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Thread: Heartworm meds question...

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    Supporter kalynraye's Avatar
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    Heartworm meds question...

    Its 9 p.m. and I think I am going to go to bed now. I have work at 7 a.m. its my first full day of normal stuff and I'm nervous and excited. The boys did great with their shots and blood work. I learned from the vet that I couldn't get heartgaurd for Brexton because he's a border collie and apparently this doesn't work on border collies. Rae'ya do you know why this is? I going to believe its the truth and not that they were just trying to get me to buy the more expensive heart worm treatment because they didn't push for me to get the other with Rocky.
    Last edited by thalassa; 03 Jan 2016 at 02:44. Reason: moved this to its own thread in Pets, for future reference for the peoples...
    "If you want to know what a man is like, take a good look at how he treats his inferiors, not his equals." -- Sirius Black

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    sea witch thalassa's Avatar
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    Re: Whatcha thinking about now?

    Quote Originally Posted by kalynraye View Post
    I learned from the vet that I couldn't get heartgaurd for Brexton because he's a border collie and apparently this doesn't work on border collies. Rae'ya do you know why this is? I going to believe its the truth and not that they were just trying to get me to buy the more expensive heart worm treatment because they didn't push for me to get the other with Rocky.
    Rae'ya can definitely explain this better and correct me if I missed any of the details, but I sat next to this discussion 3 times at the SPCA vet just a few weeks ago:

    There's a gene that is common in Collies, German and Australian Shepards, English Sheepdogs, and a few other breeds that makes them more sensitive to the medicine in Heartgard than other dogs that can result in seizures, coma, or worse.

    BUT

    The problem is that the sensitivity issue it is dosage dependent (and the dosage isn't enough in any of the heartworm preventives), and its actually present for the entire family of medicines--but the company has marketed the alternative medications quite strongly as being "safe" for those breeds and some vets still go by this because of the "public perception" issue--there are lots of anecdotal stories of "my dog got sick on Heartgard"* Also, farm dogs have been known to OD because of eating the poo of recently treated livestock (with the same meds)...one of the three dogs was a working dog, so they had some discussion about how to time when to give him his meds.

    If you are concerned, there is apparently genetic testing you can have done (and the SPCA vet would require this before prescribing that family of meds in a high dosage for any treatment).



    *Having been a people medical person, rather than an animal one...I'm going to assume this is probably because of the same operator error that causes people to have problems with med en masse---if one is good, two must be better; ooops, I forgot last time, lets take another just to catch up; and my ever favorite--I just exposed my loved one to place with tons of germs, but it has to be the flu shot that that has given them the flu (even though the symptoms look very little like the flu), etc.
    “You have never answered but you did not need to. If I stand at the ocean I can hear you with your thousand voices. Sometimes you shout, hilarious laughter that taunts all questions. Other nights you are silent as death, a mirror in which the stars show themselves. Then I think you want to tell me something, but you never do. Of course I know I have written letters to no-one. But what if I find a trident tomorrow?" ~~Letters to Poseidon, Cees Nooteboom

    “We still carry this primal relationship to the Earth within our consciousness, even if we have long forgotten it. It is a primal recognition of the wonder, beauty, and divine nature of the Earth. It is a felt reverence for all that exists. Once we bring this foundational quality into our consciousness, we will be able to respond to our present man-made crisis from a place of balance, in which our actions will be grounded in an attitude of respect for all of life. This is the nature of real sustainability.”
    ~~Llewellyn Vaughan-Lee

    "We are the offspring of history, and must establish our own paths in this most diverse and interesting of conceivable universes--one indifferent to our suffering, and therefore offering us maximal freedom to thrive, or to fail, in our own chosen way."
    ~~Stephen Jay Gould, Wonderful Life: The Burgess Shale and the Nature of History

    "Humans are not rational creatures. Now, logic and rationality are very helpful tools, but there’s also a place for embracing our subjectivity and thinking symbolically. Sometimes what our so-called higher thinking can’t or won’t see, our older, more primitive intuition will." John Beckett

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    Opinionated Rae'ya's Avatar
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    Re: Heartworm meds question...

