- Location
- Andorra and Spain
Advantix is the one for ticks and fleas (and black flies etc). I use both Advantix and Advocate, every four weeks, staggered by two weeks.
Carbón beats heartworm: treatment and recovery journal
- Thread starter Emily_Babbelhund
- Start date
Cath
MLF Sales Coordinator
I use it too on both of mine.
Glad Carbon is getting the help he needs. You are a Star Emily
- Location
- Buckinghamshire UK
Emily and @snowbunny Alex's test results came back this morning. He is negative for heartworm. 
Boogie
Moderator
- Location
- Manchester UK
Marvellous news!Emily and @snowbunny Alex's test results came back this morning. He is negative for heartworm.
.
- Location
- Andorra and Spain
Yay! Great news, I know it was very unlikely, but it must be a weight off your mind, anyway. Keep on rocking, Alex! 
Emily_Babbelhund
Mama Red HOT Pepper
- Location
- Regensburg, Germany
Emily and @snowbunny Alex's test results came back this morning. He is negative for heartworm.
Wonderful, wonderful news! Good boy, Alex!
- Location
- Ontario, Canada
Woohoo!!Emily and @snowbunny Alex's test results came back this morning. He is negative for heartworm.
We are using slippery elm now, it helps intestines, throat and stomach by coating it and soothing inflammation. It can help with diarrhea as well. I'm doing one week on, one week off, as it creates a coating and could affect absorption of medications/nutrients after prolonged use, and there have been no formal studies on the impacts. I would check if this is safe to use as mine clearly states on the label that it can interfere with some medications.
Emily and @snowbunny Alex's test results came back this morning. He is negative for heartworm.
Jacqui-S
Moderator
- Location
- Fife, Scotland
Emily_Babbelhund
Mama Red HOT Pepper
- Location
- Regensburg, Germany
As Carbon has been doing so well with his food for the past week, this morning I tried giving him some chicken wings. This is the first meat he's had in a week, as I've been feeding only fish and eggs for protein. I thought trying this in the morning may work, as he has his stomach protector in the morning and when he had an issue before, it was always after his evening meal.
Unfortunately he also got into human poo on our walk today - yuck, yuck, yuck - so this may have also influenced the tummy upset that followed.
Anyway, to make a disgusting story short, his entire breakfast of 6 chicken wings came up along with some other unmentionables about four hours after it went in. I now know what I've suspected: Carbon eats raw chicken wings pretty much whole. Not good.
We'll be going back to fish.
On a much less disgusting note, I bit the bullet and ordered a bucket load of supplements for him yesterday to help him survive the gauntlet of antibiotics that he'll be on for the foreseeable future.
Impromune from Spain to help boost his immune system and Florentero from Italy for his gut function. Both are used by vets in Spain with dogs with multiple issues, especially when multiple issues combine with Leishmaniasis. Carbon's buddy Paul was on both during heart worm treatment and Carbon was also on both when he was initially so anaemic. I'd stopped them as he was doing so well - and frankly they are both pricey - but I thought it was time to re-up.
The vet has already cleared him on his green lipped mussel powder for joint health, so he'll continue that as well. I looked up side effects thinking it may be adding to the nausea, but apparently it can cause gas and loose stool - neither a problem for Carbon. Well, he can be gassy but I figure that's more down to the half a kilo of broccoli he eats per day!
I will ask the vet about maybe alternating with slippery elm as well and if he can have kefir on the weeks where he does not have to take the doxyclycine. Hopefully a combo of a bunch of gut solutions will keep his tummy in working order despite the antibiotics onslaught.
Now if I could just keep him from the human poo. Did I mention?
Unfortunately he also got into human poo on our walk today - yuck, yuck, yuck - so this may have also influenced the tummy upset that followed.
Anyway, to make a disgusting story short, his entire breakfast of 6 chicken wings came up along with some other unmentionables about four hours after it went in. I now know what I've suspected: Carbon eats raw chicken wings pretty much whole. Not good.
We'll be going back to fish.
On a much less disgusting note, I bit the bullet and ordered a bucket load of supplements for him yesterday to help him survive the gauntlet of antibiotics that he'll be on for the foreseeable future.
Impromune from Spain to help boost his immune system and Florentero from Italy for his gut function. Both are used by vets in Spain with dogs with multiple issues, especially when multiple issues combine with Leishmaniasis. Carbon's buddy Paul was on both during heart worm treatment and Carbon was also on both when he was initially so anaemic. I'd stopped them as he was doing so well - and frankly they are both pricey - but I thought it was time to re-up.
