Help, Possible Heartworm

[TxRider]

Originally Posted by Melina

I just looked it up and this is what I found:

"Heartgard (slow kill)

The "slow kill" method, which is a newer approach, is the one prefered by us for treatment of dogs who are in Stage 1 of the infection. It consists of giving the dog Heartgard on a monthly basis. This heartworm preventative medication has some effect against the adult worms and should gradually eliminate them over a period of one to two years; without treatment, the worms can live up to five years. The earlier the treatment is started after infection, the more quickly it will work to eliminate the adult worms. Note that only Heartgard (ivermectin) should be used, as Revolution (selamectin) affects far fewer adult worms, and Interceptor (milbemycin oxime) almost none at all.
Although this method is gentler than the use of Immiticide, the danger from the dying worms is still present, and for a much longer period. A recent Italian study showed that pet dogs (as opposed to the caged laboratory dogs this method had been tested on before) did get pulmonary emboli and some of the dogs died of it. The more active the dog, the higher the risk"

Edit:
I found this website too, how odd is this, another GSD Koda with heartworm:
Slow Kill Heartworm Treatment For Dogs

*One more edit quote:

"Definitely the "long slow kill" does work, but with many risks. There was an Italian study presented at the American Heartworm Society Symposium this year (2004) that followed actual client owned dogs treated with this approach, and the incidence of pulmonary changes and other problems was very high - higher than with the standard "fast kill" protocol.

If you use the "slow kill" method, which takes around 18 months to three years to kill the worms, you have to keep the dog quiet for the whole time. It might be safer than the immiticide (it's basically just giving the regular preventative dose of Heartgard once each month - not a higher dose) from the point of view of drug reactions, but the risk of emboli is the same, or even worse, since you're stretching it out over a much longer time."

Yes everything I read says the risk is there for embolism either way, if my dog was not very active I might go the long route.

My sister adopted an older dog with a light case and did the ivermectin route, her dog did fine but she was an older not very active dog.

I did the 3 shot method, worse case though, it cost me about $700 and she had to stay calm inside for 2 months. She stayed at the vets overnight for one shot, then home for a month of no activity (though she wanted to) then a two night stay with two shots and another month of no activity, and she's free to do anything now, and gets monthly heartguard.

I would think that the risk of emboli would be fairly low for light case either way, you should talk it over with your vet.

My vet also told me they don't use arsenic any more, they used to, my dog as a kid in the 60's got a bad case, an the arsenic did harm her health, but she still lived to 16 but with health issues.

My vet said they isolated the particular chemical in arsenic that kills the worms and separate it out and that's what is used now. Unless the dog has some kind of allergic reaction they usually do fine.

If you want to see what they look like, watch this... if your squeemish don't watch it. This is a worst case where they have to physically go in and pull the worms out of the aorta and heart itself.

You Tube

You Tube

[Melina]

Rider - He's very calm at home, but the Vet thinks he's only a year or two old, and I don't want to deprive him of a year of the dog park and hikes if I can only deprive him of two months, you know? He's a young dog and I'd like him to experience life, it doesn't seem like his previous owner let him to much, if you ask me. When I got him home, his coat was disgusting, which leads me to believe he had been left in the back yard (I don't think he was on the streets for too long because he wasn't too skinny), he also had no clue how to get into a car and was getting car sick the first few times we went anywhere due to the stress of it, he's since gotten over it because he now associates car rides with the dog park and Petco This tells me that whoever had him before me never brought him anywhere in the car, you know? I just feel like with the slow kill method I'll be scared he could suffer an embolism at any moment over the course of the next year, or even longer, and he won't get to do anything or go anywhere. My Vet didn't really get into the slow kill method anyway, she just talked about the 3 shot method, so I don't know if that was even an option for her. I still haven't received a call yet from her, so I'm not even certain he's positive on the heartworm test yet, I'm still crossing my fingers that there's a possibility he'll come up negative. When I get a call later today, if it's positive, I'll be talking to her about both methods of treatment, the fast and slow, and see the pros and cons to both...

[Melina]

I just watched the video, sorry it took me so long to finally watch it (I'm not squeemish, just wanted to take the time to watch the whole thing), and my god, that was incredible the amount of worms! I still haven't received a call from my Vet, I'm not sure what's going on, but I'm calling her first thing tomorrow morning...

[Melina]

Well, it came back positive. He's going in tomorrow for bloodwork and X-Rays to see what stage it is and then we're going to decide what course of treatment to pursue.

[Melina]

Does anyone know the difference between treating with Melarsomine (Immiticide) and Ivermectin? When I talked to my Vet on the phone, she only mentioned the Melarsomine, which I looked up and found out was the Immiticide. I'm trying to find out some information on Google right now, but I'm not finding anything in layman's terms. I want to be able to have some idea of what I'm talking about at the Vet's office tomorrow...

