A Diary: Fighting Heartworm Disease, the Treatments, the Options

The focus here is on Gisele the Collie who was adopted by Maureen, however, Reed’s Bandit, Spartan, Jackson Browne and Brooke (now Holly) are being treated for Heartworm.

This post will be produced in diary format. The purpose of this post is so that we can learn.

 

 

Written by Maureen about Gisele 02/10/10: She is really exhausted this evening. She slept in her bed next to our bed last night and only coughed a few times but was mostly congested in her nose. Sometimes she sneezes. We have been trying to encourage her to rest more and are keeping the lights and sounds low around here. Jan and I move her bed to what ever room we are in. She loves to be near us. In fact, she is snuggled up in her bed sleeping next to me now while I am writing this.

She is still pretty nasally congested even with the medications. The vet gave me a prescription for hydrocodone which is an antihistamine to help dry up some of the secretions while waiting for the antibiotics to kick in. She had to get the initial dose of the antibiotic IM because of the pneumonia starting. The x-rays showed a touch of pneuminia. She has had a few short spells where she is breathing only through her mouth and seems uncomfortable and her tongue isnt as pink as it should be. The doctor agreed that her lungs didnt sound too bad even though the x-rays showed some fluid starting to build up.

This week all of the blood results will come back and the stool panel for parasites. The vet reassured me that everything she has can be healed. Her heart is only slightly enlarged but the surrounding vessels already show significant swelling from the inflammation so the heartworms are moderately advanced but the damage may be minimal once it is treated. She agreed !00% that Gisele needs to be feeling much better before starting treatment. Shes a sick little girl right now.

Discussed heartworm treatment options including the slow kill method and the Ivermectin injections. My brain is fried from all the different opinions and information out there on the treatment of heartworm. I still want to research this subject more in order to make the best decision for Gisele. I would like to talk with the vet friend that you mentioned when the time comes to make a final decision on that. For right now I will do my best to get her back in top physical condition. Also got her some high quality vitamin, mineral, and Omega 3’s and 6″s supplements to add to her food. One of the supplements even has a nice combo of healing herbal ingredients. I have been talking to her and loving on her every chance I get.

I brush her and do light massage for healing- she really loves being groomed as I’m sure you noticed. Her surgical incision looks good. As you can tell, Gisele is well on the road back to feeling like the 2 year old that she is (my vet also agreed she is about 2) We decided that her 2 year old birthday will be on Valentines Day because her heart is so full of love and she is such a sweetheart!

Written by Maureen about Gisele 02/13/10: Hi Gisele, Just a quick update as I am getting ready to sleep now. Stopped by the vet on my way home from work this morning and picked up the results of all the lab tests. Went over everything with the vet and got some medication to treat the Giardia, Whipworms and Hookworms. She is still on the antibiotics and the decongestant and all of the nutritional supplements.

Everything else on the medical workup looked good. There were microfilaria from the heartworms which was no surprise. She is young and strong and is healing nicely from the pneumonia. She still has some congestion and sneezing and cough but no more choking spells where she is gasping to catch her breath and her tongue was turning pinkish white. The nasal drainage has changed from green to clear – a very good sign the strong antibiotics are doing their job.

Written by Maureen about Gisele 02/17/10: She is so intelligent and eager to please and her heart is so full of love. You know what an amazing animal you gifted us with. Yesterday I wrote about how improved her health was but last night during the night she woke up having a really bad respiratory attack of coughing. She couldnt get her breath and seemed panicky. The nasal drainage and congestion had just about dried up and she was doing great. I was so worried that we were going to have to take her to the emergency vet if she didnt come out of it. I held her and we talked to her to keep her calm and she was finally ok but we headed back into the vets office this morning anyway. I seriously thought she might die in my arms.

The vet suspected that she is having bronchospasms related to either the pneumonia which is better but not gone entirely or from the inflammation of the large pulmonary vessels that are full of heartworms. I was able to see where those vessels really were swollen on her chest Xrays. Maybe a combination of both. She is healing nicely but she is not out of the woods yet as I had thought. The vet ordered a strong bronchodilator that will help with the inflammation whatever the cause.