The vet has already cleared him on his green lipped mussel powder for joint health, so he'll continue that as well. I looked up side effects thinking it may be adding to the nausea, but apparently it can cause gas and loose stool - neither a problem for Carbon. Well, he can be gassy but I figure that's more down to the half a kilo of broccoli he eats per day!
I will ask the vet about maybe alternating with slippery elm as well and if he can have kefir on the weeks where he does not have to take the doxyclycine. Hopefully a combo of a bunch of gut solutions will keep his tummy in working order despite the antibiotics onslaught.
Now if I could just keep him from the human poo. Did I mention
?
- Location
- Argyll & Bute, Scotland
Poor little man. Hope the supplements help him, he deserves a break and so do you 
Human poo!! xx
Human poo!! xxUrrgghhh!! We’ve had that—middle of the night in our bedroom. As if some homeless person pooed in our bedroom (who’s poo does Carbon find??). THANKFULLY Snowie has kicked the habit. Not sure if there is less poo around—although there are still homeless people, so I’m guessing not. I really do think he was seeking it out cos of his tummy issues. After eating kefir for so long, I wonder if that is the reason he no longer desires the human poo. Lately he’s gone off kefir, so I’m hoping he doesn’t regress!! But maybe once Carbon’s tummy issues resolve, he’ll stop seeking out human poo?
- Location
- Herefordshire, UK
Do you know, that's really interesting. I wonder if it would have any effect on poo eating in general, it does strike me sometimes that it is a problem of imbalance, I think I shall look into giving Cassie some kefir.
Emily_Babbelhund
Mama Red HOT Pepper
- Location
- Regensburg, Germany
Unfortunately he was a human poo fan before the heart worm treatment started. Ick. If kefir can help that problem, it really is a miracle! I'm seeing his vet again tomorrow morning, so I'll ask to make sure he can have it during his alternating weeks off from the doxycycline.
There's a homeless person camping - in the snow! - on the island in the Danube where Carbon and I walk with the hooligan crew once a week. Yesterday was my fault - I was walking and talking and not paying attention when I should have put Carbon on lead in the poo danger zone.
I can't believe that poor guy is still out there this time of year. Summer, I understand - actually lots of people camp out there on the island in summer. But winter! It's not been particularly cold, but still highs of around 3C and lows of -10C and today about a foot of snow. How is that poor guy still alive in that little tent?
Emily_Babbelhund
Mama Red HOT Pepper
- Location
- Regensburg, Germany
I've just gotten back from the vet with Carbon and I'm feeling quite down...as in sitting in front of my frenzied Google searches and crying.
Business first: today Carbon had a blood draw to measure the impact two weeks of doxycycline is having on his liver. I also asked for another heart worm test. We'll go back on Friday to get the results and discuss next steps. The vet also gave me his drug treatment protocol for the full 35 weeks.
She ok'ed the Impromune - was very excited as apparently the main ingredient is shiitake mushrooms and she's all in favour of that. She was still going to look up the Florentero, but did warn that the probiotic component would likely be wasted as the doxy will just kill them off. She ok'ed kefir for the weeks that he is not taking the doxy.
Then we got into my questions about activity level. On Friday, she told me he could go off lead and run. I've been doing a lot of reading about 'slow kill' and restricted activity. Most say the dog should not only be restricted, but actually crated during the whole treatment for either slow kill or
melarsomine-based methods. For slow kill that means 10-12 months (or longer) and for melarsomine injection protocol, that means three months (or longer).
Today I expressed my concern about what I'd read about activity levels.
"Well, maybe keep him from playing with other dogs."
"But you understand even if he's by himself, he runs around in circles."
"In circles?"
"Yes, he gets the zoomies."
"What are the zoomies?"
"You know, these massive bursts where he runs around and around for a minute or so and then flops down in a heap."
"He does that even with no other dogs around?"
"Of course! He's a year old dog!"
"Well, maybe no zoomies,"
"But then I have to keep him on lead, because he always does zoomies off lead."
"Oh you know, it's really probably fine."
"Probably?"
"The truth is the worms can cause embolisms even if the dog is just laying down."
"So what is SAFE? I need to know what's SAFE so I don't kill my dog."
"Well, nothing's 100% safe, is it?"
