Friday, September 07, 2012

Sympathy for the Devil

Lynn S. sent me a note a couple of days ago:
The most recent issue of Today's Veterinary Practice came at work today, and the cover story was questioning the practice of yearly heartworm tests. Since I didn't get to read it today, I checked the website to see what all's available to read without a subscription, and lo/behold: Doxycycline in the Management of Heartworm Disease.

Still have to find the HW test article, but haven't you been saying this for a while now?!"

Yes indeed. 

Yearly heartworm tests are simply not needed if your dog has been on a regular heartworm medication.  Your dog CANNOT get heartworm if you are simply a few weeks, or even a month or two, late.  Every vet knows this.  Yearly heart worms tests are simply part of a long-running scam in the the world of veterinary care -- a big dollar cash cow they will milk as long as we let them.

As for doxycycline combined with ivermectin, it remains a low-cost cure for heartworm, and this too is not closely held information.

Is curing heartworm expensive and difficult?  No it is not. Any veterinarian who tells you otherwise is not keeping up with the literature. It turns out that even if your dog has adult heartworms, if the dog otherwise appears healthy (i.e. it is active, not lethargic, and does not have a chronic cough), a monthly dosing of Ivermectin at a dosage normally used to kill roundworms (a dosage that is 3 times higher than that used to simply prevent heartworm), plus a once-a-month 5-day dosing of Doxycycline (the same antibiotic used to treat Lyme disease) will kill all the adult heartworms if it is sustained for a period of 18 months. This treatment works better than previous Ivermectin-only treatments because the Doxycline wipes out the Wolbachia microbe that grow in the gut of the adult heart worm, essentially sterilizing all of the female heart worms. A round-worm strength dosing of monthly Ivermectin will not only prevent new heartworm microfilaria from taking hold in your dog, it will also work to dramatically shorten the life of any existing adult worms in your dog. Bottom line: after 18 months of treatment, your dog will be heartworm-free at very little cost compared to other remedies.

On the upside, my heartworm, ivermectine and doxycycline post is read by a couple of hundred people a day and has helped a lot of folks save a lot of money over the years. 

On the downside, this post is also a magnet for illiterate, knuckle-dragging morons who are too lazy to read the post to the end, and/or who are too dumb to follow or understand directions. 

Of course, the doxy and ivermectin post is not the only one that seems to attract the hazy, lazy and crazy.

For example, earlier this week I got this question in an email written by someone who was so lazy and disinterested in her own dog that she did not even bother to type in a subject line:

Hello I know your not a veterinary but I have a dog that has a cut ( I think from a wild hog) on his upper back leg its about 3 inches long and I would say an 1 inch or 2 thick. Do you think putting glue would help? I have been cleaning it it myself every day but I want to make sure I'm doing something right. Its not bleeding anymore kinda looks like its healing. Thank you.

Notice the complete lack of information. No mention on the breed or size of the dog, no information on when this occurred, no pictures, etc.  

What am I supposed to do with stuff like this?

What I do is delete it and move forward. Life is too short to get in a discussion with a fool who has a dog deeply gored by a pig, and who has still not taken the dog to a vet. I feel sorry for the dog, but I managed to disenthrall myself of the notion that I can rescue every animal that is owned by fool some years back.  Rescue Ranger I am not.

Want another?  How about this email I got yesterday?

Hi there:

I just read the information you have posted regarding Ivermectin and dosing. I have a small terrier mix dog that was diagnosed almost 2 years ago with heart worms. He has been absolutely fine with no symptoms until recently. He coughs now, quite a lot. Is it possible to still treat him without him getting sick or dying? I don't want to kill the baby and the treatment from the vet is very expensive. They told me it was hard to treat after they've had them for so long. I have not had the money to do it and would like to try if possible. What do you think? I have 13 other rescues and want to try to treat them myself with Ivermectic as a preventative. I do all vaccinations myself. Is this also good for flea treatment?


You want the gravy on this one? This knuckle-dragger had the stones to embed the contact information of the law firm that employes her on to the bottom of her email!

So, let me ask you:  What do YOU say to someone who has left her dog untreated with heartworm for TWO YEARS, and only now thinks to take action, even as she whines about treatment costs?   And does it matter that this person has 13 dogs?

Guess what I said?


Jenn said...

Holy shit. I hate people.
And do you think she will sue whoever tries to help her out at this point, as the dog lies dying? Uh. Let me think....

concretenprimroses said...

Thank you for the information about heart worm treatment. I forgot a dose for my little dog and I was wondering if I should have him tested. Its good to know that he is ok missing one dose.
About the rest of your post: I think a lot of people don't understand the expense and commitment of owning a pet (or pets). I'm not sure what the best approach to help change this is.
Thanks again,

Allen said...

The last letter is textbook hoarder.

Rick said...

For several years I've been using the monthly Ivermectin regimen as a HW preventative for my pack of rescues. I was told (by a reputable, mainstream vet) that one should be sure the dog is HW negative before using this method. One dog that came to us 4 years ago was HW positive, so I treated him with a regular preventative (HeartGuard), because it contains a "time release" and would keep the HW "at bay." I had been rather lax in my monthly treatments, sometimes it was two & three months apart. This year, it was five months, and well into the summer here in San Antonio, and I finally got everyone tested, and they all tested negative, including the one that had previously tested positive. The vet told me that sometimes the HW dies off on its own. The spectre of heartworm disease is not so scary anymore.