I will take her back next week for another checkup and to discuss the plan of treatment for the heartworms for when she is strong enough. I told the vet I am adamant about using the slow kill method and would prefer to do it under her supervision. She tried to talk me into the Injections but I said no. I told her I was happy with the care and really wanted to keep her as Gisele’s vet but my mind was made up and if I had to do it on my own I would. I really do want to do this method with the help of a vet though so that I can get a prescription for the doxycycline that helps weaken the heartworm by killing off the wolbachia bacteria thet lives in the heartworms gut. She said we will talk more next week.She keeps promoting the “easy-fast kill” method. I told her I would be happy to sign a release form in case they are only worried about litigation from using the meds off label.

I have been reading everything I can find. Was wondering if Sherry the vet you mentioned in one of your posts is available for consult. I will pay her for her time even for a phone consult. I am determined to do slow kill but need a skilled veterinary practitioner I can trust to walk the path with me. This is all new territory to me and the amount of conflicting info and opinion out there is overwhelming. I want to be able to get whatever I need for her to be comfortable during the months of heartworm treatment and it would be best if it was someone that

I trusted and had developed a good rapore with. This dog is too precious and too loved to risk losing. I want to do this heartworm treatment right and I would pay any amount of money for her to be well and rid of the heartworms. After reading about the pain involved with the injections and basicly having to crate her for up to 6 months

I know that I could never do that to her. This is a highly social dog and as you can see from the pictures to shut her away in a confined area would kill her soul. Especially after the terror of what she has been through I couldnt do that to her. And I cant carry her upstairs the 17 steps since she would have to be carried up and down to go outside to pee. If she were forced to stay downstairs while we were all upstairs that would be too cruel. She would even have to sleep alone downstairs away from her pack. So as you can see, there is no option except for slow kill. Any information you have or any resources you could direct me to would be greatly appreciated. I want to be ready with a definite plan of action of how to best do this as soon as Gisele is well enough. I will be happy to share my progress and story with all of your contacts so that this treatment will be an option for others. I have a bad feeling from just what I have read and experienced already that this heartworm treatment could this be is one of the best kept dirty profitable secrets in veterinary medicine?

Written by Maureen about Gisele 02/19/10: She is feeling better but is still having 2 or 3 of those really bad breathing spells only at night. She is gasping for air and struggling to breathe when they happen.The nasal congestion and the sneezing is totally gone and she was able to stop taking the antihistamine. Talked to the vet today and now she thinks the spells may be pulmonary edema from fluid pooling in her lungs since she is having them only when she has been lying down sleeping and it definitly isn’t from nasal drainage anymore. Could be the pneuminia still clearing up or blockage in the main pulmonary artery from the heartworms. Stopped by the vets office and got a different prescription for aminophylline- stuff they use for asthma attacks in case she needs it at night.

Written by Maureen about Gisele 02/25/10: Next Tuesday she will go back to the vet for her 3 week checkup. She is healing nicely but I am thinking that possibly and worried that the heartworms could be causing most of the problems in her pulmonary arteries. The pneumonia is under much better control as well as the sinus infection. She is no longer congested or sneezing or having nasal drainage. She still has breathing spells at night mostly when she has been laying on one side for awhile. She wakes up gasping for breath and heavily rapidly panting. I can see the fear in her eyes.

I have found that gently and slowly massaging her from head to tail will calm her and help slow the breathing. She loves when you talk to her. Last night I was doing laundry and had just brought a load from the dryer upstairs when she had an attack. I wrapped one of the warm towel around her chest and she LOVED it. So at least I have figured out several ways to calm her anxiety at not being able to breath. I also do the gentle patting that you told me you did with Goldie and putting her forelegs up on my shoulders with us both sitting on the floor. All of these things definitly help.

I hope you are doing well and the remainder of the adoptions are all going along smoothly. I will let you know the outcome of the vet checkup next Tuesday. If she is still having breathing spells then even after all of the antibiotics are gone and while on the aminophylline then I will see if they would consider doing an ultrasound exam of her pulmonay arteries and heart. The chest xray did show a significant enlargemant of the pulmonary vessels but the sonogram will show more detail of what exactly is going on inside her chest.

