The Worms Crawl In, the Worms Crawl Out …

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In the course of reading up on heartworm and heartworm treatment, which I did when the test result was positive in mid-April, I considered the ‘alternative’ methods of treatment, and it took me remarkably little time to reject them. First I looked at Paratox, which is a homeopathic preparation that is given in conjunction with heartworm nosodes; I read about claims of successful treatment of heartworm-positive dogs with it, but I was skeptical. I don’t believe that homeopathy is anything other than a placebo effect, and sometimes not even that. I’ve never had success with homeopathic remedies given to my dogs for anything, and I wasn’t going to go into a life-or-death situation like this one and pin my hopes on homeopathy.

Next I read about the ‘slow kill’ method, which consists of giving ivermectin (Heartgard) monthly to kill microfilarae and at the same time, just waiting for the adult worms present to die over time. This boggled my mind. If I felt like I was having a nervous breakdown over one month of living with worms in my dog’s heart, how could I do that for several YEARS? And the more time the worms live in the dog’s body, the more damage they do, to the heart and the lungs and other organs. No, slow-kill wasn’t an option. The more I read about it, too, the more I found reports of slow-kill methods taking as long as five years to eradicate all the worms – five years before my dog would be heartworm negative? Seriously? No.

So I ended up back where I started: at the American Heartworm Society protocol, which we followed and are following, step by step.

False positives do happen, so the first step was to verify the test result. The same blood sample that had produced the positive on the IDEXX antigen test was run through a microfilarae test, to see if there were any immature heartworms in his blood: the antigen test had indicated the presence of the hormone of adult female heartworm(s). If the microfilarae test were to show immature worms, the positive result would be confirmed. But it didn’t. No microfilarae in Rowley’s sample. “Yay, it’s a false positive!” I said hopefully to our vet; he had already drawn another blood sample from Rowley and was running it through another antigen test even as I spoke. This one also came back positive, dashing my hope of a false positive on the original test.

So we had adult heartworms but no immature heartworms. That’s good! (Well, ‘good’ may be overstating it … how about just ‘less awful.’) The next step was a physical exam to see if any irregularities were noted in Rowley’s heart sounds, and a chest x-ray to see how his lungs looked; we also did bloodwork to make sure everything was in order. Without microfilarae we hoped for good results from both those things, and we got them. He showed no signs of his heart or lungs being compromised – yet – by the worms. His bloodwork was excellent. Rowley’s was a Stage One infection, and we could have every expectation of an entirely successful treatment. Okay, so let’s kill the bleeping things! — Not so fast. A step in the treatment of heartworm, added a few years ago, is to administer doxycycline for one month before the Immiticide treatment, in order to destroy the wolbachia bacteria that accompany the heartworms and facilitate their survival in the dog’s body. I read that antibiotic therapy directed against Wolbachia leads to decreases in all stages of immature heartworms and might decrease numbers of adult heartworms as well. And because the presence of wolbachia often contributes to a significant, and often dangerous, inflammatory response seen in some dogs, treating with doxycycline can decrease complications associated with heartworm disease both pre- and post-treatment. It wasn’t a step we would skip, so Rowley started taking 10 mg of Doxy per pound of body weight per day. Even though I offset this whopping dose with daily probiotics and saccharomyces boulardii, by week two I was having to trick him to get the Doxy into him – it’s not a pleasant substance. In week four he stopped eating kefir, which was one of my most frequent hiding places for the antibiotic, and it’s only now, several weeks later, that he’ll accept kefir in his food dish again. And in addition to the doxycycline, Rowley started on a monthly course of Heartgard, to kill any microfilarae that might find their way into his body.

That was a really long month. There were worms living in my dog’s heart, and every single day I was conscious of that fact. I had started to reduce his exercise, pulling him from his twice-weekly agility classes and substituting leash walks for some of our trips to the nature preserve where he always bounded about off-leash. Neither of us liked the change to our routine, and I wanted those worms DEAD. I was actually relieved when the day came for his first shot of Immiticide. Of course, my relief alternated with a terror that the Immiticide shot would kill him, but what options did we have? To anyone who has never gone through the process of heartworm treatment in one of your dogs, I can say only: you never want to repeat it. You don’t even want to be doing it at all!

