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Discussion Starter #1
Hoping to get some help with a gorgeous GSD that I'm considering adopting. Here's the bullet - I've been fostering a 3yo female for 1 month, weighed 51 lbs at intake, now 57 lbs. HW+. Rescue has her on slow kill with Ivermectin .5 ml every 2 wks. Finished 30 days of doxy. Good energy, no cough, choking or vomiting. Two questions:
1. At rest, occasionally I see rapid breathing - concern?
2. She is desperate to chase squirrels seen from the screened lanai. Does her activity have to be restricted to the same level as the fast kill?
 

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Welcome and congratulations on your failure. If you are going to fail at something - fostering is the best.

Is there a reason the rescue chose to go with the slow kill method? I adopted a pup from the south. He came complete with heartworms. My vet is using the American Heartworm Society protocol. I prefer this to the slow method, but I understand that there may be a reason it is not right for your girl. My pup's treatment started in March. He was on Doxy and Prednisone for a month. He had his first HW treatment in April. Tomorrow he gets his second treatment. On Tuesday, he gets his last treatment.

He sailed through the first treatment beautifully. I try to keep him calm, but it is hard. He goes out to potty on a leash. I put a tie out in the yard, so he can lie in the sun and spend time with me outside. I do not allow him to run around. I had read that increased activity causes HW+ dogs to get sick faster.

Obviously, I do not have the experience with HW that many members have. Rescue people deal with this all the time. Below is a link to the blog that Jean sent to me. (Thank you Jean.) It is very helpful and informative.

Big Dogs, Big Heartworm
 

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American Heartworm Society | Canine Guidelines

Here is the American Heartworm Society treatment protocol. You can check the slow kill method under the "Alternative" methods. It notes that this method may take more than two years and rigid exercise restrictions are required throughout treatment.

So, sadly, yes - your girl will need to be restricted the same as the fast kill method.
 

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First, if you want to do the "slow kill" method, please look into using Advantage Multi instead of Ivermectin. Here in Louisiana, local vets are reporting to me that they are seeing dogs test HW free in 6 months on the Advantage Multi, with a course of Doxy (which you've already done). By contrast, I've heard here it often 18 months with ivermectin -- that's a huge difference.

Second, I understand why rescues and adopters prefer slow-kill. It's much, much cheaper. While I think "fast kill" with immiticide is preferable (whether the full 3-shot protocol recommended by the AHS, or the alternative 2-shot protocol that's also widely used), it's better to do slow kill than not treat at all. Sometimes with health-compromised dogs, slow-kill may be easier on the system too. No judgments on this from me on this -- I've had adopters who have wanted to go this route (with the Advantage Multi), and the dogs did fine.

If you do want to investigate the "fast kill" option with immiticide, here's some info to help. I've heard that the wholesale cost of immiticide (the "fast kill" drug) is about $40/vial to the vet's office -- if the rescue can work out with the vet office they are partnered with to buy it "at cost" through that vet, and have the vet donate the time to do the injections, the fast-kill method can be very affordable. I know of a few local rescues that have worked out a deal like that with at local vet. Then they treat a bunch of their dogs at once (immiticide only "keeps" for about 24 hours once opened, so they have to plan out the weight of the dogs for the number of vials the rescue purchased so that none is wasted).

Finally, no matter what method you use, you should restrict exercise until the worms are cleared. The more she runs and plays, the faster the worms damage the organs and spread, and the more harm they do. Exertion makes HW disease get worse faster.

ETA: there could be a lot of reasons for the rapid breathing. HW disease could be one possible reason (but isn't necessarily the only one). Does she occasionally have a hacking cough, like she's trying to cough up something, briefly? Has your vet listened to her heart and lungs with a stethoscope? Did you get blood work from the spay? The vet needs to be keeping a close eye on the progression of the disease, and the dog should be carefully examined before anyone makes a decision that these worms should be allowed to persist for another 18 months in this dog's body. If she's beyond Stage 1, then I think you really ought to have a conversation with the vet about fast-kill. If it's not financially feasible, there are ways of cutting the cost on it -- let me know and I can explain.
 

