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Posted on 04-22-2016

Ah, one of the most frustrating and sad things a veterinarian faces in our day to day lives. It is sad because  for the most part, it is preventable.  And frustrating because there is a lot of mis-information out there (on the internet, mostly) that people believe and it puts their pet's lives at risk.

A heartworm begins its life as a tiny, microscopic organism living inside a mosquito.  When the mosquito bites your pet - either dog or cat (yes, your cat CAN get heartworms) - the mosquito sucks out blood and the tiny heartworm swims down the mosquito's mouthparts into your pet.  So that one mosquito that gets into your house, or that one time a day your pet goes outside to go to the bathroom- that is enough.  It does not take a dog who lives outside or a swarm of mosquitoes to put your pet at risk.  Almost every pet is at risk.  

Once that tiny heartworm is inside your pet, it makes its way through the body to the heart.  This process takes a long time, though.  The first two months of its journey, it stays in muscle tissue and is not even in the bloodstream yet.  It is during this time that the monthly heartworm prevention is effective at killing this tiny worm.  After the first two months, though, it enters the bloodstream and heads toward the heart itself.  Once it does this, the prevention is no longer effective to kill it.  That is why it is important not to miss any of your monthly prevention.  Just one or two months off- even if it is a winter month here in Virginia (because, face it, does it ever reliably stay cold enough to really kill off all the mosquitoes for an entire month?) - could put that tiny heartworm past the point where the prevention will kill it.  

Six months after the mosquito bit your pet, the tiny, microscopic heartworm has made its way to the heart and is now a full grown several inch long actual worm living inside your pet's heart.  As the heart is beating, this worm is in the way, causing the heart to be ineffective and causing irritation to the heart.  It is at this point that our test is going to be able to find them.  The first six months, we cannot find them with out blood tests, so we do not even know there is a problem.

If not treated, the heartworm will live for 5-7 years in your dog's heart or 2-3 years in your cat's heart.  Have you heard of the "slow kill" method of heatworm treatment?  It involves giving some medication to decrease the inflamation from the dying worms and going ahead and giving the heartworm prevention while the dog has heartworms and waiting for them die naturally.  So for the next 5-7 years of the dog's life, the worms will continue to cause damage while slowly dying off and causing inflammation and potential lung reaction to the dying worms too.

The only other option for treatment of heartworms once your dog has them (yes, dog only, since there is no treatment for cats once they have them) is a drug called Immiticide.  It is currently difficult to get and thus very expensive.  You will need keep your pet very calm and quiet for several months worth of treatment.  So you see, not only is it cheaper, but it is much easier and safer on your pet to give them the monthly preventative pills.

BUT!  Stop the presses- prevention is not just the monthly pills any more.  There is an injection now that lasts for 6 months.  For those people that have trouble remembering to give the pills, we can help.  There are also topical options too. (These are particularly helpful for our feline friends- because who wants to give their cat a pill?)

And finally, what about that test every year?  Why do we do that?  Unfortunately, dogs are dogs, and they are known to spit pills out, throw them up, hide them, or various other devious things that make you THINK they got the medicine and they did not.  Even the most compliant owner in the world can be fooled.  The second and frankly, more worrisome reason is that we are starting to see some resistance to some of the preventatives.  Meaning, even when we KNOW that the pet got the medication exactly as directed and exactly on time, some cases of heartworms are still happening.  This happens with insects and parasites- over time, they develop resistance to the medications we use to kill them.  We see in farming with the chemicals/additives used on crops, we see it with fleas, and now we are starting to see it with heartworms.  So even if you give the pills every month without fail, there is still a small risk.  And as your veterinarian, I would rather know there is a problem as soon as possible.  The sooner we treat your dog, the less permanent damage the heart will have.

For more information, go to: http://www.heartwormsociety.org/

I posted on our Facebook page a short, funny commentary about heartworms you might want to look into.  For those people who want a funny but informative (and much more regular) look into the life of veterinary medicine, check out the "Cone of Shame"- it's a YouTube channel hosted by Dr. Andy Roark (http://www.drandyroark.com).   Still, even after practicing for 17 years, I learn things from him.  But what I really want to know is:  how does he find the time?  He practices full time, blogs, has the YouTube channel, has a website, facebook page, you name it.  

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