Heartworm Disease is alive and well in Colorado! Not good news!

“Kirby” a young Great Pyrenees didn’t know just how lucky he was when he was adopted by our wonderful client, Jack.  Jack found this pup through the Great Pyrenees Rescue, and it was love at first sight.

Kirby had been seen for regular wellness visits like clockwork.  The day I first met this handsome boy, he was 2 years of age.  He had come in for a routine physical exam and basic blood work.  The bad news came the next day when the heartworm test was POSITIVE.  Another test confirmed the positive result.  Kirby’s disease could have gone undetected had Jack not fallen in love with this dog when he did.

Many folks will hear that we don’t have heartworm disease in Colorado. This couldn’t be further from the truth.  We don’t see as much as many other states, thankfully.  But, we see it.  In fact, Care Animal Hospital has seen 7 positive heartworm cases within the last 2 years!!! 

Disaster situations such as Hurricane Katrina and the tornado in Joplin, Missouri result in the displacement of family and shelter pets.  Shelters become overcrowded on a good day.  Disasters make the shelters even more congested.  Where do these dogs go?  Colorado is known to have some of the best pet owners in the country.  We are also known to have a high adoption rate of shelter animals.  It stands to reason that many of these animals come in to our shelter system.  They bring with them heartworm disease and other parasites in many cases.

WHAT IS HEARTWORM DISEASE?

Heartworm disease is the infection of the parasite, Dirofilaria immitis.    When a mosquito bites an infected dog, it picks up the microfilarial (pre-larvae) stage of D.immitis from the dog’s bloodstream.  These microfilariae transition through three larval stages while inside the mosquito.  The third larval stage is the “infective” stage. 

Now the infected mosquito bites  another dog.  The third-stage larvae are deposited next to the site where the mosquito’s mouth parts puncture the dog’s skin.  Within 3-12 days, the larvae can be found within various tissues of the dog.  In this time, they also molt from third-stage to fourth-stage larvae.  They continue their travels in the dog’s tissues until days 50-70 when they take up residence in the vessels around the lungs.  By now, they have molted to the final stage and are full-fledged worms.  By day 70, these worms are nearly 1.5 inches long.

The worms migrate to the lungs.  They are forced into small arteries with increasing blood pressure.  The worms grow larger and eventually find their way into the right side of the dog’s heart.    Ultimately, this can lead to interference with heart valves and blood flow.

WHAT ARE THE SYMPTOMS OF HEARTWORM DISEASE?

The following summary is from the American Heartworm Society.

HOW IS HEARTWORM DISEASE TREATED?

Treatment is a sequence of events that is often spread out to deal with the organism’s ever-changing life stages occurring within the dog.  Several weeks to months of medication to kill the third- and fourth-stage larvae are often implemented to prevent these juvenile organisms from maturing to adult worms.    Chest radiographs are essential to try to classify the severity of disease (Class I, 2, 3, or 4) and to determine the extent of injury to the heart, lungs, and blood vessels.

The use of the antibiotic, Doxycycline, may be used to attempt to sterilize the female worms within the dog.  While this will not kill the worms, it may reduce their likelihood of reproducing. 

Lastly, the dog will receive a total of 3 staged injections over 2 months to kill adult worms.  This final drug is Immiticide, also known as Melarsomine.   Unfortunately, there is currently a large backorder of this medication in the United States making heartworm treatment much more challenging.

Immiticide is given with a long needle, deep in the muscles in the lower back.  The injection can be quite painful.  After the first injection and close observation for side effects, the dog will go home with strict instructions to be kept very quiet for another month.  The dog is generally kept in a crate or closed off area the entire time.  He does not receive any exercise.  He is on a leash to urinate and defecate, and then returned to his crate.  The dog often receives sedative to help quiet him down during this timeframe.

The goal is to not allow the dog to get excited which causes the heart rate to increase.  As the heart rate increases, so do the odds for a severe reaction as dead worm carcasses are carried in the blood stream and can block a pertinent vessel or heart valve.  This would result in an embolism which can immediately kill the dog.  Second, as the worms are dying, chemicals are released from their decomposing bodies that may result in a severe reaction, including anaphylaxis.  This, too, can be life-threatening.

After one month, the dog returns and receives 2 more injections given 24 hours apart.  The dog will go through at least another month of sedation and no activity.

