Download o Heartworm testing - Metro Paws Animal Hospital

Metro Paws Animal Hospital Heartworm Treatment Plan
Heartworm Testing:
If your dog’s test was positive for heartworms we will recommend retesting to confirm a true positive result. If the
second test is positive, we will then recommend starting a treatment plan for your dog’s heartworm disease. If your dog
is positive for heartworms this means that adult heartworms are currently alive in your dog’s heart. When a dog is
bitten, by a mosquito, carrying heartworm larvae, it can take up to 6 months for that dog to show evidence of that
infection on our current heartworm test. At that time dogs will have adult heartworms living inside their hearts. They
can also have multiple stages of the worm’s lifecycle living in their muscles, and blood vessels. Those young worms are
working their way to the dog’s heart as they are growing. The worms can cause side effects in the dog’s heart and lungs,
that can include ongoing heart damage, heart failure, coughing, coughing blood, pulmonary thromboembolism (blood
clot in the lungs), Stroke (blood clots in the brains), collapse, and sudden death. Our treatment plan is devised to kill
each life stage at different treatment stages. A rough estimate for full treatment plan is approximately $1200-1800 and
does not include all possible complications that may occur during or after treatment. We will ask you to sign a
heartworm treatment contract to ensure you have read and understand the process of heartworm treatment.
Preparation for Treatment
- The purpose of the pre-evaluation is to try and identify the high-risk patient so that TREATMENT PLANS CAN BE
MODIFIED TO REDUCE RISK. There is a chance we will elect not to treat your dog until any problems can be
corrected.
- All pre-existing medical conditions should be addressed prior to undergoing immiticide therapy. Treatment of such
conditions may not have been included in your original financial estimate.
o Physical Exam
 The death of adult heartworms during treatment can be a severe insult to the dog's lungs,
worsening an existing medical condition. Advanced pulmonary vascular disease, allergic
pneumonitis, or congestive heart failure may require a delay in heartworm treatment until these
problems can be corrected.
o Chest X-ray
 A chest x-ray will be taken to assess the severity of the damage caused by the heartworms to the
heart and lungs. Radiographs may indicate that heartworms have caused high blood pressure in the
lungs (pulmonary hypertension). If radiographs show changes to the lungs or heart, your pet may be
placed on steroids after treatment to reduce the risks caused by dead heartworms passing into the
lungs.
o Heartworm testing
 The heartworm test will be sent out to an outside lab (Antech) for confirmation.
 A Difil test for the immature microfilaria (baby heartworms) may be performed.
o Complete Bloodwork
 CBC - Changes in the CBC may indicate a pre-existing medical condition, which may require attention
before heartworm treatment. A low platelet count will increase the risk to your dog. We may
prescribe an antibiotic and/or steroids to be administered for 2-3 weeks immediately prior to
treatment.
Metro Paws Animal Hospital - Lakewood
1910 Skillman Street – Dallas, Texas 75206
214-887-1400 Fax: 214-887-6340
Email: [email protected]
Metro Paws Animal Hospital - Oak Cliff
1021 Fort Worth Avenue - Dallas, Texas 75208
214-939-1600 Fax: 214-939-9240
Email: [email protected]

Chemistry panel – This panel assesses overall organ function - in particular, the liver and kidneys.
Both of these organ systems are utilized in the processing of the anti-parasitic drug and can be
affected by a high worm burden.
Treatment:
Treatment for heartworm disease consists of a multiple step process to ensure maximum rate of success. No heartworm
treatment protocol can give 100% guarantee, but we try to plan a treatment protocol that will give us the highest
possible rate of success. You also have the option to not treat. If you elect not to treat, then starting heartworm
prevention and an antibiotic called Doxycycline, to prevent further infection, can be instituted. There is growing
evidence that giving only preventives may be contributing to heartworm prevention resistance. This is one reason that
heartworm prevention is not strongly recommended as sole treatment for patients recently diagnosed with heartworm
disease. If you elect this option the adult worms can live in your dog’s heart for 2-3 years before they die of natural
causes. During this time the worms can cause side effects in the dog’s heart and lungs that can include ongoing heart
damage, Heart failure, coughing, coughing blood, pulmonary thromboembolism (blood clot in the lungs), Stroke (blood
clots in the brains), collapse, and sudden death.
