Wolfy is almost 13. He has severe arthritis (for which he takes Previcox) but seems to be in good health otherwise. However, the vet said his bloodwork revealed that one of his kidneys is compromised, and this could be a problem if we decide to treat the heartworm because the treatment (which involves arsenic) is very hard on all the organs.

I read up on the treatment, and it sounds brutal. Given Wolfy's age, I don't know if I want to put him through that. So I'm exploring all options.

I see lots of websites devoted to natural remedies for heartworm. The only thing I've read so far are several first-hand accounts from several people who had success using black walnut and/or wormwood. This particular website was not selling anything.

Have any of you heard of, or tried, an alternative treatment for heartworm?

Thank you!

Susan

I understand that the owner, Marina Zacharias, is an herbalist who works closely with holistic veterinarians. I just read several accounts there of successful herbal/nutritional protocols for the treatment of heartworms.

Hope this helps.

First thing to do is to get your dog on heartworm prevention, specifically Heartgard, immediately. This will prevent further infection.

There are 2 different protocols for treating heartworms using melarsomine, the arsenic-LIKE (we don't use straight up arsenic anymore) medication. The standard protocol uses 2 injections of melarsomine 24 hours apart. It is good for dogs with minimal heart damage.

The second way to use melarsomine is to split the treatments, so you don't kill all the worms at once. The dog is given one injection, then 4-6 weeks later given 2 injections 24 hours apart. This is actually the preferred method of the cardiologists at school, because the risk of pulmonary thromboembolism is much lower. Pulmonary thromboembolism occurs when the worms die, and migrate into the vessels of the lungs, cutting off blood supply to the lungs. It is the most serious complication of treating heartworms as it can result in sudden death.

A third way to kill heartworms is the "slow kill" method. This is administering Heartgard once monthly year round for 2 years. It is only appropriate for asymptomatic dogs who are not very active, so your dog may qualify for this treatment.

In severely compromised dogs- those in congestive heart failure- surgery to remove the worms is possible only by a cardiologist. I've seen this also successfully done in cats.

Another consideration is Wolbachia infection. This is a parasite that lives inside heartworms and contributes greatly to the adverse effects of treatment. Dogs should be pre-treated with doxycycline 30 days prior to heartworm treatment (using melarsomine) to minimize the effects of sudden exposure of wolbachia due to the killing of heartworms. Here is a link for more information: http://www.dogaware.com/heartworm.html

No matter what treatment you end up using, keeping your dog from being active is the single most important thing you can do for him. The risk of pulmonary thromboembolism is much greater in active dogs than in dogs whose exercise is properly restricted.

As far as the risks to your specific dog, your vet is the person to ask about that after complete staging is done. I want to emphasize that heartworm disease is 100% fatal when not treated, and while there are certainly risks to treating heartworm disease there are ways to minimize those risks specific to your dog. While I am generally for a natural approach to treating most diseases, there is no scientific evidence that any of the "natural" remedies actually work or are safe. I personally would not treat my dogs with anything other than the most appropriate scientifically proven recommended protocol- heartworms are WAY to dangerous to justify playing around with unproven remedies.

Lisa

I haven't heartworm tested my dogs in years because I give them prevention year round. I tested my strays immediately when I got them and again 6 and 12 months later to make sure they were not infected (it takes 6 months for an infected dog to test positive), but they were on HWP as soon as I got them. The other reason to test is to make sure the product is working, or if you don't give prevention year round, in case of an early spring or late fall mosquito.

The alternative treatment that was suggested to me consists of heartworm nosode, Tibetan Anti Parasite (I don't know yet what's in that) and an organic Black walnut tincture. I'm still weighing my options.

Mazer, yes, Wolfy is on Previcox (canine version of Celebrex) for his arthritis. He tolerates it well, but it's so expensive! It costs about $100 a month, which is a lot for me.

Susan

Meghane, you're a vet, aren't you? My vet is young (I'm guessing early thirties), and I would think she'd be on top of this issue. The woman who recommended the alternative treatment also said it was imperative that Wolfy get started on Heartgard immediately. I can check with other vets in the area, but I'll be surprised if they don't all think alike. Although Wolfy's original vet (whom he saw up until last month) never even suggested heartworm prevention, so who knows?

She said that given Wolfy's age, if we don't treat the heartworms it's possible, even likely, that he will die of another cause.

The treatment she outlined included the following: HWtreat, adulticide, and Ivomec. Cost is about $480.

