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Discussion Starter #1 (Edited)
A thread about a loved pet dying of advanced HW disease because the owner didn't keep it on prevention got me thinking that we need a thread collecting LOW COST options for people struggling to provide basic care.

First, it's important to keep in mind what basic care is part of being a dog owner. Dogs need an annual check-up. Even if no vaccines are needed, having a vet's eyes on them is the best way to catch small problems when they are easily treated, and avoid big ones.

Annual heartworm testing is part of basic dog care. It's not optional. If you live in an area with heartworms, please don't skip this! Check out this 2016 map:

https://www.heartwormsociety.org/images/incidence-maps/IncidenceMap2016Final.pdf

Please know that the incidence of HW is increasing and expanding to more territory in the U.S. If you grew up hearing "we don't have heartworms," check the latest map -- you might have them now. It's also a myth that inside dogs don't get heartworms -- if mosquitoes ever find their way into your home, find your dog when it goes out to potty, one bite is enough to transmit them.

Heartworms kill dogs, if left untreated. If you neglect heartworm testing and prevention in an area that has them, that decision could be deadly for your dog. They're very hard to treat. The treatment costs $1000 or more, and it's very painful. It requires about 3 months of strict crate rest -- they can't even go for a walk. Some dogs don't survive it. All dogs will die if not treated though -- and it's an awful death. They experience very painful, slow organ failure, and they can drown in their own fluids. No dog should have to die that way.

You can prevent all this for as little as $5/month! It's better than hiding your head in the sand and hoping mosquitoes don't find your dog.

For anyone out there reading this who feels like you cannot afford prevention, here are some low-cost prevention options to help you do right by your dog:

1. Feedstore, Tractor Supply, and Petco Clinics: You can get an annual HW test at a feed store or Petco vaccination event for about $30. Tractor Supply Stores offer similar clinic events -- their HW tests are sometimes as low as $12 if you buy HW prevention at the same time! Some city/county shelters offer this service for even less (call and ask about community vet clinics at the shelter). These low-cost clinics nearly always offer generic heartworm prevention products for sale. They are staffed by a licensed vet.

2. Fill your heartworm prevention prescription at Walmart, Sam's, Costco, or at an accredited online pet pharmacy -- and ask your vet for suggestions to save money: You can ask the vet who does the HW test to give you a written prescription for one year worth TriHeart Plus and fill it at WM/Sam's pharmacy, or online at valleyvet.com for about $60 for 12 months or $30 for 6 months (just $5/month). A generic version of Heartguard like this is the cheapest prescription option.

Swallow your pride and tell the vet you want to do right by your dog but that you're struggling to afford it, and explain why you need to fill it somewhere inexpensive--they'll understand! Sometimes they might even be able to pull out some samples or a short-dated doses given to them by their pharmacy rep, or coupons for free doses or rebates that will bring the cost down. I've even known a vet who will price match the lowest online price in order to get clients to buy it from him, so that he can remind them when its time to refill and help them keep up with prevention. He just needs clients to be honest with him so he can try to help -- he wants to help keep the dogs on prevention.

3. Regularly price check your pet meds (including HW prevention) using GoodRX for Pets: You hopefully know about checking for the lowest cost of your human meds at GoodRX.com. They also offer a similar real-time price-check service for pet meds. Example:
https://www.goodrx.com/tri-heart-plus?form=package&dosage=6-chewable-tablets-of-26-50-lbs&quantity=1&days_supply=&label_override=Tri-Heart%20Plus

4. Buy as much or as little as you can afford -- even a single dose each month: If you can't come up with the money to buy a year's worth of prevention for $60, then buy 6 months worth for $30, and refill it later. The pharmacy will keep your refill on file until you need it. If you can't come up with money to by 6 months' worth, ask the vet to sell you a single dose, a month at a time -- some vets will! It's actually pretty common for vets to do this in areas where lots of people are struggling to make ends meet. They often have several clients who come pick up single doses at the reception counter at the time of the month when Social Security or veteran disability payments come in -- it's just how these clients manage to make things work, and there's no shame in that.

