Shawn M. Finch, DVM

Wouldn’t that be something?  If we went through this entire month and NOBODY was diagnosed with heartworm disease??  We just saw another case of heartworm disease very recently…So sad.  I know I have been on an “I hate cancer” kick lately, but as always, I am on my “I hate heartworm” kick too.  (I have quite a few kicks…)  Heartworm disease is 100% preventable, and though treatable (treatable in dogs - not so much cats and ferrets), prevention is so much less expensive and easier on the dogs’ systems.

I promised to be more upbeat here at Riley and James as soon as possible!  So here goes…

Today’s monthly heartworm post is on how heartworm preventative medications work!

Science…medicine…the wonders of canine physiology…heartworm examined not as a pet stealer or dog damager, but more clinically, as a very cool (disgusting) mortal, intricate parasite.  How exciting is that??  Well, I think it is exciting…

The Medicine

All heartworm preventative medications currently on the market are a form of macrocyclic lactones, medications derived from bacteria in the Streptomyces genus.  They do not prevent heartworm infection in the strictest sense, they prevent heartworm disease - they kill the larvae (L3 and L4, “baby heartworms”) before they can mature into adult worms.

(Interesting side note!  Until the late 1980’s, only daily medications were available because they were only powerful enough to kill the “L3″ stage, which lasts only two or three days.)

Macrocyclic lactones are neurotoxins to the heartworm larvae (L3 and L4), paralyzing their mouthparts and causing them to starve to death.  The medication needs to be repeated monthly because they kill all of the parasites that are in the pet’s system that have infected him or her in the last thirty days.  The picture that came to mind when I was trying to make it understandable was one of a rainstorm.  Bear with me…

Heartworm preventatives are not umbrellas - they are windshield wipers.  Your dog is continually at risk of being bitten by a mosquito that is carrying heartworm larvae (L3) - the mosquito would be the cloud and the heartworm larvae would be the raindrop…if clouds were buzzy and annoying and raindrops were potentially fatal.

The Worm

We think of heartworm preventatives as protecting our pets against heartworm disease, and they do.  But they do it more as a windshield wiper (that sweeps every thirty days) than an umbrella that is a constant barrier to infection.  Our pets are at risk of being infected by heartworm larvae - but are protected from heartworm disease that is caused by adult heartworms in the pulmonary vessels and heart.

The Disease

I think the disease should be called subcutaneous-tissue-then-pulmonary-arteries-and-if-it-is-a-really-heavy-infestation-even-right-heart-and-vena-cava-worms, but it is not.  Heartworm is too cute of a name for such a horrid disease.

That’s All I’ve Got.

If that helps you understand the pathogenesis of heartworm disease, awesome.  It helps me to be disciplined when giving heartworm preventative medication to my pets to think of it as a “windshield wiper” stopping heartworm larvae that may have already started their unholy travels to the very heart of my pets, rather than a barrier or “umbrella” that I can just put up when it is sunny and warm and just right for a heartworm attack.  If it just grosses you out, and you like being grossed out, that is good too, I suppose!

Coming Soon…More Awesome Heartworm Information of Some Sort

Let me know what other heartworm related topics you would like to cover.  Ideas…heartworm disease in cats and ferrets, treating heartworm disease, I would love a guest post from someone who has had a pet with heartworm disease, or worked in a rescue organization and dealt with heartworm disease, or any guest post with a heartworm-related story!  Let me know if you have topic ideas or would like to write a guest post here!

Today’s To Do List:

Noodle the Poodle - Wormshield tablet

Max the Cat - topical Revolution

(Joy the Puppy is on injectable Proheart 6.)

Coming Next Month…

How do injectable sustained release heartworm prevenative medications (Proheart 6 and Proheart 12) work?

Previous Happy Heartworm Free Month Posts…

January 2011

February 2011

March 2011

American Heartworm Society Website

Isn’t this FUN?

-Dr. Seuss

Yes, of course they do!

I tend to anthropomorphize, I am highly (not excessively, highly!) emotional, I love, love, love pets and I spend most of my time at home and at work with them.

I realize that I am not unbiased.

So instead of just saying “yes,” I wanted to share this sort-of-a-scientific-case-but-more-of-an-intriguing-story…

Joy the Puppy has a built-in stress barometer…

localized juvenile demodicosis that manifests as periocular alopecia.