Today she recommended a urine test to see how his kidneys are functioning because his bloodwork showed an elevated BUN. She explained that we wouldn't want to embark on treatment that would cause his kidneys to fail. So I guess the next step is for me to collect a urine sample.

Not all vet schools are as good at teaching about heartworm disease. I noticed you are in the frigid zone 4b, so there probably isn't a lot of heartworms there, and therefore vets don't keep up with the recommendations so much. NC happens to be in a very endemic area, so we see a LOT of heartworm disease and do a LOT of treating, plus we have to use prevention year round, or the dogs WILL get heartworms.

This is directly from the American Heartworm Society Guidelines except I inserted the brand names of products in parenthesis.

"Administration of a chemoprophylactic dose of a macrocyclic lactone (Heartgard/Ivomec, Interceptor, Revolution) should begin as soon as the dog is diagnosed with a heartworm infection. While controversial due to the theoretical risk of inducing resistance to macrocyclic lactones, it may be beneficial to administer a macrocyclic lactone for up to six months prior to administration of melarsomine (Immiticide), when the clinical presentation does not demand immediate intervention. The reasoning for this approach is to reduce circulating microfilariae and kill migrating D. immitis larvae, and in the case of ivermectin (Heartgard, Ivomec), stunt immature D. immitis and reduce female worm mass by inhibiting the reproductive system. Milbemycin also sterilizes female worms, but it does not affect worms older than four months. Administration for greater than three months should result in reduced antigenic mass, which in turn may reduce the risk of pulmonary thromboembolism. Depending on the season and geographic locale, administration for three months also will allow immature worms to reach an age at which they are known to be susceptible to killing by melarsomine."

As far as using Immiticide in renal disease, the drug label states that at 2-3 times the recommended dose every day for 14 days, some dogs developed renal disease. Immiticide is not renal toxic at normal doses, so there is no contraindication for treating based on that.

That said, your vet is correct that you're not likely to buy him a bunch of time by killing off the worms immediately, and since he isn't clinical and probably already calm (wouldn't need exercise restriction) his quantity and quality of life would remain at least the same.

OTOH, the renal disease may actually shorten his life. I'd ask the vet about if there are other options besides NSAIDs that would help Wolfy with his arthritis, as all NSAIDs can have bad renal effects. Since he already has some degree of renal disease (how much depends on additional diagnostics such as urine specific gravity, urine protein:creatinine ratio, etc.) it would be better to avoid NSAIDs for him. A different medication such as Tramadol may help control his pain, and big bonus for you, it's a LOT cheaper than piroxicam. There are other options too if just Tramadol is not enough, such as gabapentin, but they tend to be more expensive (we have awesome pain management service and club).

Just based on what you have said, I'd be inclined to do just the monthly Heartgard as a slow kill and try to manage his renal disease and arthritis.

The vet I was seeing when I started this thread flatly refused to prescribe Heartgard. I went back to Wolfy's original vet, who readily agreed to prescribe it, and in fact said it was his preferred treatment for an elderly dog with heartworm. I was relieved to get this resolved so readily.

AND, after making a game of it and tossing the Heartgard (by halves) over and over to the reluctant Wolfy, I'm delighted to say that he finally ate his first dose.

Thanks again for the invaluable help.

Susan

My ferret loves his Heartgard (yep, ferrets get it too, usually fatal) prevention every month, but he doesn't play catch. He grabs it from my hands and runs off into a corner to eat his very special treat. My dogs are on Interceptor and take their prevention in peanut butter, along with the rest of their pills.

So my vet put him on some antibiotic that he said is to treat all sorts of worms, except heartworms. I also decided to change him back to his old food, just to be safe.

So now two weeks later, he's only thrown up once since, but lately that snorting, gagging, dry coughing that I described earlier he's done since a puppy, has turned from every now and then, to several times a day.

I'm concerned... could this be heartworms? If it isn't... any ideas what it could be? And even if it isn't heartworms, or if it is... should I put him on Heartguard? Thanks in advance for your help.

PS. Since he's in indoor dog, he's never had fleas. But recently I took him to get groomed and shortly after, I found fleas on him, so I put him on Advantage. Could there be some link to what's happening to him now, and the fleas?

The cough could be a lot of different things though, including collapsing trachea (common in small breed dogs), allergies, or any other number of problems; impossible for me to say. I don't think Advantage had anything to do with it; I've never heard of coughing as an adverse reaction to it.

In regards to my comment about the fleas and Advantage, I wasn't assuming it was the Advantage causing him problems, I was thinking maybe the fleas did. Any thoughts?