5. If you use a farm vet for your livestock, ask them for help with your dog's heartworm prevention. You can ask any farm or country vet about diluting a very specific product used for your cattle down properly and safely for dogs to prevent HW. Note: you easily can kill a dog by overdosing it on cattle meds or using the wrong med, but vets know how to dilute the right one and dose the drops safely for dogs. Don't use Internet calculations that try to avoid the vet -- the ones I've found online, I had shelter vet review and she calculated that they were dosing at 1000x or more above what is safe for prevention (some of them were at a level that can blind or neurologically damage a dog--VERY dangerous). It's critical to have YOUR VET do the dosing calculation and dilution, but farm vets do this pretty routinely for clients, thereby creating HW prevention that costs pennies from a product that cattle owners might already have in the barn. They can possibly also show you how to safely use some livestock dewormers for your dogs, at the correct dose. The critical thing is have a VET help you--don't guess on dose and potentially kill your dog! Just ask!

6. Don't forget flea/tick prevention: Fleas transmit tapeworms, and ticks transmit several potentially deadly diseases. Your dog needs protection from them -- this is doubly true for outside dogs who live constantly exposed to biting insects. If Frontline still works in your area, there's a generic with the same active ingredient sold at Walmart called PetArmor (and there are often online printable coupons you can find for it--try googling "PetArmor coupons"). You can look for an ingredient called "Fipronil" in generic flea meds -- this is what's in Frontline, at a higher cost. (It came off patent a few years ago, so there are many generics now.) Otherwise look into a Seresto collar (it lasts up to 8 months, for about $40 online) or Scalibor collar (good for 6 months, for about $30 online) -- there are often great online sales on both of them, and they don't require a prescription. They're more effective and safer than the cheap mass-market flea collars, and they're quite economical because they last so long.

Others here may have creative suggestions to add, based on experience. Lots of us have had times in our lives (especially when young), when we struggled to come up with money for vet care. Hopefully we can help with some useful options that may save some canine lives by preventing a deadly disease.
 

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What a good post.


I don't mess around with this one and give Heartgard all year. Our property backs protected wetlands, the mosquitoes are awful. We are outdoors all year. In the dead of winter, in Ohio, when it's cold I have found darn mosquitoes on me. I also do the annual blood work as well, no exceptions. My vet usually has buy so many, get some extra tabs for free.


I remember someone saying just treat for heartworms, no big deal. That does not look like a fun treatment for the dog at all. Looks like it wipes them out. My childhood heart dog died of heartworms, it was the 80's. That was awful. Not sure if there was a preventive available at that time.
 

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Such a thoughtful thread. To take the time and type this out so articulately. And to help others to especially help their dogs in HW area's
I consider Magwart the HW guru as this is not the first time I have seen such a well thought out helpful post
 

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@Magwart thank you for this thoughtful article. We know it will be very useful for a lot a people.

Magwart, can I ask you some further questions regarding vaccinations?

So my boy will be 1 year on the 12th (of July). I got him on September 8th 2017 (7 1/2 weeks). I got his next vaccinations timetable:

Rabies 18 Oct 2018
DA2PP 18 Nov 2018
Bordatella 18 Oct 2018

We will have our 1st annual check up some time this month. Does that mean I have to get him vaccinated again before the ones on the timetable (since he's hitting the 1 year mark)?

And I live in LA. In your opinion, should I get him on the heartworm prevention? If yes, is it once a month DIY or per year?

Thanks Magwart. I'm a newbie when it comes to overall health and stuff.
 

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Discussion Starter #6 (Edited)
Thanks, all. I really appreciate all the kind words! If the info is useful, please share it far and wide. I'm tired of good dogs dying needlessly because people don't know or can't afford to do what's needed. Nearly every dog I'm pulling out of shelters now is HW+...it's an epidemic where I live.

McGloomy, I used to live in Los Angeles County, and we had a case of HW in our neighborhood. HW became more prevalent in So Cal after all the Hurricane Katrina dogs showed up. My dogs were on HW prevention for all the years that I lived there, and when my neighbors' dog came up positive, I was so glad mine were protected. I had opted for the cheapest generic one at the time, but it was good enough.

