Tough Decisions - Medical Interventions, Heartworm Treatments

Poor Sully is still testing heartworm positive after over a year of treatment for heartworm prior to my adopting her. She was treated in the south with their typical, less-aggressive heartworm treatment. The vet here in New England wants to treat it in the much more aggressive, Yankee manner. I know I am not the first person who has had to decide whether to treat heartworm more aggressively or more conservatively, but seriously, Sully is a remarkable dog who deserves nothing less than an extensive research and review before deciding which treatment is best. It could be worse, to be sure, but I risk losing Sully regardless of whether I try to wait for the heartworms to die of "old age," or I flood poor Sully with poison to kill them quickly. I truly think the vets in the south and the ones here in New England are equally dedicated and kind. I just can't decide which treatment is more effective but less dangerous. I am so worried that the treatment will kill the worms, but may kill Sully in the process. I am also worried that trying to wait for them to die naturally will damage her heart and lungs so much she cannot be saved in that case. The options are so scary and sad. Any ideas? My poor little buddy. I feel like I swallowed a tennis ball.

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It really is amazing how differently the north and south view the treatment options. So many dogs in the south get heartworm that they seem to have a very low key approach to the treatments. They very rarely use the aggressive treatment in the south, but the medications they use down south to treat it slowly are impossible to get up here. I fact, I had to have them sent from the shelter in the south that I adopted her from. The treatment kills the baby worms and weakens the adult worms until they die of old age and the effects of the slow kill medicine. Having talked to the vet in the south I was really scared about the risk of the treatment used here but the pros and cons are swaying toward aggressive treatment since she is still testing positive. Sully never asks for anything or complains about anything. She has been through so much I hate to put her through any more suffering but I may not have a choice. I really appreciate the feedback and support from everyone.

Holly, Mowgli never suffered any side effects  from any of the treatments and was never in any discomfort from it.  They were probably harder on me (because I worried) than on him.  The hardest thing was to limit his activity as he was young.  The treatment cost me $1,000 and it does not surprise me that in areas where heartworm is prevalent ( which means many dogs have heartworm and many people do not use preventive on their healthy dogs ) other treatment options may be more cost effective to the owner. This would certainly apply to a Shelter.  If you have a trusted Vet, discuss your fears with him/her ask how many cases of heartworm they treat in a year and what, if any, side effects they have personally seen in their practice.   In the end there is no perfect choice, as we cannot see into the future, so trust your comfort level, make your decision and don't look back!

The only experience I have with heartworms is that they killed my daughter's cat.  He was a stray she got from a shelter.  It is far different in cats..fast and deadly...and there is no preventive for cats.

What I am hearing is that in the south they don't seem to take heartworm in dogs seriously and aren't big on the preventive.  Living in the north I find that disturbing.  Do the vets in the south even prescribe the preventive for dogs?  Is it something that is hard to get down there?  In the next 5 years or so we will be relocating to TN and even if Max and Katie aren't here go with us due to their age I will have dogs.

@Linda, I didn't know cats could get heartworm.... is it the same type of heartworm that can infect the dogs?

We winter in GA and have seen several vets there for various things with the 2 Corgis. We are always asked if they are on heart worm preventative so I don't think it is a "southern" thing with vets.

I think monthly prevention is recommended everywhere. It is the actual treatment for heartworms that seem to have two schools of thought. Not sure why fewer dogs might get the preventative I the south but I was told fewer animals get spayed or neutered in the south as well. Not sure if that is true, but they have more mosquitoes due to the warmer weather which would explain some of the higher HW infection rate.

Honestly?  I just think there are way, way more people in the south who keep yard dogs and the like that don't get very good care.   There are several rescues that bring hundreds of dogs from the south into our area every year for adoption because we don't have enough rescue dogs to meet the demand and the south is euthanizing many, many dogs in shelters.  Throughout the Northeast, shelters and private rescues van in more dogs from the south than you can count to adopt out.   Were it not for pit bulls coming from fighting and drug rings, our shelters here would be half empty.

Just throwing my two cents in but I agree that parts of the south do have issues with shelters and taking care of animals. I worry about my grandmother a lot because her area in Luisiana doesn't have an animal shelter so we always see packs of strays just roaming around. Plus people also let their own dogs just roam outside on top of that.. It can be a huge problem.

That being said.. some parts of the north may have shelters but those shelters have issues of their own.. One I worked for in VT wasn't a good place to be for an animal.. that's all I can say.. there's a reason I stopped working there... :/

I lived in North Carolina for 10 years (where I got Dillon from).  In the South, animals are animals with the majority of the population.  They are hunting dogs, or a lawn ornament.  They aren't pets.  It was nothing for me to see 2 or 3 dead dogs on the side of the road every day.  I saved more strays than I can even remember.  Dogs aren't given vaccinations, heart worm or flea treatment.  It's pretty rare that an animal is treated as having a soul that deserves a good, comfortable life where it's loved as family.  I could tell you stories from when I worked as a tech at the Emergency Vet Clinic that would turn your hair gray.

@Anna....I never knew cats could get heartworm either and I have always had cats, I have 3 now.  My daughter said her cat had not shown any signs of illness, he was sitting on the windowsill one morning and he suddenly started acting like he was strangling and struggling for air.  She was just getting out of the shower so her boyfriend rushed the cat to the vet but Otto was already gone.  The vet said it was most likely heartworm and did do an autopsy and it was. We never knew they could get it.  Her vet explained that it reacts differently, quickly and more violently with cats. And there is no preventive as of yet.  Her cat been a stray but they figured he was about a year old.  Broke my heart, she had grown up with a house full of dogs and cats and this was her very first pet that she had as her own in her own home, she had him only about 8 months.  It's been 2 years and she still hasn't gotten another.

Thank you all for giving me an insight to the difference between north and south.  Mine will always be on preventive whether I am in NY or TN.

@Beth....I will make sure I mention this to my friend.  She is looking for a rescue Havanese and one rescue group had one that was from GA but he was not a good fit for her lifestyle.

My beloved Dillon had heart worms at 8 months of age when I adopted him from the Humane Society in 1992.  I'm not even sure if they had gentler treatment back then, but he was treated with arsenic.  We followed the instructions to a "T" and he lived to the ripe old age of 16.  I'm sure the aggressive treatment is just as rough physically as it was back then, but science has come a long ways in evaluations of side effects and how to stop them.  I would rather do the aggressive and be done with it, then keep doing the simpler treatment--wasting money and time where the damage may be permanent or fatal.

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