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I agree with Magwart completely. Bless the rescues for doing HW treatment. It can be so expensive. Often, they get no break on the cost and this is NOT passed on to the adopter. There may very well be a reason, cost or health related for opting for the slow kill method. Absolutely no judgement for the rescue's decision.

Personally, I wanted to be rid of the darned things. My pup is just under a year now. I want him to be able to play and enjoy life. The sooner he is well, the sooner he can get back to normal.

Below is a breakdown for Boh's first HW treatment cost. I am in Maryland. I understand that the cost may differ, depending on location.

The first treatment was on April 18th. The total was $207.70. Here is the breakdown:

Recheck $34.00
Hospital 21-50 lbs $29.00
Torbutrol $6.00
Pain inj. admin. $27.00
Immiticide $76.00
Tramadol (20) $9.50
Vetprofen (7) $16.70
Methocarbamol (10) $9.50

She gave me enough meds. (pain and muscle relaxers) to cover the next two treatments.
 

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Discussion Starter #7
Thank you everyone for your responses. The rescue's reasoning for using the slow kill method is two-fold which you have brought up:
-cost
-how difficult the shots and fast kill treatment is on the dog and that the Immiticide is arsenic-based.

After discussing with my vet, he is willing to cut the rescue a major price break on the cost. He is very aware that rescues are cash-deprived and he has grants to pay for Immiticide, grouping dogs according to weight to maximize on his supply. So cost shouldn't be an issue. Heck, I'd pay for the treatment myself. However, the rescue hasn't been responsive at all to the vet's attempts to discuss this. I have a strong suspicion that the rescue will be just as resistant to my recommendation for the fast kill tx.

If I adopt and proceed with the fast kill, I realize that the dog's activity will be really restricted to try to avoid emboli - God forbid. How do you put a lid on an active girl for months at a time especially when I'm away from home 8 hrs/day?

The dog is a joy - could use a little training to get along with my senior GSD and the kitties better but I think I want to keep her. She's become my baby and she deserves a long, healthy life.

Thank you for your help!!:help:
 

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Discussion Starter #8
Magwart, I've never heard her cough. The vet did listen to her heart and lungs with a stethoscope. She hasn't been spayed because she had an URI and the vet advised against spaying with HW d/t potential anesthesia complications.
 

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She'll feel lousy enough the first week that she won't feel like running. For the next three weeks, you just have to keep her on a leash inside if she's prone to playing "zoomie" through the house, and definitely on a leash outside, even in the back yard.

One person I know takes the dog for car rides during HW treatment -- the dog loves it, and it doesn't require any exertion. I think that's a great idea! With the fast kill method, the most intense exertion-restriction is the first 30-days. That goes by quickly.

While you are at work, either crate the dogs, or put them up separately in the house (I use a large master bathroom for a dog that cannot be crated). Give them a kong stuffed with good treats, and they should be fine. The only hiccup in this is if the vet prescribes prednisone (sometimes they do, sometimes they don't) as part of the treatment. That has a side effect in many dogs of causing them to drink a lot, and then pee a lot (and dogs who are perfectly housetrained sometimes have accidents while on pred -- they just can't hold it).

I've taken two dogs this year through HW treatment (one with the 2-shot protocol, as she had a very light load and very young; another older dog with the 3-shot protocol). Both came through it beautifully, and relatively easily -- the exercise restriction was harder on them than the treatment, as they really wanted to play "zoomie" together. It was worth it to get it over with so that they could start enjoying life!

If you adopt the dog, can you then make your own decision to do the fast-kill treatment?
 