The dog does not have another heartworm test for 7-9 months after the final treatment.   Some cases require a second treatment which is costly, dangerous, and hard for both the pet and owners.

Severe cases may require more aggressive means of removing the worms.  Manual worm extractions can be done in specialty practices with a device that travels directly to the dogs heart and removes worms through the jugular vein and right heart. 

HOW CAN I PREVENT HEARTWORM DISEASE?

You can reduce the likelihood of an infection by giving a recommended heartworm preventative on time each month for the life of the dog.  We recommend Merial’s Heartgard Plus™ .  This product is used in early diagnoses to kill off the young larvae before they can mature into worms.   Heartgard Plus™ also contains an added ingredient to protect against a variety of intestinal worms too.

Test your dog yearly.  The increasing number of positive cases we have seen warrants annual testing.  The most diligent owner cannot always know if their dog receives his medication then goes outside and vomits.  You would never know that this dose was missed.  Testing yearly is worth every penny and gives us all peace of mind.

The American Heartworm Society’s website is a wealth of information!

http://www.heartwormsociety.org/

The bottom line…

Heartworm disease is deadly.

Heartworm disease treatment is painful.

Heartworm disease is expensive.

Treatment can be life-threatening.

HEARTWORM DISEASE IS PREVENTABLE!

What happened to Kirby, the Great Pyrenees?

 He just had his first follow-up blood test, and he was HEARTWORM NEGATIVE!!!!  This is Kirby with his owner, Jack!

Broken lower canine tooth brings large problem to a small dog

Meet Spumoni, an eleven year old spayed female Shitzu owned by Zack and Kim D.  They adopted her as an adult so her prior life is a bit of a mystery.  She had a dental cleaning on August 9^th and the technician performing the cleaning noticed a broken lower left canine tooth. 

As you can see on the x-ray, the top of the tooth has separated from the bottom of the tooth. You will also notice that there is very little bone below the root of the tooth.  Since the root of the tooth makes up so much of the jaw, there is a chance that when this tooth is removed, the jaw will break.  If the broken root is left, then there is a strong possibility that the broken tooth will transmit bacteria to the end of the root and infection will break the jaw.

The owners and Dr. Garnett talked about all options (including a root canal of that tooth) and it was decided to extract the tooth.  Luckily, as you will see, the tooth came out completely and the jaw remained intact. 

Spumoni trotted out of the hospital that night on antibiotics and pain relievers, joining her favorite people that cared so much about her that they helped her with this serious problem.

Visitation Cat Brings Joy to People in Pain

(Bull pictured with Flower at Jennifer's home)

Bull was adopted from the Care for Strays program at Care Animal Hospital many years ago.  He was 2 ½ and had been a stray living in an Arvada neighborhood.  A lovely neighborhood lady brought him into CAH when someone threatened to shoot him.  Although he had made himself comfortable at CAH, a long-time client just couldn't pass him up and took him home. 

Bull is now 7 ½ years old and a therapy cat.  He walks on a leash and has been visiting patients at Manor Care nursing home in Denver for more than 4 years now.  He is usually accompanied by one or more dogs who also visit the residents in conjunction with a therapy program run by MaxFund.

When Bull finds a resident who loves cats, he settles down right next to them on the bed.  Patients don't want to let him go.  They'll pet him for up to 20 minutes, while chatting about their own animals at home, usually cats of course.  Many of the patients are in rehab, and there for only a few weeks or months.  So they really miss their cats waiting for them at home.

When Bull was ill last year, and being taken care of by Dr. Garnett and Dr. Clark, he wasn't able to visit the nursing home for several months.  The number of people asking where he was, how he was doing, and when he was coming back, was amazing.  And, of course, once he was able to return to visiting patients early this year, he was literally welcomed with open arms by everyone from the receptionist to the nurses on the floors.  They all know Bull.

by Jennifer O., Bull's owner

Team Dog Tire-d raised $10,000 to help those fighting multiple sclerosis

    

     On June 26th, Team Dog Tire-d mounted up and rode from Westminster to Ft. Collins with 9 of the 12 members of the team able to ride (son Chris had too much on his plate to train, but supported the team at the end of day 2 with a vehicle and hugs from grandson, Jason  His funds  raised  still went to the team, so his impact fighting MS carried on). 

