Canine Heartworm Disease – Is Your Dog Protected?


April is Heartworm Awareness Month – but it’s not only during spring and summer that we need to worry about heartworm infection in our canine companions.  Any dog can be infected with heartworms, no matter how much or how little time they may spend outside.  The picture above is of a actual dog’s heart infected with large numbers of heartworms.

What are heartworms and what is Canine Heartworm Disease?
Heartworms are a type of parasite found primarily in domestic dogs as well as wild canids, such as foxes and coyotes. They are long, thin worms that reside mainly near the heart chambers and in the large blood vessels around the heart and lungs. They can make dogs sick by causing damage and inflammation to these organs and can be fatal if left untreated. Signs of heartworm disease in a dog include coughing, labored breathing and lethargy.

How do dogs get heartworms?
Heartworms are transmitted between dogs by mosquitoes. A mosquito bites an already infected dog, picks up the larval (immature) form of the heartworm, and then transmits them to the next dog it bites. If the dog is not on preventative medication, the larvae go through a series of developmental stages in the dog’s body and within 5 to 7 months, become adult heartworms. The adults produce their own larvae and the cycle repeats itself.

My vet’s office often asks me to bring in a stool sample from my dog to check for “worms” – does that include heartworm?
Stool samples are used to check for intestinal parasites – meaning those that infect the gastrointestinal system, such as roundworms and hookworms. Heartworms need to be tested for by use of a simple blood test that often can be performed right in your veterinarian’s office.

Heartworm testing and prevention seems awfully expensive – is it really necessary?
Only if you don’t want your dog to get heartworms! All dogs are at risk, regardless of how much time they spend outside or how many mosquitoes you think are in your yard. Heartworm disease is fatal if not treated but the cost of treatment if your dog has heartworm can equal 10 YEARS worth of preventative medication! It also takes several months to completely rid a dog of a heartworm infection and they must be strictly confined during this time to minimize the risk of complications, including deadly blood clots. Depending on the size of your dog, preventative medication may only cost you between $7 and $12 per month – a lot less than what you will spend on dog food!

What kind of preventative medication is there and where can I get it?
The most widely used heartworm preventatives are in the form of a chewable tablet that you give to your dog by mouth once a month. Most of these will help protect your dog against intestinal parasites as well, and some contain additional medication to help control fleas. There are also topical spot-on products that are also used monthly. It is important not to get these products confused with other topical spot-ons that only treat for fleas and ticks. It is also imperative that the preventative medication be given every 30 days, to kill any larval heartworms that your dog may have been infected with, at the life stage when they will be killed by the medication.  All heartworm preventatives can be obtained at your vet’s office and they can help you decide what is the best product for your pet. A blood test to check for adult heartworms is needed once a year to make sure the medication is working properly. If your dog has not been on preventative, or has been in the past but not currently, the blood test will need to be done first. Even though it only seem like a priority during the warmer months, heartworm prevention is now recommended all year round. For pet owners that travel down south over the winter with their pets, it is absolutely essential!

Can’t I save money by just skipping the test and getting the medication from another pharmacy or on-line?
Skipping the heartworm test is not recommended. The blood test is to check for adult heartworms and without testing, an adult heartworm infection could be missed – which needs to treated in a much different manner than giving the monthly preventative. It may seem like a cost savings to get the medication from a source other than your vet’s office but be warned – the companies that make and produce these medications only guarantee their products if they are purchased directly from a veterinarian, meaning they will not cover the cost of treatment if your dog happens to be diagnosed with heartworm. Even with a written prescription, you cannot be assured you are getting the real thing, or that it has been stored or handled properly and will still be effective. If you find a website that allows you to purchase heartworm preventative without a prescription, that is a huge red flag! Veterinarians generally try to keep their prices competitive with what can be found on-line and from human pharmacies. In addition, manufacturers often provide rebates and other incentives for products purchased directly from the veterinarian, saving you more money in the long run.

My vet told me cats can get heartworms too – is this true?
Indeed it is! Cats that spend time outside are more at risk, but even indoor cats can be exposed if mosquitoes make their way into the house. Heartworms in cats can cause respiratory symptoms and breathing difficulties similar to asthma and in some cases, even sudden death. Because there is no approved treatment for heartworm infection in cats, this makes prevention even more imperative. There are heartworm preventatives formulated just for cats, usually as topical spot-ons that are applied monthly and can help protect cats against fleas and other parasites as well. Again, your family veterinarian is your best source for information as to what is best for your pet and to answer any questions that you may have! We are here to help you keep your pets happy and healthy, and help them live as long as possible!