I dropped Rowley at our vet clinic in the morning and returned to collect him late that afternoon. He received the shot at about 9 a.m. and our vet called to tell me that all had gone well, there had been no problems and indeed, Rowley had been very cooperative. This is pretty amazing because that shot’s a nasty one: it’s a deep IM injection given in the lumbar (back) muscles. It’s a lovely compound that features arsenic, and it’s a carcinogen. Wow, could this get any better?! When I picked up my dog that evening, he had a square shaved patch on his back at the injection site. It looked like someone had stuck a Post-It on him. He’d been given Benadryl before the shot and generic Rimadyl after, and he had some more generic Rimadyl to take home, since we assumed his back would be sore. It probably was – and boy, was he tired! If I know Rowley, and I do, he didn’t sleep in the kennel at the clinic at all. And judging by the ten-minute leg-lift in the back yard at home, he didn’t relieve himself there at all either. There’s no place like home! He went right to his bed and zonked out. An hour or so later, he showed up in the kitchen when I was putting the dogs’ dinner together; he ate every bite – no doxycycline in it for a change! – and went out again to relieve himself and then went back to bed.

The relief I felt that a killing blow had been struck against the worms was enormous, and it was magnified by the fact that Rowley seemed to have handled the whole thing remarkably well. Whew! And in a perversely positive note, I requested and received an exemption from the requirement for any more rabies vaccinations for Rowley. Illinois is one of many states that now allows medical exemptions from rabies vax requirements if a veterinarian will state in writing that the administration of that vaccine would be harmful to the health of the dog. I felt, quite reasonably, that if I had to have my dog injected with a carcinogen in order to kill his heartworms, I sure shouldn’t have to have him injected later with a rabies vaccine that might have the effect of dropping a lit match into a pool of gasoline. So the request was made and granted, a short time later, by the County Department of Public Health.

 

Then came the lesser challenge of the treatment: keeping him quiet. More about that in the next post.

 

What the hell do you mean, it was positive?!?!

DSCF2029I learned that Rowley had heartworm when our veterinarian called me on the morning of April 14 with the news.  Yeah, I took Rowley in for his annual exam and heartworm/tick test on Friday the 13th – I probably won’t do that again!

It took me several minutes to process what I was hearing.  Heartworm?!  What the HELL?!  No, I was halfway prepared for the news that Rowley had tested positive for some kind of tick disease – in 2016 he was positive for Lyme, which necessitated a month of doxycycline and several very expensive Quant C6 tests; but Lyme, although nasty, doesn’t feature WORMS LIVING IN MY DOG’S HEART!

So as we staged his treatment for heartworm, which I’ll detail in a later post, I gave a lot of thought to the question:  how did we get here?  Because once I know that, I’ll know how to never get here again!  And after a good deal of remembering, and considering, and admitting stuff to myself, I found that we got here because of a really bad vet that I saw back in 1999, and because I, like many people in my area, allowed myself to become complacent about a pest that was rarely seen in our own backyards:  the mosquito carrying heartworm microfilarae.

Now, the bad vet of nearly 20 years ago isn’t responsible for Rowley’s heartworm in 2018.  Certainly not.  The effect the bad vet had on me was to turn me against pretty much everything I heard from a vet, any vet, for quite a few years.  The bad vet was the vet who vaccinated my first Sheltie, Briar Rose, literally to death, by administering every vaccine he could lay his hands on to a dog who had dermatomyositis (an autoimmune disease similar to lupus, and found in Shelties and several other breeds) and was on Prednisone to ‘manage’ that disease.  And yeah, he did it knowingly.  He told me once that Briar NEEDED the vaccinations because her own immune system wasn’t working well enough to protect her from parvo, lepto, distemper, blahblahblah.  Makes you wonder why the vaccine companies put the instructions to not vaccinate immune-compromised dogs in with the vaccines, doesn’t it?  To be fair, I think Dr. W truly believed in the miraculous properties of vaccines; but his faulty grasp of basic immunology, and his failure to heed the instructions in the vaccine packets, sure harmed my dog.  She died when she was only 9 years old, and I can’t count how many annual vaccinations she’d had – it still bothers me when I think about it, and she has been gone since 1998.  I also think his heavy hand with the vaccine needle contributed to, or might even have caused, Sander’s cancer, which was diagnosed three weeks after Briar Rose died.  Two dogs, two calamitous collapses of the immune system, that pretty much shot his credibility with me, and rightly so.

