30. heartworm treatment

Question 1

what stage of heartworm in dog

Answer 1

L3-L5
microfilaria
adults

Question 2

which stage in vector for heartworm

Answer 2

microfilaria- L3

takes 2 weeks to mature

Question 3

why decrease exercise for heartworm

Answer 3

exercise causes increased lesions

tell owner to limit exercise

Question 4

live heart worm cause

Answer 4

endarteritis
muscular hypertrophy of arteriolar walls

Question 5

dying or dead heart worms cause

Answer 5

thromboembolic disease- float off and cause problems

capillary rupture, fibrosis
heart failure
more active= more severe disease

Question 6

1st step of heartworm treatment

Answer 6

stabilize

can only detect after 6 months- there is already significant damage to heart and lungs

use steroids, diuretics, vasodilators and fluid therapy to make dog stable

Question 7

— It is the only adulticide drug approved by FDA for heartworm

Answer 7

Melarsomine

Question 8

how to give melarsomine

Answer 8

deep IM
3 part dose

kills 98% of adult heartworms

Question 9

what happens after you use Melarsomine

Answer 9

adult worms die

will lead to Pulmonary thromboembolism as dead worms move and get stuck in the body

presents as fever, cough, Right sided heart failure

7-10 days post treatment, up to 4 weeks later

must restrict exercise, try to limit movement of dead worms

Question 10

symptoms of pulmonary thromboembolism

Answer 10

presents as fever, cough, Right sided heart failure

Question 11

adjunct therapy for heartworm

Answer 11

steroids

doxycycline- filaria might have intracellular bacteria such as Wolbachia

macrocyclic lactone

Question 12

why use doxy for heartworm

Answer 12

give 1 month before melarsomine

filaria might have intracellular bacteria such as Wolbachia

vertical transmission in worms

will cause inflammatory reaction after worms are killed

Question 13

doxy or melarsomine should be given first

Answer 13

doxy- give 1 month before

will kill wolbachia bacteria, might also kill worms and cause inflammatory reaction

want to decrease overall amount of worms before the big wipe out

Question 14

— drug is Effective against Dirofilaria immitis microfilariae and larvae.

Answer 14

Macrocyclic lactones

Question 15

macrocyclic lactones wipe out —

Answer 15

microfilariae and larvae in dogs

Question 16

treatment of caval syndrome

Answer 16

surgically remove worms before treatment

there are so many worms that if you treated the dead worm would cause host death in 2 days

caval- interfere with tricuspid valve and cause hemolytic anemia and right sided heart failure

Question 17

slow kill heartworm

Answer 17

use only macrocyclic lactones

only kill larva and microfila- DO NOT KILL adults

cheaper but takes years

need to restrict exercise for years!

Question 18

elective surgeries for heartworm +

Answer 18

mild signs- yes

moderate, severe no

surgery can be preformed 6 months after treatment

Question 19

treatment for heartworm in cats

Answer 19

spontaneous cure

usually asymptomatic, single infection

melarsomine is not recommended- dead worm cause anaphylactic type reaction

Question 20

vector control of mosquito

Answer 20

eliminate standing water

ectoparasiticide products

reduce exposure of dogs

Question 21

when to test for MF after treatment

Answer 21

9 months for Melarsomine
6 months for slow kill

Question 22

can blood transfusion cause infection?

Answer 22

no need L3 from mosquito