For more information on heartworm disease in pets, contact your veterinarian, or visit the website of the American Heartworm Society,, or the website of the Companion Animal Parasite Council,

“I Read On The Internet…”

Whenever I have a pet owner start out saying those words, I try to be ready for anything – because depending on what follows, they may be onto something, or it may be utter nonsense.

I graduated veterinary school from Michigan State University in 1997, back when we used to treat dinosaurs and woolly mammoths and before the internet was the vast wealth of information that it is today.  This means that I have been a practicing veterinarian for close to 19 years and if you count vet school and the years I worked in a vet clinic prior to vet school, I have been actively involved in the veterinary field for nearly 25 years (if one were to use the term “seasoned” I would call myself “lightly seasoned”). Veterinarians have always had to contend with misinformation and generally bad advice, doled out by those with good intentions but very little actual knowledge.  Whether it was Uncle Bob or Aunt Betty or the dog groomer or the guy that ran the local feed store, “old wives tales” and other myths made the rounds and some still persist to this day.  These include believing that all female dogs should have a litter of puppies before being spayed (not true), that motor oil poured over an animal’s skin will cure mange (it does not), and that puppies sick with parvo virus can be treated by making them drink water mixed with bleach (please don’t do this!).  The difference between then and now is that we now have the internet, and any information from anyone on any subject can be found right at your fingertips using your home computer or smartphone.

Believe me, I get it.  It is fast, easy and convenient, requiring minimal effort on our part.  And you can find a lot of very good and reliable information on pet care from various sources online – but the internet is also a huge source of bad information, and it’s easy enough for any individual, however unqualified, to post whatever they happen to believe, regardless of whether it is true or not.  Many a well-meaning a pet owner has been steered wrong by “Dr. Google” and while sometimes it makes for an amusing story, and no harm is done, sometimes it results in tragedy.  An article I read recently outlined the following cases where “Dr. Google” ended up being wrong:

1.  A woman purchased a puppy from a breeder and was told the puppy was female.  After getting the puppy home, she noticed a small bump on the puppy’s abdomen.  A Google search on “lump on female puppy’s belly” came up with the answer that it was an umbilical hernia and nothing to worry about.  When she took the puppy to her veterinarian for it’s first check-up, she was dumbfounded to find out that the puppy was actually male – and the “bump” on the pup’s belly was, in fact, his penis.

2.  A dog was prescribed an antibiotic capsule by the family’s veterinarian.  Upon administration of the first dose at home, the dog began to appear to be “bleeding from the mouth”, according to the owner’s description.  In a panic, the owner did a Google search and came up with “allergic reaction” and that oral administration of hydrogen peroxide would get the medication out of his system.  The hydrogen peroxide caused a good deal of vomiting, but the red-tinged slobber persisted, at which point the client brought the dog back to the veterinarian.  A quick look by the vet inside the dog’s mouth revealed that the antibiotic pill had gotten stuck between the dog’s teeth, causing the red coloring of the pill to get mixed with the dog’s saliva, producing the “blood”.  Dog ended up being fine, but needed to be given IV fluids and anti-nausea medication to counteract the vomiting caused by the hydrogen peroxide.

3.  A snake owner read on-line that he could save money by feeding his pet boa constrictor wild rats that he trapped himself rather than purchasing domesticated rats.  Unfortunately, a rat that he did trap and placed in the cage with the snake decided it was not going to be lunch that day.  The snake sustained approximately 40 bite wounds from the rat, resulting in severe skin and muscle trauma and the loss of it’s eyes.  It made a full recovery, but was permanently blind.

What these cases illustrate is that everyone who reads anything online needs to take most of it with a grain of salt, and not necessarily hold what they read over what their veterinarian may tell them.  This is especially true when reading about so-called “natural remedies”.  I recently saw a dog who had a ruptured bleeding mass on it’s tail that the owner had been attempting to treat with a home-made paste of raw honey and turmeric.  This was after she had gone online and tried to figure out for herself what the mass could be, then read that raw honey and turmeric could be used to help heal wounds. It made the hair around the area very sticky and stained it yellow but it wasn’t doing anything for the mass that really needed to be removed and biopsied.  It’s fairly common for me to be presented with a pet where the owner states “I’ve tried everything!” (except for actually bringing it to the vet until now) and “I just don’t know what it is!” (well that’s our job to figure out, isn’t it?). It’s understandable that many pet owners want a cheap and easy fix, and “natural” certainly sounds better than “dangerous antibiotics” and “poisonous flea medication” (or worst of all, “risky anesthesia and surgery”),  but it’s in your pet’s best interest to at least call your veterinarian first and find out if what you are thinking of trying is really a good idea.  Sometimes we can offer some advice over the phone, or at least tell you that whatever you read is wrong and should not be attempted, but oftentimes it will be recommended that you actually bring your pet in for an exam.  Sometimes pet owners grumble about that – it’s time out of their busy schedule to actually make an appointment or head down to the emergency clinic, and it’s going to cost them some amount of money.  But a Google search can’t replace an experienced veterinarian taking a history and looking at, listening to, feeling over, and yes, in some cases, smelling your pet (we draw the line at tasting), then deciding what other diagnostic tests may be needed or treatment initiated.  We also can get ourselves in some deep legal trouble if we offer incorrect advice or prescribe medication without seeing the pet first.

