New Spirit 4 Aussie Rescue Heartworm Treatment Protocol as of Fall 2011
Introduction: The drug, Immiticide, has been the treatment of choice for heartworm positive dogs. New Spirit has always opted for full treatment with Immiticide, even though it’s very expensive. In conjunction with a pre- and post treatment protocol, this was our preferred approach. and we had very good outcomes with it. But the maker of the injectable medicine that kills adult heartworms, Meriel, announced in June 2011 that it was no longer being manufactured in the US due to production problems and it has largely been unavailable since then. As of October 2011, the FDA has approved Meriel bringing in Immiticide manufactured for them overseas for use abroad. However, it will only be available in very limited amounts and Meriel will decide which dogs get it on a case-by-case basis. Vets will need to present the case of each specific dog and hope Meriel agrees the case warrants Immiticide, if available. In other words, it can’t simply be bought if they have some. Our new approach: New Spirit is responding to what looks like a long-term situation of non- or very limited availability of Immiticide by adopting the “slow kill” method for dogs who are heartworm positive. Slow kill is not actually killing heartworms: it is merely preventing any more larval stage heartworms from maturing into adults, and allowing the ones already present to die of old age. This method has long been used by many rescues and private owners who could not afford the $500-1,500 cost of full treatment. We will use this approach for dogs under age 4, and not showing any outward symptoms, such as shortness of breath, pale gums, coughing, and so on. Younger dogs will typically have a lower burden of heartworms to start with, and our hope is that plus their youth will enable them to do fine for the 2 years it takes the existing adult heartworms to die off naturally. Treatment with slow kill is far preferable to doing nothing in hopes that Immitcide will become available again at some point in unlimited quantities. “Slow kill” Method Details Month 1: doxycycline daily 5 x body weight (ex. 40 lb dog x 5= 200 so give 200 mg daily). Round to nearest 100 mg., give all at once. One Interceptor at start of month Month 2: give Interceptor at start of month Month 3: repeat month 1 dosing Month 4: repeat month 2 dosing, and so on Continue for 2 years. Discontinue doxycycline at that time. Continue Interceptor monthly for the rest of the dog’s life, as you would/should anyway. 6-12 months after the 24 month mark, they should get a SNAP negative for heartworm. We suggest waiting the full 12 months, so at the 3 year mark.
It is measuring antigens to heartworm, not the existence of actual heartworms. Each dog differs in how long their body continues to produce antigens once the adult heartworms are all dead, but at 12 months after the last one dies, we would expect to see a negative test. There may be some rare exceptions, such as when a stage 4 or 5 microfilaria (the early stage of heartworms) matures and attaches just as we are starting Interceptor to control the microfilaria. None of the preventatives fully kills larval stage 4 or 5. So one might slip past, mature, attach, and then have a full 2 year lifespan before it dies of old age. Even then, we expect by 3 years post start of treatment (Month 1) to see a negative heartworm test the vast majority of the time. Conclusion: You may read elsewhere that “slow kill” is giving only the monthly heartworm preventative (products such as Interceptor, Heartguard, Sentinel) for two years. We add doxycycline because good evidence suggests it helps control an organism associated with heartworm (Wohlbachia), and produces better outcomes. Doxycycline is cheap and well-tolerated in the dose suggested above. If you have any questions, please consult with your vet or feel free to contact us with other non-medical questions. Slow kill treatment chart: record treatment dates here Interceptor Doxycycline- 1 dose daily at 5 x body weight (ex. 40 lb dog x 5= 200 so give 200 mg daily). Round to nearest 100 mg.
20130826 11/10/2013 A & R MULTIMEDIA SRL20130833 11/10/2013 ACTIV CARGO GROUP SRL20130834 11/10/2013 ACTIVE-TRADE IND. SRL20130835 11/10/2013 ACTUAL CONSULTING SRL20130839 11/10/2013 ADI & LUCI TRANS SRL20130840 11/10/2013 ADI & NEL TRANS SRL20130383 11/10/2013 AFTENIE TRANS COM SRL20130389 11/10/2013 AGROMIXTA DEALUL OCNEI SA20130393 11/10/2013 AKA DESING & CONSTRUCT SRL2
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