Yorkie has ALT level of 680+ and Dehydrated... Help please!

[Ellie May]

Originally Posted by ladyjane

I am sure they used Immiticide.
And, I have never heard of Heartgard daily? That dog is stage 3 and does need the Immiticide treatments. Interesting that they use the Doxy which is fairly new......I just wonder why they did not give Heartgard for a couple of months first which really is a slower safer treatment and the recommended way now.

Hmm, come to think about it, it's monthly. It's the new "slow kill" method which doesn't really kill anything at all and always disease to progress. It's supposed to weaken them. Standard of care is still definitely Immiticide in most cases.

Now I'm more confused. One Ivermectin shot a year for heartworms?

[ladyjane]

Originally Posted by Ellie May

Hmm, come to think about it, it's monthly. It's the new "slow kill" method which doesn't really kill anything at all and always disease to progress. It's supposed to weaken them. Standard of care is still definitely Immiticide in most cases.

Now I'm more confused. One Ivermectin shot a year for heartworms?

The only way it is recommended to do that is if a dog cannot withstand the treatment; and, yes you are correct, it will not kill the adult heartworms.

I think the OP has it wrong...there is no heartworm treatment like that. There is no ivermectin injection and certainly not once/year. I am sure the vet told her to get the rabies again in a year...maybe even the other vaccine; but not the ivermectin which I suspect was really immiticide.

[Madraga]

Originally Posted by ladyjane

As Ellie May said: Ivermectin does not kill adult heartworms. The injection you are referring to, I am quite sure, is Immiticide.

Here is a link that explains heartworm treatment clearly:

Heartworm Treatment

I have never heard of weekly treatments for heartworms...and I have never heard of treatments being spread out over an entire year.

I don't see how the protocol could be any different in any country. I think you really need to ask your vet for more details about what protocol he is following. Her bloodwork would have nothing to do with heartworm treatment unless it was altered from the beginning in which case she would be considered high risk for treatment with Immiticide.

Hi, rabies vaccine and all the rest of the vaccines are actually once a year also. They didn't give her immiticide I'm sure of it. It was ivermectin. I think they gave her the heartworm shots that is done once a year. I don't know why they didn't let her have the oral ivermectin coz I did see it for sale in the vet's place. They gave her the once a year shot.

The doctor who attended her during the dehydration is different from her actual vet. She was released today and I was given these other antibiotics to help with her liver. I told them that those meds might make her liver work double time again but she said it won't. They want to see her again after 3 days to do a blood test to check her status. That'll be the last time I go there. I've found a different vet who prescribed a treatment that's similar to what you guys are talking about. Ivermectin every week or every month or something like that. I'm still afraid of immiticide. I know that's the only thing that'll cure her but she's too skinny and too frail. I think immiticide will kill her and not really help her so I'll have to wait till she's fatter and her health is better before I can go through with that. For now, I'll go see the other vet and have him assess on the Ivermectin shots that was given. See if doing a weekly thing will still be advisable or if it'll be too toxic.

My main concern right now is she still won't drink water on her own. I put water on my palm and she'd drink that but on her own she won't. Sometimes she just won't drink from my hand. It's like she's just not interested in drinking. I have water bowls in front of her crate so she just needs to come out and she can drink. I have the water near her everytime she's in the living room, I let her see where it is. She won't drink. I'm afraid she'll get dehydrated again. She eats boiled chicken breast with no skin, if I put the stock in her feeding bowl with the chicken, she won't drink the stock. If there's too much stock, she won't eat until I've taken out the stock. So far the vet is not worried as much about her condition so they're not looking into her feeding habits, she's been eating quite a lot but my problem is she won't drink. She won't poop either. She can eat 3 times a day but will poop once a day sometimes once in 2 days. I know she's on the shy side, i took her in from a friend who got her from someone else. I don't know how she was treated in her old home but she seems quite jumpy and nervous around people. Not very sociable and she's afraid to potty in front of us. She pees in my presence now but pooping is still another thing.