Occasionally, when I talk to pet owners about why I recommend a particular vaccine, or the importance of heartworm prevention, or why I don’t think feeding a raw diet is a good idea, the response I get back from them is that they are going to “do some research”.  Now I am all for owners getting more information that maybe helps them feel more comfortable with their decisions, and ultimately keeps their pet healthier.  If someone tells me they are interested in feeding a home-cooked diet, or they are having issues with their pet’s behavior, I am happy to provide them with websites that I know will provide the legit unbiased information that they need (I never said all internet was bad!).  However, all too often, I have found they have already formed an opinion or belief based on what someone else has told them, or what they would like to be believe, and their “research” consists of going online and finding whatever tidbits of information they can find that will support their position – regardless of the qualifications of those providing said tidbits.  It seems people these days tend to be more skeptical of conventional medicine in general, are looking for alternatives, and so may be more apt to grab onto whatever falls in line with what they already feel – they are already leaning that way and whatever they find that is in congruence with their beliefs helps them feel more justified in their position.  You can find all kinds of folks on the internet that will tell you that heartworm prevention is a scam, that you can prevent fleas with garlic, that the Leptospirosis vaccine will kill your dog, that veterinarians are in cahoots with the big name pet food companies to keep pets sick so they have to visit us more often and make us more money.  Just because it’s on the internet doesn’t mean it’s true. (And believe me, if I wanted to be wealthy, there are easier and more effective ways to do that then being a veterinarian!)

I recently came across the website of a dog breeder that was essentially a manifesto of her own personal beliefs about what it takes to keep dogs healthy and in it she stated that vaccines weaken a dog’s immune system and as long as the dogs were fed an “all natural raw diet” and a laundry list of magical herbs and spices, their immune system would be strong enough to not need “toxic medication”  to prevent heartworms and other parasites.  Problem is, first of all, this woman is not a veterinarian and has never worked in the veterinary medical field in any capacity. Secondly, the information she cited to support her beliefs simply consisted of quotes from other equally unqualified individuals.  Using so-called anecdotal information to bolster your position does not change your opinions into facts. Real research consists of having a hypothesis, and then doing actual scientific controlled studies to prove or disprove the hypothesis – this is the basis for what is known as “evidence based medicine” and is the approach the majority of veterinarians utilize in practicing their craft.  It means we are going to look at these claims with a more critical eye and not just fall for the latest too-good-to-be-true scheme.  Just because coconut oil is currently being touted as the latest and greatest cure-all, for everything from psoriasis to allergies to cancer, doesn’t mean I am going to start recommending it across the board to all my animal patients – show me the hard data that it actually works first.  Just because your aunt believes she cured her dog of parvo virus by giving it apple cider vinegar and Gatorade doesn’t mean it actually happened that way.

Don’t get me wrong – I am not saying that all veterinarians are right all the time.  Or that all of us practice at the same level or all pay attention to what the latest research tells us or attend continuing education on a regular basis.  If your veterinarian is still treating every animal and every condition with antibiotics and corticosteroids, or believes that pain medication after surgery is not needed because “a little pain is good” and keeps the pet from being too active, or a dental cleaning should not be done on your senior pet because they are “too old”, you should probably think about getting a different vet.  If you are not sure about what your vet is telling you, by all means seek a second opinion from another vet.  And I welcome pet owners’ inquiries from what they have read online and the questions they may have – I see it as my opportunity to educate them a little and share my knowledge, that I have worked so hard to earn, with them in order to help keep their pets healthier.  If they are looking for something else I don’t offer or don’t personally believe in, maybe I am just not the right vet for them – and I’m okay with that.  I just ask that pet owners, in their effort to find out more about their pet’s health, whether it is from the internet, a breeder, or their neighbor up the street, to consider the source – most likely whomever they are listening or reading to has never worked in a vet clinic, or attended veterinary school, or does not hold a veterinary degree.  I ask them to still look to their pet’s veterinarian, and their knowledge and experience, with the respect they deserve.  Because while looking up information online may be quick and easy, getting through and graduating vet school, passing the required exams to get licensed, then accumulating years of experience “in the trenches” is not.  I’ve already done the hard work so you don’t have to. The internet may be a useful tool in our tool kit, but your veterinarian will be one to actually know which tools to use.  And they will be able to tell a girl puppy from a boy puppy.


