Doxycycline has been used to (presumably) rid the parasite of Wolbachia organisms; therefore, D immitis organisms do not thrive, may deteriorate and die, and have reduced reproductive potential, which helps manage HWD in infected dogs and reduces potential for infection in other dogs.

The good news, though, is that treatment of heartworm in dogs is generally both possible and likely to be successful. Heartworm treatment is a fairly involved and lengthy process and so it is best to give your dog a monthly preventatitve like Trifexis to avoid them getting heartworm. In most cases, heartworm is treated through a two-pronged operation: In one treatment adult heartworms are killed, and in another, the microfilaria, or baby heartworms, are killed.

The order of these treatments varies and may be determined by the health of your dog, as well as the severity of the disease. Veterinarians will also prescribe medications that attack Wolbachia, which are themselves a parasite attached to heartworms.

However they have had her for 3 days and her platelet count is 40, and she also has a low red blood cell count. They are treating her with doxycycline. They believe this is caused by the lyme's disease, but the question I have is could it be cancer? She has a tumor under her neck that they don't seem to be the lease bit concerned about. Thank you in advance for your response. Read More When the fever showed up last week, the vet did blood work which showed that her red blood cell count is diminishing slightly, and she is slightly anemic.

They did blood tests for Lyme and Heartworm 4DX test which came back negative. X-Rays came back clean. She had an ultrasound which indicated slight abnormality and swelling of the liver and spleen and some suspicious nodules on the spleen. They did biopsies of liver, kidneys and spleen and they came back negative for cancer. Prevention of maturation of recently acquired infection tissue phases Reduced pulmonary reaction to dying worms More rapid and complete eradication of microfilariae potentially reducing risk of heartworm resistance to macrocyclic lactones Enhancement of vermicidal efficacy of ivermectin, if using slow-kill method.

The American Heartworm Society recommends that, if the slow-kill method is used only out of necessity , doxycycline should be repeated in 60 days, so the dog receives ivermectin monthly and doxycycline 1 month on, 2 months off, 1 month on, 2 months off, etc, until the antigen test is negative. Should We Worry About Resistance?

Concern has been raised about the potential development of bacterial resistance if doxycycline is administered in all cases of HWD. In my opinion, this concern is worth considering as doxycycline is widely used and valuable to our profession and physicians for treatment of a variety of infectious processes.

On the other hand, concerns for resistance generally occur when drugs are used at suboptimal dosages and durations of therapy. Neither of these result from the current treatment recommendations for HWD. Figure Credits Figure 2.

Laura Kramer Figure 3. Is there a better way to administer heartworm adulticidal therapy? A study published in demonstrated that treatment with a combination of ivermectin and doxycycline has the following effects on heartworm infections: Sterilizes female heartworms Prevents the infected dog from infecting other dogs via mosquitoes Hastens the death of heartworms Limits inflammation and other damage caused by the presence of heartworms in the body Reduces risk of serious adverse reactions to Immiticide These effects are significantly improved when the two drugs are used together rather than one without the other.

Questions about Dosing Different theories and protocols exist for how much, how often and how long ivermectin and doxycycline, should be given in treating heartworm infections. One recommendation is to give doxycycline at normal doses for 30 consecutive days before starting in this case Immiticide. However, a laboratory study conducted in indicates intermittent treatment with doxycycline is more effective in killing Wolbachia than continuous treatment. In another study published in , 11 heartworm-infected dogs were given doxycycline daily for 30 days and ivermectin every 15 days for six months, with the following result: Of the 7 dogs that were positive for visualization of parasites at echocardiography, 6 Treatment was well-tolerated by all dogs.

These results suggest that a combination of doxycycline and ivermectin is adulticide in dogs with D. Using this therapy, the gradual death of adult heartworms dramatically reduces the risk of pulmonary thrombosis -- blood clots in the lungs that pose a serious adverse effect associated with other adulticides.

This is the protocol I have used in my practice with percent success. The American Heartworm Society has its own set of dosing and care guidelines, which you can find here. Surgery to Remove Heartworms Also in response to the ongoing Immiticide shortage, veterinary cardiologists at the University of Florida are offering surgical extraction of heartworms from dogs with severe infections.

Using specialized instruments, these doctors can manually remove heartworms from the heart and pulmonary arteries by way of the jugular vein.

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