Have you guys had problems like this? What do you think cause her to refuse to drink? I'm just concerned more about dehydration again so I went and got bottles of pedialyte just in case. So far she just got back from the hospital so she's not dehydrated but I don't know how long it'll last before she gets dehydrated again coz she won't drink.

Thanks again for all your posts and I'm so grateful for your concern and suggestions. She's not the prettiest dog but she is loved by everyone in my home, from my brothers to my maids. They know what she's gone through and everyone is trying so hard to give her as much love and affection. I hope she settles down and see that we're not gonna harm her.

[Rhetts_mama]

Ivermectin DOES come in an injectible form and has an "off label" (aka extra label) use to kill the microfilaria in heartworm disease.

How Ivermectin Is Supplied

Ivermectin is available in 10 mg/ml and 2.7 mg/ml injectable form; 0.153 percent and 1.87 percent paste form; 10 mg/ml liquid oral form and 68 mcg, 136 mcg and 272 mcg tablets.


Ivermectin can be used in an extra-label manner to kill microfilaria (microscopic offspring) in heartworm infected dogs.

Ivermectin (Ivomec®, Heartgard®)

[ladyjane]

Originally Posted by Rhetts_mama

Ivermectin DOES come in an injectible form and has an "off label" (aka extra label) use to kill the microfilaria in heartworm disease.

How Ivermectin Is Supplied

Ivermectin is available in 10 mg/ml and 2.7 mg/ml injectable form; 0.153 percent and 1.87 percent paste form; 10 mg/ml liquid oral form and 68 mcg, 136 mcg and 272 mcg tablets.


Ivermectin can be used in an extra-label manner to kill microfilaria (microscopic offspring) in heartworm infected dogs.

Ivermectin (Ivomec®, Heartgard®)

Thank you...I stand corrected! While it may come in an injectible form, again, Ivermectin, DOES NOT kill adult heartworms...ONLY the microfilaria.

If it were my pup, I would be asking the vet why he is using that form of "treatment". Perhaps he is concerned due to her health...I don't know, but if it were my pup, I would be very clear on it.

[ladyjane]

Here is the link to the Heartworm Society. I had posted the other link above because it speaks about treatment in more lay terms, but this is a good site:
American Heartworm Society

[Woogie Man]

Originally Posted by ladyjane

Thank you...I stand corrected! While it may come in an injectible form, again, Ivermectin, DOES NOT kill adult heartworms...ONLY the microfilaria.

If it were my pup, I would be asking the vet why he is using that form of "treatment". Perhaps he is concerned due to her health...I don't know, but if it were my pup, I would be very clear on it.

The off label ivermectin is what I use for prevention. it is the same active ingredient as is in Heart Guard. It comes in a 1% solution and says 'injectable' on the label but is given orally to dogs. For small dogs it must be further diluted to avoid giving too much. I like it over the commercial dog products as it can be dosed to the exact weight of the dog instead of a weight range for commercial dog products.

As far as I've read, ivermectin is the only preventative that can be given to a heartworm positive dog. There are various 'slow kill' methods for heartworm positive dogs. One of the most common is to simply give the monthly preventative dose. The ivermectin will kill the microfilia, but does not 'kill' the adult heartworms. What it will do is render them unable to reproduce and will shorten their lifespan. Severely affected dogs have been cleared using this method but the dog may show 'positive' for up to 1 1/2 years until they are completely clear.

As I said, there are many variations of the slow kill method. Some call for increased doses and/or increased frequency of dosing in an effort to rid them faster.

The issue in selecting a treatment is what is effective and safe for a particular dog. The immiticide will kill them fast but there are risks to an already weakened dog. Then there is the risk of pulmonary embolism if the dog is allowed to be active while undergoing that treatment. The slow kill avoids these issues but you have to willing to be patient and understand that the dog will remain positive for heartworms for a longer period.

I wouldn't 'recommend' any particular plan for someone else's dog. Everyone must make their own decision for what is best for their own dog if confronted with this. There are also holistic treatments but I don't have faith in their effectiveness so won't go into them here.

