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Discussion Starter #1
My new rescue dog has tested heartworm positive.

I've read that the treatment is expensive and sometimes difficult.

How expensive and difficult is it?

I'm not sure if I should I treat her at the clinic the rescue recommends (low cost, rotating staff) or should I treat her at the vet I normally use (high cost, doctor I know and trust.)

Is the doctor's judgment a big factor in treatment?
 

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I am certainly no expert on HW Positive animals but I have a friend that recently rescued a an older dog who tested HW+. The vet was concerned about the age of the dog and being able to handle treatment so told my friend just to start the HW medicine Heartguard as if she was not HW+ and see what happens. I have also heard of other people doing this and having very good results, but I guess it works only according to what stage the dog is in when the dog is found to be positive.
 

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You can treat by giving heartgard, which means that no new worms will develop. However, the adult worms already present in the dog's body will take up to 18 months to die. In that time they can cause irreversible heart damage if there is a heavy infestation.

You need your vet to determine how heavy the infestation is as a first step. If you decide to treat with immiticide, I have heard that the best option is 3 injections, rather than two. I have also heard that many vets are pre-treating with doxycycline prior to treatment in order to weaken the worms.

dd
 

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I'm not sure what kind of costs you are looking at - in my area they are prohibitive. But if it were my dog I would go to a vet I know and trust and bite the bullet.

The treatment is very hard on the dog's body - essentially it is an injection of poison. You want experienced, trustworthy professionals to be administering it.

dd
 

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I have rescued three heartworm positive dogs, all seniors. The first I had my regular vet treat. He took radiographs, did bloodwork and told me that Caoimhe would be fine to treat. Unfortunately her burden was way higher than he could know from these tests and she went into heart failure resulting from all the worms dying off. Thirteen days later I had to have Caoinhe euthanised ...

With Feidhlimidh and Duncan I decided to take them to the local vet school. They did bloodwork, radiographs and most importantly had an echocardiogram done, which as well as allowing for visualisation of the worms, gave a measure of blood pressure. Duncan's results were good - he was put on Heartgard for a month to start a slow kill, then was given the immiticide, but split, one injection on day one, and then another two a month later. he did great, and now two years on his only reminder is a very slight heart murmur.

Feidhlimidh, in contrast, had good labwork and ok rads but his echo showed he had a high burden plus hypertension. The cardiologists said they did not believe he would survive the treatment, so instead we did a slow kill with Heartgard (we elected not to give Doxycycline for the Wolbachia). Nine months later I had to euthanise Feidhlimidh. I had a necropsy done and they only found a couple of heartworms. Feidhlimidh died from metastatic cancer (brain, liver, prostate, testicular), not heartworm disease.

Cost wise, the vet school was actually cheaper than my regular vet! If you have the option of seeing a cardiologist I would recommend doing so.

Wishing your pup the best.
 

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Spiritsmam, that is incredibly sad. I am so sorry. I have so much respect for people who choose to rescue the seniors.

Bless you

dd
 

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Thinking of Caoimhe still makes me cry, 3 1/2 years after she passed away, feeling like I failed her. The other seniors who have graced me with their presence only briefly I have very happy and fond memories of, and am grateful that I could make them comfortable in their final days/months. There is nothing in this world to beat living with an old dog ...

Joanne and Angels:
Bonnie - Lab/GSD mix, 19 yrs
Shep - Lab/Border Collie mix, 15 yrs
Bram - Lab/GSD mix, 15 years
Jim - GSD mix, 16 years
Feidhlimidh - GSD mix, 16 years
Caoimhe - Lab mix, age unknown
Drift - Border Collie mix, crossed the bridge too soon at only 4 years
 

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Can you please educate me - I believe your dogs were given Celtic names - how do you pronounce Caoimhe and Feidhlimidh?

You didn't fail them - those who could have kept them safe and healthy failed them. Every time I see a senior in a shelter my heart sinks.

dd
 

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Discussion Starter #9
Thank you for sharing your experiences with heartworm.

Joanne, I'm sorry about your Caoimhe.

I have a better understanding of the difficulty of treatment.

What's the story with the expense? Is it the length of treatment and follow up, or is the immiticide particularly costly? It's the whole thing, isn't it


Elly is only 3 years old. I had/have every expectation of seeing her senior years....
 

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The treatment should be easier for a younger dog if she has no health issues. I think the treatment cost is a regional problem. I live in the north where heartworm is virtually not seen. I got a southern dog 18 months ago and started doing research because there was a chance he would need treatment. (Thankfully, he did not!) My own vet has seen and treated only two heartworm cases in his career. He quoted me $900 and it was the lowest quote I got.

Compare that to between $250-$400 in the southern U.S. I think vets there get more cases, are more used to treating and therefore have more reasonable prices. I certainly do not think it is the cost of the drugs.

dd
 

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Caoimhe = Kee-va

Feidhlimidh = Fell-im

Yes, I like gaelic names for my black lab mixes - (Bonnie, Bram and Duncan). I was going to change "Sam I Am's" name when I adopted him, but it really fit him, so Sam he has remained.
 

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I would use a vet that has experience with HW treatment. Many fancy vets that charge a fortune have seen very few cases in their career, partly because they scare away clients with the costs. There are very few vets in my area that have a lot of experience with treatments and they tend to charge much less than those who have none.
 

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Discussion Starter #13
I decided to treat with my vet. It's costing me an arm and a leg (I had that tax refund for three short days,) but the peace of mind is worth it. The low cost clinic "misplaced" my entire litter (4 foster pups) once, and gave me someone else's discharge instructions another time. Much as I'd like to keep some of that refund, I can't trust them with heartworm.

Her labs were good, but her rad showed heart damage, so my vet recommended immiticide.

She's there now, getting her first injection tonight. We'll follow up with 2 injections in a month.

My next question--restriction of activity. How in the world am I going to keep her calm for 2 months??!! In the 3 months that I've had her, she has never eliminated while on a leash. Our yard is huge and it backs up to several hundred acres of woods. She sees it as her prime responsibility to chase away the neighborhood raccoons. Obviously, I'll go out with her & we'll work intensively on recall...hey, maybe I should try a long line in the yard....

I am open to suggestions!
 

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It is imperative that your pup is kept very quiet. My dogs were crated and only walked outside on a leash to go to the bathroom.

As heartworms die, they break up and are gradually reabsorbed by the body. The main complication of heartworm treatment is pulmonary thromboembolism where the pulmonary arterial blood flow is reduced by worms blocking the arteries. The risk if your dog is active, is that large numbers of dead worms could break away at one time and lodge in the lungs. This can cause coughing, coughing up blood and even sudden death.

Wishing you the best
 

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What Joanne said is absolutely right. My vet told me people would think they could allow a dog offlead, or even onlead movement more than a walking pace (and not saying to actually go on walks-no) and they'd be calling in less than 10 minutes because the dog had collapsed. It is scary stuff and deadly serious to keep the dog quiet.
 

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Thanks for the warning.

My vet said basically the same thing--strict crate rest. He shared a scary story.

The good news is, she will go potty on lead. I guess the need just hasn't been great enough until now.

It's going to be a long two months for my sad Elly
 
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