Vet prescribed Trifexis for my heartworm-positive dog. Is this right?

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.

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

A "low positive" may mean a low adult heartworm burden. The preventive is to kill any immature heartworm (microfilariae). The doxycyline is to kill the wolbachia bacteria. This is an organism that lives within the heartworm parasite as a symbiont. This portion of the treatment lasts 30 days after which medication is given via injection to kill adult heartworm. Treatment is outlined at the link below. https://d3ft8sckhnqim2.cloudfront.net/images/pdf/HeartwormTreatmentGuide_PetOwnerColor.pdf?1561720859

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).

Yes and no. There are two different protocols for treating heartworm infections. The first is a rapid kill method and this is generally preferable to a slow kill method. The rapid kill method will be completed within two months including the cage rest. This protocol tends to be preferred because it decreases damage to the heart from the worms. It does carry some potential side effects such as anaphylactic reactions and potential embolisms from dead worms. Some pets are not a candidate for this protocol. This protocol uses a specific medication called Immidicide. The slow kill method does utilize drugs like ivermectin. The worms will not be completely killed for 1 to 3 years and so on going damage is possible. During this time the dogs must make sure to take all the medications on time and as prescribed. Talk to your veterinarian about which option is best for Hollywood. I hope this is helpful and please feel free to post any additional questions.

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.

Hello, & thank you for using Petco Pet Education Center, formerly Petcoach. We usually do a test where the antigen to heartworms can be quantified using a very small amount of blood. There are many companies that make these tests & they usually are less than $40 to run. The test only takes 10 minutes & shows either positive or negative. If a dog has a significant number of heartworms, sometimes you can see them directly in a drop of blood under a microscope. If the test comes back positive, depending on the overall health of your pet, we start therapy first with a round of the antibiotic Doxycycline, then we use a form of medical grade arsenic, injected into a muscle, either 2 or 3 times over a short course of time. This will kill any adult heartworm that are in the heart & in the vasculature in the lungs. It sounds pretty intense, but most dogs come through very, very nicely. I hope this helps. Take care.