I need some information about heart worm treatment for dogs..?

Question

Iam going to take over my mom's friend dog since he is moving and he cannot afford her anymore. She has heart worms and I heard that it's painful for the dog to go through heart worm treatment and they have to be kept inside in a cool area, no noise's. How long is this treatment go on for? and Is there a chance that the dog will not make it while being treated? I don't know too much about this, I keep my dogs healthy and buy the preventive. I know it's costly and Iam willing to do the treatment because she is a very sweet dog and she deserves another chance..so please give me some input on this and if anyone has gone through this kind of treatment please tell me what happens and does any medical issue's pop up after. Will her heart return to normal or will it be slightly scared and have some difficulties. Thankyou

Answer 1

Some patients are very tired and sleep a lot for two to four days; some have temporary difficulty getting up because of the muscle soreness. Though some dogs do not experience the muscle soreness, it is particularly important not to pick up the dog or put any pressure on the back for 2-4 days after the injections. Even a gentle dog might cry out and snap in pain if that area is touched. You will know the dog is feeling better when the eyes brighten, tail wags, and the dog resumes interest in the caretaker and home activities, usually in just a few days. Let the dog sleep in a crate or on a preferred doggy bed or blanket, wherever she is most comfortable, while you watch her and  keep her quiet; some dogs think they’re feeling well and may even want to play, but it is imperative that  no heartworm patient exercise during the recovery period. The dog may not run, play, or go for walks during the four-week period. Even after heartworm treatment is successfully completed, the patient should not go for long walks or engage in strenuous play for another month: each patient should be allowed to gradually build his or her strength. Go out in the yard with him to make sure he doesn’t run but just eliminates and comes back in. If he wants to run or chase squirrels in the yard, then take him out on a leash. The most important observations are the following: (1) Keep an eye on the gums; they should be pink. If they get very red or white, along with listlessness, call us and take the dog to the vet: the dog may have a secondary infection (red gums) or anemia/shock (white gums) and need quick intervention (2) Pay close attention to combination of lethargy, increased respiration, restlessness, and coughing; if you note these symptoms after treatment, call us and take the dog to the clinic. She will probably be put on Prednisone and will respond quickly (3) Watch for vomiting or any bloody discharge combined with listlessness, fever, rapid breathing/heart rate, and pale gums. Although extremely rare, also watch for hindquarter paralysis and urinary incontinence. With the symptoms in (3), which are life-threatening, the dog goes immediately to the nearest HSS Clinic because the signs point to embolism (worm clot from the die-off of the parasites during treatment); the doctors will keep her overnight, possibly a couple of days or even a week, put her on IV to hydrate her, sometimes oxygen if she's in distress, and give her cortisone injections to break up the clot. If hindquarter paralysis, which we have only seen twice and seems to be caused by muscular 'grip' or possible embolism pressing on the nerves, the doctors will treat with injections of corticosteroids and antibiotics. In both of our cases, the paralysis eased within a few days, and the dogs fully recovered. We will assist with all decisions for treatments in the clinics and cover the medical expenses.

The above warning signs are the most serious to watch for and are rare in our experience. Most HW+ dogs do go through a certain amount of coughing and/or gagging reflex which could start at any time, but some patients rarely cough at all. The worms are dying and dissolving, being passed through the bloodstream and lungs; the dog has to cough up the resultant phlegm – not the same as real vomiting which you’d recognize. If coughing starts, call us and the clinic; they will want to listen to his heart and lungs and may want to put the dog on cortisone. The coughing/gagging is alarming for the caretaker; even more so for the dog: pet him if he wants it; talk to him to let him know he’s loved and secure. However, if the coughing/gagging reflex seems heavy and uncontrollable, causing the dog distress, call the vet and us as he may be starting an embolism. Again, this is rare in our experience, and we do expect some coughing/gagging a few times a day or a few times a week for a couple of weeks; then it gradually subsides as he improves.