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I have treated many dogs with the fast kill, some vets in the Northeast charge an arm and a leg for it (i received $1200 estimates). It is good because the worms die more quickly, but it is also more risky if the dog has a reaction to the immiticide. Unfortunately I lost one to the immiticide treatment, two weeks after the injection. He started bleeding internally and from the lungs. I heard of other dogs having a similar reaction. In rescue keeping the dog for a year for the slow kill treatment is not really an option. If the Advantage multi works that well, it is an excellent alternative and I personally would consider it (especially if time is not an issue, like in rescue) after having had a really nice dog die in my arms. Recently there were serious problems with the immiticide supply, and often the fast kill was not available because of the lack of immiticide.
In the past the slow kill was also used for active dogs that were not candidates to be kept still for 1-2 months. They were allowed normal activity, although limiting activity is probably better. I have not heard of dogs dying from the slow kill.
 

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My dog is less than a year old, light HW load and otherwise healthy. My vet was going to opt for the 2 shot treatment, however the American HW Society calls for three shots, regardless of HW load. I was fine with that. Just so they are dead in the end. I do understand that sometimes 2 shots are used, instead of three.

Magwart is right about the Prednisone. My pup had accidents while on the twice a day doses. After that, he was fine. I was home with him, so could take him out frequently, or clean it up. If you aren't home, put newspaper down and keep you girl in a confined area.

"Natty Boh" really did great after his first treatment. He did not seem to be in any pain. He came home with muscle relaxers and pain meds. I only gave them to him for a few days. Restriction is not as bad as you might think. We bought lots of antlers - moose antlers. They keep him busy and quiet for a LONG time. Crate her or confine her space.

I realize the Immiticide treatments are not fun for the dog, but neither are the heartworms. If I were you, I would consider adopting her and going ahead with the treatment. Until Natty Boh, other than driving rescue dogs to and from treatment, I did not have to care for them during recovery. I know that some of the rescue dogs were in sad shape - like the small dog who was pregnant and HW+. The vet was willing to go ahead and spay her and she was treated with the Immiticide. She did great.

I wish you the best, whatever you decide. I'd be happy to update you on Natty Boh's progress tomorrow and Tuesday.
 

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The prednisone is critical with dogs that have advanced disease. I did many treatments before doxy became popular, without problems. I am not sure how useful it is, it probably won't do any harm.

Reactions to the immiticide are rare , but are life-threatening. The dog I lost was 2 years old and we felt he should have sailed through the treatment.
 

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The prednisone is critical with dogs that have advanced disease. I did many treatments before doxy became popular, without problems. I am not sure how useful it is, it probably won't do any harm.

Reactions to the immiticide are rare , but are life-threatening. The dog I lost was 2 years old and we felt he should have sailed through the treatment.
I was hoping you would chime in. I know you have had a ton of experience with this.
 

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Discussion Starter #14
I've just about decided to have the dog re-tested since I have no idea what her load is, then discuss all of the info that you've graciously provided with the vet including the use of the Advantage Multi. Plus, I'm becoming more concerned with the rapid breathing at rest. She has a great appetite although a bit picky. Have you found a healthy kibble that is irresisitible to GSDs?

I'll cover the cost of the tests - once the results come in, I'll make a decision about adoption. And yes, once I adopt her, I can make all decisions about her.
 

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Discussion Starter #15
My dog is less than a year old, light HW load and otherwise healthy. My vet was going to opt for the 2 shot treatment, however the American HW Society calls for three shots, regardless of HW load. I was fine with that. Just so they are dead in the end. I do understand that sometimes 2 shots are used, instead of three.

Magwart is right about the Prednisone. My pup had accidents while on the twice a day doses. After that, he was fine. I was home with him, so could take him out frequently, or clean it up. If you aren't home, put newspaper down and keep you girl in a confined area.

"Natty Boh" really did great after his first treatment. He did not seem to be in any pain. He came home with muscle relaxers and pain meds. I only gave them to him for a few days. Restriction is not as bad as you might think. We bought lots of antlers - moose antlers. They keep him busy and quiet for a LONG time. Crate her or confine her space.

I realize the Immiticide treatments are not fun for the dog, but neither are the heartworms. If I were you, I would consider adopting her and going ahead with the treatment. Until Natty Boh, other than driving rescue dogs to and from treatment, I did not have to care for them during recovery. I know that some of the rescue dogs were in sad shape - like the small dog who was pregnant and HW+. The vet was willing to go ahead and spay her and she was treated with the Immiticide. She did great.

