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Discussion Starter #1
ok so saturday. i found a white GSD male at our local humane society, and we adopted him. they keep him until hes neutered which was to be done on wednesday, and we could pick him up on thursday. my husband just got a call saying hes heartworm positive, ive had several dog in my life but ive never had to deal with heart worms. i guess im just asking if someone can explain exactly what the treatment is goning to be like and what were gonna have to do... i know its pretty expensive it treat it. and if i need to be worried about my current shepherd, she's on trifexis.
 

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You can do the treatment two ways. The slow kill method (not as expensive) or two shots. I think part of which one you use depends on the load of heartworm the dog is infected with. It's passed thru mosquito's. You should not have to worry about your current shepherd. You'll need to keep the boy on crate rest during treatment as the worm dying off is hard on them.
 

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bumping this up hoping someone with experience will respond!
 

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Our boxer got heart worms and we were worried about him having the 2 shots. Our vet recommended giving him heart guard for at least 2 years and that it would kill them off. The only fear with the slower method is that damage can still be done to the dogs heart until all the worms are killed. The slower method did work well for our boxer and he recovered well.


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My dog came into rescue HW+. He was treated with Immiticide shots. He is 100% now. The protocol is to keep the dog quiet (no strenuous exercise) for one month following the treatment.

The rescue I volunteered for had a lot of HW+ dogs. All of the dogs were treated with the shots and they, like my dog, have all done great following treatment.

I would not worry about any of your current dogs assuming they are taking HW preventatives. HW is transmitted via mosquitos. If you are not treating your current dogs with HW preventative and mosquitos are present where you live, I would start the dogs on a preventative.
 

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Your vet will probably have a couple of different options to recommend depending on what you can afford, what your lifestyle is like (more or less: whether you can keep a dog on strict crate rest for a month), how old the HW+ dog is, and what the HW+ dog's health condition is otherwise.

Immiticide injections are hard on a dog's system. Young and healthy dogs often recover with no complications, but they have to be kept as inactive as possible until the heartworms are flushed out of their system. Older and less healthy dogs may not be able to cope with this type of treatment. Additionally, there are some breeds that are known to be susceptible to bad side effects from certain HW medications, but iirc it's mainly Border Collies and Australian Shepherds that have shown the worst reactions.

"Slow kill" basically involves waiting for the heartworms to die of old age, which takes 18 to 24 months. In the meantime, you continue to dose the dog with HW preventative to kill off any baby worms and prevent the population from replenishing. Some vets will supplement this treatment with other medications to weaken the adult worms, which is believed to increase their susceptibility to the medication in HW preventatives. This is usually a significantly cheaper option and easier on older/sicker dogs, but it takes a lot longer and you have to be vigilant about giving the medication regularly every month for two years.

I've had to do it both ways and personally I prefer fast kill when the dog can take it, just because it gets the whole thing over with in a more expeditious fashion. You do have to get creative to keep your dog entertained for a month with very little physical exercise, though. I've found that tricks training works really well. That and stuffed, frozen Kongs are my best friends when it comes to giving HW+ dogs some busywork.

Like LifeofRiley said, your current dog should be fine as long as she's being given a preventative regularly.
 

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Discussion Starter #8
With the slow kill method, does your dog have to stay in the crate for a month or can you just limit there activity, i've been looking everywhere and so far haven't found the answer. i'm trying to avoid doing the "fast" kill method because i don't think the dog could necessarily handle it. he's approximately 3yrs old is very skinny and is infested with fleas. the ladies at the shelter don't know much about him since he was picked up as a stray, which is CRAZY, because he's so happy to be around people, and just wants out of there.
 

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I would pull up the protocols on the American heartworm society's website. Theoretically yes you should keep you dog quiet during the slow kill method, the entire time, meaning the whole 1-2-3 years it takes to come up negative on a test. I would not cite low weight and fleas as reasons not to do the injections, you start out with giving heart guard/iverheart for a few months beforehand anyway and doxycycline for a month. That's more than enough time to improve on those things. Unfortunately my own GSD came up positive while on monthly prevention when I lived in GA.
 

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We deal with this all.the.time with rescued dogs in the South. I've taken two dogs through fast kill this year, and helped adopters take several fosters through it. My last foster is starting fast kill this week, in fact. It's serious, but manageable.

Here's what I've learned from dealing with this with my foster dogs, and recently adopted dogs -- I'm just reporting what I hear from several different vets, and talking with lots of people in the rescue community, and my own experiences:

1. The dog needs to be limited in activity as long as there are worms -- if you go slow kill, that's a lot of months on exercise restriction. The harder the heart pumps, the more the disease will progress--exertion will make it worsen faster. ABSOLUTELY NO RUNNING OR "ZOOMIES" -- slow walks, not long ones, and easy-going play only.

2. 4 weeks on Doxycycline Hcl. (antibiotic) -- you'll likely need to do a month of this regardless whether you do slow or fast kill. Unfortunately, it's expensive. There's a shortage of this drug for dogs and people both right now, and you'll easily spend $200-$300 for a month's prescription of this generic antibiotic.

