The Importance of Heartworm Preventatives

[Karen, Jasper and Jackdoodle]

Some of you have been following Krista Sumlin's blogs about her foster (and now forever!) doodle Matthew. Matthew had been left outdoors and neglected, and came into the DRC program infested with heartworms. He is currently undergoing treatment. 

(You can read the latest installment of Krista's blog here: Krista's Blog )

Many people who read about Matthew's treatment were surprised at how complicated, painful, risky, and restrictive the process is. Although I knew that the treatment was painful and dangerous, I had no idea that the cost to treat a standard doodle is approximately $1500. Now that mosquito season is beginning, it's crucial that we all understand how important it is to prevent our dogs from becoming infested with heartworms. A simple chewable "treat" once a month would have spared Matthew all of this.

Here is some information about heartworm treatment from Veterinary Partner:

http://www.veterinarypartner.com/Content.plx?A=610

 

Excerpt from the article:

 

Heartworm Treatment

Related Articles * Heartworm Information Center Diagnosis of Heartworm Disease Feline Heartworm Infection Heartworm in Los Angeles Heartworm Preventive Comparison Heartworm Treatment Heartworm: The Parasite Preventing Heartworm Infection in Dogs (Chemoprophylaxis) What Happens in Heartworm Disease

It has been said that the treatment of heartworm infection is somewhat of an art. There are several strategies that can be used depending on the dog's medical condition including the option of not treating at all. The important concept to realize is that harsh arsenic-based drugs are necessary to kill adult heartworms and that treating for heartworm infection is neither simple nor safe in itself.

 

The only product currently available for the treatment of adult heartworms is melarsomine dihydrochloride (Immiticide® by Merial). If you follow the manufacturer's recommendations,  treatment can be done in two doses or three doses depending on the class of infection. Most universities, however, opt to treat all patients with the three-dose protocol as it creates a more gradual kill of the adult worms, which is safer in terms of embolism and shock.

The patient receives an intramuscular injection deeply in the lower back muscles as shown above. This is a painful injection with a painful substance, and it is common for the patient to be quite sore afterwards at home. Pain medication may be needed. Be careful of the injection site as it may hurt enough to cause a dog to bite. An abscess may form at the site, which requires use of warm compresses. Approximately 30% of dogs experience some sort of reaction at the injection site that resolves in 1 to 4 weeks. Some dogs develop a permanent firm lump at the site of injection.

In the two-dose protocol, the dog receives a second injection the next day on the opposite side of the lower back. In the three-dose protocol, the dog comes back one month later for two doses 24 hours apart (the first dose represents an introductory treatment to kill some of the more sensitive worms.) Keep in mind, too many worms dying at once creates circulatory shock.

After treatment, the patient must be strictly confined for one month following the final treatment. No walks, no running around. The dog must live the indoor life. The reason for this is that embolism to some degree is inevitable and it is important to minimize embolism-related problems. Exercise increases heart rate and oxygen demand and we need the heart to rest during this recovery period.

 

Illustration of treatment injection:

 

I know there are many of us who did not realize how dangerous mosquito bites can be to our dogs, or even how serious heartworm disease is. Many people may think of it more as an annoyance, in the same category as a dog getting fleas.

Please let Matthew's experience help other dogs from having to endure what he is enduring. Please make sure your doodles are protected against heartworm. Thank you from the DRC, Krista, Matthew, Jackdoodle, and me.

 

 

 

[April Cliber]

This is a great post and reminder! Thanks! :o)

Can I cross post it?

[Karen, Jasper and Jackdoodle]

Absolutely! The more who know, the better!

[Adrianne Matzkin]

I am sure that this has been posted 100s of times, but I thought this would be a perfect place to discuss again.
So we are back to the big question, which HW and flea medicine works?
Is there a different in the monthly treatments for the prevention of HW?

I have been using Revolution but I have been told it is not the best for fleas. I need to get more in the next week so - Frontline or Advantix? I live in NJ - ticks are more of issue here than fleas (ah, now that I said that.......) so what works the best?