Written by Maureen about Gisele 03/04/10: TRUE LOVE! This is one big puppy…she always wants me to pick her up and hold her! I have to stretch out just to get her up into my “lap”. She is now up to 56 pounds! A weight gain of 7 pounds since you took her to the vet for her first exam after you rescued her. This Monday was her 3 week checkup. The vet said to keep her right about at that weight and not to let her get over 60 pounds.

My husband has been taking her for brisk walks everyday to build up her strength and endurance – and his too! She even lets him know when its time to get the collar and leash. All of the sneezing and nasal drainage has stopped. Her coat is soft and shiney from the frequent brushing and her gums even look nice and pink from all of the nutritional supplements. They took a stool sample to see if the first round of meds got rid of the heavy infestation of hookworms and whipworms that she had. I should get the results of that tomorrow. Hopefully she wont need a second round of treatment. She is finally off all of the antibiotics and the pneumonia is healed nicely.

The only bad news is that the heartworms are blocking the main pulmonary vessel. Blood and fluid are dangerously pooling whenever she is laying on her side sleeping for any extended period. Even though the additional tests I requested showed that her heart was not badly enlarged or damaged yet, the pulmonary vessels are all badly inflamed, enlarged and one is heavily blocked. I could actually see it on the pictures even before the vet pointed it out to me. Now we are back to square one on which treatment is best for her. The vet and I were in agreement about my preference for using the slow kill method. Even though the vet isn’t a big fan of that method she was fine with giving me the madications and prescribing the doxycycline that weakens the worms by killing off the microbes they need in their guts for digestion.

Now that the upper respiratory infection is gone and the pneumonia is cleared up the only reason she is still having the occasional coughing and nightly breathing spells (only 1 or 2 now a night) is from the pooling of fluid in her lungs and heart from the heartworms blocking the main vessel. The slow kill takes about 2 to 5 years to kill off the adults…the vet said she has actually had some good results with it but still prefers the Immiticide injections. They feel its better to kill the adult worms off fast to prevent possibly several more years of breathing discomfort and potential longterm damage that could shorten her life span. She also said that she hasn’t lost a dog yet or had any really bad complications from either one of these treatments.

She said I still have a few weeks to think about it because Gisele still needs to continue to build up her strength after being so severely ill and having the spaying surgery and going through so many other changes of God only knows what all at one time. I worked out an agreement with the vet that if I do decide to go through with the fast kill treatment, I will sign a release form allowing me to take her home at night so she will not be left in a cage or alone the night of the injection. She would have to stay there during the day for IV fluids and observation but we could put her bed in the SUV to ride home in. The guys could carry her to the car and into the house and I could stay up all night caring for her and keeping her quiet. I just can’t bear the thought of ever putting her in a cage. I would get several baby gates so we could block her off to stay in whatever room we are in. She pretty much does that by her own choice now! She is not hyper at all and would be a really easy dog to keep quiet.

The daily walks would have to stop for a few months but she could still go outside in the yard with supervision. Everyone in the family has offered to help in any way they can in order to do whatever she needs to get well. The vet included pain medications and steroids for muscle swelling at the injection site in the estimate for what it will cost to keep her as comfortable as possible. My heart doesn’t want to cause her this pain but when I am holding her in my arms duing her breathing spells and see the fear in her eyes I know I cant let her suffer like this for several years. I will give it 2 more weeks to see how she is doing and if the breathing spells will stop on their own before making a final decision. I love this special animal as if she were a child and want to get her whatever is best for her health and happiness. She has been such a blessing coming into our lives. I want her to live a long happy peaceful life here with us. I will keep you updated.

Update 03/16/10 on Brooke renamed Holly written by Jamie. Holly did undergo the heartworm treatment at the Titusville SPCA. Jamie writes:

Hi.

Holly is doing great! I took this pic and some others this past Sunday. She only has the oral treatment to go and then she is done.

The light patch on her back in the other pic I am sending you is where they shaved her hair to do the injection.

Update 03/26/10 about Gisele written by Maureen:

Hi Gisele, Just wanted to give you a status post heartworm treatment update. So far, so good….no problems at all. The first night was rough for her trying to get comfortable and there have been a few very heavy panting spells that scare me to death but otherwise she seems happy and comfortable.

