Hookworm in my new dog. Questions

[Ericthegreat]

So my new pup has hookworm. My vet said she want to prescribe a three day de-wormer. I have two other dogs and I asked for the same for them as a preventative.

She said no, because she wants to run fecals on my other two before prescribing a de-wormer. I find that irritating.

I use Simpirica Trio monthly, and my new girl had her first dose of that on Monday. Hookworm is on the list of parasites Simpirica takes care of.
If that’s the case, why do I need a separate prescription?
Since I have my other two on Simpirica, do you think don’t have to worry about them getting the worms?
I have heard that hookworm is very hard to get rid of once it’s in your yard. Is that true?

[trubandloki]

@Ericthegreat

So my new pup has hookworm. My vet said she want to prescribe a three day de-wormer. I have two other dogs and I asked for the same for them as a preventative.

She said no, because she wants to run fecals on my other two before prescribing a de-wormer. I find that irritating.

I use Simpirica Trio monthly, and my new girl had her first dose of that on Monday. Hookworm is on the list of parasites Simpirica takes care of.
If that’s the case, why do I need a separate prescription?
Since I have my other two on Simpirica, do you think don’t have to worry about them getting the worms?
I have heard that hookworm is very hard to get rid of once it’s in your yard. Is that true?

That is my experience, that hookworms are a real nuisance.

I think it is fair for your vet to want to treat your dogs individually.

Why not drop off a fecal sample for testing from the other dogs and move forward with facts on what they have?

[dogsbody1]

I would be annoyed by that, too. Sometimes it feels like small animal vets really nickel and dime you… how long have you had your new dog/how long have the other two been exposed to her? If they’ve been on simparica the whole time, I personally wouldn’t be too worried. Hook worms will eventually be symptomatic, so if you see blood in their stool, then take them in and get the fecal. But given they are on a broad spectrum preventative I doubt they would pick it up. It would be nice to get your vet’s POV on that (assuming she’s the one who wrote the Simparica script for you in the first place), but I have a sneaking suspicion she’d ask you to come in and get fecals done anyway. Hate to sound so cynical but I have had bad experiences with small animal vets and had to look high and low to find one I trust.

[dogsbody1]

@Ericthegreat

Hookworm is on the list of parasites Simpirica takes care of.
If that’s the case, why do I need a separate prescription?

Oh re: this one, my intuition would be that yes, you do need a separate prescription, because often these preventative drugs are designed to target parasites in the larval stage, and may not be effective/as effective against an active infection. But having said that, I googled “simparica trio hookworm efficacy” and saw this study:

“Based on geometric mean worm counts, efficacy of Simparica Trio™ was ≥ 98.4% against L4 larval stage of A. caninum , ≥ 99.8% against immature adult (L5) A. caninum , and 100% against adult A. caninum and adult U. stenocephala.” [https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-020-3951-4]

I would probably still accept whatever the vet prescribes given you know the dog has an active infection, and I’m not sure if the dose you get in the commercially available tablets is as high as the study (doses in the study were “1.2 mg/kg sarolaner, 24 µg/kg moxidectin and 5.0 mg/kg pyrantel (as pamoate salt”). But I would find that pretty reassuring not to be too concerned about your other two dogs.

[trubandloki]

@dogsbody1

I would be annoyed by that, too. Sometimes it feels like small animal vets really nickel and dime you

I guess then, my large animal vet is nickel and dime-ing me because I do a fecal on all of my horses and treat them as individuals, I don’t just mass de-worm them based on the fecal of one of them.

[dogsbody1]

@trubandloki

I guess then, my large animal vet is nickel and dime-ing me because I do a fecal on all of my horses and treat them as individuals, I don’t just mass de-worm them based on the fecal of one of them.

Where I live, horses are routinely wormed every 6 months. That seems to be the standard of care. The only time I ever had a fecal count done was when I was concerned that my horse wasn’t gaining weight. Now… having said that, I can see a case for testing first and worming less frequently, because all that routine wormer use probably contributes to resistance, especially if you don’t alternate products like you’re supposed to. BUT that would only make sense if a reasonable % of horses routinely tested each year were parasite-free and didn’t go on to need worming. I think the assumption is that because parasitic infections are so common, screening first isn’t justifiable, but routine treatment is.

[Annie10]

Hooks are a major PITA. I had a rescue dog show up at my farm and lo and behold it ended up with hooks. As long as you’re picking up the puppies poop and the hooks and eggs aren’t able to get into the soil you might be ok. Hooks can be absorbed through dogs feet and their skin as opposed to other types of worms, likes tapes that are from ingested fleas. This dog showed up here 3 years ago and I’m still battling hooks.

[Ghazzu]

Likely trying to minimize the development of anthelmintic resistance by appropriate use of drugs.

[JB]

It’s “fine” for a single residence to use a dewormer for a parasite that doesn’t exist. The odds of creating resistance issues one time, are pretty slim.

