# Heartworm meds



## Dugie (Jan 24, 2017)

Hi Everyone!
I'm new to the forum and would like to get an opinion on the different heartworm meds. My chocolate lab became heartworm positive on oral Heartgard. I have heard some pretty horrible stories about the injections and mixed opinions on the topical. I have a 16 week GSD and we live in South Louisiana so mosquitoes are a huge problem here. I welcome any opinions/experience/recommendations with the available options. Thanks!


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## Jax08 (Feb 13, 2009)

I use Interceptor Plus. Not in a high HW rate area though.


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## GypsyGhost (Dec 29, 2014)

Jax08 said:


> I use Interceptor Plus. Not in a high HW rate area though.


Same here.


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## MishkasMom (Aug 20, 2015)

We use Revolution, its a topical prevents ticks, fleas and heartworm. Had good luck with it so far


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## Magwart (Jul 8, 2012)

Hi, and welcome!

I'm in South Louisiana, and I rescue lots and lots of dogs who test heartworm-positive. I've spent hours reading peer-reviewed literature on the disease. We're in the center of a HW epidemic -- it's all around us, year round. There are break-through infections reportedly happening here (with dogs on prevention testing positive). I say that because I want you to recognize that you live in a special place where what works for northerners who have a real winter, low HW incidence in the natural population, and no ivermectin-resistant mosquitoes isn't what is likely to be best for _your _dog. You are in one of the most dangerous places in the United States for HW -- our infection rates top even Florida's.

The ONLY product I personally like for our area is Advantage Multi -- NOTHING ELSE. We beg adopters to keep our dogs on it when they adopt, and not switch to something else. We'd rather they use something else than nothing, but this is the gold standard product we ask them to please ask their vet to prescribe. I switched to it after I moved here because what was safe to use out West isn't the best protection for this area.

The reason I believe A-M is the best protection is that an Auburn University study on HW resistance a few years ago showed A-M is the only product that is still 100% effective against the new ivermectin-resistant strain that's emerging. Every other product had some incidence of failure. This is incredibly scary. The strain is still rare (they think), but no one really knows how fast or slowly it's spreading. Socialize with dog people down here, though, and you'll find some pretty easily who've experienced a break-through infection with a dog kept on prevention.

A-M works very differently from other products because it builds to a steady state in the blood serum after 3-4 months. This means it's killing the larvae constantly at that point, all month long. The other products work by killing whatever larvae built up for the past 30 days when you give the dose, and then the liver filters the drug out, to let the larvae build up again for the next 30 days -- so the drug's only in the dog for a day or so. If it fails to mop up all the larvae in that day or so, whatever survives can create the HW infection.

As a bonus, A-M's flea prevention is effective in our area. That makes it very cost-effective. From KV Supply, it runs about $14/month. 

The key is applying it correctly: separate the fur so it all goes on the skin (not the fur). The only major down-side is it stinks pretty badly and you have to keep them dry for a few days.

This interview helps explain the resistance thing:
Interview with a Heartworm Specialist: Part 2 | petMD

This may help too:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406940/
http://veterinarynews.dvm360.com/heartworm-preventive-efficacy-study-results-revealed-navc


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## Magwart (Jul 8, 2012)

This paper explains the steady-state phenomenon in killing HW larvae:
https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-016-1293-z


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## Jax08 (Feb 13, 2009)

@Magwart - do you also use a preventative to repel mosquito's?


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## eugenepi1025 (Apr 14, 2016)

I use nexgard+heartgard combination!


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## Dugie (Jan 24, 2017)

Thank you so much Magwart! That is exactly the information I needed. There are so many instances of heartworm here with dogs on preventative. This makes sense and I will start Roux on this with his March dose!


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## Dotbat215 (Aug 19, 2015)

Magwart said:


> Hi, and welcome!
> 
> I'm in South Louisiana, and I rescue lots and lots of dogs who test heartworm-positive. I've spent hours reading peer-reviewed literature on the disease. We're in the center of a HW epidemic -- it's all around us, year round. There are break-through infections reportedly happening here (with dogs on prevention testing positive). I say that because I want you to recognize that you live in a special place where what works for northerners who have a real winter, low HW incidence in the natural population, and no ivermectin-resistant mosquitoes isn't what is likely to be best for _your _dog. You are in one of the most dangerous places in the United States for HW -- our infection rates top even Florida's.
> [/URL]


Sadly, my area (Philly), has had two very mild winters back to back. Hoping it's not a trend. I'll be keeping your post in the back of my mind. Thanks!


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## lalabug (Oct 20, 2016)

@Magwart can we get A-M HW over counter at local pet store or do we need to get it from vet?


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## Magwart (Jul 8, 2012)

All canine HW prevention in the United States requires a vet RX (including Advantage Multi). Most vets give a 12-month RX at the annual wellness check-up, or they allow you to have your preferred online pharmacy fax them a prescription request for you. 

For anyone in LA, if money's tight when it comes time to re-up your HW prevention meds, in NOLA the LA-SPCA does this sort of wellness stuff at their community clinic -- their exam fee is $25 plus a few dollars more for the HW test. In BR, the Spay Spa would be the place for a $28 exam plus a $15 HW test. These are public rates posted on their websites (not rescue discounts). I'm very sure the Spay Spa would give a written RX that could be filled online, and I think SPCA surely would too.

KVsupply.com has the best prices I've been able to find online -- they're Vet-VIPPS accredited (which means they're a reputable, licensed pharmacy selling FDA-approved, legitimate meds.) Some vets I know in rural areas even sell it by the single tube to help their fixed-income clients who can't afford a 6-pack -- folks just come into the clinic every month on their pay-day and buy one tube to keep the dog on prevention until the next month. Whatever works.


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