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Dr. Emily
Dr. Emily, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 945
Experience:  Associate veterinarian at a small animal clinic
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My dog just had a blood test while having her teeth cleaned

Customer Question

My dog just had a blood test while having her teeth cleaned at a dental vet. The blood was sent out to a lab. The vet called and said the lab results were inconclusive, that there was a possibility she (Lilly - my Yorkie) may have heart worms. They recommended another blood test in 3-4 weeks. They suggested the blood be sent out to a lab rather than in house. Due to my ignorance, I thought dogs got heart worm from other dog feces. Therefore last September I gave her the heart worm preventative for only the first 2 months since she never was with other dogs or dog parks. Unfortunately I am a worrier! What is your regimen for treating heart worm if the test comes out positive. She recently threw up several times, occasionally has a hacking cough, and makes a wheezing noise with every intake breath. Should I have her heart and lungs x-rayed now? My daughter just adopted an 8 week old puppy from the Humane Society. She, as yet, has not been put on a heart worm regime. Is it safe for the two to be together w/in the next two days? Im anxiously awaiting your opinion.
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  Dr. Emily replied 2 years ago.
Dr. Deb is currently not available but I wanted to help so you didn't have to wait any longer. First of, as far as your daughter's dog, it is safe for them to be together because heartworm is not transmissible between two dogs. It is transmitted via mosquitoes. I still recommend the puppy getting on prevention for his/her own health though. As far as far how it is treated, there is quite a few details I'd like to go over.
Expert:  Dr. Emily replied 2 years ago.
Currently available heartworm antigen tests (in house or at a lab) detect protein secreted mainly by adult female Dirofilaria immitis. The earliest that heartworm antigen and microfilariae can be detected is about 5 and 6 months post infection, respectively. Whether screening a population of asymptomatic dogs or seeking verification of a suspected heartworm infection, antigen testing is the most sensitive diagnostic method. It is now recommended, however, that microfilaria testing be done in tandem with antigen testing. This is especially important if there is a high degree of suspicion or if the heartworm prevention history is unknown (e.g., dogs adopted from shelters). It has come to light that in some dogs infected with heartworms, antigen–antibody complexes may lead to false-negative antigen test results. These dogs will be antigen negative and microfilariae positive
Expert:  Dr. Emily replied 2 years ago.
Treating heartworm infections in asymptomatic patients or those exhibiting signs of mild disease usually is not problematic if exercise is curtailed. Infections associated with moderate or severe heartworm disease or in patients with concurrent disease often are challenging. The goals of any heartworm treatment are to improve the dog’s clinical condition and to eliminate all life stages of the heartworms with minimal post-treatment complications. Dogs exhibiting significant clinical signs of heartworm disease should be normalized as much as possible before administering an adulticide.
Expert:  Dr. Emily replied 2 years ago.
Melarsomine dihydrochloride is the only adulticidal drug approved by the FDA for heartworm treatment. The American Heartworm Society recommends the three-dose protocol, one deep intramuscular (IM) injection in the muscle near the spine, followed at least 1 month later by two IM injections of the same dose 24 hours apart in all cases due to the increased safety and efficacy compared with the two-dose regimen.
Expert:  Dr. Emily replied 2 years ago.
Anti-inflammatory doses of glucocorticosteroids can help to control clinical signs associated with respiratory trouble, which can be severe after adulticide therapy if infection is heavy and lung disease is extensive.
Expert:  Dr. Emily replied 2 years ago.
Many heartworm contain a bacteria called Wolbachia (Rickettsiales). Wolbachia have also been implicated as a component in the complication from heartworm diseases. Doxycycline reduces Wolbachia numbers in all stages of heartworms. The AHS recommends administration of doxycycline for 4 weeks before administration of melarsomine.
Expert:  Dr. Emily replied 2 years ago.
In addition to adult heartworms, a heartworm-positive dog likely harbors juvenile stages of heartworms. The efficacy of melarsomine against juvenile stages (less than 4 months old worms) could present a susceptibility gap, where some stages of heartworm might not be susceptible to either the melarsomine. The susceptibility gap can be minimized by administering a routine heartworm preventive (like Heartgard) for 2 months prior to administering melarsomine. This will reduce new infections, eliminate existing susceptible larvae, and allow older worms (between 2 and 4 months of age) to mature to a point where they would be more susceptible to melarsomine.
Expert:  Dr. Emily replied 2 years ago.
I know this is a lot of information, so please review it and let me know what questions I can answer further for you.