Even after treatment and health clearance, in rare cases some former heartworm patients can still test positive for the heartworm antigen for four to six months after treatment, which is why the dog should be re-tested in four months and again six months later while being kept on the monthly preventative. This does not necessarily mean the dog still has heartworms and must go through the treatment again but that it is taking longer for the antigens to leave his system; however, in rare cases, the treatment may not have killed all the worms, and the doctors must make a case-by-case decision about re-treating the dog. Thus we want to monitor every heartworm patient a full year after the treatment and then yearly after that as for all dogs. Also, in rare cases, a dog that initially tested HW- when brought into our program may actually have heartworms because the antigens don't show up in the test for 4-6 months. We re-test our dogs, but this is another reason we want our adoptive homes also to re-test. HW+ dogs almost always have some e

Answer 2

The best heartworm treatment is PREVENTATIVE treatment, which is for a lifetime, as dogs can alway be exposed to them through mosquitos. You are in a critical time with the dog if it already has heartworms. Getting rid of worms of any kind AFTER infestation is always harder on the dog than preventative treatment.

The adult heartworm lives in the right chamber of the heart and pulmonary artery which routes blood through the lungs where carbon dioxide is removed and oxygen is added to the red blood cells. I have actually seen hearts so chucked full of worms that only a trickle of blood can get through. This all begins with a single mosquito bite! The mosquito bites an infected dog and picks up some microfilaria from the blood meal. The microfilaria live about two weeks in the salivary glands of the mosquito. Now is that a tiny worm or what? When the mosquito bites a dog or cat it punches a little hole with some pinchers. It then releases some saliva that prevents the blood from clotting. As the mosquito sits back sipping at the blood some microfilaria find their way into the wound. The microfilaria then begin to migrate through the tissue following veins to the heart. As the larva migrate they molt and continue growing in size ( since insects have a rigid exterior they must molt or shed the exterior to grow in size). This process takes about six months to reach adult size in the heart and begin giving birth to offspring, the microfilaria. The process then can continue. Note: The offspring cannot grow to adults without coming out of the animal and spending time in the mosquito at cooler temperatures. In other words, the mosquito is necessary. If it released one microfilaria into the wound only one adult heartworm would lodge in the body of the pet. The more times the pet is stung by infected mosquitos, the more heart worms they can aquire.

There are several tests for heartworms based on two principals.

The oldest principal is where we look for the offspring (microfilaria) in the blood. A few drops of blood are drawn from a vein in the front leg and then passed through a fine filter which traps any microfilaria passed through it. A drop of stain is applied to the filter which outlines the microfilaria and it is viewed under a microscope at from 100X to 400X magnification. If a Once-A-Day heartworm preventative with diethylcarbamazine in it is to be given this test must be used (If microfilaria are present and DEC is given it can cause a fatal anaphylactic reaction to occur). This test was great before we started using the Once-A-Month heartworm preventatives which can kill the microfilaria and prevent this type of test from detecting the presence of adult heartworms in the heart. A better method had to be developed.

Today we must use what is referred to as an "Occult Heartworm Test" As above we first draw a drop or two of blood. The blood is then processed in a detection kit. This kit actually detects antibodies to the adult heartworms by causing a color change in the media of the test. (Antibodies are proteins produced by the dog or cat's immune system in attempting to control the heartworm from within). Since this test does not rely on actually finding microfilaria, it is much more sensitive for detecting adult worms present in the heart. In the old days the microfilaria test would yield a false negative if the adult heartworm wasn't producing microfilaria as in all female or all male infections. Yes they can happen! Also for some crazy reason microfilaria do not circulate in the blood during the day hours as much as at night. God only knows where they hang out during the daytime. Aren't parasites strange?

How do we treat heartworms?



In the dog we can treat heartworms but it is very risky and expensive. The tests listed above do not tell us an all important consideration - how many adult heartwroms are present. This can alter the outcome of treatment.

When we start treatment, we need to first access the condition of the liver and lungs. X-rays are taken and blood tests performed. If all is well treatment is begun. Either an intravenous or intramuscular drug is given for two days in a row to begin killing the adult heartworms. What we want is a SLOW kill. A sudden killing of the adult heartworm would cause them to release and flow downstream into tiny blood vessels (arterioles and capillaries) and block blood flow causing the death of the patient. With a slow kill, the defensive cells of the patients body (macrophages) have a chance to go in and eat up the remains of the adult worms. After two days of hospitalization the pet goes home. During the next six weeks the dog must not get excited at all! If the heart races the worm debris can break loose and plug vessels. So it's a pretty boring life for the dog over six weeks of time. I have actually had certain clients box their dogs up in plywood cages so they see nothing ( they lived). During this time many cases of pneumonia can occur d