My dog has heartworms. Is ivermectin the best treatment option?

I'm so sorry to hear that Buford has contracted heartworms. I adopted a dog with heartworms and it can be challenging to decide on the right treatment protocol for a high energy dog. First, let's clarify that at some point the adult worms are going to die. That can occur from us killing them with the medications that we call an "adulticide" or it can occur when the adult worms reach the end of their life expectancy. At that point. if Buford is exercising, the worm dying can results in a clot to the lungs. An adult worm can live up to 5 years, so you really should keep Buford exercise restricted until his heartworm disease has resolved regardless of how you treat it. Second, a higher dose of ivermectin does not result in the adult worms dying faster. It only keeps Buford from getting any more adult worms which will make his infection worse. I am attaching the following information from the American Heartworm Society ( https://www.heartwormsociety.org/images/pdf/Canine-Guidelines-Summary.pdf ). "In cases where arsenical therapy is not possible or is contraindicated, the use of a monthly heartworm preventive along with doxycycline at 10 mg/kg BID for a 4-week period might be considered. An antigen test should be performed every 6 months and the dog not considered cleared until two consecutive NAD (no antigen detected) heartworm antigen tests, 6 months apart, have been obtained. If the dog is still antigen positive after one year, repeat the doxycycline therapy. Exercise should be rigidly restricted for the duration of the treatment process." So, their recommendation is just to do regular heartworm prevention monthly (not higher doses of ivermectin) combined with Doxycycline for the first 4 weeks, then recheck a heartworm test in 6 months. At some point, if you keep Buford on heartworm prevention monthly, we expect that the worms will die and he will clear the infection. The worry is that the longer the worms are there, the more damage they can potentially do to the blood vessels. Good luck! I hope that was helpful and answered your question. Thanks for using PetCoach.

Some veterinarians treat heart worms with a slow kill method by giving heartworm prevention monthly which will kill the adult worms over time and prevent new ones. The more common treatment is with injections to kill the worms quickly. Both methods have advantages and disadvantages. Doing it with a slow kill method is much less expensive. The shots are expensive, can be painful and you would need to keep your dog very quiet for six weeks. Thanks for using Petco Pet Education Center, formerly Petcoach to help you care for Duke.

There is really only one treatment for adult heartworm disease which is given by injection. The other method is just continuing to use preventative medications so they don’t continue to be bitten and infected with more heartworms. The hope is over time the worms will die. This may take years and the worms will continue to do damage to the body while they exist. Heartworm disease is complicated and devastating and the treatment does have the potential for side effects. If Scooby does have heartworm disease then a long conversation with your veterinarian about treatment plans would be advised. American heartworm society https://www.heartwormsociety.org. Has some great information and resources as well. Best of luck and thank you for using Pet Coach.

Melarsomine is the only medication that can kill adult heartworms, and there unfortunately is not a less expensive option. Sometimes veterinarians will discuss what is commonly known as a 'slow kill' method, but in reality this means starting an antibiotic to weaken the heartworms and then giving a monthly preventative and waiting for the heartworms to die on their own. Some veterinarians do not recommend this due to the potential to develop resistant heartworm infections. If Waylon is not symptomatic this might be an option. He would be at risk for developing side effects from the dying heartworms for 1-2 years and exercise restriction is recommended during that time. You should talk to your veterinarian and ask about all of your different options, and you could also try contacting rescue groups in your area to see if there are any that could help with heartworm treatment. You also may want to look into Care Credit (www.carecredit.com).

Hi, thanks for using PetCoach! Unfortunately no. There is a slow kill method using oral Heartgard monthly but it can take a year or more and allows more damage to occur to the lungs of the dog. You would also need to get the medication for your Vet. Rocky would have to be exercise restricted for 1-2 years. The 3 injection technique using adulticide is the standard of care. Below is the protocol from the American Heart worm Society. I wish you and Rocky the best! https://www.heartwormsociety.org/images/pdf/Canine-Guidelines-Summary.pdf

The heartworms will kill her if you don't attempt treatment. At least with the treatment there is a chance she will survive. The vet can do a "slow kill" protocol and uses the immiticide injections over a longer period of time. That is what we do here in the States when we have a dog with advanced stage heartworm disease. Hope this answers your question. Best wishes.

I am so sorry that Tucker has tested heartworm positive. I adopted a dog that was heartworm positive, so I certainly understand how difficult it is to make a decision on treatment. I am attaching a link below to the American Heartworm Society (AHS) which has a lot of good information for you. https://www.heartwormsociety.org/ The AHS does not recommend the "slow kill" method as it's treatment of choice, but does recommend the following for an alternative treatment if needed. They recommend Doxycycline and either ivermectin or topical Moxidextin. ("Topical moxidectin is now FDA-approved for use in heartworm-positive dogs.") They do not list ivermectin or topical Moxidextin as being better than the other, so they should have the same efficacy. Injectible Moxidectin (Proheart) is not listed by the AHS as recommended and the company that manufactures Proheart lists that it "should be used with caution in heartworm positive dogs". I am attaching the exact recommendation from the AHS below. " In cases where arsenical therapy is not possible or is contraindicated, the use of a monthly heartworm preventive along with doxycycline at 10 mg/kg BID for a 4-week period might be considered. An antigen test should be performed every 6 months and the dog not considered cleared until two consecutive NAD (no antigen detected) heartworm antigen tests, 6 months apart, have been obtained. If the dog is still antigen positive after one year, repeat the doxycycline therapy. Exercise should be rigidly restricted for the duration of the treatment process." So, I would recommend reviewing the AHS website, then discussing it further with your vet. Good luck! I hope that was helpful. Thanks for using PetCoach.