An introduction to heartworms

Note: this post originally appeared as a series of instagram posts under the hashtag #OurPitStopTakesOnHeartworms.

If you have a dog, or are thinking of getting a dog, chances are you will have, at some point, heard of heartworms, or heartworm disease. Yet, those of us who don’t live in areas of the country where it’s particularly prevalent have a lot to learn. Lucky (?) for me, our 13th foster dog, Mama Julep (a Hurricane Harvey survivor who I fell in love with while doing relief work in Houston) came to us with heartworm disease, and I quickly got a crash course on the disease, its treatment, and the severity of both. I am not an expert on heartworms, but consider this an introduction, and please continue your research by visiting The American Heartworm Society‘s incredibly helpful website.

The Disease

Photo of adult heartworms from The American Heartworm Society

• Heartworm disease is caused by worms that live in the heart, lungs and blood vessels.
•  Heartworms most frequently affect dogs, wolves, foxes and coyotes, but can also be found in cats and (extremely rarely) humans.
• The disease is most frequently transmitted between animals by mosquitos. The insects pick up baby worms from the infected animal’s blood, then bite another animal and transmit infected larvae.
• Puppies and adult dogs have the same risk of heartworm disease.
• There are rarely any signs of disease when a dog or cat is first infected.
• As the disease progresses, symptoms in dogs include coughing, reluctance to exercise, fatigue after moderate activity, decreased appetite, and weight loss.
• The symptoms of advanced heartworms in dogs include a swollen belly due to excess fluid in the abdomen, and heart failure due to worm blockage.
• In other words, heartworm disease is fatal if left untreated.
• Adult heartworms can grow as long as a 12 inches and hundreds of adult worms can live in one dog.
• Heartworms cause lasting damage to the heart, lungs and arteries, and can affect a pet’s health long after the worms are gone.
• Adult heartworms can live for up to 7 years in dogs and 3 years in cats.
• Heartworms have been found in all 50 states.
• The disease is most prevalent in Southern states (think warm winters, more mosquitos), particularly near the Atlantic and Gulf coasts.
• Increased transport of pets from Southern states to the North has increased the prevalence of heartworm disease in the North, and some states have considered or passed legislation regarding the “importation” of heartworm positive pets.
• According to a national study, the average number of heartworm positive dogs per vet clinic is up by 21.7% nationwide.

The Treatment

foster dog Mama Julep’s “bad haircut” following her second Melarsomine injection

• The FDA-approved treatment for heartworm disease in dogs lasts at least 4 months.
• During the first two months, the dog takes antibiotics and heartworm preventative pills to prepare for injections.
• After two months of prep, dogs get their first injection of a drug called melarsomine.
• Melarsomine is a type of arsenic (yep, you read that right) that kills heartworms living in the dog’s body. The drug is no joke, though, and it’s strength and intensity are why dogs are kept at the vet for observation all day after the injection is given, and a long rest period after injections is critical.
• The injections are generally given on the dog’s back, and a  small square is shaved at each injection site.
• After the first injection of Melarsomine, the first 30 days of rest begin. Full crate rest is recommended because elevating the heart rate or panting could lead to dead worms blocking blood flow, which could be fatal.
• During the rest period, dogs are generally prescribed prednisone or another anti-inflammatory to reduce side effects. (Julep is on prednisone. Woohoo nonstop peeing!) *30 days after the first injection of Melarsomine, a second injection of it is given, and then the very next day a third is given. Then, it’s 30-60 more days of rest while on prednisone.
• After the second rest period is over, dogs are tested for heartworm again, and everyone crosses their fingers and toes that they’re clear!
• The average cost of treatment is $400 to $1,000, depending on the size of the dog (Mama Julep’s total cost will end up being approximately $1,600 – everything is more expensive in the NYC-metro area!)
• Compare that cost to the average cost of monthly heartworm preventative: $5 to $15 per month. I’d say that’s worth it to avoid all this treatment, wouldn’t you?

The Rest Recovery Period

Snuggling: the secret to keeping Mama Julep calm.

• 4-6 weeks of rest means no walks, zoomies, wrestling, you name it. For dogs that are unable to stay calm inside, a crate is recommended.
• Embrace the tie down. We use a leash looped around a couch leg. When Julep (or any of our other past fosters) can’t settle, we place her in a tie down with a bone to work on.
• Ditch bowls and feed all meals out of toys.
• Rotate toys to keep interest. We have a closet of toys that stays closed, and every few days I put away the toys that are out and bring out new ones.
• If you have multiple dogs, keep the non-resting dog tired so he or she doesn’t instigate! During Mama Julep’s treatment, Beau got lots of long walks, hikes, and flirt pole sessions, and he ate all of his meals out of food dispensing toys, too. Because of that, we only had a few days (out of the many weeks) when Beau tried to engage Mama Julep in play, which was huge.
• Keep a leash on outside at all times. Even our foster dog Mama Julep, who is super calm, couldn’t help herself if she saw a squirrel in our backyard during her recovery period. The leash took away the temptation.
• If your dog likes ca rrides, and is calm in the car, consider substituting daily car rides for daily walks.
• Know what excites your dog, and avoid it as best you can. For instance, during her treatment I learned that Mama Julep is friskiest on cold mornings, so we were extra diligent with the leash on those mornings. Our cat, Zora, was also very exciting to Mama Julep so we kept them completely separate with baby gates and doors.
• Know what calms your dog, and lay it on thick! For Mama Julep, it was all about snuggling.
• For more ideas, check out the great book “No walks? No worries!: Maintaining wellbeing in dogs on restricted exercise,” and get creative!

Have you had any experience with heartworm disease, or lengthy rest recovery periods? Tell us about it in the comments below!

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