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Case #8

Case of the week 3/20/18

CC: Vaccines

Signalment: 8y M German Shepherd
History: No known issues. Hasn’t seen a vet since 2014, received DHLPP and a Rabies at that time

  • Not on meds or HWP

Physical exam:

  • Vitals WNL
  • Patient is panting but respiratory effort is normal, lungs sound clear
  • Cryptorchid
  • Overweight
  • Dirty, but no evidence of ectoparasites

Heartworm test: Positive

Heartworm Transmission

  • Transmitted by mosquitos
    • Act as a vector but also as a required intermediate host
  • Infected dogs serve as a reservoir
    • Mosquito bites infected dog, ingests microfilaria with bloodmeal
    • Microfilaria developed into infective 3rd stage larva
    • Infective larva transmitted to the next dog that mosquito feeds on
      • L3 →  L4 → adult heartworms
      • Preventative products work by killing off L3s and early L4s

Heartworm Disease Staging

    • Determines diagnostic protocol
    • Thoracic radiographs
    • Bloodwork

Heartworm Disease Treatment

  • Immiticide: Melarsomine (dose: 2.5mg/kg IM)
    • 2 dose protocol
      • 2 doses 24 hours apart
    • 3 dose protocol – currently the recommended protocol
      • 1 dose
      • Wait 30 days
      • 2 doses 24 hours apart
    • Concurrent medications
      • Doxycycline
      • Prednisone
    • Exercise restriction
      • Recommended for 4-6 weeks following immiticide administration
      • Risk of acute death
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