Look!  The scientist in me is coming out!  Let me explain that super-nerdy sentence and then move on to how it supports the theory that pets do indeed mourn.  I know that this is a case study of one subject.  Still, I would believe it with no proof, so it is more scientific than my usual carrying on here, wouldn’t you say?

localized - in one or a few areas.  Generalized demodicosis would typically be more serious and warrant a more aggressive search of an underlying cause and more aggressive treatment.

juvenile - puppy disease.  Again, adult-onset would typically be more serious and warrant a more aggressive search of an underlying cause and more aggressive treatment.

demodicosis - a form of “mange” - Many mammals have a species-specific mite, demodex, which is present in small numbers even in healthy individuals.  Since I am an animal doctor, not a human doctor, I will not say “human” or “eyebrows” to you.  Dogs have a species-specific demodex mite called Demodex canis.  It can become a clinical problem if there is an immune system issue or stress, though the underlying cause is not always known.

microscopic view of Demodex canis

periocular - around the eyes

alopecia - loss of hair

When Joy was a pup, she had a mild case of localized juvenile demodicosis that manifested as periocular alopecia.  It came and went pretty quickly and quietly, with no discomfort to Joy.  I treated it with “benign neglect” and she did great.  She had no symptoms for over a year.

When Ebony Dog passed away last month, the disease came back with a vengeance.  Joy moped around the house.  That is, she had decreased energy levels and was much less active than usual.  She circled on the bed that she and Ebony had shared, finally flopping down every night with a deep sigh and her chin on the floor at the edge of the bed.  She would come to a complete stop during walks with Noodle the Poodle and look around as if confused.  For her whole life, walks had always been the three of them:  Joy, Ebony and Noodle.  Most telling of all, the area around both of Joy’s eyes went completely baldy-bald…um, I mean alopecic, again.

Here is Joy in all her shiny gorgeousness…

Here is Joy at the worst of her recent bout of demodicosis…

And here, I believe, is the reason for the stress that has caused this most recent flare-up…

She and Ebony were so close…

In fact, Joy wanted to be Ebony when she grew up…

Joy the Puppy is mourning the loss of her friend Ebony Dog.

I saw it with Wuzzy Rat when Fuzzy Rat passed away…

(She had no hair to let fall out as an outward sign of her mourning - ha!)  I have seen it with other personal pets.  I have seen it with clients’ pets.  This is the first time I have seen it with such clear physical manifestations.  Have you seen this with pets you have known?  The mourning, I mean?

My Prescribed Treatment for Joy: Routine cleaning with a gentle cleanser and topical medication, extra attention, extra love, extra walks and extra empathy.*  Her stress levels are going down, her immune system is becoming strong again, her demodicosis is going back into remission and her hair is growing back.  That is to say…her heart is healing.

*I miss her too Joy.  We’re going to be ok though Puppy, I promise.

Our herd is down from eight to three, 37.5% of capacity, and we are not repopulating.  Fortunately, Max the Cat, Noodle the Poodle and Joy the Puppy all tolerate hugs*, because they have been put on Grief Duty.  I find myself asking “Who’s next?” and waking the poor things up if they are sleeping too comfortably.  Noodle has been known to sleep with all four paws up on occasion.  He has been the recipient of the rudest awakenings.

In an attempt to back off from this dangerous path, I am making the conscious decision to appreciate my pets on a day-to-day basis and enjoy the time I have with them.  Yes, approximately 67% of the remaining herd is oldie-old, but they are also all healthy, and probably tired of being included in my late night panics.  So hold me accountable.  There is much grieving yet to do, but I do not want to miss out on today.

I can’t really pull myself out of this of course, even with all of your wonderful support (And you ARE wonderful - thank you so much for walking through this with us) - This is going to take the power of God Himself.  While I hope you are in a happier season, this next quote is a good reminder to us all, and then a word of “encouragement” from my very favorite singer ever, Rich Mullins.  And then, I will come visit the blogs of other pet blogger friends on the Saturday Pet Blogger Hop.  And then…I am going to go hug my cat.

“Do not worry about tomorrow, for tomorrow will worry about itself.  Each day has enough trouble of its own.”

-Jesus

“It’s hard to be like Jesus.”

-Rich Mullins

*Note:  Hugging most dogs is ill-advised.  Normal dogs do not like hugs.  Hugging most cats is just asking for it.  Our pets are all sorts of special.  Do not attempt this at home unless you are a Trained Pet Hugger.  I am not.  I just have really tolerant pets.

