30. heartworm treatment Flashcards
what stage of heartworm in dog
L3-L5
microfilaria
adults
which stage in vector for heartworm
microfilaria- L3
takes 2 weeks to mature
why decrease exercise for heartworm
exercise causes increased lesions
tell owner to limit exercise
live heart worm cause
endarteritis
muscular hypertrophy of arteriolar walls
dying or dead heart worms cause
thromboembolic disease- float off and cause problems
capillary rupture, fibrosis
heart failure
more active= more severe disease
1st step of heartworm treatment
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
— It is the only adulticide drug approved by FDA for heartworm
Melarsomine
how to give melarsomine
deep IM
3 part dose
kills 98% of adult heartworms
what happens after you use Melarsomine
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
symptoms of pulmonary thromboembolism
presents as fever, cough, Right sided heart failure
adjunct therapy for heartworm
steroids
doxycycline- filaria might have intracellular bacteria such as Wolbachia
macrocyclic lactone
why use doxy for heartworm
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
doxy or melarsomine should be given first
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
— drug is Effective against Dirofilaria immitis microfilariae and larvae.
Macrocyclic lactones
macrocyclic lactones wipe out —
microfilariae and larvae in dogs
treatment of caval syndrome
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
slow kill heartworm
use only macrocyclic lactones
only kill larva and microfila- DO NOT KILL adults
cheaper but takes years
need to restrict exercise for years!
elective surgeries for heartworm +
mild signs- yes
moderate, severe no
surgery can be preformed 6 months after treatment
treatment for heartworm in cats
spontaneous cure
usually asymptomatic, single infection
melarsomine is not recommended- dead worm cause anaphylactic type reaction
vector control of mosquito
eliminate standing water
ectoparasiticide products
reduce exposure of dogs
when to test for MF after treatment
9 months for Melarsomine
6 months for slow kill
can blood transfusion cause infection?
no need L3 from mosquito