     The first day was under cloud cover for about 3 hours, which made the ride ideal.  Going north was definitely the easier of the two directions, so the entire team arrived at the finish line by 2:00 p.m, where son, Christopher, and grandson, Jason, met us and our team re-united.   Day two, we started our climb out of Ft. Collins at 6:00 a.m. to try and beat the heat, and scaled the hills of Horsetooth when it was still pretty cool.  The day, though, heated up and as we rode the numerous hills returning to Westminster.  The temperature rose to 94 degrees, and the firemen  that turned on their hose to help  cool  us down were my vote for the best incentive to keep on riding we received.  They had changed the route a bit from last year with more hills but less traffic, a fair trade. 

     This year, there were many more people riding who had multiple sclerosis – which in itself was a testament to the increased success of drug treatments for some people afflicted.  One man I followed was wearing a sign that said he was riding “For his fantastic wife, Heidi” who had MS.  Every day, 200 people in the United States are diagnosed with multiple sclerosis, and their lives from then on are changed.  You have just helped 11,000 Colorado and Wyoming residents living with the disease, and our $10,000 raised by the team could be used for 100 bathroom safety grab bars, 20 air conditioning window units, or two months of post doctoral fellowship training for a future MS researcher or physician.  Congratulations on making a big difference in so many people’s lives. 

Thanks for your generosity in helping our team and all those with MS whose lives will improve.

Girls Gone Miles - Avon Breast Cancer Walk Completed!!

Girls Gone Miles did indeed cover some miles this past weekend. Joyce Clark, Mandy Molliconi, Diane Jurgens, Emilie Ward, and Geri Athearn spent 2 days and each walked up to 39 miles in the Rocky Mountains to support the Avon Foundation for Breast Cancer. With support from so many generous people like our friends, family, and clients, our team raised over $10,000 to support a cause that has personally touched each of our lives. We walked along side over 800 walkers and together we all raised over $1.9 Million -- much of which was distributed immediately at the Closing Ceremony to breast cancer organizations throughout Colorado to support the remarkable work they do in the fight against breast cancer. We have already started talking about next year!!! Thank you, thank you, thank you for helping Girls Gone Miles be part of such an amazing journey and helping so many people get the support and help they need at the most critical time in their lives!!

Sick Puppies Test Positive for Giardia

Meet two darling dachshund puppies, Pinball and Rambo, owned by Susan and Daniel Donaldson.  These brother and sister puppies were purchased from a breeder and checked out well at their first exam.  Within days, Rambo became very lethargic and had diarrhea, and Pinball got significant diarrhea but wasn't as depressed.  They came in to Care Animal Hospital and were seen by Dr. Tracie Grubb.  She did two different tests on the feces and the samples tested positive for giardia. 

So - what exactly is Giardia?     Giardia is sometimes confused with "worms" because they invade the gastrointestinal tract and can cause diarrhea.  Giardia is a one-celled parasitic species classified as a protozoa.

How do dogs get Giardia?     A dog becomes infected with Giardia when it swallows the cyst stage of the parasite.  Once inside the dog's intestine, the cyst goes through several stages of maturation.  Eventually, the dog passes infective cysts in the stool.  These cysts lie in the environment and can infect other dogs.  Giardia may also be transmitted through drinking infected water.  Most streams and lakes in Colorado are infected with Giardia. 

How did we diagnose Giardia in these puppies?     At Care Animal Hospital we perform two different tests on fresh stool to try and identify giardial cysts.  One is called a fecal centrifugation test, where the feces are spun in a specially designed centrifuge machine using a specific kind of liquid to help separate the cysts.  The coverslip sitting on the centrifuge tube is placed on a slide and the sample scanned under the microscope looking for cysts.

Recently we obtained another type of test known as an ELISA test - which looks for some of the markers on the outside of the giardial cysts and reacts with a color change.

Both tests miss about 15% of the positive dogs, but they miss a different 15% so using both tests together helps us to be over 90% sure that the dog is infected if we get a positive ELISA test or we identify the cysts under the microscope

How is giardiasis treated?     The typical drug used to kill Giardia is metronidazole (flagyl), an antibiotic that is either a tablet or we can create a liquid for smaller animals.  It is normally given for 8 days (two times a day) to treat giardiasis.  Other drugs are also used if diarrhea and dehydration occur.  If Metronidazole is not effective, other medications may be recommended. 