Step 1) Pre-Treatment
Once you have decided that you would like to go forward with treatment, the first step is to make a consult
appointment. At the appointment we can discuss any questions you have about heartworm disease and treatment. The
appointment should be made early in the morning on a Monday-Thursday, so that if you elect to continue with our
treatment plan, your dog can be left for the day to institute the first step of treatment.
First your dog will be given medication to help prevent allergic reactions that may occur due to the killing of the
parasites in your dog’s body. Then, an oral medication called ivermectin (same medication found in heartworm
prevention at a higher dose) will be given to kill off larvae (baby worms) before they grow into adults in the heart. Your
dog will then stay with us for the remainder of the day (at least 4-5 hours) to ensure that we can intervene if any
adverse reactions occur. Possible adverse reaction include anaphylactic shock, coughing, vomiting, respiratory distress,
clots etc. We pretreat with medications to help prevent these from occurring, but they are still possible. When ready,
your dog will then go home with medications (prednisone/steroid and Doxycycline/antibiotic) to help prevent and treat
inflammation and secondary infection that may be caused by the Heartworms. You will also be sent home with
heartworm prevention to ensure your dog is not re-infected during this stage. You will wait 3 months before scheduling
the next appointment. This is to ensure the juvenile worms (in-between stages that are harder to kill with any of our
current treatments) grow into adults. This helps to ensure the best possible success rate for the treatment plan. During
this time you will treat monthly with heartworm prevention (Iverheart).
Estimate of Cost for Step 1 :
(includes Initial Examination, Ivermectin, Medications to go home, and hospitalization for the day, 3 months of Heartworm Prevention)
0-25 lbs:
$165.00 -$185.00
26– 50lbs:
$195.00 – 205.00
51- 75 lbs
$220.00 – 230.00
> 76 lbs:
$240.00 – 250.00
Step 2) Prescreening diagnostics, and one Heartworm injection
Metro Paws Animal Hospital - Lakewood
1910 Skillman Street – Dallas, Texas 75206
214-887-1400 Fax: 214-887-6340
Email: [email protected]
Metro Paws Animal Hospital - Oak Cliff
1021 Fort Worth Avenue - Dallas, Texas 75208
214-939-1600 Fax: 214-939-9240
Email: [email protected]
An appointment should be made (Monday-Thursday only) to drop off your dog for Heartworm treatment. At this stage
we will run diagnostic tests (blood work, Xrays) on your dog to ensure that he/she is in good enough health to move
ahead with treatment as planned. Blood work and xrays may be declined, but are very strongly recommended to ensure
your pet is healthy enough to undergo this treatment. At this stage we will again pre-treat your dog with oral and
injectable medications to reduce the risk of possible adverse reactions. We will also keep your dog in the hospital that
day to monitor for any adverse reactions. Your dog will be given the injection to kill adult heartworms at this time. This
injection is reported to kill a large percentage of worms in the dog’s body, but will not kill all of the worms. For this
reason we will repeat the treatment again in 1 month. We will also send home medications again to help prevent
inflammation and infection.
Once home you will need to strictly cage rest your dog for 10 weeks following initial heartworm injection, to prevent
increased heart rate which can lead to increased propensity for reactions. This means no playing and running during the
treatment and several weeks afterwards. Your dog must be kept indoors and quiet or YOUR DOG MAY HAVE A SEVERE
REACTION; including death, while the body is dealing with the dead/dying heartworms. In case of cough, fever, or loack
of appetite, please call immediately:
- Metro Paws Animal Hospital (Lakewood): 214-887-1400
- Metro Paws Animal Hospital (Oak Cliff): 214-939-1600
- Afterhours: Emergency Animal Clinic– 214-520-8388
Potential Complications:


Pulmonary Thromboembolism - When the heartworms die, they are carried by the blood stream into the lungs.
This causes a blood clot in the lungs. Symptoms would be coughing, fever, or lack of appetite. A platelet count
and/or x-rays may confirm the diagnosis.
o Treatment consists of:
 Antibiotics to prevent pneumonia
 Steroids as an anti-inflammatory
 Cough suppressant
 Strict confinement for an additional 3 weeks
Systemic Thromboembolism – Blood clots of any kind have the ability to enter the bloodstream. If this happens,
your pet could suffer a stroke or even die.
