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August Case of the Month: Maddie's Heartworm Surprise

Maddie's Heartworm Surprise

Heartworm in San Diego.  Dangerous disease, but 100% preventable.

Maddie the Pit Bull - Heartworm found in San DiegoMaddie is a young pit bull mix recently adopted after being found by a lake outside Riverside.  At 10-months old she was a happy, tail-wagging ball of joy who had our entire staff cooing with puppy love.  During her first exam, she quickly won us over with her adorable face and exceptionally sweet disposition.  Her new owners were ecstatic about their new addition and expressed how happy they were that she seemed to be adjusting so well to her new “forever home.”

Her first new puppy exam went beautifully and on physical exam she looked just perfect.  We recommended vaccines, a fecal screen, a heartworm test and to start Maddie on a monthly heartworm, parasite and flea product called Trifexis.  We let the owner know that the test results would be in the next day, and sent Maddie on her way after receiving a big, sloppy puppy kiss goodbye.

The next morning I received the results of Maddie’s tests and had to do a double-take.  The puppy was positive for Heartworms!  While heartworm is on the rise in Southern California, it was still very unexpected in this little dog. Surprised at the result, I recruited the help of a few specialists in the area.  With a simple blood draw, we repeated Maddie’s Heartworm test and submitted a specific test to look for an elevation in a certain white blood cells that can indicate a parasitic infection.  After all of the confirmations, the diagnosis was the same: Maddie was Heartworm Disease Positive.

Heartworm disease is transmitted by mosquitos and left untreated the disease is ultimately fatal. While the disease is treatable, the protocol is expensive and hard on both pet and owner.  Luckily, this fatal disease is 100% avoidable with a proper Heartworm preventative.  At All Pets Animal Hospital we are dedicated to providing your pet with the best care through preventative medicine in order to maintain a healthy quality of life. Education is a large part of this dedication; therefore we, along with Maddie’s family, wanted to share Maddie’s story to help raise awareness about Heartworm Disease. 

Treating Heartworm disease is not a simple matter for you or for your pup.  Treatment is long, costly and rough on the dog. Luckily, while the treatment is tough the good news is that most infected dogs can be successfully treated.  Maddie’s Mom and Dad were absolutely receptive to the treatment and were dedicated to Maddie’s recovery.  They never gave up on her and neither did we! 

 Once we received confirmation of Maddie’s Heartworm Disease, All Pets Animal Hospital jumped into action to prepare a personalized treatment plan that would best suit her recovery.  The first step was to gather a few additional blood samples for testing to be sure that Maddie was healthy enough for Heartworm disease treatment.  

The first phase of treatment began by starting Maddie was started on an oral Heartworm preventative called Heartgard that can help start to kill some stages of the Heartworm itself.  Additionally she was given an oral steroid medication and an oral antibiotic/anti-inflammatory called Doxycycline to decrease inflammation and infection while reducing the chances of anaphylactic shock as the worms begin to die within the heart and associated vessels.

During this first 30 days of treatment, Maddie’s Mom and Dad noticed her start to cough – which is common during the treatment of Heartworm disease.  We took x-rays of her heart and lungs to help evaluate the extent of the disease and potential risks associated with administering the treatment. 

Throughout the entire treatment process, it is extremely important for dogs to remain quiet and rested.  Heartworm disease can often cause lethargy, shortness of breath, coughing, and exercise intolerance.  After treatment is started, the Heartworms in the body will start to die and decompose.  These worm fragments are carried to the lungs and are hopefully just reabsorbed into the body; however, if the pup is too active, these worm fragments can cause severe breathing problems as well as lead to fevers and infections.   Maddie’s X-rays did not show anything alarming, so we prepared for the next stage of treatment.

All Pets Animal Hospital made arrangements to obtain Immidicide, an injectable medication derived from arsenic that kills adult Heartworms while preventing further development of these worms.  These injections can be painful and are administered at very strong doses in order to rid the body of the Heartworms.  Because of the strength of the medication, the injections are spread out in 30 day increments.  An injectable pain medication and sedative are also administered prior to each Immidicide injection to help Maddie stay relaxed and pain free during treatment.  Poor baby Maddie had to stay calm and quiet for about 3 months to be sure she was comfortable, healthy, and tolerated the injections well – a tough thing for a fun-loving puppy!

At every Immidicide treatment, Maddie had to spend the day with us. This allowed us to make sure she stayed quiet and tolerated the medication.  The injections kill actual living worms and the body needs a lot of energy to fight off these dying parasites.  We also wanted to be sure that Maddie’s blood was still flowing properly through the lungs as the dead Heartworms can create a blockage, and be sure she didn’t experience an anaphylactic reaction to the dying Heartworms.  Luckily Maddie was such an exceptional patient that the process was easy!  She was quickly a staff-favorite during her treatment stays and spent a lot of time “recovering” on a bed in the doctors’ office, where she could be properly “monitored” (cuddled and spoiled). 


Maddie on a comfy bed being "monitored" in the doctors' office.

After the first treatment was behind her, Maddie’s family was prepared to follow the guidelines set out by the American Heartworm Society for the next few weeks as the medication continued to help Maddie fight the disease.  As the dead worms continue to break apart over the course of the following six to eight weeks, Maddie had to be kept calm and walked on a leash to avoid running around.  Maddie did amazingly well during her treatments as we all fought to battle her Heartworm Disease.

While treatment of Heartworm Disease is not easy, prevention is safe and simple.  The first step in prevention of this deadly disease to bring your pet in for annual physical exams and have them tested yearly for Heartworm disease, even if they are currently on a Heartworm preventative.  The scary part of Heartworm disease is that like Maddie, most patients with Heartworm disease do not show any clinical signs until the disease is significantly progressed. The disease acts as a silent killer unless identified early, so regular testing is key.  Maddie was very lucky that her new family was diligent about having her evaluated by a veterinarian and electing to pursue preventative care. 

The second step in prevention is to keep your pet on Heartworm preventative medication year round.  These products are easy to give, extremely effective, and have been on the market for many years.  As a bonus, the same medication that prevents heartworm infestation also treats against Roundworms and Hookworms – common intestinal parasites that can even be transmitted to people!

We are very happy to report that sweet Maddie is currently doing well after treatment.  We continue to monitor her closely for any signs of disease.  Routine Heartworm tests will be important in establishing her Heartworm Disease free status as we move forward with her future preventative care.

We hope that Maddie’s case of Heartworm Disease has helped shed some light on this dangerous yet preventable disease.

Maddie wants you to remember to test and prevent for success!  To avoid the possibility of your pet contracting heartworm disease, you will want to administer heartworm prevention year-round for the rest of your pets’ life and get your pet tested for Heartworm disease annually.  Both Maddie and her family are lucky to have found each other; and now they can enjoy a long and happy life together!

Client Resources:

Heartworm basics:  https://www.heartwormsociety.org/pet-owner-resources/heartworm-basics

Incidence Map:  https://www.heartwormsociety.org/pet-owner-resources/incidence-maps

Heartworm Life cycle:  https://www.heartwormsociety.org/pet-owner-resources/2014-03-24-22-40-20

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