[Dan, Judi, & Timbow]

Great post Karen! This is wonderful information!!

Adrianne, We use Interceptor for heartworms and Comfortis for fleas. We give them two weeks apart from each other to make sure they don't have a bad reaction to each other. We are very happy with both.

[Karen, Jasper and Jackdoodle]

I disagree that this the perfect place to discuss flea & tick preventatives. I would really prefer not to confuse the issue by bringing flea & tick preventatives into this discussion. Various forms of preventatives for fleas and ticks have been debated here hundreds of times, as you said, and there is plenty of info on that.
Heartworm is far more serious, and is a separate issue. Part of the reason for this discussion is to point out the seriousness of heartworm disease and treatment. Dogs rarely die from treatment for fleas or ticks, and the treatments aren't painful. Many people choose not to use any preventatives for fleas and ticks. But not using an Rx preventative is not an option for heartworm, and that is the point of this discussion.
I have always used Heartgard to protect against heartworms. That's an issue best discussed with your vet.
But FYI, neither Frontline nor Advantix protects against heartworm.

[Adrianne Matzkin]

Yes Karen, I know why you wrote this. I am not trying to negate the impotance of monthly HW preventative. There are many if us here, both experienced doodle parents and newbies that need education on what works and what doesn't - from reading what others post.
I am not sure that Revolution is the best for HW prevention so I asked. I know it works for fleas and ticks for us but are they getting the best HW protection?
Revolution which is supposed to treat HW, flea and ticks. They get that once a month in 1 liquid to the skin dose. Now I read that Comfortis and Interceptor are given on separate weeks. Is that what is recommended?

[Karen, Jasper and Jackdoodle]

Again, I do not want to discuss flea & tick preventatives here. There is too much controversy about using them, people are concerned about using the topicals, and start asking about "natural" remedies. That's fine for fleas & ticks if one so chooses, but heartworm is a separate issue and prevention is not optional. Which is why I did not want that to become the focus of this discussion. You bring up Frontline, Advantix, and now Comfortis. None of those have anything to do with heartworm. That doesn't educate anyone, it confuses them.
Again, if people need "education on what works and what doesn't", they can learn about flea & tick prevention from the other 9 million discussions about that here on DK. THIS discussion is about heartworm treatment.
Revolution is not as effective against heartworm as Heartgard or Interceptor. The most effective treatment is to use a separate product for heartworm. "What is recommended" should come from your vet.

[F, Calla & Luca]

Here is another good site about heartworms. The important thing I think is that it is reommended you treat year round even in seasonal areas. I use Intereptor, year round.

http://www.heartwormsociety.org/pet-owner-resources/canine-heartwor...

[Jacquie Yorke (DRC)]

I agree that we should not confuse the issue here....This is a discussion about the importance of monthly Heartworm preventatives. I also think it's worth mentioning that depending on where you live, you should give HW preventative monthly throughout THE ENTIRE YEAR......

Keep in mind that HW preventative does NOT keep the dog from getting the heartworms in their system....It only serves to kill the larvae in the blood before they mature and reproduce......So the dose you administer this month will kill the larvae that were contracted the previous month......I use Interceptor......

Heartworm preventative is NOT OPTIONAL!...

[Adrianne Matzkin]

Thanks Jac. I didn't know that the HW meds kill the larvae from the previous month.
Should a dog be tested before starting HW meds if they never used them before? What if they miss a dose?

[F, Calla & Luca]

Absolutely. Testing is literally vital before treating for the first time. It can be fatal to use the monthly medication if the dog has been infected. I would think one missed dose is probably
OK but I'd check with the vet before giving the med. certainly I've been a day or two late and that Isn't something I'd worry about.

[Adrianne Matzkin]

Thanks F! I am usually very good with our schedule. I was a week late when we were in Florida because the girls had gotten a bacterial infection from stagnant water at the dog park so I had to wait. I will make an appt with the vet to have them both tested.

I am sure there are others who don't realize just how urgent it is to stay on schedule and what needs to be done if they are late for any reason.