Posts Tagged ‘Proheart’

Happy Heartworm Free September!

Thursday, September 1st, 2011

If you give your pets their heartworm preventative medication on the first, it’s the first!  And, as a friend pointed out, if you do not…it is still the first. :)

Happy September!

Recent Heartworm Related News:

Immiticide, the ONLY approved heartworm disease treatment, is once again unavailable, and Merial does not know when it will be available again.

Read more here:

Treating Heartworm Disease – Another Immiticide Shortage

In response to the Immiticide unavailability, American Heartworm Society published recommendations for veterinarians who have heartworm positive patients waiting for treatment.

Read more here:

Guidance for Heartworm Disease Management During the Adulticide Unavailability

Pfizer modified their recommendations for ProHeart use.  Included in the updates is provision for dogs with allergic dermatitis to receive ProHeart injections.  The recommendation has been changed to “Use with caution in dogs with allergic disease.”

Read more here:

ProHeart 6

We are waiting on confirmation that Revolution for Kittens and Puppies (and they should add, dogs) under five pounds pleases Ernie Dog.

Read more here:

A Story of Ernie Dog

In Finch Family news…

We have decided to switch Joy the Puppy back to Wormshield (oral monthly ivermectin) from ProHeart (injectable twice a year moxidectin) because of her allergic dermatitis (food allergies, recently diagnosed).  I do not think ProHeart made her worse by any means, but I would rather have her on a medication without the known risk of complicating allergic dermatitis!

We have switched Max the Cat’s Revolution application to the 15th, which coincides with Joy and Noodle’s flea and tick topical medication application.  That is neither here nor there, but I did not want you to think poor Max is off of the heartworm preventative checklist.  May it never be!

Today’s Checklist:

Noodle the Poodle – Wormshield tablet

Joy the Puppy – Wormshield tablet

See full size image


 

Happy Heartworm-Free May!

Saturday, April 30th, 2011

January

February

March

April

Actually we have had two cases of heartworm disease this spring, which is really discouraging.  Another sobering fact – last year Banfield Pet Hospital diagnosed over 5000 cases of heartworm disease in dogs!  I did not hear how many cases were treated or how the dogs did, but FIVE THOUSAND!  Granted, there are 750 + Banfields across the country, but that is still so many for a disease that is 100% preventable.  As a community of pet people, we can do so much better.  The number will not be zero this year (It will be at least two) but I hope it is WAY lower than 5000!

This month’s topic…

Proheart 6

Where does Proheart 6 fit into the world of heartworm preventative medication?

Proheart 6 is an injectable sustained release medication labeled for dogs only (not cats or ferrets).  Its active ingredient is moxidectin, which, like the heartworm larvae killing component of all of the oral and topical preventatives available, is a macrocyclic lactone.  Moxidectin is also found in Advantage Multi, a combination topical heartworm-flea preventative that is applied monthly.  Proheart 6 is also labeled to treat hookworms.

Why is Proheart 6 only given every six months?

The moxidectin in Proheart 6 is in a sustained release formula, which means medication is constantly released over several months.  It stays in the dog’s body at therapeutic levels for six months, after which it tapers off to levels that are both ineffective to kill heartworm larva and are also safe when combined with another full dose.

Will Proheart 6 save the world?

No.

Pfizer recommends that veterinarians not give Proheart to dogs who are too thin, dogs who are ill, puppies under six months of age, and dogs who have not had Proheart before the age of seven.  If they have had Proheart before the age of seven, they may then have it at any age.  They also recommend that Proheart not be given to dogs who have allergic dermatitis.  Generally, allergic dermatitis includes any allergies, food, inhalant, or contact allergies that manifest as itching or skin problems.  Reactions to Proheart may occur.

Who should be on Proheart 6?

Every other dog, unless he or she has issues your veterinarian has deemed incompatable with injectable moxidectin, should be considered for Proheart 6.  I really think this is a great tool in the fight against heartworm disease.  Joy the Puppy had her first dose of Proheart 6 on February 1, 2011 and has done great.

Things to consider when deciding whether to use Proheart 6:

  • Proheart 6 is an injection given every six months (thus the clever name).  You have two chances a year to space giving your pets’ heartworm preventative instead of twelve!
  • Even better, the responsibility, at least in part, for remembering your pets’ heartworm preventative switches from you to your veterinary team!  You will receive a reminder when the time for Proheart is approaching, and the visit itself will be a quick one, or incorporated with a biannual wellness exam you would already have planned.
  • The cost of Proheart tends to be similar to that of monthly topical and oral heartworm preventative medications.
  • You will not be tempted to flout the American Heartworm Society‘s year-round heartworm prevention recommendations and guess at future weather patterns  and presence of mosquitoes in those iffy (AND VERY DANGEROUS AS HEARTWORM RISK GOES!) spring and fall seasons, as the twice yearly Proheart administration will protect your pet all year.
  • You could put a box of chocolates for yourselves on that safe-from-pets tip-top shelf where you used to keep the box of heartworm preventatives.

