# 2 rescues - heart worm help please!



## JJDBike (Dec 11, 2003)

Hello
I posted this in the health forum also. I'm hopping for some good advice. I'm really worried.
I have two newly adopted "falied fosters". They are of course wonderful but have issues. The female, approximatly 5, is submissive, timid and physically frail. She was starved and physically abused. She is working through various health issues as she is trying to gain weight, strenght and confidance. She currently has pnumonia. The male is younger at about two. Although he was thin and had skin problems and infected ears, is sturdy, assertive/dominant and active. He is so bright and has so much potential. The heart breaker is he has heart worm w/ signs of adult worms present. He is so active that the suggested two months will be absolute torture for him and everyone around him.
He needs love, training and a job to do. I have read so many differeing opinions on heart worm treatment. I am looking for advice on how to best get him through this with out making him feel like he is back in a kennle, breaking his spirit and still progressing on his training. Any treatment advice is also appreciated. What would you do and how would you do it?
Thanks


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## Spiritsmam (Nov 10, 2007)

Hi

Thanks for all you are doing for your "foster failures". Unfortunately I have all too much experience with heartworm disease. I adopt seniors/special needs and have / have had 6 heartworm positive dogs. Of these one had caval syndrome when I picked her up and passed away 12 hours later, 1 died during treatment, two were untreatable, 1 was successfully treated and one is currently being treated.

What I have learned is that it is important to get labwork, radiographs and, if possible, an echocardiogram. For two of my guys, labwork and rads looked ok, but the echo showed heart damage and pulmonary hypertension. In both cases the cardiologists said treating would likely result in the dog dying - so we did a slow kill (Heartgard) instead. Both dogs died later of unrelated diseases. Several years ago my Duncan was successfully treated, pretreating with Heartgard and using a 3 injection protocol, 1 followed by 2 a month later.

Currently I have Brigh, a 12 year old Lab mix that I adopted in January. Her labwork was good, but thoracic radiographs showed a pattern indicative of inflammation. Adult worms were seen in her heart on the echocardiogram, but the heart itself was ok. She was started on Heartgard and Doxycycline for a month before we gave the first injection. Brigh had a few complications (coughing and dyspnea), so her second treatment was postponed. She has thus far had 2 rechecks and only now is felt well enough to have the second and third injections (next Wednesday and Thursday).

Would I always aim to treat heartworms - yes. Would I do so if there was a significant chance of the dog dying - no, I'd use Heartgard as a slow kill method. Does your vet have much experience with heartworm disease? What are their recommendations?

As for keeping them quiet - it's vitally important - I have crated both dogs undergoing treatment. As the worms die and break up they migrate to the lung where they are absorbed into the body. During this time there is a significant risk of complications due to pulmonary thromboembolisms. 

Wishing you the best


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## pupresq (Dec 2, 2005)

I know keeping a young and energetic dog quiet for 2 months is hard and unpleasent for everyone, but I think it's definitely worth doing. The alternative could greatly shorten his life. You can have him assessed via x-ray and condition for the slow kill method - a combination of Heartguard and doxyclycline but either way he's going to need to take it easy for a while. I would definitely start some kind of treatment ASAP. We have treated MANY young energetic dogs like him with the 3 injection protocol: First they get heartguard and a course of doxy which kills any circulating microfilaria, weakens the adult heartworms, and reduces the chance of inflamation. Then they get a single injection. They are kept quiet for a month. They then get two more injections and another month of quiet, and then in 99% of cases you're done!







We have had good success with this protocol even in older and more debilitated dogs. I like the slow kill Heatguard/Doxy protocol also, it just depends on the dog. There is a lot of good info on Cornell's website about both protocols. Either way, the longer those worms are sitting in his heart the more damage they're doing. They need to be killed ASAP so that his heart can heal and he can get on with the rest of his hopefully long and happy life. Two months of inactivity feels like an eternity but it will be over before you know it and then you can get on with all the fun things he hasn't gotten to do yet. And since your other pup is under the weather too, it might be just as well to go on and get it over with so that you're not waiting until she's up and running around more which is going to make keeping him calm that much tougher.