Nearly all HW meds are given monthly. The American HW Society now recommends giving them year-round. They come in pill form (like the inexpensive generic alternatives to Heartguard), or topical (with convenient flea prevention added), like Advantage Multi or Revolution. All are prescription-only in the U.S.

If you have trouble keeping up with it, for adult, healthy dogs, there's now a 6-month injection called ProHeart6. It cannot be used in puppies, seniors, or sick dogs, but it's incredibly convenient for those who have trouble with monthly meds.

As for vaccines, I'll send you a PM McGloomy. I doubt you'll have anything due until this fall, but it's great that you'll see your vet and do your first HW test. HW testing begins at 1 year old because they cannot test accurately when they're younger (the worms themselves have to be about 7 mo. old before they produce enough antigen to turn the test positive, even though they're too old to kill with most prevention then).
 

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This is why we need forums! So newbies and experts can learn from each other! I didn't even know what Bordatella and DA2PP are specifically for. Thanks a bunch again to @Magwart
 

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Wow @Magwart, thank you for the info!

I wasn’t aware about the heart worm testing. I recently got the ProHeart6 injection for Katsu and they did a HW test. I’m positive she is fine, as she was using my Shiba’s HW meds until she broke the weight limit, but it’s good to know that the test only shows 7mo+ worms. They’re both on ProHeart now since I’m horrible with remembering things.

In MD, the animal control/ASPCA seems to do monthly vaccine clinics and there are low cost speuter options as well for people struggling to make ends meet. They post upcoming events to their Facebook page.
 

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Thanks for this! So glad we started Mei on monthly HW treatment a few months ago! Even though we fall into the 1-5 cases category.

She does not like it though. I have to conceal it in her food!
 

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Discussion Starter #10 (Edited)
I want to update this thread with a few new resources.


Some Petco stores now have Thrive Affordable Vet Care Clinics in the store. Exams are just $25. That is an excellent price for an annual exam. I think the HW test adds another $25, but that could vary by location. (For $9/month, you can also get unlimited vet visits (that covers the exam fee only--diagnostics, treatment, etc. is not included...so it's not a great deal unless you have a dog that just has to go to the vet a lot for minor stuff and can't afford good pet insurance at 5x the cost of this plan)). The one near me is full-service (offering x-rays, surgeries, etc.), but no overnight hospitalization.

https://www.thrivevet.com/

Right now, the Thrive clinics are in CA, CO, FL, GA, LA, MO, NC, SC, and TX -- but they're growing.

Walmart is also now rolling out their in-store PetIQ vet clinics, with $10 check-ups and $20 HW tests -- prices are here:
https://vetiqpetcare.com/services/dog/

WM vet clinic locations are currently in OK, AR, MO, NC, OR, and PA...but they keep adding too.

These new in-store, low-cost options are likely to bring annual HW prevention within reach of more dogs. If you know anyone struggling to afford basic care, please be sure they know about these options!
 

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Thanks for starting this thread Magwart. My dog is currently on year round monthly doses of Interceptor Spectrum for heartworm and intestinal parasites, and NexGard for fleas and ticks. He's also on daily Ketoconazole and Cyclosporine.

I'm considering changing to NexGard Spectra as its cheaper, and only requires me having to dose my dog once per month. I currently space the Nexgard and Interceptor doses a few days apart. My concern is if NexGard Spectra would be too much of a 'chemical hit' with the other meds he's on.

What would you recommend for my situation? Thanks!
 

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Discussion Starter #12 (Edited)
I'm not familiar with Spectra. Our rescue's vet has us put 2 weeks between NexGard and Advantage Multi (sold as Advocate outside the U.S.) when we have dogs that need to be on both...so that would be my instinct when combining overlapping products, but some HW products can be given safely at the same time as monthly flea/tick products. I don't use Interceptor, so I have no experience with it. Have you checked with your vet?

Ketoconozole given internally (vs. topically) has its own set of potential side effects -- cyclosporin is one of the drugs with potential cross-reactions with it, so go over that with your vet and let your vet guide you on what to watch for. I'm sure your vet is monitoring doseage and response carefully with this in mind.
https://www.petmd.com/pet-medication/ketoconazole
 

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I'm not familiar with Spectra. Our rescue's vet has us put 2 weeks between NexGard and Advantage Multi (sold as Advocate outside the U.S.) when we have dogs that need to be on both...so that would be my instinct when combining overlapping products, but some HW products can be given safely at the same time as monthly flea/tick products. I don't use Interceptor, so I have no experience with it. Have you checked with your vet?