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Because Dr. W told me such arrant bullshit about that aspect of veterinary science, I decided that everything he said and had on offer was equally suspect.  (Remember, I’ve got my first dog dead at 9 and my second dog diagnosed with cancer at 7, and all I’ve done is everything this vet told me to do.)  That included the need for heartworm preventive in any chemical form.  And here I fell into the second part of the cause of today’s problem, the ability of dog owners in the Chicago area to discount the likelihood of heartworm because it’s not nearly as frequent or prevalent here as it is in other, warmer, parts of the country.  We do have winters that feature entire months of temperatures below freezing, when even if mosquitoes can survive, heartworm microfilarae certainly cannot.  I stopped giving Interceptor or any other chemical preventive in 2002, and since then, I’ve had more than a dozen dogs in my household, and none of them tested positive for heartworm – and all were tested annually for as long as they were here.  This made me think that the non-chemical protocol I was using to prevent heartworm was working, although there’s no way I can ever prove or disprove that.  But where would my dogs get heartworm – that’s something that rescue dogs coming up from Southern states have, it’s not something that my dogs can get in my yard, in my neighborhood, at my training centers!

But, of course, it is, and Rowley did.  And Marina Zacharias, who set the protocol that I used for more than a decade, isn’t around any longer, and I can’t ask her if there was, in fact, a scientific basis for the herbal preventives we used:  does black walnut hull extract kill heartworm microfilarae in the bloodstream of a dog?  I really do want to know that, and maybe some time I will find an answer to that.  Last summer I didn’t use black walnut hull, for the first time since 2002; I went with a preparation called HeartwormFree (HWF) (news flash – it doesn’t work) and abandoned Marina’s protocol.  Would Rowley have heartworm now if I’d stayed with Marina’s program?  I’d like to think I could go back to Marina’s program, but I know I won’t, because the risks are too great.  Unless I can verify the efficacy of black walnut hull extract, I’m not going to put my faith in it again.  (Marina also used heartworm nosodes, and I consider nosodes and homeopathy to be utter bunk, so she and I weren’t always on the same page.)

Once I left Dr. W and stopped doing things the way that had been so toxic to my first two dogs, I quit giving vaccinations after the initial shots, and I avoided rabies vaccinations whenever I could, and I switched all my dogs to a raw diet; but I did those things with a pretty solid foundation of proven cause and effect.  Titer tests showed me that my dogs had ample circulating antibodies to any given disease, even rabies; and the purpose of a vaccination is to raise the circulating antibodies, so I wasn’t assuming they had the protection conferred by a vaccination, I could verify it.  Raw diets had enough research behind them that I was very comfortable with what I fed (and still feed), and I never went to the extreme end of the raw-feeding spectrum, never went ‘prey model’ or even BARF.  I just gave/give my dogs unprocessed food, including grains, vegetables, dairy products, and meat and fish.  I never had the feeling that I was playing Russian roulette with their health, although the third time that my Sheltie, Sundance, tried to swallow half a turkey neck and only horked it up as I was putting him into the car to go to the emergency vet, I did stop giving HIM raw bones of any kind.

