Heartworm a real threat

Dear Dr. Forsythe:  Our 4-year-old dog has tested positive for heartworm.  We are still waiting for another test to confirm the vet’s diagnosis.  I am very concerned because we never saw a single mosquito and didn’t think it would happen to our dog.  Is there an outbreak of heartworm disease?  Is there any truth to the rumor that the medicine to treat it is in short supply?

A.S.
Sonoma

Dear A.S:  I’m sorry to hear that your dog has tested positive for heartworm disease.  This is an easy disease to prevent, but over the last year I’ve noticed more and more clients asking to decline their pet’s annual heartworm test, and I believe that some clients have relaxed about the disease so much that they are not being vigilant and giving the once a month Heartgard prevention to their animals.

Like you, many people just don’t think heartworm disease will strike their pets.  Many people who keep their dog or cat inside most of the time don’t think there is a significant risk of becoming infected.  But as you are now aware, most people never see a single mosquito on their pet.  Many pet owners in Sonoma also travel to Tahoe or spend long periods of time in the desert for part of the year. Some veterinarians in  lower incidence areas where mosquitoes are rare have a lackadaisical attitude about heartworm prevention.  However, heartworm disease is nothing to be cavalier about.  All pets should receive an annual heartworm test and be given monthly preventative as a basic minimal standard of care.  Your pet’s chances of coming down with heartworm infection is virtually zero if you consistently give your pet the monthly preventative.

The medicine used to treat/cure heart worm disease is different from the monthly preventative and it’s currently on indefinite manufacturer back order.  Treatment for an active infection involves injections of a drug called Immiticide, a potent anti-dirofilarial drug that causes a slow death of the worms inside your pet’s heart.  Because the drug is in such short supply, it is extremely important to use the preventive to keep your pet from acquiring an active infection. Dirofilaria immitis infection is serious, difficult to treat, expensive, and eventually fatal if not treated.

Your veterinarian will have to pull a few strings to get the medication for your pet—assuming that the positive infection is confirmed by the lab. If that is the case,  locating some Immiticide is crucial and going through the treatment protocol is mandatory for your pet to survive.  I wish you the best of luck in getting your dog through this situation and hope the prognosis turns out well. – Dr. F

Dear Dr. Forsythe:  I recently moved to Sonoma from the Bay Area.  My dog, a 5-year-old Viszla, has had a couple of terrible allergic reactions in the past.  One time he got stung by a bee or wasp and almost died when he was young.  Is there anything I should have on hand in case he gets another sting that I could use to help him if he has another reaction?
Y.B.,
Sonoma

Dear Y.B:  Yes, it would be a good idea for you to have Benadryl on hand at home.  In the event of a bee sting, spider bite, or anything else that causes your dog to have facial swelling, trouble breathing, or vomiting,  I recommend that you give him 25mgs of diphenhydramine (Benedryl) which is available in a liquid or a capsule, and call your veteirnarian for advice.  Some animals are very sensitive to bites and stings, and they can react with an anaphylactic reaction that is akin to a child with a peanut allergy accidently eating something with nuts in it.  The most common reaction we see is facial swelling if the pet is bitten on the mouth or face.  Other shock-like symptoms can occur, and in some pets the reaction can be fatal if not treated.  Since your dog has already sufferend from a bad reaction in the past, you may want to speak to your veterinarian to make sure he covers you for after-hour emergencies.  Some of my high risk patients have learned how to administer an injection of steroid and keep one on hand at home in case of a life-threatening reaction.  Clients with very allergic pets like the peace of mind that comes with having an antidote at home they can administer immediatly even before they contact me about the emergency.  Good luck with this concern, and I hope you can prevent a possible future attack through the help of your veterinarian. – Dr. F