February 17, 2015
I am writing this blog to help other people who get the terrible diagnosis that your dog has heartworms. Let me first say that I am not a veterinarian, nor should you take anything written in my blog as medical advice for your dog. Please ask your veterinarian for medical advice. It is intended to be a written account of everything we are going through with our dog Lakota's treatment for heartworms. There is very little written on the web from the dog owner's perspective.
On Sunday February 15, 2015, we took both of our dogs for their check-ups. Lakota, our one-year-old Chow, Papillon, Shepherd, Collie mix (we did the DNA) was due for a number of shots, and Bandit, our ten year old Chow, Springer Spaniel, Dachshund, Schnauzer mix, had been acting like an old man, complete with legs shaking and lumps and bumps on him. My biggest concern was Bandit, as he is getting on in years. We had lost our beloved dog Bailey just a year ago, at the ripe old age of 15 1/2. I wanted to make sure we could keep Bandit young and lively.
To our surprise, the veterinarian informed us (after a blood test) that Lakota has heartworms. "How can this be?" I asked the vet. I had religiously given her Trifexis (M
ilbemycin) each month since we got her a year ago, and she had come with a negative heartworm test. The vet explained that the antigen test used to detect heartworms doesn't always detect infections less than 5 months old. It detects presence of adult heartworms that are 7-8 months old (Lakota was only 8 months old at the time of her first heartworm test). She likely had her first heartworm test shortly after becoming infected, resulting in a negative test. She also told us that the Trifexis we had been giving her could actually kill her, because it kills heartworms at a much faster rate than other preventatives, causing circulatory shock in dogs with heartworms. We would need to switch to Heartguard (Ivermectin). Ironically, we had already been giving Bandit Heartguard. I sure wish we had given it to both dogs. We had elected to use Trifexis for Lakota because she had had intestinal worms when we first got her, and Trifexis also kills hookworms, roundworms and whipworms, all intestinal worms. It is a moot point, since none of the heartworm preventatives kill adult heartworms, aka, L5 worms. They only kill the baby heartworms (microfiliae), L3 and L4 worms.
I was so shocked by the diagnosis, that I feel like I didn't hear much else the vet said. She was coming up with a treatment calendar, Lakota would have to be put on an antibiotic, yada yada yada. It was only later that evening when I started to digest this awful news that I was able to read through the calendar and notes the vet gave me, as well as look on my trusty friend Google for answers.
Starting that day, Lakota was to start a month-long regimen of Doxycycline (antibiotic), prednisone (steroid), and exercise restriction. No walks (we normally walk her twice a day on long walks), no running in our backyard, no overexcitement. How in the world is that going to work for a 1 1/2 year old puppy dog? We have to come back next week for xrays and more blood work to determine what class of infection she has. I am hoping it is class I, as this is the lowest risk. The worst is class IV, which is called Caval Syndrome. Based on Lakota's symptoms, I do believe she may be class I or class II.
I emailed a friend who I had remembered adopted a dog with heartworms. She immediately emailed me back saying, "It was a very difficult time for us when ****** had to go through treatment... It was almost like getting chemotherapy and she was weak after. But we all got through it and she was fine." Then I found out that our neighbor right next door's dog had heartworms just prior to their adopting her. This is comforting, as I know both dogs are thriving now.
Looking back over the past year with Lakota in our lives, there were definitely signs that she had heartworms. Last spring, she developed a bad cough and started losing her hair over the course of only a few days. When I took her to the vet, she tested positive for intestinal worms. We had her dewormed, and she was fine after that. Her hair grew back, and there was no more coughing. Shortly after that, Lakota had a bad reaction to a vaccine. We had to take her to an emergency vet (of course it happened late on a Saturday night), who gave her a steroid shot and Benadryl. Once again, she recovered quickly and we didn't think anything of it. I also noticed that when I would jog with her, she would breath very heavily, and not in a normal way. The vet didn't think much of it because her heart and lungs sounded normal. Then about a month ago, she developed a bad cough again. We took her to the vet, and she was given antibiotics. The cough quickly went away again. I remember thinking at the time that we had a sickly dog, as she had been sick so much in the past year. The reality is that the steroids and antibiotics probably helped with the heartworms. Thank goodness that we took her for her checkup, because I now know she would have become much sicker without treatment.
The vet told us that the Doxycycline antibiotic is prescribed in the initial treatment because the bacteria living inside of heartworms cause inflammation in the dog, resulting in more problems for their heart and lungs when the worms die. The prednisone also reduces the inflammation. It also causes increased hunger, thirst and the need to urinate more often. Fun! We also have to give her Heartguard on our normal day (in our case, I always give it on the first of the month).
After this phase of treatment is done, we start the next most difficult phase. Lakota will receive an injection in the muscle of her back of Melarsomine, a compound made from arsenic. The injection is very painful for them, and the Melarsomine causes pain in their body, as well. She will need pain medication to control her comfort. This will be done in the vet hospital, where she will stay for observation. Once she comes home, she must be caged and prevented from moving around. Extreme exercise restriction will be necessary. This is because when the adult worms die, they break up into little pieces that circulate through their blood stream and can cause an embolism. Exercise increases their blood flow, increasing the risk of a blockage. This is the part I am most scared of. I am so worried that I won't be able to keep Lakota from trying to chase a squirrel (even on a short leash) or bark and go crazy when she sees or smells her arch enemy, Dante the Cairn Terrier. My plan is to bring the dog cage into our family room and cover a portion of it so she has limited view of anything that will get her excited. I will probably move her into the bedroom at night, so she is not alone.
A month after the initial Melarsomine injection, Lakota will receive two more injections, a day apart. We will need to continue caging her with no exercise at all for another month. That's basically 4 months with no walks, no chasing squirrels, no digging gigantic holes in the back yard, no barking at Dante, and no fun for Lakota.
A month after the 3rd injection of Melarsomine, Lakota will be tested again, and we will continue the monthly Heartguard. She will then be retested again at the 6 month mark.
I will update this blog during each step of Lakota's treatment, including exactly what she (and we) are going through. Until next time.
Lakota's Mom
