Heartworm help, please :( Update post #10

[jazzharmony]

For what it's worth, i've already been made to feel like a horrible non-vaxing mother in an ER with her baby so there's no need to judge us for not doing heartworm med prevention. We got all that from the vet's office.
We felt we had made an informed decision. I really just need some help with what to do next. We just want the best possible outcome, with the least risk, for our dog. Reading online is pretty scary. Treatment can cause death and the vets don't discuss those details or help us make an informed decision now about which is the safest route to take.
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Our 6yo dog recently tested positive for heartworm and lyme. The test was a 4DX in office test which shows results in 9 minutes.

They immediately gave us Doxycyclene antibiotics to give him for the next 28 days (vet says for both lyme and heartworm). Today we brought our other dog in for testing and he was negative for both. While we were there, we discussed the next step for our 6yo with heartworm. This vet was filling in and the other one had not put clear information in her notes, according to him. There was confusion and I did not feel very secure with what I am understanding the protocol to be or what our options are or what the possible outcomes are (I have read about outcomes online now )

We are wondering if, considering the risks of the treatment, we should get a second opinion. We could take him to a cardiologist if it might be worth doing, though it is very very expensive. As is the treatment, which we won't hesitate to pay for - we just want our dog healthy.
What I read online is that false positives are possible. I also read that in order to determine treatment, one needs to find out whether there are baby heartworms in his system, not just adults. The vet just has us coming in 1 month for an x-ray to determine heart damage and then a shot, followed by 2 final shots. He is to remain very calm for the next few months.

Some links I read and wondered about.

http://www.thebark.com/content/value-screening-tests

http://www.vetinfo.com/dencyclopedia/dehwtest.html

Any help at all would be much appreciated. I was at the vet today and am still processing everything and feeling very worried. I'm downplaying it so my kids don't become distraught but i'm really concerned.

[greenmagick]

I do not know much about this, and I am getting ready to hop off here, but from people I know in rescue who deal with heartworm all the time, the slow kill method seems to be the safest....

[stardogs]

Any idea how severe of a worm load your dog might have? If it's light the slow kill might be an option, but if it's heavy the slow kill will still allow damage to be done to the heart/lungs by the worms before they die (several years I believe).

Is the vet doing bloodwork and urinalysis in addition to xrays before the immicide? At the very least I'd request both and ask if they have looked at the blood under a slide (to see if there are microfilaria present).

The American Heartworm Society has a ton of info. I'd look there for more details.

I hope you'll consider a preventative for you negative dog - my holistic vet suggests Interceptor since it is gentler on the system. Avoid black walnut - it's often touted as a preventative but is more toxic and has a smaller window of safety than regular preventatives, despite being "natural".

[sarafi]

Gosh, it really depends on how often you test. If you test every year and they can do a count I personally would be comfortable using an regular preventative to kill the worms. If this is something you are just now testing for in a six year old dog and can't get a count for I would consider a more aggressive treatment.

Vaxing/Non-vaxing I don't think is an issue, worms are quite common and if you live in an area where heart-worm is common you really need to weigh the risks much more seriously than if you didn't. Some areas are crazy high, some you would never have to think about it.

Hugs to you and your pup, even if he has to have an aggressive treatment it's not really that big of a deal, just keep him calm low energy for a month or so.

Yes an aggressive treatment is very toxic, but you have a much shorter period of time to keep your dog sedentary so that any dying worms don't cause lung/heart failure. This really depends on the case and your vet should be able to tell if he is a "strong positive" or a "weak positive" to help you make that choice.

Again, it really depends on how long your dog has had this from my experience.

[jazzharmony]

I had a post typed up from my phone but it's lost in space...

Yes, our other dog is now on Heartguard preventative, prescribed by the vet yesterday.

Heartworm isn't something common in our area which explains why all three of the vets in this clinic seem to have no information for us and don't seem to know much themselves.

No, they did not do a urinalysis or other testing. They did not discuss treatment options or possible outcomes. They just put us on a plan for immiticide, which begins in 4 weeks. For now, our dog is taking antibiotics and we are keeping him calm. He will have the chest x-ray on the day we give the first immiticide shot, in 4 weeks. I just feel like we need to be doing something now.

We don't see heartworm in our area so that explains why our vets don't seem to have any experience or answers.

I have looked at the heartworm association's site and will continue to research. Our vet said not to read online as it would just scare us...

Maybe we need to see the vet cardiologist at our city animal hospital. I don't know. Maybe a second opinion from another vet? People around here only seem to know what's on the package of the preventative and nothing more.

I would like to know some statistics on the possible outcomes for our dog, so we can prepare. Our vet didn't have any to give us.

[Ola_]

I think a second opinion would be great, especially if your vet told you not to research (what?!) and won't give you any information. I agree with looking into the "slow kill" option, I'm not sure what is required before you can use it (i.e. a low heartworm load?) but it is safer to use. You probably already read this, but here is some more info on the different options from dogaware.com, which has a lot of info about a lot of dog stuff:
http://dogaware.com/articles/wdjheartwormtreatment.html

[stardogs]

I second the second opinion suggestion given the additional info - a cardiologist or an internal medicine specialist would both be good options for you.

I worked at a large animal shelter and we only ever used the immiticide method, I recall only a handful of cases where the dog was in pain or otherwise not comfortable due to the immiticide and that was with the shots being given on back to back days vs separated by a month or so. In general, the older and poorer the dog's condition, the rougher treatment was on them; I don't recall any dying or having lasting side effects from the treatment in the 3 years I was there.

[mamallama]

My understanding is that the slow kill is only safer with a low load. As I understand it, the American Heartworm Society recommends the immiticide treatment for dogs with a moderate and high load.

I adopted a hw+ dog. I have a good, longstanding relationship with my vet, and since she recommended the immiticide treatment for our case, we went with it. The treatment period was tough--crating, leash walks, No excitement...but it was ok, and by the time it was over she was as well trained as I think she ever could hope to be (she's pretty thick...)

IMO, it's really important to have a vet you can trust. Either way you go, the treatment for hw is tough. You'll want to be able to trust the person helping your dog through it. If you don't feel so sure about this vet, I think you should ask for recommendations and find someone else--someone you can trust.

[Mirzam]

I have a copy of research paper on heartworm and the various treatments: allopathic, alternative and natural. Its in a pdf, so pm me with your email if you would like it and I will get it off to you.

[jazzharmony]

Quick update as I take care of a sick houseful...


Mirzam, thank you so much. That paper was truly eye opening.

We took our dog to the cardiologist who did a heart ultrasound. He not only found no damage to the heart, but also found no evidence of heartworm. We are perplexed. Our original vet did a snap test which was positive and then we had a retest (different type of test) done at a pet store to confirm. They said he tested high positive.

Right now our sweet dog has other issues going on healthwise (eye related) but once that is over, we need to get on the phone with the original vet clinic who tested him for heartworm first. We will need to decide how to proceed based on all of the information and likely without help from the vet(s).

Thank you for all your help.

[Mirzam]

Thanks for the update. I am glad the information I sent you was useful.