This drug cost less than $10 at Walmart Pharmacy just 6 months ago, now it's 20 times that. It's infuriating, but the cheap sources of it have all dried up due to mysterious manufacturing issues. The FDA keeps saying it's temporary, but they've been saying that since January. Brace yourself for sticker shock at the pharmacy -- and if your vet inflates it more, ask for a written RX and price shop it around town (you can check out GoodRX.com for local price listings--it varies a lot from pharmacy to pharmacy).

3. There's slow kill, and then there's ultra-slow kill. It used to be people sometimes used ivermectin (e.g., Heartgard) for slow kill, and it took 18-24 mo. to clear the worms, with a month of Doxycline every three months. I don't know anyone who still does that where I live.

In Louisiana, the vets I know are mostly shifting to using Advantage Multi for slow kill -- I'm hearing it's clearing the worms in just 6 months, with one cycle (month-long) of Doxycycline at the very beginning.

I'm hearing that the Advantage Multi is showing itself to be a way better form of slow kill than ivermectin. I can't point you to any websites or literature -- I can just say that here in the Deep South, vets who are on the "front lines" of heartworm battles are telling me this. If your vet doesn't know about it, have them call a friend who practices in the Gulf states -- or a vet school down here.

4. Fast Kill - if you can afford it, and the dog is Stage 1 (no symptoms) this is generally the preferred protocol for most vets. It's the only "approved" method of treating HW. (Slow kill is not "approved" even though it's quite common.)

The AHS recommends a 3-shot protocol, with Immiticide. There is a 2-shot alternative protocol. AHS claims the 2-shot protocol isn't as effective (I've done it with a dog with a very light load though, and my vet has done it on a lot of dogs, with good success...so I suspect there's a range of views on the 2-shot vs. 3-shot protocol....).

5. The cost of fast-kill varies widely. The wholesale cost of the immiticide is only about $40/vial (I'm told on good authority...). Many vets nevertheless charge over $1000-$1500 for the 3-shot treatment. I know one who does it for about $300 plus whatever the people-pharmacy gets for the Doxy. I know other vets who charge $1500, plus Doxy. Part of the difference is radiographs, and the length of overnight stays in the clinic. My own vet chooses not to do radiographs on asymptomatic dogs (stage 1) if the bloodwork is clean, since the radiographs don't affect the treatment protocol.

Immiticide treatment is hard on the dog (esp. with the severe exercise restriction post-treatment), but the benefit of fast kill is you get the treatment over with, and the worms will be dead and gone, and you can get on with life. This means they won't keep damaging the organs for another 2 years--very important. You also get the dog back off exercise restriction faster. It is not risk-free, though.

Here's how it works:

First, some vets want you to keep the dog on a HW preventative for 3 months before treatment (so that all life stages of HW will be dead after treatment). Since Advantage Multi is killing worms faster than Ivermectin, that's what I'm putting my HW+ foster dogs on for this initial three months.

Second, at least 4 weeks before treatment, you start the Doxycycline (2x day for 4 weeks, in my experience). This is not optional--it's a very important part of the treatment.

Third, they'll do the first immiticide shot. The dog will feel really lousy afterward for a few days and sleep a lot. You'll start the most severe part of the exercise restriction now -- on leash even in the backyard, just walk out to potty, and then back in the house; lots of crate rest and couch-snuggling, no playing at all. We used car rides during this time to break up the monotony of lying around--they can look at the window and feel like they're going somewhere, without getting the heart rate up.

If you do the three-shot protocol, you'll have to wait a month, then there are two more shots 24 hours apart. A few weeks later, the exercise restriction gets lifted, and you can start re-conditioning the dog.

The exercise restriction during fast kill is serious. This is the most dangerous time of the treatment. While the worms are dying, exertion is extremely dangerous for the dog. Clumps of worms can die at once if the heart pumps too hard, sending them into the capillary bed of the lungs. We want the worms to pass through slowly, a little at a time. Thus, no exertion. You must follow your vet's instructions closely if you go this route.

Also, after the first shot, expect to have the dog on prednisone after the treatment. It has a side effect of causing dogs to drink a lot, and pee a lot. Most dogs have accidents in the house, no matter how perfect their house training is -- they just can't help it. The pred helps protect them from complications as worms are dying, though.

I know this is a lot of info. I know many dogs who've gone through treatment successfully and gone on to be very athletic, active dogs. One of mine is now up to running 3 miles a day after his treatment last winter.

Good luck!!!
 

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Great post Magwart!!!

I will say that my dog, in rescue, received 2-shots. I was his foster mom, so he came to me immediately after being at the vet. He did not receive doxy before or after. It wasn't too hard for me to keep him quiet afterwards because he had been through A LOT and seemed to need the decompression time. By a lot, I mean having just come from a high kill shelter, being transported to Chicago, getting treated for HW, being neutered and having mange.

But, he came through it all and is an amazing dog. HW is treatable and those who adopt should never think of it as something that permanently handicaps a dog. Treat it and they will be fine!
 