But if you’re “allowed” to do that, and every other person is also allowed to do that, and enough of those dogs now have a tiny bit of resistance that they pass on when they defecate at dog parks, or a neighbors yard, or anywhere else that makes it easier for another dog to pick up that resistant stage, then you’re spreading the resistance issues around.

Animals shouldn’t be dewormed “just in case”, unless there’s a good reason to suspect something you can’t see. In this case, you can see hookworms, so it’s a much better idea to test first.

It’s easy to think “it’s just me, that won’t make a difference”, but then if a large enough % of the population also thinks “it’s just me, it won’t hurt”, then it does start to make a difference. That goes both way, for things we don’t want to happen, and things we do want to happen.

[JB]

@dogsbody1

Where I live, horses are routinely wormed every 6 months. That seems to be the standard of care. The only time I ever had a fecal count done was when I was concerned that my horse wasn’t gaining weight. Now… having said that, I can see a case for testing first and worming less frequently, because all that routine wormer use probably contributes to resistance,

6 months is a GREAT schedule for most of the world. But it also depends on which drugs are being used. Tapeworms and bots aren’t seen on FECs, and most horses, in the US anyway, should be treated for them at least once a year, and most of the US twice a year, Spring and Fall.

@dogsbody1

especially if you don’t alternate products like you’re supposed to.

Alternating between/among what? There aren’t a lot of truly effective drugs anymore. Ivermectin and moxidectin are the most effective for most adult horse parasites. It IS a good idea to alternate between those 2, Spring and Fall, 1-2 of those including tapeworm control, but sometimes a horse shouldn’t have moxidectin, so you’re left with ivermectin.

@dogsbody1

BUT that would only make sense if a reasonable % of horses routinely tested each year were parasite-free and didn’t go on to need worming

Bots and tapeworms - need to target them based on the enviornment, regardless of FECs which are looking at strongyles and ascarids.

Besides, the goal in horses is never to get to totally parasite free. It’s not possible, and not a goal.

In dogs and cats, that IS possible, and IS the goal.

[thatmoody]

I’ve dealt with hookworm and it’s a PITA. My vet prescribed a 6 day course of panacur, but tested my older dog and we never ended up treating him. I had to pick up all of the poop for weeks, till the recheck was clear (I mean, I would have anyway but we have a lot of property so I was chasing around this tiny puppy and it was awful LOL)

[dogsbody1]

@JB

It’s “fine” for a single residence to use a dewormer for a parasite that doesn’t exist. The odds of creating resistance issues one time, are pretty slim.

But if you’re “allowed” to do that, and every other person is also allowed to do that, and enough of those dogs now have a tiny bit of resistance that they pass on when they defecate at dog parks, or a neighbors yard, or anywhere else that makes it easier for another dog to pick up that resistant stage, then you’re spreading the resistance issues around.

Animals shouldn’t be dewormed “just in case”, unless there’s a good reason to suspect something you can’t see. In this case, you can see hookworms, so it’s a much better idea to test first.

This makes me wonder (and I don’t know the answer): How do monthly preventatives play into this issue of resistance? My dogs are also on Simparica Trio…feels like most dogs are on some kind of flea/tick and at the very least heart worm preventative. I don’t know how these drugs work or if they’re relying on a fundamentally a different mechanism from a drug like ivermectin. But it almost sounds like dosing our dogs every month preventively isn’t that different from worming them every month, practically speaking?

[JB]

Heartworm preventive works by killing the larval stages of the heartworms, before they mature to any degree to cause problems. Mosquitoes cause the infection, and as long as you dose roughly every 30 days, with the dose for your dog’s weight, you’ll be killing the larva before they get to a damaging state.

Since no drug is 100% effective 100% of the time, it is conceivable that a few larva survive, which is why it’s still critical to have your dog tested 1-2 times a year, so more measures can be taken if he’s positive. Any larva that matures to the adult stage, which then sheds eggs, which then could be picked up by a mosquito feasting on that dog, could conceivable be just a little less susceptible to the drug, and if you repeated that scenario enough times, you’d get resistance. But the odds of all that happening is really, really slim in most situations, unlike horses who are sharing a pasture, depositing manure, grazing close enough to ingest infective larva, etc.

[dogsbody1]

In the study I linked earlier in this thread, it mentioned that simparica trio is actually more effective at treating adult hookworms, and also one of its ingredients is moxidectin, which you mentioned as one of the few effective alternatives to ivermectin. So, it does seem like the standard monthly preventatives for dogs do boil down to worming every month “just in case.”

I guess it’s food for thought. Maybe there should be more nuanced guidelines based on geography and tracking where these parasites are most prevalent.

Either way, it makes me stand by what I said that the OP’s vet is making a brazen cash grab to advise her to do fecal egg counts on her other two dogs when they were both already on a drug that appears to effectively wipe out hook worms at every stage.

[JB]

@dogsbody1

So, it does seem like the standard monthly preventatives for dogs do boil down to worming every month “just in case.”