I guess my confidence about the vaccination and diet aspects of my dog care program carried over to the heartworm prevention part of that program.  That was a pretty serious mistake, and not one I will make again.  Rowley is on Heartgard; Alex, Dee and Beau are on Interceptor; and the Merle Girls are on Sentinel.  I’ll give the Sentinel and Interceptor at 6-week intervals and I’ll stop when the weather gets cold, but I’m not confident anymore that anything other than chemical preventive can kill heartworm microfilarae that might end up in my dogs’ bloodstream courtesy of a passing mosquito.  I don’t think this positive test was a fluke; I think it was an indicator that heartworm is here and not going away, and it’d be as stupid to ignore that as it would have been to let Sundance eat more turkey necks.
Seriously – WORMS WERE LIVING IN MY DOG’S HEART!  No, no, no, no and NO.

 

 

Next:  The step-by-step guide to eradicating those worms.

It’s the CinnamonDog Blog!

Welcome to the blog!  For anyone who doesn’t know, the CinnamonDog was my Sheltie, Sander, who left this earth in January 2006 at the age of 14, after having lived half his life with an inoperable cancer that the vets said would kill him in a matter of months.  Sander’s story is too long to detail here, but if anyone would like a (free) PDF of Sander’s Book:  The Education of a Dog Owner, which I wrote in 2007, just let me know and I’ll e-mail one to you.

Sander was a BFF dog, a dog who was always an equal partner in everything and who had insights and opinions that I believe he shared with me.  And although he’s been gone for 12+ years now, I still refer to him from time to time, and his portrait still keeps an eye on things in my household from a kitchen wall.  Here’s the essence of what Sander imparted to me in the course of 14 years of life, 7 of which included a malignant tumor:

  1.  Fear is a waste of time.
  2. You can learn something from anything that happens, and you should.

I recalled those two points when I adopted a rescue Finnish Lapphund, Heikki Takkinen, in 2009 and found that he had chronic ehrlichia.  Heikki, who became My Dog Mike or just Mikey, died in July 2013 when he was 14, and after we had kept the ehrlichiosis at bay for four and a half years — no mean feat!

I recall them again now as my Border Collie, Rowley, is undergoing treatment for heartworm.  This hasn’t been an easy couple of months for me, but the opportunity to learn comes in many forms, and I’m learning a few things here.  I’ll share them in my next posts.

For this introductory post, I’ll finish by introducing the canine members of my household, for anyone who doesn’t know them:
Rowley is 9, a BC who came to me from a rescue when he was 10 months old.  He, like Sander, is a BFF dog.
Beau is 10, a Sheltie who came to me from a rescue when he was 4 1/2.  He is the small auxiliary dog who orbits Rowley, but has also shown a willingness to orbit Alex.  He keeps a respectful distance from Dee.
Alex is 5, a Finnish Lapphund who came to me at 8 months of age.  He is a work in progress and defining himself more as he matures; he is a wonderful sniffer dog and loves Nosework.  He also loves me, Rowley, sweet potatoes, and getting muddy and full of burrs at the nature preserve.
Dee is 5, a Sheltie mix (with SharPei in her!  She’s our Exotic!) who came to me from a rescue when she was 2.  Dee is a very self-possessed girl and does as she pleases, which is why she’s not trusted off leash.  Ever.  LOL!  She recently certified in animal-assisted therapy work.

 

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That’s my crew.  I also have senior rescues, all of whom I took in thinking I would give them good endings to their lives, and all of whom have apparently discovered a fountain of eternal life in my front bedroom, the dog room.
Peekaboo and Posey are 14-year old Sheltie sisters, who came to me from a rescue that took them from a hoarder in the summer of 2015.  Together they are the Merle Girls.
CharlieBear is a Sheltie/Pomeranian mix, and the worst half of both, as PL Travers said.  He’s got to be 15 now.  He’s blind, gimpy, grumpy, irascible, and uninterested in being friends with either people or dogs.  When he arrived in March 2014, my vet thought he might last a year.  We think he’s been zombified, which would account for quite a few things.

 

I intend to write mostly about dogs:  my dogs, dogs in general, dogs I know and dogs I wish I could know.  Life with dogs; dog training; dog behavior; dog health; and how I manage those things.  Here goes!

 

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