[ladyjane]

Originally Posted by Woogie Man

The off label ivermectin is what I use for prevention. it is the same active ingredient as is in Heart Guard. It comes in a 1% solution and says 'injectable' on the label but is given orally to dogs. For small dogs it must be further diluted to avoid giving too much. I like it over the commercial dog products as it can be dosed to the exact weight of the dog instead of a weight range for commercial dog products.

As far as I've read, ivermectin is the only preventative that can be given to a heartworm positive dog. There are various 'slow kill' methods for heartworm positive dogs. One of the most common is to simply give the monthly preventative dose. The ivermectin will kill the microfilia, but does not 'kill' the adult heartworms. What it will do is render them unable to reproduce and will shorten their lifespan. Severely affected dogs have been cleared using this method but the dog may show 'positive' for up to 1 1/2 years until they are completely clear.

As I said, there are many variations of the slow kill method. Some call for increased doses and/or increased frequency of dosing in an effort to rid them faster.

The issue in selecting a treatment is what is effective and safe for a particular dog. The immiticide will kill them fast but there are risks to an already weakened dog. Then there is the risk of pulmonary embolism if the dog is allowed to be active while undergoing that treatment. The slow kill avoids these issues but you have to willing to be patient and understand that the dog will remain positive for heartworms for a longer period.

I wouldn't 'recommend' any particular plan for someone else's dog. Everyone must make their own decision for what is best for their own dog if confronted with this. There are also holistic treatments but I don't have faith in their effectiveness so won't go into them here.

I see rescues doing this because of cost. I would honestly rather see them turn the dogs over to people who will give them the recommended treatment. There are plenty of other dogs they can save while not cutting corners on others. What people do not understand is that the heartworm disease is progressing for those two years. The adult worms are what cause the problems. So even though the microfilaria are no longer being produced, damage is being done. A very healthy dog may be able to handle that, but I personally would never do it to them because it is a huge risk.

The only time I could see it done is if a dog was just SO sick that he/she could not withstand the immiticide treatment...and honestly, if they are that ill, they are probably not going to withstand the two years of letting those adult worms wreak havoc on their hearts.

To me, slow kill is giving Heartgard (Ivermectin) for two to three months and then doing the injections after that.

[ladyjane]

To the OP: As for her looks: I am quite sure she is a lovely girl!

Sometimes they don't drink a lot of water. If she is eating, that is a good thing! Just keep checking her gums....they should be wet to the touch. If you find them getting dry and sticky feeling, she is getting dehydrated.

I will say a prayer for her. I am glad she is home with you!

[beausgrrl]

So sorry for what you are going through Madraga.

I agree that the vet should not have given vaccines with the immiticide. How harsh for the poor baby!

I wanted top post here so others could learn that things don't always work even when you do the "right" method. Ok, I am probably out of line here because my dog is a rescue Lab and not a Yorkie. But I've been researching high and low for all information on the slow kill methods for heartworm. We rescued our dog 2 years ago and he has been on preventative the whole time and also supposedly while in his foster home b4 our adoption... Anyway at his annual I brought him in for knee probs and he tested heartworm positive. Fast forward and our vet did the 2 shot injection of immiticide and now almost a year later we have had several followups and the vet believes there are still adults even though June's test result was "negative" for adults...So, the immiticide failed! There are many microfilareas still in his blood and now we are doing doxy 3pills/2x a day for a month, ivermectin(heartguard) once every 2 weeks for 3 months with a followup in Jan.

So, I wanted to share with others that we did "what is recommended" and are so sad that a year later and there must be more damage done and is being done to his heart and lungs (although he shows no signs) and he's still considered positive even though the test said negative as all the followup blood smears show more and more babies....

I wish you luck on treatment....

oh and we have also noticed alot of panting on our walks since starting the high doses of doxy so they have been cut very short.....

Good luck.
-Tracey

[ladyjane]

Originally Posted by beausgrrl

So sorry for what you are going through Madraga.

