year round heartworm preventative?

[ClantyreSheltie]

This is something of a sticking point with certain segments of the profession, particularly those promoting 'evidence based' medicine- that the monthly heartworm pill is not a preventative, it is a treatment.

Or those of us that have paralegal degrees and very narrow definitions

I think if you ask 100 pet owners, 90 of them will think that heartworm pills protect for x period of time, like flea treatment. They don't understand that the pills are a one shot treatment that has no long term effect on heartworm.

 

[DogIsMyMantra]

However she used the term chemoprophylaxis earlier, and I was just curious as to why prophylaxis was acceptable but preventative was a dubious term.

I used the term chemoprophylaxis in that sentence because that's the term chosen by Dr. Knight in the title of the article I was referring to! I was simply trying to reference to the article in such a way as to include the bulk of the article title ("seasonal timing of heartworm chemoprophylaxis in the United States") in case people were curious and wanted to check it out. Having the bulk of the title and author makes finding a paper much easier. No intentional ulterior motives there!

This is something of a sticking point with certain segments of the profession, particularly those promoting 'evidence based' medicine- that the monthly heartworm pill is not a preventative, it is a treatment.

Or those of us that have paralegal degrees and very narrow definitions

I think if you ask 100 pet owners, 90 of them will think that heartworm pills protect for x period of time, like flea treatment. They don't understand that the pills are a one shot treatment that has no long term effect on heartworm.

This is why I used the quotations. Heartworm preventatives are presented to owners in such a way that they are led to believe the timing of administration needs to be before the dog may be exposed. So Joe pet owner thinks, "mosquitos will be out soon I'd better make sure my dog is on preventative before that happens," when in reality it's the 60 days post exposure that matters regarding timing of giving the dog the pill. It's a preventative in the sense that it prevents heartworm disease, but since it works retroactively killing microfilaria, the timing of administration need not be pre-exposure.

It has been my experience that most people/vets/companies leave out this information and insist that everyone must keep our canines on HW medicine all year round and anyone who doesn't is just paranoid, irresponsible or trying to save money despite their pet. There is evidence to the contrary however (for example in the article mentioned) and I personally find this evidence useful in evaluating my dogs' risk and deciding how/when I want to administer microfilaricides. I don't mean to be aggressive about it, but perhaps my negative personal experiences with fellow dog lovers and many vets have tainted my ability to convey my views on this topic without some passive agression leaking out.

 

[The Quahog]

Fair enough. So to ensure that I do not mislead and take advantage of my clients in the future I shall make it clear that we are not practicing 'prevention' but rather 'prophylaxis'.

And when they ask me what the difference is, I shall reply, 'Absolutely none.'

But I still thinks its a tad pedantic. - Dr. Mac

 

[Lightplum]

Fair enough. So to ensure that I do not mislead and take advantage of my clients in the future I shall make it clear that we are not practicing 'prevention' but rather 'prophylaxis'.

And when they ask me what the difference is, I shall reply, 'Absolutely none.'

But I still thinks its a tad pedantic. - Dr. Mac

The way I understood it (up till a few years back) and Im sure the majority of pet owners see heartworm with the term prevention, that its exactly that it prevents them from getting heartworm, you know kinda like frontline for example prevents the ticks/fleas from biting them. When in actuality heartworm is just killing whatever the dog has already picked up, since it works backwards its killing what ever nasty mosquito has biten them and infected them within say the past 4-6 weeks. So in all actuality its not a prevention in terms of what people think, its prevention from having to do the full out heartworm treatment.

 

[JessicaR]

I had always thought it prevented them from getting heartworm, I didnt know it killed the microfilaria after they had contracted it.

I have decided that I will skip December and January's preventative. During those months, really February is cold too, it never gets above freezing at night, and most of the time the days are not above freezing. THat will save me 8 pills a year. With 4 dogs having to go to the vets every year, and the failing health of my oldest one, every bit saved helps.

 

[The Quahog]

Heartworm preventatives are presented to owners in such a way that they are led to believe the timing of administration needs to be before the dog may be exposed. So Joe pet owner thinks, "mosquitos will be out soon I'd better make sure my dog is on preventative before that happens," when in reality it's the 60 days post exposure that matters regarding timing of giving the dog the pill. It's a preventative in the sense that it prevents heartworm disease, but since it works retroactively killing microfilaria, the timing of administration need not be pre-exposure.

It has been my experience that most people/vets/companies leave out this information and insist that everyone must keep our canines on HW medicine all year round and anyone who doesn't is just paranoid, irresponsible or trying to save money despite their pet.

Just to clear the air, I should say that in general I tend to agree with much that Dogismymantra is saying. The 'evidence based' movement has been a good thing for the profession, basically challenging us to prove that we are not overtreating, that what we are doing is actually of benefit, and that individual treatment plans fit individual patients. This is why, for example, in stark contrast to hman medicine, most veterinarians are giving about a quarter of the vaccinations we gave ten years ago. We now have extended protocols and the concept of core and optional vaccines. For example, in my practice we are on 3 year schedules for distemper and rabies, and Lyme and Bordatella are optional based on individual risk assessment. a far cry from the 'every vaccine every patient every year' of 20 years ago.

Unfortunately, some zealous 'evidence based' authorities do seem to go overboard, loudly preaching that such treatments as spaying pyometras and repairing cruciates are also bogus, which does cause problems.

All this having been said, i still do not get the problem with calling medication which prevents heartworms'heartworm prevention'. And to substitute the word 'chemoprophylaxis ' (prevention of disease by means of chemicals) really does seem to be an attempt to confuse rather than enlighten. (Perhaps this is why it appeals to the paralegal mind.)

It is certainly true that monthly heartworm medication prevents 'back' rather than 'forward'. People think that since it is given monthly it lasts a month, it does not. But the other side of that coin is that if you give the last pill Nov 1, and your dog is bitten by an infected mosquito Nov 2, there is no protection. So, true, 'the timing doesn't have to be pre-exposure', but it has to be post-exposure, which , when considering how many month require treatment, amounts to pretty much the same thing, only a month later at both ends. - Dr. Mac

 

[ClantyreSheltie]

Do people really not spay a pyometra? That violates my simplicity rules. Just yank it out and be done with it. If the dog is compromised enough to get pyo once, I'd think it could happen again. I guess it depends on if it's open or closed, but still, I'd be more than likely to have her spayed. But my tolerance is pretty low, I spayed a bitch who had a false pregnancy (a really good false pregnancy, I admit, she fooled us all).