Can humans become infected with Giardia?     Giardia can cause diarrhea in humans.  If your dog is diagnosed with giardiasis, environmental disinfection is important.  We recommend thoroughly cleaning the pet's living and sleeping areas and then allowing the areas to dry out for several days before reintroducing pets.  One cup of bleach in 1 gallon of water is effective in killing the cysts. 

Are dogs with giardial cysts always sick?     Most dogs that are infected with Giardia do not have diarrhea or any other signs of illness.  When the dysts are found in the stool of a dog without diarrhea, many times we consider them transient and sometimes do not treat these dogs.  However, as Rambo and Pinball taught us, in puppies and debilitated adult dogs, Giardia may cause severe, watery diarrhea that may be fatal. 

We are happy to report that Rambo and Pinball are currently doing very well.

Degenerative disk disease in a little dog (Or…Adventures in immobilizing a terrier for the good of her health)

Isabella has been with us over nine years and will be turning ten in October. She has been a happy, healthy little dog and a great addition to our family.

In mid-March, 2011, our kids noticed that Isi wasn’t herself: “Mom, something’s wrong with Isi. She won’t even look at the ball when we throw it to her. Something’s definitely wrong.” Isi, being female and a terrier, can certainly have her moods. I didn’t think much of her disinterest in play until the following day when she wasn’t interested in much of anything. She was clearly uncomfortable and was having a hard time lying down and getting up the stairs. She hadn’t eaten in two days and hadn’t gone number two for at least a day. When I put my hand under her belly (which had become tense) to move her aside, she yelped. Of course she had waited until Sunday evening to show us these troubling signs and we decided to make a trip to urgent care.

Once at urgent care, Isi had a fairly loose bowel movement in the middle of the floor – completely unlike her. We suggested that her anal sacs might be full and they certainly were. Isi appeared to feel better after having them expressed so we left with antibiotics and pain medication and hoped we were on our way to recovery.

The following morning, however, Isi wasn’t getting back to normal the way we expected. Over the course of the day we realized something was still going on. On late Monday afternoon, we called Care Animal Hospital, our regular vet clinic, and were told to bring her in immediately to see Dr. Garnett. After checking Isi over and reviewing her case, Dr. Garnett was not convinced that this was a stomach or anal sac issue; she began to explore the possibility of a disc problem. Isi would need to be immobilized immediately and Dr. Garnett decided to keep her overnight in anticipation of x-rays the following morning. We knew it would be best for all of us, especially Isi, so we said goodbye and waited anxiously for news.

The next day, Dr. Garnett called and said her suspicions had been confirmed; that the x-rays showed evidence of degenerative disc disease. The radiologist would later confirm Dr. Garnett’s diagnosis so we prepared to immobilize Isi for at least the next two weeks so that she could heal and hopefully return to normal. We also prepared for the worst case scenario – full paralysis.

So how would we immobilize our otherwise energetic little terrier with two kids in the house? The emotional logistics would actually prove to be the most difficult. Fortunately, we had done most of the work when Isi was a puppy – we had made the decision to crate train Isi many years ago. While Isi typically has the run of the house, she does love her crate. She sleeps, travels, and seeks respite (when the kids get to be too much) in her crate. Over the next two weeks, we would come to find out that it was probably harder for us than for Isi to be in her crate that long. Diligently, several times a day we carried the crate outside, put her on a leash for short bathroom breaks, and carried her back inside in the crate. We brought her food to her door where she could eat - from her crate. She watched tv in the family room with us – from the crate. We missed her warm little body at our feet and her pretentious prances across the floor but slowly and surely, she improved.

We decided to continue to restrict movement for the next two weeks – letting her out only to eat or relieve herself and have a good stretch. We saw Dr. Garnett nearly one month after Isi’s initial signs and everything checked out ok!  Isi is restricted from jumping on the couch or the bed (easy, because we never allowed that anyway) but otherwise is looking like her old self. The kids couldn’t be happier that she wants to play ball again and I’m happy to have her sit at my feet. It wasn’t easy (mostly for us) but we’re glad Isi spent most of that month in her crate.

My family has been coming to Care Animal since 1989, when we had Quincy, a sweet little Yorkshire Terrier. We have had confidence in Dr. Garnett and her staff since that time and are happy to share a partnership with them in the health of our pets. Thank you! 

-- Darcie B.