I agree that the vet should not have given vaccines with the immiticide. How harsh for the poor baby!

I wanted top post here so others could learn that things don't always work even when you do the "right" method. Ok, I am probably out of line here because my dog is a rescue Lab and not a Yorkie. But I've been researching high and low for all information on the slow kill methods for heartworm. We rescued our dog 2 years ago and he has been on preventative the whole time and also supposedly while in his foster home b4 our adoption... Anyway at his annual I brought him in for knee probs and he tested heartworm positive. Fast forward and our vet did the 2 shot injection of immiticide and now almost a year later we have had several followups and the vet believes there are still adults even though June's test result was "negative" for adults...So, the immiticide failed! There are many microfilareas still in his blood and now we are doing doxy 3pills/2x a day for a month, ivermectin(heartguard) once every 2 weeks for 3 months with a followup in Jan.

So, I wanted to share with others that we did "what is recommended" and are so sad that a year later and there must be more damage done and is being done to his heart and lungs (although he shows no signs) and he's still considered positive even though the test said negative as all the followup blood smears show more and more babies....

I wish you luck on treatment....

oh and we have also noticed alot of panting on our walks since starting the high doses of doxy so they have been cut very short.....

Good luck.
-Tracey

I am sorry this happened to your dog. When you adopted this dog, was a heartworm test done? You said "supposedly" the dog was on preventatives...perhaps he was...and perhaps not. The rescue should have provided proof. And, was testing done a year later? What I can tell you is that if you have proof that he was negative and you gave Heartgard monthly, the company will pay for treatment.

[Madraga]

Originally Posted by beausgrrl

So sorry for what you are going through Madraga.

I agree that the vet should not have given vaccines with the immiticide. How harsh for the poor baby!

I wanted top post here so others could learn that things don't always work even when you do the "right" method. Ok, I am probably out of line here because my dog is a rescue Lab and not a Yorkie. But I've been researching high and low for all information on the slow kill methods for heartworm. We rescued our dog 2 years ago and he has been on preventative the whole time and also supposedly while in his foster home b4 our adoption... Anyway at his annual I brought him in for knee probs and he tested heartworm positive. Fast forward and our vet did the 2 shot injection of immiticide and now almost a year later we have had several followups and the vet believes there are still adults even though June's test result was "negative" for adults...So, the immiticide failed! There are many microfilareas still in his blood and now we are doing doxy 3pills/2x a day for a month, ivermectin(heartguard) once every 2 weeks for 3 months with a followup in Jan.

So, I wanted to share with others that we did "what is recommended" and are so sad that a year later and there must be more damage done and is being done to his heart and lungs (although he shows no signs) and he's still considered positive even though the test said negative as all the followup blood smears show more and more babies....

I wish you luck on treatment....

oh and we have also noticed alot of panting on our walks since starting the high doses of doxy so they have been cut very short.....

Good luck.
-Tracey

So sorry to hear this, Tracey. So you mean to say the immiticide didn't work for your dog? Do you think it's coz they didn't give enough dosage? Or maybe she's like Stage 4 when you got her?

My dog got tested for those blood smear things as well and we did see those heartworm babies under the microscope. So the vet says the infestation is widespread and she's probably at stage 3. I really don't know if seeing larvae in her blood is an indication of the stage of heartworm infestation, but I do notice her coughing sometimes when she's been running. I have her for 3 weeks only so her full self is just slowly coming out. She likes to play in the garden and she jumps and plays with us when she sees us. I've only hear her cough today for 2 -3 times. So far, for the duration that I've had her, she's coughed for like maybe 5 times. She is very very skinny though. So I don't really know the extent of her heartworm problem. I've asked the vet for x-rays and ultrasounds but they say those don't really show the heartworm unless the heart is completely infested.

