Hello, my veterinarian says he is very skeptical about giving my dog heartworm treatment because she is very hyper and containing her for months is unrealistic. (I adopted her from Animal Control without knowing she had heartworms.)

A friend of mine sent me a link to a site recommmending herbal treatment for heartworms. What do you think about holistic remedies for heartworms?

Elizabeth
Kingsland, GA

Heartworms are blood parasites of dogs and cats that are spread by mosquitoes. They are worms that live in the heart and the arteries leading out of the heart. They can lead to heart failure and lung problems.

The most commonly used treatment for heartworm infestation in dogs employs an aresenic-containing compound called melarsamine. Melarsamine has a relatively low margin of safety, and side effects such as pain at the site of injection are common.

After melarsamine treatment, dogs must be kept very quiet. This is not because of the melarsamine’s toxicity. Rather, it is because the dying worms pass into the lungs and cause damage that can be exacerbated by activity.

Any effective heartworm treatment that relies on killing rather than removing the worms will require activity restriction as a part of the treatment. I am not aware of any effective holistic therapies for heartworm disease. However, even if you found one your dog would need to stay quiet during treatment.

A new treatment has recently been described in dogs (and was mentioned by an ahead-of-her-time commenter on this blog a while back). It involves the use of two medicines (ivermectin and doxycycline) that, in combination, kill heartworms. The drugs kill the worms incredibly slowly (it takes up to 18 months for the therapy to work), which means that complications from dying worms are reduced (but not eliminated). It also means that the damage the worms do to your dog continues for months on end.

Another new therapy may be promising for your dog, but it is not widely available. A special catheter can be passed into the heart and used to snare and remove the worms. If all of the worms are removed, there is no need for activity restriction afterwards. To my knowledge, this procedure is available only through veterinary school teaching hospitals. Realistically speaking, this form of treatment probably won’t be an option for your dog.

I’d recommend that you seek a second opinion about heartworm treatment. There are tricks to keep dogs quiet during treatment. A good vet will be able to assess the severity of your dog’s infection and discuss the risks and benefits of the various treatment options with you.

And, as always (and I do mean always), you should check out my website. More information about heartworm can be found there:

http://drbarchas.com/heartworm

Photo: Joel Mills