Great Heartworm Posts I Have Read This Month:

“Reading About Heartworm is One Thing, Watching a Dog Suffer is Another” – guest post by Pet Saver Ashley on Dawg Business by Jana Rade

“Don’t Let Heartworm Become Heartbreak” – guest post by Awesome Veterinarian Lorie A. Huston on Dawg Business by Jana Rade

…And maybe the best, and also the most discouraging, heartworm post I have read this month is on heartworm preventative resistance:

Heartworm Prevention for Dogs:  New Concepts and Concerns – by Lorie A. Huston, DVM on her website, Pet Health Care Gazette

Yes, heartworm preventative resistance does indeed seem to be a reality in a very, very small portion of the dog population…*sigh*  I was hoping it was not.  But I trust Dr. Blagburn, one of the very best veterinary parasitologist in the world – I have always very much admired his work, and I trust Dr. Huston…It sure looks as if it is true.  All the more reason to be neurotically vigilant about heartworm prevention…And because Proheart is so easy and convenient, you can be vigilant without being neurotic…if you want.

Tomorrow’s Checklist…

Noodle the Poodle – Wormshield tablet

Max the Cat – topical Revolution

(Joy the Puppy is on injectable Proheart 6.  Perhaps I will spend the few saved minutes reading her this post.  Naw, I will give her a cookie!)

 

Happy Heartworm-Free April!

Friday, April 1st, 2011

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?

 

The more that you read,The more things you will know.The more that you learn,The more places you’ll go.

-Dr. Seuss

Happy Heartworm-Free March!

Tuesday, March 1st, 2011

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:

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.

:)

The Year in Review – Veterinary Medicine in 2010

Monday, February 21st, 2011

This was meant to be a summary of veterinary medicine in 2010 in 500ish words – ha!  I picked some highlights.  What would you have added??  If I talked about my personal year as a veterinarian, that would have been a completely different article.  This was very fun to write.

The Year in Review – Veterinary Medicine in 2010

Shawn Finch, DVM

Stem cell therapy has become fairly common, the melanoma vaccine is being used in dogs with great success, Proheart returned to the veterinary market, we were all affected by the melarsomine shortage, the balance tipped from a majority of male veterinarians to a majority of female veterinarians…2010 has been quite a year to be a veterinarian!

This year has seen exponential growth in veterinary internet involvement.  We started out dealing with the internet “defensively,” trying to undo problems created by false information.  We quickly learned to proactively add our voices as reliable authorities on animal health issues.  We have had to deal with client feedback in a more public way than ever. As disconcerting as that has been, we have handled it with the prompt attention and grace that we always have.

The increase in online interactions between pet parents and veterinarians has raised many ethical issues.  We can put all sorts of medical information onto the internet, but we still cannot diagnose or treat without a valid patient-client-doctor relationship firmly in place.  We have the ability to post patient pictures and cases onto the internet in full view of the world almost instantaneously.  We have shown tremendous restraint in doing that only when we have permission from our team leadership and clients.  Clients know that in this age of instant information, they can still trust us completely with their privacy and that of their pets.

Many of our veterinary journals have become accessible online.  As much as I have enjoyed the internet explosion and accompanying learning curve, I still request paper copies of my favorite journals.  I will probably be among the last of us to give that up.  Just admitting that makes me want to plant a tree.

We have always advocated humane breeding practices.  As restrictions on high-volume puppy sellers have tightened in the United States, international puppy sources have become more popular.  Our next battle may be assuring that the puppies imported into our country are shipped humanely and legally and enter the country free of contagious and zoonotic diseases.

A second report on veterinarians and suicide was published in England earlier this year.  The authors’ first report revealed that we are much more likely to commit suicide than people in the general population.  Their second report explored the reasons this may be true.  Everyone is an individual, and the sample size was relatively small, so we are not doomed.  Do keep a caring eye on your colleagues though and take good care of yourself.

Finally, the United States Congress recently proclaimed 2011 “World Veterinary Year” in honor of the 250th anniversary of our profession.  The resolution was introduced by the two veterinarians serving in Congress and passed with support from veterinarians across the country.  2010 was quite a year to be a veterinarian.  I am excited for what is to come, next year and beyond.

This was first published at The Wagging Tail for Veterinary Professionals on December 28, 2010 as “A Great Year for Veterinary Medicine.”