A New Year For You and Your Pet

The start of a new year is when many of us make resolutions to do something better than we’ve done before; we decide to eat more healthy, to exercise more, hopefully lose some weight; maybe you decide to quit smoking or save more money or make some other stab at self-improvement.  Personally, I’ve always figured that any time of year is a good time to decide to do something better – no need to wait until the calendar says January 1st.  However, this year I do find myself wanting to be more organized – to get my house in better order and dispose of all the clutter and useless items that take up space, cause me stress, and hold no purpose.  I want to have more patience with my daughter, even as she tests it daily.  I want to continue to grow as a veterinarian and practice the best medicine that I am capable of.

As pet owners, we all love our pets in equal measure, but not everyone holds the same ideals when it comes to what constitutes the best care for them. We see pets who get veterinary check-ups on a regular basis, for both wellness care as well as any medical issues that crop up – and there are pets we see maybe once every three years, when their required-by-law rabies vaccine is due.  We have pets that are routine kept up-to-date on all their vaccines, screened once a year for heartworm and intestinal parasites, and kept protected against said parasites as well as fleas and ticks.  We also see pets that never see a veterinarian except as a last resort – and in some of those cases it’s not been until a medical issue has gone on for so long that treatment options have become limited to humane euthanasia.  Some pet owners feed their pets so-called “super premium” diets, regularly get them groomed, and lavish them with treats and toys – and at the same time question if the dental care we recommend or heartworm prevention we prescribe is really necessary – or simply decide it’s too expensive or not worth the cost.  There are pet owners who will seek second opinions from specialists and pursue aggressive diagnostics and treatment for everything from skin allergies to cancer; while others, either because of financial limits or personal philosophy, will do what they can to make their pets comfortable until it is no longer possible.

By no means do we judge those pet owners who choose to do “less” versus those who do “more” – the amount of money spent on a pet does not necessarily reflect the amount of love felt for their pet.  Everyone has their different reasons for choosing what they choose for their furry four-legged companions – sometimes it comes down to money, and sometimes it comes down to what people value and what is a priority for them.  Since there is no “Obamacare” for pets and less than 5% of the pets we see are covered by some form of pet health insurance, owners’ choices may be limited by how much discretionary spending one’s personal budget allows.  As a veterinarian, I’ve always tried to present pet owners with the best medical plan possible for their pets, and then allowed them to decide what they afford to do – I’ve never thought less of someone for choosing “Plan B”.  I get it – I’ve been there myself.

However, with the start of 2016, it might be worthwhile considering that perhaps, in many cases, there is more that we, as “pet parents”, can do for our “fur-kids” – maybe something we have not done before but we can do now.  Maybe your dog or cat has never had a dental cleaning – but if it’s been recommended every year that they are seen for their check-up, perhaps this is the year we decide to schedule it.  Maybe your dog was never spayed or neutered – but as they get older, the odds of them developing some serious diseases increases, so maybe this is the year we get it done.  Maybe your cat has not had a vet check-up since it was a kitten – after all, she stays inside all the time and appears normal and healthy on the outside – but a routine check-up at least once a year can find issues that may be easier to treat if caught early.  Maybe your dog has never been on heartworm or flea/tick prevention – it’s never been an issue for them before and maybe you’ve even had dogs before that never had an issue either – but not having them protected against parasites is gambling that they will still be okay; treating theses parasites is more difficult than preventing them in the first place – and in the case of heartworm, exponentially more expensive, as well as potentially deadly.

So this New Year’s, consider making a resolution that you will do something more for your pet’s long-term health that you have not done previously.  Cut back snacks and other extra calories and take them for more walks or play with them more instead.  Talk to your vet about scheduling a dental cleaning, or having your pet spayed or neutered if has not already been done.  Have them seen for a wellness exam and find out what vaccines are recommended if it’s been more than a year since their last vet check-up.  Have your dog heartworm tested, and on regular heartworm and flea/tick preventative – and consider it for your cat as well.  Such steps don’t have to cost a ton of money – but they can potentially save you much more money, and spare you a lot of heartbreak, by preventing serious medical issues down the road.  Our pets give us so much love and bring such joy to our lives – shouldn’t we do a little more to give something back to them?

Kirsten Ura-Barton, DVM