March 2011…Safety of heartworm preventative medication - Is it safe to give my Collie heartworm preventative medication?  Why is Joy the Puppy getting Proheart but not the old dogs?  Are some pets developing heartworm preventative medication resistance?  Are there valid drug-free options for preventing heartworm disease?

Confused?  You won’t be after this episode of…Pets!

Who knows that super-awesome…I mean cheesy…I mean awesome…reference?  First person to tell me wins coffee…or cocoa…or whatever.  (C’mon, Dad!)*

Is it safe to give my Collie heartworm preventative medicine?

Short answer…yes.  However, this is a very valid concern that stems from the genetic tendency of some dogs (most notoriously Collies, but some herding and other breeds) to process ivermectin and other medications less efficiently than they should.

A veterinarian at Washington State University, Dr. Katrina Mealey, DVM, PhD, Diplomate, ACVIM (American College of Veterinary Internal Medicine), has done a great amount of research on this drug sensitivity issue.  Some dogs have a mutation in a gene (called the MDR1 gene) that should make a protein (P-glycoprotein) that is an important part of the blood-brain barrier.  If they have one abnormal gene, they are carriers (They will not have the drug sensitivity, but their offspring may).  If they have two abnormal genes, they will have the drug sensitivity.  Because the barrier is not normal in these dogs, they are less protected from the effect of some drugs, and doses that would be safe in dogs without the gene mutation can be dangerous.

The amount of ivermectin in heartworm preventative medication is such a low dose that it is safe in dogs even if they have the gene mutation that makes them extra-sensitive.  If you are at all worried, there are many ivermectin-free heartworm preventative alternatives available.

A genetic test is available to determine if dogs have this genetic mutation.  This could be especially helpful if your pet needs to be treated with higher doses of ivermectin than that used in heartworm preventatives OR if he or she needs other medications to which they may be sensitive OR if you are considering breeding.

For a MUCH more articulate discussion of the MDR1 gene and genetic drug sensitivity, you may want the information right from the horse’s mouth (Animal joke in a pet blog!  Always funny!)

Ivermectin Toxicity in Collies

on

Washington State University College of Veterinary Medicine Website

Why is Joy the Puppy getting Proheart but not the old dogs dog? *sigh*

Proheart is intended for healthy dogs over six months of age who are not underweight.  Not that old dogs can’t be healthy!  And they usually are…but, to be safe, we administer this medication to dogs who are over six months of age and under seven years of age the first time they are given Proheart.  Because Ebony and Noodle were over seven when it came back onto the market, we kept them on monthly oral Wormshield (ivermectin) tablets.

Are some pets developing heartworm preventative medication resistance?

Honestly, we just do not know yet.  I suspect it is the same old compliance issue.  (Please correct me if your pet has been a victim of heartworm preventative resistance - I hope it is not real, but realize it could be.)  If some pets are resistant, it is such a low number of the population, that consistent heartworm preventative use is still warranted.  For an excellent discussion of the issue, see Dr. Lorie Huston’s October 2010 article:

Concerns About Potential Heartworm Medicine Resistance in Dogs

Are there valid drug-free options for preventing heartworm disease?

No!  That was kind of a trick question - there are no valid drug free options that will kill the larval (L3 and L4) stages of heartworm (the little guys in the subcutaneous tissue and bloodstream - ick) but all the medications are VERY safe and used at VERY low doses compared to other things they are used for.

So I always always recommend staying on heartworm preventative medications even though there ARE good non-drug ways to decrease mosquito exposure - you just can’t keep every one away.

Georgia Little Pea…I would say your Mama wins coffee for making me think through that question!  Again…as soon as I have my private jet I will come right over!  *sigh*

Next Month: How do these medications work?  Plus I will address any other questions you have!  Let’s do what we did in February - we can discuss it all in “real time” in the comments (or over coffee if you win the contest!) and I will also incorporate your questions and answers into the next month’s post.

Today’s Checklist…

Noodle the Poodle - Wormshield tablet

Max the Cat - topical Revolution

Joy the Puppy received a Proheart injection on February 1, 2011 which has a six month duration.  Thus, she got a biscuit at the exact second Noodle got his Wormshield tablet, which they both deemed “fair.”

*UPDATE: Dad did indeed win the contest - the reference is to the show SOAP, which my parents loved when I was a kid…I think as much as Russ and I love Scrubs.  Dad tied with Russ, who yelled “SOAP!” as I was posting the picture.  I initially called cheating, but revised my ruling to a tie and will be taking both of my favorite guys out for coffee next week.

