method to treat the infected animals it has up for adoption, Cross said.

 

The slow kill method, which only kills worm larvae, involves giving a dog monthly heartworm preventative medication -- which costs about $15 a month -- and waiting a year or more for the adult heartworms to die.

 

Dr. Duffy Jones, a veterinarian and owner of Peachtree Hills Animal Hospital, who works with Atlanta Lab Rescue, said the slow kill method is "not ideal" for two reasons -- it takes a year or more for the adult heartworms to die, which can lead to additional scarring of the dog's heart and lungs; and the animal cannot exercise during that time.

 

"The Immiticide being gone is problematic but not catastrophic,” said Jones, who stressed the need for routine preventative medication.

 

Dr. Susan B. Krebsbach, a veterinarian with the Humane Society Veterinary Medical Association, said the extended treatment schedule is likely to slow the adoption rate of shelter dogs.

 

"Dogs that test positive are going to be positive for a lot longer," she said.

 

Krebsbach said Merial's production problems have made vets more aware of less expensive drugs, such as doxycyline, an antibiotic that has proven to reduce the viability of heartworm larvae, which should reduce transmission rates. The antibiotic, combined with a heartworm preventative, also shortens the lifespan of the adult heartworms and lessens problems associated with worm death, she said.

 

Merial, the animal health division of Sanofi, employs 5,600 globally. About 600 work at the company's Duluth headquarters.

[Anna and Achilles]

Thank you for the reminder and information

[Jennifer,Chloe & Myla]

Thanks-I would like to know how many people give it year round. (Heartguard that is) We are in Wisconsin and I've posted this before that our vet said June-Nov but I've heard other things too. I want my doodles to be safe so is there any harm in giving it all year long and still get them tested every spring???

[Jane, Guinness and Murphy]

I give Heartguard year round per my Vet's advice.

[Karen, Jasper and Jackdoodle]

I give it year round as well.

[Tina, Clover, Plus 5 More]

I give it year round too.

[Jacquie Yorke (DRC)]

I also give it year round.

[Rose]

I give it year round.

[Leslie and Halas]

I give it year round, and I'm in central Illinois.

[Jane, Guinness and Murphy]

The impact of this is absolutely frightening.

[Ginny Nightingale]

My vet sells me a preventative liquid rather then the heartguard pills (same ingredient)--she mixes it up herself and since i have three dogs now, it saves me a bundle. A small bottle (60cc)  costs $ 32 and will last me more than a year, since I need 3.5 cc a month. I don't know if other vets offer it, but it might be worth it to ask!

[Ginny Nightingale]

PS I give it year round.

[Cindy M, Zachary & the Frenchies]

I give it year round but do it with reservations - because when all is said and done, I would rather not expose my dogs to more toxins than is necessary. My concern is that if I don't give it year round I will forget to start it on time.