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## JJDBike (Dec 11, 2003)

Thanks for all of the great info.
My next step is to have his chest x-rayed. 
I did look up the Cornell site.
I have some more questions before I speak w/ the vet. Honestly, I don't know how much the rescues vet hospital knows about treating heartworm & not sure they will admit it if they aren't experts. Other than testing positive for adult heartworm, he has no symptoms. He's young and otherwise healthy.
My questions are:
1st. What are the pros and cons of slolw kill (i.e., doxy & heart guard then arsnic a month latter) vs the arsnic 1st?
2nd. Seeing he's young & healthy, depending on what the x-ray shows, exactly how quiet do I need to keep him? Are short indoor training sessions w/ basic come, sit, down ok? Can I let him out for mellow family cuddle time at night? As long as I don't let him get wound up & keep him on a leash, can he sniff around in the yard?
3rd. How do I know if he should get an EKG?
Looking foward to the answers (well, kind of).
Thanks so very much!
JD


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## Spiritsmam (Nov 10, 2007)

I live in NC where we see a lot of heartworm +ve dogs. As a result, the local vets here deal with heartworms on a regular basis. If your vet has less experience and you have the money I would consider going to a cardiologist.

The slow kill just kills off the microfilaria ("baby" heartworms"), leaving the adults in the pulmonary arteries and sometimes the heart. These worms eventually die, but it can take several years, during which time they cause damage to the vessels and heart. For this reason, treating with immiticide is the preferred route as it kills the adult worms. You definitely want to pretreat with Heartgard (NOT interceptor) and Doxycycline. Thge Heartgard starts killing the microfilaria and the Doxycycline kills Wolbachia. Wolbachia are bacteris that live inside the heartworm and can exacerbate the adverse effects seen during heartworm treatment (e.g. embolisms and allergic reactions). By giving Doxycycline for a couple of weeks prior to treatment you kill off any Wolbachia and weaken the heartworm, making it unable to reproduce and be more susceptible to the Immiticide

You need to keep your pup as quiet as possible. My guys are/were allowed out of their crates just to urinate/defecate (on leash). You don't want to do anything that will cause stress, increased heart rate/respiratory rate etc. so I personally wouldn't do any training. If he would just lie and rest outside of the crate that should be ok.

It's not an EKG that is needed but an echocardiogram. The echo enables a cardiologist to look at the structure of the heart, its valves, blood flow, turbulence etc. After my experiences I now would never treat a dog for heartworms without first doing an echo. As I mentioned it was the echo that found heart damage on two of my dogs which excluded heartworm treatment as an option.


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## JJDBike (Dec 11, 2003)

Thanks for those answers.
I appreciate it.
JD


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## CampPappy (Sep 10, 2007)

WOW! What a wealth of information! Some of us up here in the north know very little about hearworm and treatment. I told Jim that the Forum members from the south would have a lot of tips. I know I've learned a lot and will be printing out this info!!!


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## JeanKBBMMMAAN (May 11, 2005)

Heartworm Society Site:
http://www.heartwormsociety.org/

Pet owner info:
http://www.heartwormsociety.org/article_1143.html

Vet tx info:
http://www.heartwormsociety.org/article_48.html

Some stuff from them but posted on Foster/Smith site-more on prevention and I thought it was interesting:
http://www.peteducation.com/article.cfm?c=0+1275+2032&aid=3414

I like this and the caveat:
http://www.houstonsheltiesanctuary.com/heartworm_treatment_aftercare.htm

One thing I worry about is that using the Ivermectin treatment (which is a great tx) and catching a dog with the MDR1 mutation...anyone have comments on that?


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## Kay13411 (Jul 24, 2003)

Here is a link to the treatment that I tried on my first HW+ dog. She was a the time 3 to 4 years old.

http://www.banditsbuddies.com/treatment.shtml

I did this treatment for 6 months with her, and it did make a difference. The problem I was having was it took so long. So after 6 months and knowing the some of the adults had been killed off I did the traditional treatment. Don't know if this will help, but I though I would share anyway.


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## aspatter (Mar 8, 2005)

Any advise as to how to "ready" a dog for treatment. Male 1 1/2-2 years old. Skin and bones, no muscle. Very active. This is my first heartworm + experience.


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