Ketoconozole given internally (vs. topically) has its own set of potential side effects -- cyclosporin is one of the drugs with potential cross-reactions with it, so go over that with your vet and let your vet guide you on what to watch for. I'm sure your vet is monitoring doseage and response carefully with this in mind.
https://www.petmd.com/pet-medication/ketoconazole
Thanks, I have a great vet, Cyclosporine and Ketoconozole were our last treatment option. I'll ask her at our monthly appointment on Friday.
 

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Discussion Starter #14
If anyone needs a low-cost exam to update a dog's prevention (e.g., get your annual HW prescription), check your email if you are a member of Petco's PALS store loyalty program! They just emailed out a coupon good through 6/15/19 for a FREE vet exam at their new low-cost Thrive vet clinics in stores that have them.



I think the clinics will charge $20 or so for a HW test even with a free exam -- but you could get a REALLY cheap prescription for a generic HW med this way.
 

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Hello all, I have 10 week old and was wondering if I should buy these medications now or wait until his appointment with the vet and talk to him/her on Sept 4th? I live in So Cal.
 

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Discussion Starter #16 (Edited)
Hello all, I have 10 week old and was wondering if I should buy these medications now or wait until his appointment with the vet and talk to him/her on Sept 4th? I live in So Cal.

The official American Heartworm Society recommendation is to start puppies at 8 weeks of age, based on their weight. Here's their page of FAQs for pet owners:

https://www.heartwormsociety.org/pet-owner-resources/heartworm-basics#at-what-age-should-puppies-and-kittens-be-started-on-heartworm-prevention-what-do-i-need-to-know-about-prevention-in-my-new-pet


Advantage Multi is labeled as young as 9 weeks (it covers fleas too), so a week later if you want to use that one. Heartgard and its generics are labeled as young as 6 weeks depending on weight.

All that being said....I've had several sets of rescue pups that came to us around 12 weeks that were started on Advantage Multi as soon as we got them. They didn't get HW disease (and I'm in one of the worst states for it). OTOH, Ad Multi kills juvenile heartworms readily when used monthly, so even if there were some immature worms in the pups I had, it would have taken care of them them (it's the only one that has been shown to kill juvenile worms...it's why we use it!). I have no idea they'd have had the same positive outcome with Heartgard, as I only ever use Ad Multi on rescue dogs.


If you're not starting them until your pup is 12 weeks soon, I would perhaps ask the vet about prescribing Advantage Multi instead of one of the cheaper pills. It ends up being good value because it also gives decent flea protection (like Advantage II combined with HW and deworming). You'll just need to buy a single tube at a time in the beginning when the pup is growing fast, as the pup will need a bigger size at 20 lbs. and again at 55 lbs. (and again if it ever gets over 88 lbs.). Once you're over 55#, then you can *probably* safely buy 6-packs online at Allivet for around $75 per 6 pack (a GOOD price for both flea and HW). You have year-round fleas in So Cal, so the pup will need something for that anyway. Or in 6 months, you can switch to something else, as at that point, it will have killed any immature HWs that might have been in the pup growing already.
 

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The official American Heartworm Society recommendation is to start puppies at 8 weeks of age, based on their weight. Here's their page of FAQs for pet owners:

https://www.heartwormsociety.org/pet-owner-resources/heartworm-basics#at-what-age-should-puppies-and-kittens-be-started-on-heartworm-prevention-what-do-i-need-to-know-about-prevention-in-my-new-pet


Advantage Multi is labeled as young as 9 weeks (it covers fleas too), so a week later if you want to use that one. Heartgard and its generics are labeled as young as 6 weeks depending on weight.

All that being said....I've had several sets of rescue pups that came to us around 12 weeks that were started on Advantage Multi as soon as we got them. They didn't get HW disease (and I'm in one of the worst states for it). OTOH, Ad Multi kills juvenile heartworms readily when used monthly, so even if there were some immature worms in the pups I had, it would have taken care of them them (it's the only one that has been shown to kill juvenile worms...it's why we use it!). I have no idea they'd have had the same positive outcome with Heartgard, as I only ever use Ad Multi on rescue dogs.