Original estimates do not cover complications associated with heartworm treatment. You may incur additional charges
at our hospital and/or an emergency clinic.
Estimate of Cost for Step 2 :
(includes Examination, Diagnostics, 1st Immiticide Treatment, and Overnight Hospitalization)
0-25 lbs:
$520.00 – 530.00
26– 50lbs:
$600.00 – 630.00
51- 75 lbs
$630.00 – 660.00
> 76 lbs:
$710.00 – 750.00
Step 3) Two Heartworm treatment injections Twenty four hours apart
An appointment should be made (Monday-Thursday only) to drop off your dog 1 month after step two for 2 days (one
night) so that we can give the next round of injections for the adult worms. You should schedule a discharge time on day
Metro Paws Animal Hospital - Lakewood
1910 Skillman Street – Dallas, Texas 75206
214-887-1400 Fax: 214-887-6340
Email: [email protected]
Metro Paws Animal Hospital - Oak Cliff
1021 Fort Worth Avenue - Dallas, Texas 75208
214-939-1600 Fax: 214-939-9240
Email: [email protected]
two of the treatment anytime between 4pm and closing. This time we will be administering 2 injections 24 hours apart.
We will again pre-treat your dog with oral and injectable medications to reduce the risk of possible adverse reactions
prior to each heartworm treatment injection (Melarsomine). We will also keep your dog in the hospital 2 days (one
night) to monitor for any adverse reactions after each injection. We will also send home medications again to help
prevent inflammation and infection. Once home you will need to strictly cage rest your dog to prevent increased heart
rate which can lead to increased propensity for reactions.
Estimate of Cost for Step 3 :
(includes Recheck Examination, 2nd Immiticide Treatment, 6 months of Heartworm Prevention)
0-25 lbs:
$330.00 – 360.00
26– 50lbs:
$430.00 – 460.00
51- 75 lbs
$540.00 – 570.00
> 76 lbs:
$640.00 – 670.00
Step 4) Difil test (Cost $37.48)
Please schedule a technician appointment 6 weeks after last heartworm treatment injection for a Difil test. This test will
look for offspring of adult worms still living in the blood vessels.
Step 5) Heartworm test (Cost $41.00)
6 months after the Difil test you should schedule a technician appointment for a heartworm test to make sure
heartworm treatment was successful.
Step 6) Heartworm prevention (Cost will depend on your choice of Preventatives)
Please continue to use heartworm prevention monthly for the rest of your dog’s life. You can switch to combo HW/Flea
preventives after your dog is negative on the Heartworm antigen test in step 5.
Metro Paws Animal Hospital - Lakewood
1910 Skillman Street – Dallas, Texas 75206
214-887-1400 Fax: 214-887-6340
Email: [email protected]
Metro Paws Animal Hospital - Oak Cliff
1021 Fort Worth Avenue - Dallas, Texas 75208
214-939-1600 Fax: 214-939-9240
Email: [email protected]
HEARTWORM TREATMENT CONTRACT
By signing below, I understand and agree to the following:
All price quotations are approximate. Because treatment must be individualized for each patient we cannot quote exact
prices.
Charges incurred from complications related to heartworm treatment have been included in any estimates provided.
I have been informed of the risks to my pet, including death, and have received and read information on heartworm
treatment. Declining any of the recommended diagnostics and/or treatments for my dog may increase their risk of
complications, including death.
I have been informed that heartworm treatment does not always get rid of all the heartworms.
I have been informed that the use of ivermectin as a microfilaricide is not approved by the FDA and is considered an offlabel use of this drug. I have been informed of the risk of using this drug and consent to its usage.
I understand and agree to follow all post-treatment instructions:
Pet’s Name: __________________________________ BREED: _________________________________
AGE: _______________________________________ WEIGHT: ________________________________
CLIENT NAME: _______________________________ SIGNATURE: ______________________________
STAFF MEMBER/WITNESS: ______________________________________________________________
**This page of the treatment plan is kept on file and scanned into pet’s medical record**
Metro Paws Animal Hospital - Lakewood
1910 Skillman Street – Dallas, Texas 75206
214-887-1400 Fax: 214-887-6340
Email: [email protected]
Metro Paws Animal Hospital - Oak Cliff
1021 Fort Worth Avenue - Dallas, Texas 75208
214-939-1600 Fax: 214-939-9240
Email: [email protected]