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4 weeks on Doxycycline Hcl. (antibiotic) -- you'll likely need to do a month of this regardless whether you do slow or fast kill. Unfortunately, it's expensive. There's a shortage of this drug for dogs and people both right now, and you'll easily spend $200-$300 for a month's prescription of this generic antibiotic.

This drug cost less than $10 at Walmart Pharmacy just 6 months ago, now it's 20 times that. It's infuriating, but the cheap sources of it have all dried up due to mysterious manufacturing issues. The FDA keeps saying it's temporary, but they've been saying that since January. Brace yourself for sticker shock at the pharmacy -- and if your vet inflates it more, ask for a written RX and price shop it around town (you can check out GoodRX.com for local price listings--it varies a lot from pharmacy to pharmacy).
Yikes! I had no idea that the cost of doxy had gone up so much. I have a lot of it from when I was a VERY ACTIVE foster home for a rescue. In fact, at the time, the rescue would give Doxy to active foster homes as just in case measures... i.e. since it is so commonly used for shelter dog conditions, it seemed wise for foster homes to just have it in hand.

Now that I know it has become so much more expensive, I think I should definitely give back the supply I have to the organization as I am not fostering as frequently as before. Never thought about that before because I just didn't see it as $$$ issue. Is there a shelf-life to the meds?
 

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Can anyone tell me what a heartworm infection-site generally looks like? In other words, where the mosquito bit the dog..? Does it present as a lump or bump or open wound? I am having a hard time finding any info in regards to this. Thanks.
 

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It doesn't show at all.

The 3 shot fast kill is the safest method as well as the most effective.

Big Dogs, Big Heartworm: June 2011

I blogged my foster's heartworm treatment above. A ton of information and I need to do a table of contents, but please do browse it.

MichaelE - I believe that HW prevention is one of the most important things there are, and also that the HW society - though funded by people who have an interest monetarily in HW prevention - is doing amazing work. Someday when I have time, and you can remind me, I can do a heartworm sticky with info in it.
 

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Everyone is into something for money. Nothing is ever free in this world. I fail to understand why making a profit is detrimental to heartworm treatment.

Are the people who invent and offer these drugs bad because they charge money for them? This is a capitalistic society. If you would rather get everything for free, there are plenty of European countries that cater to Socialism where the rich provide everything for the poor with your money.
 

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2. 4 weeks on Doxycycline Hcl. (antibiotic) -- you'll likely need to do a month of this regardless whether you do slow or fast kill. Unfortunately, it's expensive. There's a shortage of this drug for dogs and people both right now, and you'll easily spend $200-$300 for a month's prescription of this generic antibiotic.

This drug cost less than $10 at Walmart Pharmacy just 6 months ago, now it's 20 times that. It's infuriating, but the cheap sources of it have all dried up due to mysterious manufacturing issues. The FDA keeps saying it's temporary, but they've been saying that since January. Brace yourself for sticker shock at the pharmacy -- and if your vet inflates it more, ask for a written RX and price shop it around town (you can check out GoodRX.com for local price listings--it varies a lot from pharmacy to pharmacy).
Doxy is crazy right now. The shortage is actually over and more than one pharmacist had the opinion that this is nothing more than price gouging a this point.

OP - call around to pharmacies. RiteAid in my area had the best price
84 pills - 100 mg each
Kmart - $561
Walmart - $278
RiteAid - $51
Crazy right?

Someone else found Walgreens still had it under their prescription plan for $20 script.
 

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If you would rather get everything for free, there are plenty of European countries that cater to Socialism where the rich provide everything for the poor with your money.
That's not really how their health care works. But this is a political statement and against the rules of the board.
 

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And so is being against a company(ies) that provides medical service for profit. Or an organization that solicits advertising or monetary support from those that do.
 

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Someone else found Walgreens still had it under their prescription plan for $20 script.
They did as of a month ago, if you joined their RX Club. They no longer do, according to a friend who was filling a RX for her HW+ foster dog there last week -- the pharmacist said they took Doxy off the RX Club list recently. That was my last reliable source to get foster dogs started on meds at a reasonable price. I'll check RA here. I have seen coupons at various local pharmacy on GoodRX.com

BTW, the vet I know who does the treatment for $300 instead of $1500 says at that price she still doubles her wholesale cost of immiticide and gets her regular office visit fees -- she's making enough profit at that $300 price for her to be happy. I think she's building a lot of long-term clients this way, as adopters go to her for HW treatment over their regular vet, and end up staying because they like her and her reasonable prices. She also happens to be a very experienced, good vet. Win-win.

The take-away message on pricing for fast-kill HW treatment is that varies widely, even in the same locale.
 

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Before you do ANYTHING you want to get the dog tested to find out how BAD the load of worms is.

If the dog only has a light load of immature worms, then you can put them on the regular monthly HW drugs and it will kill them.

If the dog has a heavy load you want to go with the fast kill method in order to prevent any further damage to the heart.
 
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