Look, she is a very nice and patient woman who truly loves her patients. I fully appreciate that she is in new territory here with the slow kill method but I do not feel comfortable with all this. Every answer seems to come with a "let's see" or "should do", which is not inspiring confidence.
Regarding the activity, she did say that she's getting this from a massive shelter in Hungary where they are not able to restrict activity. Also in Spain, I was told to restrict Paul's activity for 24 hours after his melarsomine injections - that's it. The AHS says dogs should be crated 100%. All that to say that how long and how much to restrict activity seems to be a BIG question mark.
Now let's have a look at slow kill. The thing is, it can mean MANY MANY different things. So when you have the American Heartworm Society saying that slow kill doesn't work and to use melarsomine (arsenic derivative) injections because 'slow kill' will just prolong the damage to the dog and not kill the adults, it sounds really scary. Plus slow kill is continually cited as an irresponsible option used by dog-owners who can't afford the very expensive melarsomine injections (aka immiticide).
But what is slow kill? Depending on what study is cited, slow kill uses these drugs:
1. Moxidectin topical (Advantage Multi) plus doxycycline
2. macrocyclic lactone (often ivermectin which is in the Macrocyclic lactone family) topical plus doxycycline
3. Ivermectin tablet form ("Heartgard") alone
Complicating matters, one reason the American Heartworm Society is so gung ho against slow kill is that they define it as #3 above. Why? Because due to the USA's screwed up drug manufacturers, it is very hard to get doxy, and when you can get it, it runs over $600 for a month supply. That would be over $7000 for 12 month treatment. Melarsomine injections (aka the fast and recommended protocol) is a relatively inexpensive $1000.
Anyway, back to the treatment. Within options 1-3 above, there are a myriad of protocols. Take doxy for a month and apply topical ivermectin once per week. Take doxy for two months, then one month off, then six months ivermectin twice a month.
There have been a few studies with slow kill - one with beagles that was the thing that got me crying like a baby - but none use the same protocol or the same medications. None mention exercise. Efficiency of clearing the dogs from adult worms ranged from 70 to 96%. The study with a 96% success rate used the same drugs as what my vet recommends, but in a much shorter study and without alternating the doxy on/off. It used 16 dogs, so a relatively small study. Another study shows that alternating the doxy as my vet wants to do has been shown to boost the doxy's ability to clear worms. In theory - and keeping in mind the very small sample size - that should mean that my vet's slow kill protocol should be around 97% effective over a 12 month period.
Finally, for comparison, the 'gold standard' recommended treatment using melarsomine injections has a success rate of 89% for the two injection method. This protocol also uses two months of doxy prior to the melarsomine injections. Of course with melarsomine, if the dog doesn't test negative with follow up heartworm tests, they repeat the melarsomine.
So to summarise my neurotic fears:
It's really hard to know what it is the best for Carbon and to not worry, worry, worry.
Business first: today Carbon had a blood draw to measure the impact two weeks of doxycycline is having on his liver. I also asked for another heart worm test. We'll go back on Friday to get the results and discuss next steps. The vet also gave me his drug treatment protocol for the full 35 weeks.
She ok'ed the Impromune - was very excited as apparently the main ingredient is shiitake mushrooms and she's all in favour of that. She was still going to look up the Florentero, but did warn that the probiotic component would likely be wasted as the doxy will just kill them off. She ok'ed kefir for the weeks that he is not taking the doxy.
Then we got into my questions about activity level. On Friday, she told me he could go off lead and run. I've been doing a lot of reading about 'slow kill' and restricted activity. Most say the dog should not only be restricted, but actually crated during the whole treatment for either slow kill or
melarsomine-based methods. For slow kill that means 10-12 months (or longer) and for melarsomine injection protocol, that means three months (or longer).
Today I expressed my concern about what I'd read about activity levels.
"Well, maybe keep him from playing with other dogs."
"But you understand even if he's by himself, he runs around in circles."
"In circles?"
"Yes, he gets the zoomies."
"What are the zoomies?"
"You know, these massive bursts where he runs around and around for a minute or so and then flops down in a heap."
"He does that even with no other dogs around?"
"Of course! He's a year old dog!"
"Well, maybe no zoomies,"
"But then I have to keep him on lead, because he always does zoomies off lead."
"Oh you know, it's really probably fine."
"Probably?"
"The truth is the worms can cause embolisms even if the dog is just laying down."
"So what is SAFE? I need to know what's SAFE so I don't kill my dog."