Her appetite is excellent and the sore spot on her rump where they gave the injection doesnt seem too bad…occasionally she tries to chew that area. Today kelly came over and we gave all 6 of the dogs a bath and spa day. This photo is of “Holly Gisele” and Gretchie the German girl relaxing and drying out on the balcony in the sun. Her coat is becoming so beautiful. All of the dry skin and dandruff is now gone and with the twice daily brushings and Omega 3 and vitamin supplements her fur shines like velvet.

Oh my God is she ever beautiful! I will get some outdoors pictures tomorrow for you. Her next and last heartworm treatment is scheduled for Monday, April 19th. I made sure to have nothing scheduled that week so that I can stay near and be here for her the entire week. She will be coming home again afterwards instead of staying overnight at the vet. Last night was the first time she didnt wake me up with a breathing spell so maybe the heartworms are dying off or becoming less active or whatever it is that happens as they dessicate and are absorbed.

She has been taking her antibiotics and just finished the 7 days of anti-inflammatory steroid/pain pills. Maybe that is what has also helped ease the breathing spells at night. She is definitly healing slow but sure. I want to keep her with me for as many long healthy years as I can! Hope you are finding lots of time to relax but sounds like you are like me always busy doing something. Its hard to have a million interests and projects and goals….a creative mind can get ahead of you!

Will send you some better pictures tomorrow.

Take care

Maureen

Update on Spartan, HW+ Written by Nancy 03/29/10:

Hi, Bob (and Gisele):

I’ve been thinking about you! Spartan … now called Chester/Chet … is doing wonderfully. He’s put on about 5 lbs and is probably 58 lbs now … just about right. He’s so good, and so dear. A great companion! We’re sticking with monthly heartworm preventative and a daily aspirin. He takes easy walks with us every day, and occasionally tears around the back yard on his own. I figure he is as active as he wants to be.

We’ve had a few instances of growling over a toy, and once over food, but otherwise, no problems. One funny quirk is he has a real problem with my husband reading in bed! He likes Chris plenty, but a few times, when Chris has been lying down reading a magazine or the paper, Chester has growled and barked. Don’t know why! He calms down when I talk to him, though.

We still crate him at night, so our rat terrier gets to keep his domain in our bed.

We’re just enjoying him so much, and are so thankful to you and Gisele for making it possible for him to be part of our family.

Hope that all is well with you. Here are a few photos, too.

Best,
Nancy

Written by Lisa Groeninger about Lila 04/02/10:

Lila is also HW+. The veterinarian in Louisiana that vetted and spayed her felt that she would be a great candidate for slow kill HW treatment. She has a low saturation of heartworms and is healthy. So, my vet and I have set up a protocol using liquid ivermectin and a cycle of doxicycline (sp?). It was great to have Maureen’s diary of her experiences with Gisele. The information on heartworm treatment is heart wrenching – really “damned if you do and damned if you don’t” regarding fast vs. slow kill – there are pros and cons to both treatments…Ultimately it is not a cookie cutter decision but needs to be based on each dogs situation. I hope that I have made the right one for Lila.

Update 04/16/10 Written by Maureen about Gisele/Holly:

Holly is going for her 2nd heartworm injection at 9am Monday morning. I will sleep while she is there coz she has to saty there all day. I will keep you posted on her status. Please say some prayers for her. I worry to death something could happen…is dangerous and painful chemotherapy medication. I only have 1 class to go to next week and Kelly is gonna come over to stay with her while I’m gone. Otherwise I will be with her the entire week to make sure she stays calm and completely quiet. No more walks after Monday either till the vet says so. At least we are getting to the end of the treatments…then she can focus on finishing up healing over the next several months. I love her so much. Jan and I put her in the bath tub this morning and gave her a nice warm bath so she will be clean and we won’t have to move her around much next week. She knows she is beautiful. Her coat shines like black velvet now! Mary, the grooming queen video star would be proud of her! Have to brush and blow dry her one more time before I go to sleep. Her and Molly are like soft fluffy balls of fur after getting blow dryed. Love it!
-Maureen