In way it is, yes, for heartworm. But because of how prevalent they are in a lot of areas, how much damage they can do in a hurry, and the fact that the proteins produced in order to be detected don’t show up for about 5 months. The microfilaria show up in blood for 6 months, which means you’ve already got adults producing babies.

The difference here is that the goal is 0 worms, which is doable in cats/dogs. It’s not doable in horses. So monthly hw treatment will kill any larva there before they do their damage, and months before you can detect them

@dogsbody1

Either way, it makes me stand by what I said that the OP’s vet is making a brazen cash grab to advise her to do fecal egg counts on her other two dogs when they were both already on a drug that appears to effectively wipe out hook worms at every stage.

If they’re already on a monthly preventive that’s very effective at taking care of hookworms before they become a problem, why would you want to do a 3-day treatment if there isn’t anything to kill?

That would be like saying “I never treated one of my dogs for heartworms and now he’s got them, but the other 2 have been on Heartguard monthly without fail and they all go outside together where there are mosquitoes, so I want to go ahead and treat the other 2 dogs for HW as well”

But even though HW preventives do sometimes fail, every year, my vet does a fecal to see if there IS a problem, not just prescribing HW treatment “just in case”. I would bet 99.99% of vets operate that way.

My comment above still stands as well - if the “it’s just me, it’s just 1 time” mentality is held by enough people, then it’s not just you, it’s not just one time, and things get better OR worse in a much bigger hurry than if it really was just you, just once.

@dogsbody1

Maybe there should be more nuanced guidelines based on geography and tracking where these parasites are most prevalent.

I suppose you could, there ARE studies look at prevalence of infected mosquitoes (wrt heartworms). And it may be that vets in areas where mosquitoes in general are typically not a problem simply don’t recommend monthly prevention anyway

This one points to loss of mosquito diversity as a cause for decreased carrier mosquitoes, but it also says there’s a difference between suburban and undeveloped wooded sites, and undeveloped field areas

Mosquito diversity and dog heartworm prevalence in suburban areas - Parasites...

And then there’s this:

" Incidence of heartworm disease has continued to rise not only in previously known hot spots but also in unexpected locations with previously low heartworm rates, according to the 2022 Heartworm Incidence Map."

Map shows heartworm rates continue to increase in hot spots, new locations

And look at this - due to widespread use of drugs, hookworms have developed resistance, but also, look at the pretty low risk factor - 2.5-10% of dogs infected. In contrast, 40% of dogs get infected with hw.

Hook Before You Treat! Drug-Resistant Hookworms in North America

[Mosey_2003]

@JB

In way it is, yes, for heartworm.

They’re talking about the intestinal worm compound in the Simparica Trio, not the heartworm component.

[Pico_Banana]

As someone with 3 greyhounds, two of which have drug resistant hookworms because of irresponsible deworming practices, I’d suggest doing a fecal check before treating.

I will note that dogs seem to have different natural resistances to them, too. I have one girl who has had them, but we seemed to have FINALLY gotten rid of them with her. But I have a boy who we can’t seem to get rid of them in completely. The only thing we haven’t tried is the Profender treatment, which is kinda scary. On the other hand, we had an older girl, who is no longer with us, never had them and never caught them despite having housemates with them.

So your other two dogs may be just fine.

Edited to add, my newest one is from Ireland. Apparently they don’t have the same practices over there and she is thankfully not infested.

[SaddleUp158]

I am battling hooks in one of my girls currently. She is a little over a year old and I got her about 6 months ago. In January, we wormed her with Panacur (and another wormer, because the first one didn’t work) for roundworms. She has had monthly heartworm and flea/tick chews since I got her. Somehow she now has hooks. We go back for a recheck in a couple of weeks. I am not holding my breath. Every time this dog has needed antibiotics or a wormer it has taken 2-3 different rounds of meds to get the all clear. I have no idea why the worms are back, unless it is due to the neighbors behind me and their previous insane number of dogs that they never cleaned up after.

We did choose to go ahead and treat my other dog as a precaution. I clean up after the dogs as they go (morning and night), even before the hooks and rounds happened, so it isn’t a cleanliness issue on my personal property, but potentially something already in the soil or being filtered through from another yard?

Good luck getting rid of them! I feel for you!

[Pico_Banana]

@SaddleUp158 You may want to ask your vet specifically if there’s any chance these are drug resistant hookworms. There’s a whole protocol that has been developed to deal with them. What we did was use Advantage Multi monthly, followed by Drontal 24 hours later also given monthly, then repeat for a total of 3 months, then a fecal to check status.

[SaddleUp158]

Great to know, thank you. Yes, I am definitely planning on a conversation with my vet on our worming protocol moving forward with this dog. I am active with my dogs but don’t want to risk passing the parasites to others so I have been keeping her home instead of going to agility, etc. Then I get paranoid about them transmitting the parasites to me! lol