Denton, TX Bandit- Longhair sable male (adopted)

[JeanKBBMMMAAN]

It's stated in #4: Big Dogs, Big Heartworm: Urgent Post - Immiticide Unavailability - AHS Recommendations

And here:

A HUGE (CAPS!) note on exercise restriction BEFORE (CAPS AGAIN!) heartworm treatment begins.
You say to yourself, oh, pish tosh, why would that be important? The worms aren't dying. I don't need to worry about the clots they keep talking about. I need to give my dog a month of doxycycline and I'm going to let them enjoy that last month of freedom before 2-4 months of being quiet. Right?

Wrong! Sad study says that by letting dogs be more active after being diagnosed (and before treatment begins) they get sicker faster! Even if they have less heartworms to begin with.

As expected, the number of worms has an effect on the severity of disease, but of equal, if not greater, importance is the activity level of the dog.

Controlled studies have shown that dogs infected by surgical transplantation with 50 heartworms and exercise-restricted took longer to develop clinical disease and developed less pulmonary vascular resistance than dogs with 14 heartworms that were allowed moderate activity.

Or as they said in the Urgent Alert about the Immiticide Unavailability - see the CAPS - we know what that means:

Restrict ALL activity of the dog! Limit ALL exercise!
• The severity of heartworm disease is directly related to the activity level of the dog.
• As physical activity increases, pathology associated with adult heartworms increases.

So if you have a dog who tests positive for heartworm, you begin limiting activity immediately. At some point we'll talk about slow kill - that's almost 2 years of activity restriction. If you have a foster dog who is waiting to start treatment for whatever reason, restrict activity. Or your dog will get sicker, faster.

that is from: Big Dogs, Big Heartworm: August 2011

Also this: http://bigdogsbigheartworm.blogspot....treatment.html

And I am going to grab the link to the study. I hope!

[JeanKBBMMMAAN]

Here it is!
American Heartworm Society | Canine Guidelines

As expected, the number of worms has an effect on the severity of disease, but of equal, if not greater, importance is the activity level of the dog. Controlled studies have shown that dogs infected by surgical transplantation with 50 heartworms and exercise-restricted took longer to develop clinical disease and developed less pulmonary vascular resistance than dogs with 14 heartworms that were allowed moderate activity.

This was also evident in naturally infected dogs where there was no correlation between the number of heartworms and pulmonary vascular resistance and is an indication that the host-parasite interaction plays a significant role in the severity of disease. A subsequent study reported similar findings in dogs being treated with melarsomine. Whereas live heartworms can cause endarteritis and muscular hypertrophy of arteriole walls especially in the caudal pulmonary arteries, dying and dead heartworms cause a significant portion of pathology seen in clinical disease. As worms die from either natural causes or as a result of administration of adulticidal drugs, they decompose and small worm fragments lodge in the distal pulmonary arteriole and capillary beds in the caudal lung lobes blocking blood flow. These worm fragments along with the elicited inflammation and platelet aggregation result in thromboembolisms.

During periods of increased activity or exercise, the increased blood flow to these blocked vessels can cause capillary delamination, rupture and subsequent fibrosis. This leads to increased pulmonary vascular resistance and potential right-sided heart failure. This illustrates a direct correlation between the activity level of the dog and the severity of disease.

Whew! I would definitely take that and the PDF from this to the vet:
Urgent Post - Immiticide Unavailability - AHS Recommendations


Again - congrats to that beautiful boy!

[Emoore]

Crap crap crap crap crap.

I'll print this out and share it with them. Thanks for the heads up.

[JeanKBBMMMAAN]

No problem. I know people (around here in the real world probably the most!) get sick of me nagging about the whole HW/inactivity thing, because I think somehow there is this idea that worms in the dog - even in the heart and lungs - are kind of expected and that the system can deal. But my vet explained to me that cardio-pulmonary cellular sized invaders and changes can be dangerous and that hearts and lungs are just not made to handle this stuff. So I nag.

Now they can start doing that and stop the progression. And you tell your vet to read the recommendations!

[Emoore]

Not my vet, it was the vet that the shelter uses. Heart worm test and treatment discussion came with the adoption fee, along with shots and neuter etc.

You know, I always kind of secretly wondered if Cash would have lived long enough to get the ball out of his throat if his cardiopulmonary system hadn't been screwed up from having had heart worms. There was a hole in the ball, so he was able to get enough air to make it the 15-minute ride to the e-vet. They got the ball out, and only then did he go into cardiac arrest and die. I've always wondered if he would have made it if we hadn't gotten the false negative when we adopted him and let him go an entire year with heart worms.

[JeanKBBMMMAAN]

Oh my gosh - can you get that info to that shelter vet!?!? Holy crap.

Oof. Well, unless he was stage 3 or 4 HW+ when you treated him, I am going to guess that it wasn't because of that. Every time I read/think of Cash...it's just beyond comprehension and truly makes you wonder why. Lots of times you can see a reason for something, even something awful, or they are old and you expect it, but this just is upsetting through and through.

For anyone reading, because we have had dogs come in test negative and then positive 6-7 months later (meaning they were positive coming in but not enough to show up and were percolating the worms the whole time) we have adopters or fosters do the restest at 6-7 months now.