Update 05/13/10 Update on Gisele from Maureen:

Hi Gisele, Just a quick note to let you know that all went fairly well at the vet today for Gisele’s post heartworm treatment. Even though it is still a little early yet they drew blood to check for the presence of any heartworms that may still be alive just to see whats going on with her load titers. We will have the results of that tomorrow. Keep your fingers crossed and say some prayers for her. Apparently the initial heartworm test had showed a very heavy load which may explain why she has had such a long rough road and why the pulmonary edema was exceptionally bad and the pulmonary vessels so enlarged. The vet listened to her lungs and she is still rather congested most likely from the worms dessicating and disolving which creates small emboli that need to be absorbed by the lungs. In addition to the Temaril they put her on 2 weeks ago when Jan had to take her in as an emergency for heavy panting spells and coughing/gagging up white frothy secretions, the vet thought another round of doxycline antibiotics and 10 days of high dose Prednisone would also help relieve the strain that is being placed on her cardiopulmonary system right now. There is still alot of edema in the lungs but we are going to continue to fight this one step at a time. The prednisone will hopefully decrease the inflammation that’s going on inside her blood vessels. I hate having her on steroids but its horrible to watch her uncomfortable and struggling to breathe at times, so I agreed to give them a try for 10 days. The vomiting and diarrhea that she had on Monday and Tuesday has stopped. The vet thought that there could have been a significant die-off of the worms in a short period that caused her to be sick like that. They aren’t kidding when they say this treatment is really tough on an animal!!!The medication they use to kill the worms is very similar to chemotherapy. I have been giving her extra loving and brushing as her hair is really falling out now big time! Her coat is still shiney and beautiful though. She absolutely loves being brushed. She will be able to resume her walks in a few weeks if we can get the lung edema under control and the coughing/panting stops. Jan will be really happy to hear that. They both really miss their daily walks together. Almost forgot to tell you that she now weighs 62 pounds which is right where the vet said she needs to stay. She has filled out nicely and isnt over weight. She is just a large boned border collie. Everyone at the vets office adores her….they all come to see her and get kisses and hand shakes when we arrive. We always take a bag of candy for them because they all take such good care of her. Everyone that meets her falls in love with her. She is the most amazing dog. She has added so much happiness to our lives and it does my heart good to know that this sweet affectionate animal with a heart so full of love got a second chance at life. Thank you so much for taking her under your care and rescuing her. You and your group of helpers efforts and hard work put out to save her is so appreciated more than you will ever know. This sweet Collie is so worth all of the time and patience and work it has taken to help her heal from when she was deathly sick and unwanted. I am certain that she knows she was saved and is now very loved and safe in her very own forever home. The love and devotion in her eyes is so completely worth whatever it will take to get her well again. Take care Gisele, have a good evening and I will update you tomorrow when I get the blood test results back. Your Friend, Maureen

Upate by Maureen 05/14/10 about Gisele:
Hi Gisele, Im drinking my coffee trying really hard to wake up. I just found a voice message from the vets office and sweet girls heartworm test is still positive which means some of the worms may still be dying. He tested her a little early though because of all of the respiratory problems she has still been having. If it test positive again in 30 days then she will need a 4th injection. I am trying to feel hopefull but I just held her and cried into her soft fur. The thought of putting her through this horrible pain again is devastating. I just say prayers of thanks she is my dog now because the worthless human that hed such a fine animal didn’t deserve to have her if they allowed her to become so sick. I try to be patient and understanding because I don’t know their circumstances. Yet I am angry that human ignorance led to this. I wonder how many days she was left outside alone and exposed to the elements as well as all sorts of insects from the look of that collar you showed me she was wearing when you got her. This is an extremely sensitive animal that wants nothing more than to lay beside your bed at night and sleep peacefull and be wherever her humans are. I will call the vets office in the morning to find out the level of the heartworm load still alive. Have to leave for work now. The next 2 days are my 12 hour shifts but I will get back with you. Love Maureen

Here are some comments made on Facebook!
Another great link http://www.colliehealth.org/ivermectin.html

06/15/10: Just got a text message from Maureen. Collie Girl Gisele is heartworm negative!