I wish you the best, whatever you decide. I'd be happy to update you on Natty Boh's progress tomorrow and Tuesday.
Please keep me up to date on Natty Boh's progress.
 

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I've just about decided to have the dog re-tested since I have no idea what her load is, then discuss all of the info that you've graciously provided with the vet including the use of the Advantage Multi. Plus, I'm becoming more concerned with the rapid breathing at rest. She has a great appetite although a bit picky. Have you found a healthy kibble that is irresisitible to GSDs?

I'll cover the cost of the tests - once the results come in, I'll make a decision about adoption. And yes, once I adopt her, I can make all decisions about her.
Was she staged at all?

X-rays, urinalysis, etc? (it's in the blog and I can't remember the list)

That is really important.

She definitely needs to be kept quiet. Here is how my vet explained it - our body systems (any - animal, human, whatever) are set up to react to something on a cellular system as it goes through our veins - so something as small as a cell can create huge reactions in our systems. When hunks of dead worm are floating through those veins...it is just not normal, and so of course all dogs are going to throw clots, just most of them are small enough to not be noticed.

Anyway, the dogs are dealing with a lot, no matter how HW is being treated - and the only alternative to treatment is to let them slowly die. Which of course no one would knowingly do, I would hope!

The slow kill method works, but the whole time, the worms are doing damage both alive and dead.

The 3 shot AHS recommendations are the ones that seem to work best in a home environment.

Lucky dog - even if you don't keep her because of your older dog - she's got someone looking out for her.
 

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I don't think the test are able to quantify the load. There is no formal evidence that measuring the time of color change and evaluating the color of the test strip can reliably determine the load - although veterinarians who deal with it frequently do this.

Interesting that the dog I lost to heartworm treatment had everything done by the book, bloodwork, x-rays, doxycycline, steroid pretreatment and he was a young dog. Treated with three injections.

Others, even old dogs, some not in great shape did well without x-rays and without doxy (before the doxy pre-treatment became propular) with two injections, go figure. It is interesting that none of the dogs treated had visible consequences from heartworm. Most are alive, those that died, died of unrelated causes, such as cancer. Some of them were running around with heartworm for quite a few years.

It is important to treat heartworm. Those who can afford the whole nine yards, it is great and the safest. But the other treatments work as well, and it is important to give the dog a chance. Many dogs will die because potential owners are scared away by the costs and the long term consequences - some veterinarians tend to give owners the gravest scenario. Especially in the south, many dogs are treated with the slow kill method which is the least expensive, and live a long happy life.
 

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Discussion Starter #18 (Edited)
I just looked at the adoption contract - it has all sorts of provisions prohibiting the adoptive owner from all sorts of things including euthanizing the dog without the rescue's permission, implementing the fast kill HW tx and requiring the owner to notify the rescue in the event that the owner moves! Is this legal??:shocked:
 

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It is common, intended to protect the dog. Rescues don't want their dogs euthanized when the new owners gets tired of it or encounters a behavior issue. As to moving, they try to provide long-term support for the dog, in case something happens to the family. What does the heartworm treatment clause say?
 

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"Where applicable, the Adopter understands and by signing this agreement acknowledged that Adopter has been informed that this particular dog is heartworm positive. Adopter further understands that HLDR does not use the
conventional Immiticide treatment,"instead, a regimen of Doxycycline and Ivermectin 1%is utilized. This not only kills the larvae (microfilaria) but will start killing adult heartworms and the dog should be heartworm free in approximately less than one year. Adopter will be given full information concerning the implementation of this method learned from vets. This also keeps the blood vessels clear so that they do not become clogged. Adopter agrees to continue this treatment and confirms by executing this agreement, that Adopter will not put the dog through the Immiticide treatment."


I understand what the rescue is trying to do but if the dog becomes terminally ill, the decision to euthanize should be between the owner and the vet. I'm not about to wait for the rescue to give their permission if the dog is suffering! It's difficult enough to contact them as it is!
 
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