    Quote Originally Posted by kalynraye View Post
    Its 9 p.m. and I think I am going to go to bed now. I have work at 7 a.m. its my first full day of normal stuff and I'm nervous and excited. The boys did great with their shots and blood work. I learned from the vet that I couldn't get heartgaurd for Brexton because he's a border collie and apparently this doesn't work on border collies. Rae'ya do you know why this is? I going to believe its the truth and not that they were just trying to get me to buy the more expensive heart worm treatment because they didn't push for me to get the other with Rocky.
    Thalassa is pretty much right.

    Certain lines of certain breeds (and their cross bred offspring) carry a genetic sensitivity to certain drugs, the most common of which are ivermectin (which is in Heartgard) and moxidectin (which is in Proheart tablets and SR12 injectable as well as in Advocate spot on). It's not EVERY single collie in the world, just some lines. And only a few dogs within those lines. It's a LOT rarer than collie breeders would have people believe, but it does exist. And yes, you can do a DNA test to check if your particular dog has the sensitivity. It's called the MDR1 gene mutation, because it's that particular gene that is mutated in these dogs. The test is a pretty simple cheek swab, and if your dog doesn't have the mutation then they are no more sensitive to the drugs than any other dog.

    Now this is where it gets all muddied up by the existence of the internet...

    It's not that the drugs don't work in those dogs, because they do. It's just that some dogs are sensitive because of this mutated gene and will show symptoms of overdose on higher dosages that would normally be safe. Interestingly, you hear this whole 'Heartgard will kill your Border Collie' argument A LOT, and I'm starting to see the same thing with Proheart, but people almost never kick up about Advocate or Milbemax (milbemycin is also on the list of drugs that MDR1 mutated dogs are sensitive to)! I've never in my career had a dog get sick on Heartgard or any of the other drugs, but there have been cases where they have because of double dosing, or people using the incorrect size of product, or concurrent dosing with another medication (ie Proheart and Milbemax used together), or because farmers are using their cattle drench ivermectin instead of paying for Heartgard, or whatever reason. Then their owners get on the internet and spread the word around. Then the breeders start spreading the word around about the evil vets who will kill your dog by giving it heartworm meds. You also hear it a lot about Collie breeds, but not about other breeds that can carry the gene (like Aussie Shepherds and English Sheepdogs). It's really a case of a very rare circumstance being blown up into a big wad of half-understood misinformation that the internet took a hold of and ran with.

    Some vets opt to not recommend those products for collie derived breeds as a 'just in case' sort of policy, which is a bit stupid, because if they're going to do that then they also need to cross off about half a dozen other drugs for use in collies. There ARE contraindications information for us, to make sure that a collie on Heartgard doesn't then get ivermectin for say, demodex mange (which may cause an issue), but if it monthly dosing was truly a consistent enough issue with the appropriate size range, Merial would have to put warnings on their packaging (as would Novartis, Pfizer and a few others). Which they don't. Because the testing they've all done to ensure their product is safe does just that... ensures their product is safe in 99% of the population at the dosages recommended on the packaging (that's not an actual statistic... I don't know off the top of my head what the tested safety margin has to be, but it's high enough that I feel safe using their drugs).

    So basically, if Brexton has had Heartgard his whole life then it's unlikely he has the sensitivity gene and I wouldn't stress about it. However, remember that Heartgard does not treat all the intestinal worms, so it's not actually a complete parasite control product anyway. Which means that it's likely to be used with another product... which means that there's a possibility you'll end up inadvertantly combining several of the drugs on the MDR1 mutation list. I know that the US has slightly different attitudes about intestinal worming than we do... we recommend a monthly combination product or three monthly intestinal worming as well as your monthly heartwormer (or yearly injection)... but I know that lots of vets in the US recommend regular faecal testing to check if you need an intestinal wormer. If you do use a regular intestinal wormer as well as the Heartgard, then just ensure it's a straight praziquantel/oxantel/pyrantel type product and not something that also kills heartworm (the milbemycin/praziquantel ones kill heartworm too, and are often given on top of something like Heartgard or Proheart).

    Just out of curiosity... which drug did they sell you for Brexton instead?

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    Silver Member anubisa's Avatar
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    Re: Heartworm meds question...