Happy Weekend All!  I have been watching Two Little Cavaliers and their friends do the Saturday Blog Hop for a while and have been trying to figure it out.  I joined Dr. V’s Blog Hop when she suggested we all post our favorite blog posts of 2010, and that was fun.

The Saturday Blog Hop looks like a wonderful way to meet other pet lovers.  I thought I had met all of the Pet-Loving Awesomes out there, but apparently I have not yet found The End of The Internet.

So if you are visiting Riley and James from the Saturday Blog Hop, thank you for stopping by!  Nice to meet you!  And if you are already a friend of Riley and James, thank you too.  I think you are all great.

My favorite posts often contain pictures of Pets Being Cute, so I thought that would be a fun theme for today.  Here are the Finch pets…

Ebony Dog and Max the Cat

Noodle the Poodle

Joy the Puppy

Piggy the Guinea Pig

Princess the Gerbil

Fuzzy and Wuzzy Rats

OK, so Fuzzy and Wuzzy are not part of our current herd, but they JUST passed away, and I am not ready to take them out of the lineup yet.  That’s Wuzzy in the background and Fuzzy in the foreground, from July 2010.  Weren’t they gorgeous??  And so sweet too.  They are Hairless Dumbo Rex rats.

Nice to meet you all!  I will spend THIS week coming to see your pet blogs!

Shawn Finch, DVM

Finch93 on twitter : )

Coming Soon to Riley and James…

Monday, January 10, 2011 “Pet Blogger’s Challenge” from Edie of “Will My Dog Hate Me?” and Amy of “Go Pet Friendly” (both of whom are awesome and have been mentioned here before!)  I’m in - these group projects are fun!

Joy to the World!

(Public Domain)

lyrics by Isaac Watts 1674 - 1748

music by George F. Handel 1685 - 1759

vocals by Su Smith

This started out being another play on Joy the Puppy’s name, but with Su’s help, became one of my favorite posts ever.  She helped me learn how to do the slide show and post my first youtube video AND did the amazing singing in the video.  Thank you Su!  You are wonderful.

Merry Christmas all!  I hope you enjoy our video!

Picture Credits:

Hills - Saddleback Mountain, West Virginia from Terry Cunningham ♥

Nature - River and moon from Kathy Andrews ♥

Heaven, floods, rocks, plains, truth, thorns from the Awesome Aunt Jeannine Menze ♥

Grace - Olivia ♥

Earth from Space from Free Use Photos of Photobucket (Thanks Tall Sexy Mailman!)

Bruce Hansen from Joyce : )

Lion and the Lamb from predatorpress

Dragon picture from pathlights

Rainbow Bridge from Ladyhawk

Crucifixion picture from dreamstime

Adam and Eve are Expelled from the Garden of Eden by Julius von Carolsfeld

Computer Genius bringing this project to the next level - Su and Russ ♥

To the Original Owner of Joy the Puppy,

Thank you so much for the gift of Joy. She has been a wonderful addition to our family, so gentle and playful with our kids, and fitting right in with our other two dogs.  She is loved and warm and fed.  I pray that you are as well. I will keep an eye out for you in and try to make sure that you are.

If you had been in a different season of life, with a home and resources to take care of the both of you, would you still have her with you?  I bet you miss her.  I can not tell you how much I appreciate you giving her up so that she could have a healthy life.  If things have turned around for you, and there is room in your life for a puppy again, I will do everything I can to help make that happen.

Forgive me for being so angry initially that she was such a skinny thing.  I know that when you ran out of puppy food, you shared your own food with her, and probably gave up a meal or two at least, so the little bottomless pit would not have to.  She had the cutest little bug eyes-I would have held on to her until the last possible moment too, if I had been in your place.  I will remember that the next time I am getting worked up to judge someone who is probably doing the best that they can.

Be proud of your dog.  She turned out great.  She started off so cute and grew up to be gorgeous.  If you hadn’t protected her from the streets of Omaha in her first few bitter cold weeks, she may not have survived.  If you hadn’t taught her a person’s love right from the start, it would have taken us years.  Thank you so much. If this does not reach you directly, I will try to thank you indirectly every way that I am able.

Sincerely,

Shawn Finch, DVM

Two winters ago, clients of mine found a man dressed in several layers of badly worn clothing wandering up and down the dog food aisles of Petsmart with a tiny, emaciated black puppy in his arms.  He was saying to himself that he could not afford dog food.

