My dog's heartworm medicine is Iverhart Max, not Plus. Is it safe?

Hello, thank you for using PetCoach. I understand your concern but Max should be just fine. It does not appear that he got an overdose. If he was a breed with a known sensitivity to Ivermectin I would be more worried (herding dogs, collie breeds, etc). Here is a link to Ivermectin toxicity so you can know what to watch for but I don't think he will have any issues. Usually they will present with neurological symptoms. As always, if you are worried you should take him to your vet for an exam. ( http://www.pethealthnetwork.com/dog-health/dog-diseases-conditions-a-z/ivermectin-toxicity-dogs ) The treatment will still be effective. Don't worry about that! Hope this helps. Best wishes. If you have more questions please feel free to post again.

Hello, & thank you for using Petco Pet Education Center, formerly Petcoach. The general dose of the liquid pyrantal is 1 ml per 10 pounds of body weight. You can very safely give 1.5 ml to the 15 pound dog & 2.0 ml to the 20 pound dog every month with the Iverheart & this is essentially the Iverheart Plus. Take care.

You did exactly the right thing by calling around to vets to ask for help right away. It's always best to check when you aren't sure, and are worried about your pet. The Triheart dose that we give dogs for heart worms has very small doses of the two medications that are in it. Ivermectin is one of the medications that is in the Tri heart. The dose is 68 micrograms. Veterinarians use this medication also to treat dogs with skin mites and use a dose over 100 times the dose in one heart worm preventive tablet. Therefore, even if she would have eaten two or three boxes of the Triheart she should be very safe and there is not any risk of an overdose of the ivermectin. The other medication is called pyrantel pamoate which is used for deworming of intestinal parasites. This medication has a very large safety margin also, and can be given at 10-20 times the normal dose without any risks of toxicity. Therefore, just like with the ivermectin in the Triheart Plus, I would not expect any potential side effects either. These potential side effects could include an upset stomach, mild diarrhea, and/or vomiting. Monitor her for those side effects, and bring her into your vet in the morning if you are still concerned.

Yes, you can give tapeworm specific medication alongside heartgard plus. Remember that tapeworms can be transmitted by fleas so you should keep up to date with flea prevention in order to reduce tapeworm burden

Yes it is safe to use these medications together. Just make sure you are using the ivermectin dose for heartworms or better yet a pre made heartworm product with ivermectin (Heartgard or otherwise). I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

You can give him Drontal, which kills tapeworms. Heartgard contains ivermectin and pyrantel pamoate, while Drontal contains praziquantel which is needed to kill tapeworms. Do not give them that the same time, but it's fine to give a day or two apart.

I am sorry to hear about Max's heartworm diagnosis. I am glad he is receiving treatment for this. The worms you describe that have recently started appearing sound like tapeworms. Do they resemble grains or rice or sesame seeds? Most deworming medications do not contain the ingredients needed to take care of tapeworms, so I would recommend discussing this with your veterinarian so you can broaden the spectrum of Max's treatment. I would also suspect that even though you don't see any obvious fleas that Max has been exposed to some. Tapeworms can be transmitted by fleas and so management of a tapeworm issue typically needs to include a specific dewormer AND a flea preventative.