Heartworms! Best way to treat them?

Question

We just found out that our 4 yr. old lab has heartworms. I have researched & found that there are basically two options. 1-Open heart surgery & 2- Dangerous shots that kill the worms and very likely our dog. Her vet says, to put her on Heartgard. It'll kill the baby worms and she'll just have to outlive the adult worms (which live up to 2 yrs.). Money isn't a factor. We love our dog and want to do what's best for her. Any suggestions? Thanks in advance.

Answer 1

Hi Char. It is true that treatment of heartworm does carry some risks, but unless your dog is showing severe signs of disease she should cope with the treatment reasonably well.

Was the infection only diagnosed because she had a heartworm test done, or is she showing clinical signs of infection (coughing, difficulty breathing, etc.)? Also, has your vet done any further tests such as chest x-ray? This can give valuable information as to how badly the heart has been affected, and whether there are any secondary changes in the lungs.

If she has no signs at all (subclinical heartworm disease), or is only showing fairly minor signs (slight-moderate HWD), her prognosis with treatment should be pretty good.

If she has no signs at all, she can be given the drug that kills the adult worms (called melarsomine) straightaway (2 injections 24 hours apart), but then must be given STRICT REST for 2-4 weeks after treatment. 4 weeks after the first treatment, the vet can give a second drug to kill the juvenile worms (ivermectin or milbemycin) in the blood. These drugs are much safer than those used in the past- they also cause very little irritation if given by deep intramuscular injection.

If she is showing some signs of infection, treatment becomes a little more risky, but she should still have a good prognosis. She first has to be rested for 2-4 weeks and most vets will also give aspirin during this time. After 2-4 weeks of rest, the vet can give the melarsomine, and again strict rest is required. During this time, a dog may also need to be treated with cortisone if it has any respiratory problems. Again, 2-4 weeks after this, the ivermectin/milbemycin can be given.

By far, the biggest issue with this treatment is that people do not rest their dogs properly. Strict rest means that they MUST be confined to a single small room, or cage, in the house, and only go outside on a lead to go to the toilet. I actually had a discussion with my cardiology lecturer about this a few months ago- his feeling is that (with the exception of those with very severe disease) very few dogs would die during treatment if strictly confined. The use of aspirin during treatment also helps reduce the risk.

I hope that that helps you to come make up your mind, and that she does well regardless of the course you choose.

Answer 2

Re: Heartworms

I work at a veterinary clinic and the only to get rid of heartworms once your dog has them is to do the shots. Some veterinarians provide the shots in half treatments if you are concerned on how your dog will take it. The dog's overall health and age is a factor as well as the level of infestation. I have seen dogs brought in that are given Heartguard to kill the baby worms, but the adult worms can live as long as eight years. Trust me, it is horrible to watch a dog die from heartworms. Their abdomen swells up signaling congestive heart failure. After that, there is a window of 24 to 48 hours in which the dog has left to live. We had a dog dropped at the clinic with severe heartworms which went untreated and the staff watched what happened and had to dispose of her. It is not pretty. Since your lab is young and you are obviously very concerned with her health I would go the half treatment route. What that is is the vet administers a half dose and the dog stays at the clinic fro one day for observation and is allowed to go home. What might be difficult for you is the dog should not run or have an increased heartrate for an entire month whether kept in a kennel or kept in the house. She should not even run around the house. This is done because when the worms die, they travel through the vessel in the heart and are deposited in the lungs where they cause no harm. If your dog has an increased heart rate then the more blood is pumped which in turn pumps more worms. If the vessels cannot handle the number of worms then that is when congestive heart failure occurs. After a month, the second dose is given and the dog is kept for a couple of days for observation and the same for the month afterwards. After a month, the dog is brought back in for a check up and is put back on heartworm medication. Depending on where you live, it is best to do the treatment when the weather is cool. It is easier on the dog. Your vet may also suggest blood work before giving the doses just to make sure there are no hidden infections that could compromise the medicine.

Answer 3

It depends how bad the infestation is. If it were my dog and the infestation was minimal, I would go the Heartgard route. This kills the baby worms. The adults will eventually die of old age. If the infestation is more serious, you have to get them out of there more quickly. If there is imminent danger, surgery may have the best chance of saving your dog. If not, the standard course of treatment might be best. Since money is not an issue, I would go with the longer treatment where they give one injection, then two injections 24 hours apart in a few weeks. That entails one extra (painful) injection, but it is gentler on the dog's systems as it doesn't kill all the worms all at once. I had a foster dog treated this way. He was a 7 year old greyhound with a pretty bad case of heartworms as well as hookworms, whip worms, malnutrition and severe gum disease. He pulled through just fine. The new medications are not as dangerous as they used to be, but you MUST keep the dog from running or getting excited (not easy with a lab) during the treatment, which is something else to consider when deciding which route to take. Discuss all your fears and concerns with a trusted vet and decide together. Whichever way you go, PLEASE keep your dog on year-round preventative afterward.

Good luck with your baby.

Answer 4

I am so sorry this happened to your dog! The severity of the disease will make your decision for you. Go back to your vet and get the prognosis for all three of the things you mentioned. Ask him/her to be completely honest with you. You will then need to weigh the choices and pick one, because you have to.
The only information I can offer you is I had a dog who was diagnosed with late stage 2 heartworm. My vet told us that we should have the pesticide injections and keep her quiet for four weeks. Everyone I know with dogs who had experience with this said it was really no big deal-my dog was young (1 1/2 years old) and healthy and she should be fine.
No one took into account that she was a Katrina dog and her stress level from her ordeal was very high. She died of a massive stroke three days after the injections. My vet was shocked-he never expected it, and felt guilty for not doing more research first, although it really wasn't his fault. In retrospect, I would have opted for the heartworm tablets that kill the baby worms and sterilize the adults. It was not offered to me because there was no question that my dog would survive. I wish I had known about that idea back then. Can't change that now, but I can share my experience with you.

Since then I have been very cautious about radical treatments on my animals. I ask tons of questions about what may happen and try to make the most informed decision I can. My vet is great at helping me with this.

I wish you and your dog the very best, and I know you will make the right decision-you obviously love her very much. She will be in my prayers.

Answer 5

A heartworm preventative (Heartgard) is just that. It prevents heartworm. It does NOT treat an active infestation.

A dog with heartworm needs to be on a treatment regimen administered and overseen by a vet. It is costly, lengthy, and not always successful. Yes, the dog might die. But the dog certainly WILL die without treatment.

I honestly don't know why your vet would recommend a preventative for an established infestation. In your situation, quite frankly, I'd be looking for a new vet.

I'm sorry I can't be of more help, and I wish I could be. Best advice I can give you is to seek another vet's opinion for treatment options. It IS treatable, and it can be and has been cured. If you can afford it and you're committed to treatment for the long haul, please find a vet who is willing to give you another opinion, at the very least. Best of Luck with your dog.

Answer 6

I would talk with my vet again about how bad the infestation is . If there is only the slight beginning of babies and very few adults, Heartgard can cure the problem. I have been a vet. tech. and know this treatment is used if the problem is minor.

But please do talk with your vet again as soon as possible. If money is not a problem he may suggest the shots.

If you are still not comfortable, consult another vet. Your vet must be a caring Dr. , a lot would recommend shots in the beginning as it is very expensive.

But again, I AM NOT A VET. Please talk with yours again.

Answer 7

Number 1 Vet recommended remedy is Heartguard.

Answer 8

i give my dogs advantage multi. it gets rid of all worms, and fleas. great stuff