The young couple asked the man about his puppy.  He said he needed someone to take her because he did not have any money to care for her.  They asked if he would take twenty dollars for her (which they had brought with them to spend at Petsmart, but probably not quite like that), and he did.  They brought her to my hospital to be examined.  Other than her very thin body condition, I found no other physical problems.  They did not know if they were adopting or rescuing…they just saw a puppy in need and a man in distress and sort of swooped.

Two days later, Layla came home to live with us, and after much name-trying, we renamed her Joy Layla Finch.  The name Joy was suggested by the daughter of Joy King, who had been our very dear friend and had recently passed away.  We also named her in honor of our other dear friends’ newborn daughter whose twin sister had just passed away.

The conversation with Joy King’s daughter went something like this:

“Are you sure your Mom would not mind having a dog named after her?”

“This puppy is so happy, like Mom was, and has such gorgeous black hair, like Mom did…Not only would she not mind, she would be honored!”

Joy…what an odd thing to name our new puppy during what was such a sad season for so many friends we loved.  She has more than lived up to her name.

♥ ♥ ♥ ♥ ♥

When I first met Joy, I was so angry at the man who had almost let her starve to death that I could not see straight.  My friend Janelle said, “He did take her to where he knew she would get help.”  That statement stopped me in my tracks.

Having probably very little even for himself, the man who first owned Joy did everything he could for her, and maybe the reason he held on to her as long as he did was because he did not want to give up his puppy.

I feel as though I owe him an apology and a thank you, though I have never met him.  So I will write one here, and though he will almost certainly never see it, I hope it serves as a reminder to myself to let my first reaction be one of compassion, not one of judgment.

I also hope God blesses Joy’s original owner beyond what I can even imagine.  In what must have been such a difficult season in his own life, he looked past himself and reached out with love and compassion to care for a tiny, helpless, goofy puppy who needed him.

Joy the Puppy, Adoption Day!  January 30, 2008

(This is just after she finished playing at the construction site with Russ and decided he was the most awesome, fun person she had ever known in all her many weeks)

Joy the Puppy, All Grown Up!

Russ:  Aren’t dogs fully mature at two years of age?

Me:  Yes!  Didn’t happen at midnight, here’s hoping for noon!

For Joy’s birthday, we got her an ice cube.  Honestly, I have NEVER seen her happier than when she got her gift.  Today we will celebrate Grown Up Joy the Puppy.  Tomorrow, I will post more about Baby Joy the Puppy, because that was a special time too.

Happy Birthday Joy!  You are one of the two best Black Lab-Somethings I have ever known. I do hope you stop eating socks.  And paper.  And stuffed animals.  And food off the counter.  But Joy…I hope you never really grow up.

Last night I was so exhausted from a full week of work, a full day of continuing education and a full evening of dinner and Bible Study with our Super Wicked Awesome Group of friends…

that I sat down on the kitchen floor by the back door and put my head down and cried.

I tried to explain to Russ that I was just done.  I was not sad.  I was not mad.  I was just so tired.  Yes, it had been an incredibly great week.  Yes, I loved the veterinary meeting and especially the evening with our friends.  But extroversion is exhausting for me, and even good stress is stressful and I just had nothing left.  He was trying to understand, and even doing laundry and picking up last minute things so I could really be done.  But I just needed someone to really hear me.

Enter Joy the Puppy.  We still call her Joy the Puppy because she has not outgrown ANY of her puppy antics, the cute ones or the exasperating ones.  She bites Ebony’s ears.  She scatters the trash.  She pounces Max the Cat.  She unstuffs her toys, which is super cute, except that she recently decided the bed she and Ebony share is a giant unstuffable toy.  So this week I have been sweeping up fluff every day and shopping for a new bed to replace Joy and Ebony’s very flat bed.

Joy the Puppy walked up to me on the kitchen floor and put her muzzle under my arm.  She waited till I looked up and then licked the tears off my cheek.  I pet her ears and told her all about my day and my week.  She sat with me until I got up and wandered to bed.  She lay down next to me on her (very flat) bed with her chin on her paws and a watchful eye on me.  In the few minutes it took me to “read” myself to sleep, Joy the Puppy stood up and checked on me twice.

I love the stories of dogs who pull people out of rivers and out of burning buildings and off of train tracks as trains scream towards them.  I love service dogs and rescue dogs and hero dogs.  Last night I was “just” tired and I “just” needed my dog, and she was there for me.

Joy, I am writing this so when you tear apart your new bed, we can sit and read this together and I can remind myself how incredible and wonderful you are.  Thank you Joy.  You are the best puppy anyone could hope for and I love you.