"Well, nothing's 100% safe, is it?"
Look, she is a very nice and patient woman who truly loves her patients. I fully appreciate that she is in new territory here with the slow kill method but I do not feel comfortable with all this. Every answer seems to come with a "let's see" or "should do", which is not inspiring confidence.
Regarding the activity, she did say that she's getting this from a massive shelter in Hungary where they are not able to restrict activity. Also in Spain, I was told to restrict Paul's activity for 24 hours after his melarsomine injections - that's it. The AHS says dogs should be crated 100%. All that to say that how long and how much to restrict activity seems to be a BIG question mark.
Now let's have a look at slow kill. The thing is, it can mean MANY MANY different things. So when you have the American Heartworm Society saying that slow kill doesn't work and to use melarsomine (arsenic derivative) injections because 'slow kill' will just prolong the damage to the dog and not kill the adults, it sounds really scary. Plus slow kill is continually cited as an irresponsible option used by dog-owners who can't afford the very expensive melarsomine injections (aka immiticide).
But what is slow kill? Depending on what study is cited, slow kill uses these drugs:
1. Moxidectin topical (Advantage Multi) plus doxycycline
2. macrocyclic lactone (often ivermectin which is in the Macrocyclic lactone family) topical plus doxycycline
3. Ivermectin tablet form ("Heartgard") alone
Complicating matters, one reason the American Heartworm Society is so gung ho against slow kill is that they define it as #3 above. Why? Because due to the USA's screwed up drug manufacturers, it is very hard to get doxy, and when you can get it, it runs over $600 for a month supply. That would be over $7000 for 12 month treatment. Melarsomine injections (aka the fast and recommended protocol) is a relatively inexpensive $1000.
Anyway, back to the treatment. Within options 1-3 above, there are a myriad of protocols. Take doxy for a month and apply topical ivermectin once per week. Take doxy for two months, then one month off, then six months ivermectin twice a month.
There have been a few studies with slow kill - one with beagles that was the thing that got me crying like a baby - but none use the same protocol or the same medications. None mention exercise. Efficiency of clearing the dogs from adult worms ranged from 70 to 96%. The study with a 96% success rate used the same drugs as what my vet recommends, but in a much shorter study and without alternating the doxy on/off. It used 16 dogs, so a relatively small study. Another study shows that alternating the doxy as my vet wants to do has been shown to boost the doxy's ability to clear worms. In theory - and keeping in mind the very small sample size - that should mean that my vet's slow kill protocol should be around 97% effective over a 12 month period.
Finally, for comparison, the 'gold standard' recommended treatment using melarsomine injections has a success rate of 89% for the two injection method. This protocol also uses two months of doxy prior to the melarsomine injections. Of course with melarsomine, if the dog doesn't test negative with follow up heartworm tests, they repeat the melarsomine.
So to summarise my neurotic fears:
- Does my vet know what the heck she is doing?
- Do I let Carbon run or not? How much? How long?
- If I really restrict 100%, what does the slow kill method of 12 months without activity do to his quality of life and social development?
- If I don't restrict, so I just have to accept that he could keel over dead pretty much any time in the next year?
- In the year that this slow protocol takes, are the adult worms doing irreparable damage to his heart and lungs?
- What if we go through all this and he still will need the melarsomine, with the worms and damage in a much worse state after going through a year of slow kill?
- What damage will the slow kill drugs do to his immune and digestive systems?
It's really hard to know what it is the best for Carbon and to not worry, worry, worry.
Boogie
Moderator
- Location
- Manchester UK
“The truth is the worms can cause embolisms even if the dog is just laying down.”
I think this is the really telling phrase.
Vets (and doctors) have to cover all possibilities, however rare. I think I would allow some free running but no crazy play. I do know how much that is easier said than done!
I think this is the really telling phrase.
Vets (and doctors) have to cover all possibilities, however rare. I think I would allow some free running but no crazy play. I do know how much that is easier said than done!
- Location
- Andorra and Spain
I'm not surprised you are confused, scared and frustrated.
Is there any way you can get on the phone with someone from AHS so you can talk it over, rather that trying to find an article or study that replicates your situation and environment? That would be my first post of call, try to get someone who actually KNOWS about this stuff.
Is there any way you can get on the phone with someone from AHS so you can talk it over, rather that trying to find an article or study that replicates your situation and environment? That would be my first post of call, try to get someone who actually KNOWS about this stuff.