She did mention that the Melarsomine doesn't kill the adult worms, I think? Just the microfilaria? So it wouldn't be an effective treatment if Koda has adult heartworm, right?

[TxRider]

Originally Posted by Melina

Does anyone know the difference between treating with Melarsomine (Immiticide) and Ivermectin? When I talked to my Vet on the phone, she only mentioned the Melarsomine, which I looked up and found out was the Immiticide. I'm trying to find out some information on Google right now, but I'm not finding anything in layman's terms. I want to be able to have some idea of what I'm talking about at the Vet's office tomorrow...

She did mention that the Melarsomine doesn't kill the adult worms, I think? Just the microfilaria? So it wouldn't be an effective treatment if Koda has adult heartworm, right?

Melarsomine kills the adult worms, that is the arsenic based compound. It is injected into a back muscle, is quite painful and starts killing adult worms immediately.

The Ivermectin (heartguard) will NOT kill the adult worms, however it does shorten their lives. It is simply a standard heartworm preventive medicine.

Many vets will not even talk about a choice of using a slower method of ivermectin over about 18 months, and will always recommend immiticide treatment..

As I said if it's light case, and the vet says you can go the Ivermectin route, it would be the dogs activity level that would make my decision point.

If the dog is going to be getting a lot of hard exercise over the next year and a half the fast kill immiticide is probably safer.


Here is the clearest info page I have seen....

http://www.marvistavet.com/html/body...treatment.html

[Melina]

Rider - Thank you, I didn't realize that the Immiticide is the fast kill method and the Ivermectin is the slow kill, thank you for clarifying that. It sounds as though she wants to go the fast kill method, but we need to determine what stage he's in and how many shots, 2 or 3. We're going to see where he's at tomorrow. She did say that there's a Vet in Gilbert that she's going to refer me to that has more experience with treating heartworm after we determine how bad the worm load is.

[Melina]

Koda went in for bloodwork and radiographs yesterday, they weren't able to tell me exactly what stage he's in (my primary vet is working in conjunction with the other vet in the practice there, then they're both in contact with another vet in Gilbert AND the Humane Society because apparently they treat more cases of heartworm there and have more experience), but they were able to tell me from the x-rays that they can tell that his heart his strained, but it isn't too bad. This is their course of treatment right now, but they're going to talk to the other vet in Gilbert and the Humane Society and see if they have another recommendation, if not, this is what they plan to do:

First, get him on Heartgard to take care of some of the Microfilaria and treat with Doxycycline for 30 days (There's 120 pills. 2 every 12 hours = 4 a day. 120/4 = 30). This is where I'm a little confused though, she showed me a little chart that we're going to follow with a timeline of the treatment of a 4 month period, it looked kind of like this (I used my great Photoshop skills):



HG is the Heartgard treatment, which he will be on the rest of his life obviously, DX is the Doxycycline, which we started now in M1 (Month 1), then in M2 and M3 (Months 3 and 4) is when the IC (Immiticide shots) come in (We're going to figure out if we want to do the 2 or 3 shot method when we get there), but what I'm confused about is, what's going on in month 2? And should he be on Heartgard at the same time as the Immiticide treatment? I just wanted to check with you guys and make sure this sounds right. I don't think I misread the chart that the vet showed me. I'm going to call her today and make sure I got the timeline right, but if I did, again, what's happening in month 2? Is the Heartgard still working on the Microfilaria? I think I'm just missing something...

[Rerun]

Could just be differing opinions on treatment, but my foster was not on the HG until after all treatment was completed.

[Melina]

Koda's treatment is chugging along, he's been on Doxy now for a while, and I do understand what the Vet's course of action is as it was explained more fully to me, but if anyone can give me their opinion on this, that would be great:

I understand heartworm is expensive, I didn't think this was going to be cheap, but thus far we've spent $500 something on his diagnosis (radiographs, bloodwork, etc.), and the Vet says that the Immiticide is going to run $1,000. That's $1,500 thus far, plus on top of it, he's going to have to stay overnight when he gets the shots, I'm sure, that costs, plus any pain meds he needs, pretty soon he's going on prednisone. It sounds like this is going to make it's way into the $2,000 range. I know heartworm treatment varies in cost from state to state, but does this sound excessive to anyone? The reason this is coming up is that my Father spoke to someone he works with who is apparently in contact with some rescues here, and when he told him what it's cost us thus far and how much we still need to do for Koda's treatment, he said that sounded high. In reading about the range of cost in treatment, it don't remember it going above $1,200, really. Whatever we need to pay, we're going to pay it, I just want to know if around $2,000 sounds weird to anyone...