Speak to me about heartworm treatment.

[Milocalwinnings]

I am stationed in South Korea and just adopted a ~5 year old black lab from the kill shelter. Unfortunately, when I brought him to the vet I found out he is heartworm positive (vet suspects stage 2). I have to use the local Korean vet as the on post vet only does simple things like vaccines and refers out to the economy for everything else. Vet speaks ok English but I have never dealt with a heartworm positive dog before.

He has him on doxycycline and some other meds for 21 days and then says we can start treatment of 2 injections.

I have heard mixed answers on activity level. I know that he has to have restricted activity. Does he have to be confined to his crate or can he have access to a room if he doesn’t move around much? Any other tips/suggestions/experiences you can share?

[kathtray]

Hi milocalwinnings,

I’m also in SK- a lot of dogs seem to get it here and recover after the treatment. I would assume that the local vets are familiar with what’s needed.

Are you riding here? Nice to see another COTHer!

[2tempe]

http://www.marvistavet.com/html/body_heartworm_treatment.html

No personal experience, but this article describes “indoor life” for a while; So when you are home and can be sure he doesn’t get silly, you shouldn’t need the crate. The idea is to be sure heart rate kept low.
Kudos to you for getting this dog!

[jetsmom]

The most important thing once they start the injections is not getting the heartrate up. It can cause an embolism that can kill them. So if the dog will just lay around in a room beside you that is fine. If the dog gets up to go bark at the window when he hears a noise, that’s not. No long walks. Just out to potty and back in. If he gets excited and barks/pulls when he is walking and sees a dog, then try to go at times there won’t be distractions. You want really calm. No long quiet walks.

[MustangSavvy]

When is alone he should be crated. When you are with him being a small room should be fine.

[bdj]

What jetsmom said - you really want to keep him as quiet as possible, so unless you’re around all the time and can monitor his activity level, I’d crate him. (Assuming, of course, that he settles down in a crate…)

There have been several threads in the last few months about heartworm treatment, and there’s some good info in them, so they’re worth doing a search for. Additionally, I’ll (as I always do) refer you to the American Heartworm Society’s website: http://www.heartwormsociety.org/ Look under “Veterinary Resources” for the treatment guidelines.

[Milocalwinnings]

I will leave him uncrated while I am at home as he will usually lay near me quietly. I am undecided about what to do when I leave. Occasionally I will put him in the crate at night, and he gets super anxious / worked up. I listened to him panting and pawing at the crate all night last night. However, when I put him in there to go to work, he is always laying calmly when I come home. He does get anxious/whiney if I leave him (regardless of if he is crated or not) but it doesn’t last long.

[2tempe]

OP - be sure you discuss the anxiety w/ the vet. He/she may want to give the dog a little something for when you leave, to get him calmly through that time.

[vineyridge]

Down here, the vets are willing to do a “slow kill” procedure, which involves the doxycycline (here it’s 30 days first, then a gap of 30 days, then seven days each month for four months) and regular ivermectin or moxidectrin (advantix multi) heartworm preventative monthly, You are supposed to start the doxycycline on a preventative day. There is another protocol tried here that calls for doxycyline first for 30 days, followed by daily ivermectin in the preventative dose for thirty days. I’ve just started the first one for two strays and have done the second one on one of my dogs. She’s flourishing.

This is not supposed to be quite as hard on the dogs as the immiticide.

I’ve also done the fast kill before and used a crate. Never had a dog die out of at least a dozen that have gone through treatment.

I wonder if heartworms are native to North America.

[SquishTheBunny]

If you are using immiticide, its a fairly quick “danger period”. A few days of being quiet is usually enough as all the worms are being targeted at the same time. Its generally the first 48 hours that are critical in keeping the pet calm. We have some stay in hospital with strict cage rest, ECG monitoring and sedation orders if the owners feel they are excitable (ie. young labs!). The ones who don’t get anxious in the car or at home are discharged home several hours after the treatment (as long as they have retained normal ECGs).

Slow kill is a lot safer in general, for patients who are not clinical.

If your dog is suffering from the clinical symptoms of heartworm, its best to do the fast kill. If your dog is not clinical, just tested positive but otherwise feels ok (no exercise intolerance, cough, heart murmur, strokes/clots etc) then the slow kill is generally safer.