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Heartworm Treatment Guidelines The American Heartworm Society recommends the following heartworm treatment protocol for dogs. This method effectively eliminates most heartworm infections when closely followed by both you and your veterinarian. The overall goals of treatment are to safely and successfully eliminate current adult and immature heartworms, prevent new infections and minimize treatment related complications in your dog. The recommended treatment consists of the 5 steps outlined below. This recommendation is to help prevent ongoing damage to the heart and lungs during the “Slow Kill” method which only became a method of treatment when Immiticide was difficult for veterinarians to acquire. Therefore, a pet with grade 1 or 2 heartworm disease is an excellent candidate for treatment. “Slow Kill” might be effective in some pets and a better option for older pets, but with all the medications we have today to help with pain and side effects, it’s safer to treat dogs with the injections than wait for the worm to die on its own. Although, heartworm prevention and doxycycline can weaken the worm and it can die sooner, the average life span of a heartworm is 7 years. That is 7 years of heart damage. I personally recommend this protocol for heartworm treatment. I have always had good success, very few side effects and in the 13 years of practice, one death. The pets we treat must be in good health. Please fill out the Heartworm Treatment Questionnaire. Initial Treatment (Day 0/ 1st mo): Heartworm Prevention and 30 days of Doxycycline (Cost Varies Based on Size and what the rescue group has) 1. The prevention will prevent any new worms 2. The Doxycycline kills a bacteria on the worm that makes it stronger and causes more inflammation in the heart and lungs. $20, or provided by rescue group 3. CBC, Chemistry, Urinalysis available at AMVS $90 4. Prednisone $20 (if not provided) to reduce inflammation in the lungs and heart caused by the worms. To be given the entire treatment process. 1mg per 4 lbs of body weight, twice a day the first 5 days, then once a day until one month AFTER the treatment is completely done. First Adulticide Treatment (Day 30, 2nd mo) (Cost of 1 bottle of Immiticide which treats 40lbs and can be saved for further pets, pay by the bottle, $90): 1st injection of immiticide and observation for the day. We will send home pain medications and prednisone to help with any inflammation the dying worms might cause. This greatly reduces side effects. Prednisone anti-inflammatory, if not already provided or purchased $20 Tramadol for pain, if not already provided or purchased $20 Gabapentin for the inflamed nerves in the back from the injection, if not already provided or purchased $20 Second Adulticide Treatment 2 injections, 24 hours apart (Day 60, 3rd mo): (Cost of 1 bottle of Immiticide which treats 40lbs and can be saved for further pets, pay by the bottle, $90) ($10 overnight stay): Two injections of Immiticide 24 hours apart with overnight care and pain medication. Once again, we will send home pain medication and prednisone to help reduce many of the side effects of this drug. The worms will be completely dying at this point. Home Care – Your Responsibility: CONTINUE TO GIVE HEARTWORM PREVENTION EVERY MONTH DURING TREATMENT. Throughout the recovery period, please watch your pet for coughing, gagging, vomiting, diarrhea, or loss of appetite. Excessive sluggishness, respiratory distress, and coughing up blood are signs of a serious problem that require immediate veterinary attention. Many of these side effects can be prevented with medications sent home and constant rest. If the rescue group declines doing the first injection of Immiticide and decides to only do two injections 24 hours apart we will have them sign a release understanding that this may cause more side effects or a slightly less chance of effectiveness. Worksheet for cost for patient: Weight:_________ Number of Immiticide bottles needed $90 per bottle, treats 40lbs, 3 injections needed: _______ total cost Doxycycline $20 for whole treat $20 Tramadol $20 for whole treatment $20 Overnight stay (1 only) $10 $10 Gabapentin $20 for whole treatment $20 Prednisone $20 for whole treatment $20 Bloodwork and Urinalysis $90 20LB DOG WITH ALL INCLUDED (2 BOTTLES OF IMMITICIDE) $360 WITH LEFT OVER IMMITICIDE