If you're not starting them until your pup is 12 weeks soon, I would perhaps ask the vet about prescribing Advantage Multi instead of one of the cheaper pills. It ends up being good value because it also gives decent flea protection (like Advantage II combined with HW and deworming). You'll just need to buy a single tube at a time in the beginning when the pup is growing fast, as the pup will need a bigger size at 20 lbs. and again at 55 lbs. (and again if it ever gets over 88 lbs.). Once you're over 55#, then you can *probably* safely buy 6-packs online at Allivet for around $75 per 6 pack (a GOOD price for both flea and HW). You have year-round fleas in So Cal, so the pup will need something for that anyway. Or in 6 months, you can switch to something else, as at that point, it will have killed any immature HWs that might have been in the pup growing already.

Thanks for the reply, sorry for the late response. I just got back from the vet and the puppy is doing well. They started him on Interceptor plus and Nexgard Blue. Going to give them a try. The vet prefers the Interceptor to the heartgard. Going to do some research.
 

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My pup started head tremors after her 2nd application of Advantage Multi. They now have all but stopped as time to reapply is here. It never bothered the other dogs, even as pups. Looking for a safer alternative.
Those of you I’m reading that use Heartguard - it’s my understanding that GSD’s have serious problems with Ivermectin, and I’m guessing you haven’t had a problem with your dogs? My Vet said GSD’s can’t have Ivermectin? Has Heartguard changed the formula? Any Sentinel users?
 

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Discussion Starter #19
@DollBaby, you're thinking about MDR1 genetic mutation. But the information you are getting appears to be incorrect on two fronts: first, only 10% of GSDs have it -- it's much more common in other breeds:
https://vcpl.vetmed.wsu.edu/affected-breeds


If you're worried, spend $60 for the cheek swab to find out by ordering a test kit from WSU -- don't guess or wonder when the test is so inexpensive and readily available: https://vcpl.vetmed.wsu.edu/cheek-swab


Second, the amount in Ivermectin in HW prevention is safe *even for dogs with MDR1* because it's such a low dose, according to the researchers who study MDR1. Higher doses of ivermectin used for other purposes (like treating demodex) are not safe for these dogs, but the low-dose HW prevention is fine. MDR1 is thus not a reason not to give HW protection. I would worry a lot more about taking an MDR1 dog through HW treatment, to be honest. You can also use Interceptor, Sentinel, Revolution, etc. (the second paragraph of the Problem Drugs chart below refers to their active ingredients). Here's the website about problem drugs from the faculty at Washington State University vet school who are doing the authoritative research on MDR1 -- you might want to share it with your vet if your vet is giving you different information:
https://vcpl.vetmed.wsu.edu/problem-drugs
 

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Discussion Starter #20
Another HW prevention option just came on the market from Zoetis for HEALTHY ADULTS (not puppies, not seniors, not dogs with chronic illnesses): a once-a-year (12 month) injection called Proheart-12. I'm seeing prices of $125-150 or so for it.

They've had Proheart-6 (6 month injection) on the market for a while -- locally costs are in the $65-80 range. I know a lot of dogs on the 6-month shot for convenience reasons (owners aren't good at remembering monthly meds, are busy and don't want to keep up with it, etc.), and it's working great for them. Personally, I'd wait a year to see the safety profile of the 12-month shot, as one of the things learned with the 6-month drug is that it had to be relabeled for healthy adults only, but for people who live far from any vet, looking to only see a vet once a year and then not have to fool with any meds, this at least solves that. This article provides a good introduction to the history of this drug:
http://veterinarynews.dvm360.com/proheart-12-approved-use-us-veterinary-market

Since this thread is focused on lowering cost, in the U.S., Zoetis Petcare Rebates is giving $5 back on the 6-month shot and $20 back for the 12-month one (through 12/31/19). There's also up to $35 back on Revolution. Here's the rebate site:
https://www.zoetispetcare.com/rewards/
 
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