Recovery and Heartworm Treatment is Challenging
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| Tyler now in heartworm treatment |
PREVENTION: It is a horrific mosquito-borne disease that no dog should have to endure and is completely preventable by monthly heartworm pills, which kill the microfilaria deposited in the blood stream by mosquitoes before they can invade the heart, mature, consume the heart, and kill the dog.
THE CURE IS ROUGH: Fortunately, there is a cure, though it is rough on the dogs and their caretakers, and expensive, but most dogs with heartworm disease do survive through the treatment and the loving, knowledgeable care of their concerned caretakers.
STAGE 1 OR 2 OF HEARTWORM DISEASE
From the occult blood test, if a heartworm positive (HW+) dog is a Stage 1 or 2 (mild to
moderate heartworm disease, though the assessment is more complicated than this) with no
clinical symptoms (slow heartbeat, congested lungs, fever, prior coughing, and
listlessness), we do the full treatment of two injections over 24 hours. A second, milder
injection may be done in 4 weeks with re-check, OR oral Ivermectin or pill for microfilaria.
STAGE 3 TO 5 - SEVERE SYMPTOMS
If the dog is a Stage 3 - 5 (severe to critical heartworm disease--"loaded" with the heartworms),
The dog gets one injection; then the standard two injections over 24 hours in 4 weeks; recheck and
possible Ivermectin in another week.
WHAT ARE THE INJECTIONS?
The injections (called an Immiticide or Adulticide because it kills adult heartworms) are made in the lumbar region with a long needle; the Immiticide is an arsenic-based compound (though the modern compound has less arsenic than older compounds): it can hurt some dogs, cause pain to spread throughout the lower back muscles, and make the dog feel nauseated. Both symptoms will usually ease in a couple of days. Usually Rymadil is sent home with them for the after pain.
AFTER INJECTIONS
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.
CRATE THE DOG DURING RECOVERY
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 any extended 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.
THINGS TO WATCH DURING RECOVERY:
(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 vet. 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 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.
(4) If hindquarter paralysis- rare, but 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
COUGHING DURING RECOVERY: THE WORMS
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 HEAVY COUGHING: CALL THE VET
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. However, the veterinarian may prescribe
Prednisone for your foster because he hears a 'crackling' in the heart indicative of higher
level infestation or fluid build up.
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| A 100% recovered Tyler |
A GREAT POST-HEARTWORM UPDATE JUNE 2015 (2 years later).
Our Dachshund, Tyler, recovered from heartworm and is a healthy, happy dog, as your dog will be. Sometimes we wonder if the heartworms caused a strain on his heart (they will, the longer it goes untreated). However, for the last 1 1/2 years he's been in pre-agility training and has done very well. So, he's regained his health, he's happy and very active and even athletic!
