Protocols
How often do we recommend a pet that stay on prevention get tested for heartworms?
Yearly
Where do heartworms come from?
Mosquitoes
What prevention options (for heartworms) are offered at LVC?
Heartgard and Proheart12
What antibiotic do we send home with positive heartworm patients?
Doxycycline
What prevention should we recommend to clients who state that their pet is difficult to medicate- ex. picky eaters, vomits, chews up preventions then spits it out, etc
PROHEART12!!!!
For a puppy, at what age should we test for heartworms if they have not been on prevention?
6 months or older
What is the term used for baby heartworms
Microfilaria
What prevention should we ALWAYS recommend to dogs that are over 1 year of age and have stabilized in weight?
PROHEART12!!!!! ALWAYS RECOMMEND THIS!! ALWAYS ALWAYS ALWAYS!!!!!!!! AND NEVER EVER EVER TALK SOMEONE OUT OF DOING PROHEART! WE LOVE PROHEART!
What is the dosage for doxycycline for heartworm positive patients?
10mg/kg BID for 4 weeks
What is the calculation for dosing for the immiticide/diroban/adulticide injections?
2.5mg/kg
1.1mg/lb
0.1ml/kg
0.045ml/lb
If a heartworm positive dog is also positive for microfilaria, what are the first treatment steps for this patient?
1. Start patient on doxy, schedule an appointment to premed (with pred or dexSP- doctor preference) and start heartworm prevention. IF THEY HAVE MICROFILARIA THEY CANNOT START PREVENTION WITHOUT PREMED
Once an infected mosquito bites a dog, how long does it take for the larvae to travel through the tissue and reach the blood stream?
About 2 months
What does a patient have to have in order to purchase prevention? How many doses can they get?
1. VCPR aka a current exam on file
2. a current heartworm test with no lapse in prevention
3. an accurate weight
4. they cannot exceed more than 12 doses since their last heartworm test
What type of medications can you NOT give with prednisone?
NO NSAIDS- i.e. no Novox!!!
According to the American Heartworm Society- how many days in total does it take to go through the entire treatment process? (From the day the pet is diagnosed with heartworm disease to the day we retest to make sure it is negative)
365 days
How many injections of adulticide/diroban/immiticide are there to be given in total and how much time is between the injections?
3 injections total- 1st injection is after they have started prevention and doxy- 1 month on doxy and 1 month off then the 1st injection
the 2nd injection is 1 month after the 1st injection
the 3rd injection is the next day following the 2nd
Once the developing larvae reach the blood stream, how long does it take for them to develop into mature adults?
4-5 months
Who should a client call if they accidentally over dose their pet? example: a dog eats an entire box of prevention
Call poison control first and then if needed they can call the company- the number should be on the box
What is the dosage for prednisone for heartworm positive patients?
0.5mg/kg bid 1 week; sid 1 week; eod for 3rd and 4th weeks
What are some symptoms of heartworm disease?
Cough, reluctance to exercise, fatigue after moderate activity, decreased appetite, weight loss. Pets may develop heart failure and the appearance of a swollen belly due to excess fluid in the abdomen.
After a patient has been treated for heartworm disease, how many months do you wait to retest for heartworms? What is the protocol if they test positive again?
9 months after treatment (I try to line it up with their annuals if possible)
If positive again- treat with a course of doxy and 2 adulticide/immiticide/diroban injections 24 hours apart
How long do heartworms grow (in size) and how long do they live in the blood stream?
They can grow 12 inches long and can live in the blood stream for up to 7 years.
At what age can a puppy start heartworm prevention?
8 weeks or older- they can not have proheart12 until they are a year old and their weight is stable
How do you calculate the dexSP 4mg/ml for Dr. Rednour in order to premed her heartworm patients?
Weight in pounds / 4 = a
a x 0.25 = amount of mls
What is the purpose of the doxy on for 1 month and off for 1 month?
Disrupts heartworm transmission, reduces pathology associated with dead heartworms, kills the Wolbachia and allows time for the worms to wither after the wolbachia are eliminated