    What??? I didn't know that certain heartworm meds didn't work on certain dogs! Is that the same for smaller dogs? I have Yorkshire Terriers.
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    sea witch thalassa's Avatar
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    Re: Heartworm meds question...

    Quote Originally Posted by anubisa View Post
    What??? I didn't know that certain heartworm meds didn't work on certain dogs! Is that the same for smaller dogs? I have Yorkshire Terriers.

    The medicine works just fine. The problem is that in some breeds of dogs there may be a mutation that causes them to overdose on a certain drug contained in the heartworm formulations at a lower dosage than most dogs. Even so, the dosage that they have a reaction to is much higher than heartworm medications have in them, when they are administered correctly.

    And Yorkies are not one of those breeds, as far as I know.
    “You have never answered but you did not need to. If I stand at the ocean I can hear you with your thousand voices. Sometimes you shout, hilarious laughter that taunts all questions. Other nights you are silent as death, a mirror in which the stars show themselves. Then I think you want to tell me something, but you never do. Of course I know I have written letters to no-one. But what if I find a trident tomorrow?" ~~Letters to Poseidon, Cees Nooteboom

    “We still carry this primal relationship to the Earth within our consciousness, even if we have long forgotten it. It is a primal recognition of the wonder, beauty, and divine nature of the Earth. It is a felt reverence for all that exists. Once we bring this foundational quality into our consciousness, we will be able to respond to our present man-made crisis from a place of balance, in which our actions will be grounded in an attitude of respect for all of life. This is the nature of real sustainability.”
    ~~Llewellyn Vaughan-Lee

    "We are the offspring of history, and must establish our own paths in this most diverse and interesting of conceivable universes--one indifferent to our suffering, and therefore offering us maximal freedom to thrive, or to fail, in our own chosen way."
    ~~Stephen Jay Gould, Wonderful Life: The Burgess Shale and the Nature of History

    "Humans are not rational creatures. Now, logic and rationality are very helpful tools, but there’s also a place for embracing our subjectivity and thinking symbolically. Sometimes what our so-called higher thinking can’t or won’t see, our older, more primitive intuition will." John Beckett

    Pagan Devotionals, because the wind and the rain is our Bible

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    Opinionated Rae'ya's Avatar
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    Re: Heartworm meds question...

    Quote Originally Posted by anubisa View Post
    What??? I didn't know that certain heartworm meds didn't work on certain dogs! Is that the same for smaller dogs? I have Yorkshire Terriers.
    The drugs work fine.

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    Silver Member anubisa's Avatar
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    Re: Heartworm meds question...

    Quote Originally Posted by Rae'ya View Post
    The drugs work fine.
    Okay. Thanks Rae'ya.
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    Supporter kalynraye's Avatar
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    Re: Heartworm meds question...

    Alright sorry haven't been on a few days. Busy busy with work and all. Ok So Brexton was given Sentinel.I think its suppose to prevent two other types of worms in addition to the heartworms. Also thanks ladies for the info.
    "If you want to know what a man is like, take a good look at how he treats his inferiors, not his equals." -- Sirius Black

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    Opinionated Rae'ya's Avatar
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    Re: Heartworm meds question...

    Quote Originally Posted by kalynraye View Post
    Alright sorry haven't been on a few days. Busy busy with work and all. Ok So Brexton was given Sentinel.I think its suppose to prevent two other types of worms in addition to the heartworms. Also thanks ladies for the info.
    Honestly, you're new vet is a bit silly.

    Sentinel is milbemycin, which is technically also on the MDR1 mutation list of sensitivities. Theoretically, it is no different to giving ivermectin for heartworm! But it's a great product and covers roundworms, hookworms and fleas too. We sell Sentinel Spectrum, which does tapeworm as well as all the others... it's one of my preferred products.

    Basically, the only time I avoid ivermectin in collies is for mange treatment, because the doses are higher and are in the danger zone for the ones with the gene mutation. None of the heartworm products are though.

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    Supporter kalynraye's Avatar
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    Re: Heartworm meds question...

    Ugh... Well she does sound silly. Alright then so it is alright if he takes it? Just as long as I don't overdose him or mix it with other things?
    "If you want to know what a man is like, take a good look at how he treats his inferiors, not his equals." -- Sirius Black

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