I didn't want to give her immiticide just yet because I'm not sure she'll survive it. We got her frail already. Today I just spent the entire day with her and so far she's very active and she eats a lot. She drinks a little but she does eat a lot. I've seen some improvement and I think she was dehydrated already when we got her but it didn't really affect her until she got overly dehydrated during and after the vaccine shots.

I'm sorta paranoid now... I force her to drink water by all means. And I've also started giving her pedialyte. Can i always let her drink pedialyte from now on instead of water? or will this be bad as well?

Thanks so much guys for all the help.

[Madraga]

Originally Posted by ladyjane

To the OP: As for her looks: I am quite sure she is a lovely girl!

Sometimes they don't drink a lot of water. If she is eating, that is a good thing! Just keep checking her gums....they should be wet to the touch. If you find them getting dry and sticky feeling, she is getting dehydrated.

I will say a prayer for her. I am glad she is home with you!

Thank you so much Ladyjane. She is a lovely girl and she's slowly coming around and starting to warm up to us. She's very affectionate and at the same time fierce when around strangers. She bites. Hahaha.

We just try to give her space and allow her time to adjust.

Thank you for your prayers.

[beausgrrl]

I would def. find out if your dog got Immiticide (for adult heartworms) or Ivermectin (for baby/microfilarea), just to keep it straight, etc. Either the adults and/or babies dying off can cause embolisms with the Immiticide or slow kill methods....

We had the 2 shot protocol one day apart of the Immiticide last November. This was after Beau had xrays and bloodwork done to determine (I think educated guess now) what stage he was at and whether he was healthy enough to withstand the Immiticide. His xrays showed an enlarged heart which our vet said he could have been born with but could also be from heartworm disease. I don't believe seeing baby/microfilarea in a blood smear is a standard way to determine any stage before treating adult heartworm but just shows there are or had been adults... I've read that the babies can stay in circulation in a dog's blood after treatment for up to a year.

That all being said... Beau had been on Interceptor since we adopted him and when we had our vet records sent to them they helped pay for his Immiticide treatment and they sent us a year's supply of Interceptor. Just this summer we changed to Heartguard Plus as I just didn't think the microfilarea were dying off enough with the Interceptor.... who knows if I'm right.

I think our second followup to the adult heartworm treatment with Immiticide, our vet was concerned the babies were still pretty abundant in his blood smear so we asked if we could do anything for that. I think I asked about it as I'd read about a shot of Ivermectin (to help clear the babies) and she said that was possible to do. We did that and then continued to 'manage' Beau's activities to keep him as 'quiet' as possible, etc.

Now that it's a year later and he seems to still have alot of babies in the smears I don't know what stage he would be considered as he still doesn't show signs. My understanding is that when the dog does show signs, coughing, etc... the dog is in later stages and weaker. I hope my rambling helps someone.

I think also, vets are finding out the heartworms are becoming resistant to the adult treatment as well. And it's not a clear science how to rid a dog of them always... also... can't recall if this has already been discussed.. but here's a quote from a site "Ivermectin does not kill adult heartworms. It does weaken them and will speed up their death. Heartworms typically live two years. To further speed up the process of heartwormDoxycycline. The Doxycycline kills off an organism within heartworms called wolbachia. Wolbachia is a symbiotic organism that lives within adult heartworms. By treating an infested dog with a 30 day regimen of Doxycycline, you kill off the wolbachia, weakening the adult heartworms. This also is reported to lessen the inflammatory immune response of worm die off when the dog is receiving HW treatment of any kind. By weakening the heartworms and then continuing to treat with Ivermectin, you can clear a dog of heartworms typically in 18 months or less."

[ladyjane]

Originally Posted by Madraga

Thank you so much Ladyjane. She is a lovely girl and she's slowly coming around and starting to warm up to us. She's very affectionate and at the same time fierce when around strangers. She bites. Hahaha.

We just try to give her space and allow her time to adjust.

Thank you for your prayers.

Hey, don't you wish sometimes that you could bite strangers? haha I do Wish, that is.

You are a doll for caring so much for her. I am sure she will be so appreciative. They know when someone has saved them and loves them.