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Heartworms developing resistance to monthly preventatives

BCSnob
Explorer
Explorer
After hurricane Katrina there have been increasing reports of loss of effectiveness (LOE) for heartworm preventatives in the Gulf coast area. There have been many hypothesis for this increasing LOE.

Lack of consistent dosing with the monthly preventative has been a major contributor to the increasing reports of LOE.
Heartworm โ€˜lack of effectivenessโ€™ claims in the Mississippi delta: Computerized analysis of owner co...

I have wondered if the number of microfilariae (immature worms) being injected into dogs each month has increased above the number that was used to establish the minimum effective dose decades ago (100 microfilariae). In other words more immature worms are injected into the dog between each month treatment could require more drug each month to kill them all. I have seen some literature which supports the increase load in mosquitos and/or the increase in infected mosquitos.

The development of resistance to macrocyclic lactones (class of drugs of monthly preventatives) by the heartworms.
Establishment of macrocyclic lactone resistant Dirofilaria immitis isolates in experimentally infect...

A very recently published study has located in the heartworms from two dogs infected with suspected resistant worms, genetic mutations that are associated with drug resistance in other parasites.
Macrocyclic lactone resistance in Dirofilaria immitis: Failure of heartworm preventives and investig...

These data indicate there is a subpopulation of Dirofilaria immitis (heartworms) that likely have genetic mutations providing resistance to all monthly heartworm preventatives. This needs to be confirmed and then a survey of infected mosquitos needs to be performed to determine the prevalence of this resistant subpopulation.
Mark & Renee
Working Border Collies: Nell (retired), Tally (retired), Grant (semi retired), Lee, Fern & Hattie
Duke & Penny (Anatolians) home guarding the flock
2001 Chevy Express 2500 Cargo (rolling kennel)
2007 Nash 22M
4 REPLIES 4

dturm
Moderator
Moderator
Pawz4me wrote:
Ahh . . . I remember Filaribits! My dogs always liked them. Would that really be an acceptable/more effective alternative? I'm fuzzy, but I seem to remember there was more risk in giving them to an already infected dog than there is with the current preventatives? And wasn't testing recommended every six months for dogs on Filaribits? That seems like such a long time ago . . .


Yes and no. DEC (diethylcarbamazine) the active ingredient causes an immediate rapid kill of microfilaria and resulted is SEVERE reactions including death. Thus the greater risk than what we have now and the absolute mandatory heartworm test with DEC use.

We still did annual heartworm tests when dogs were on DEC all year, but if there was any break they had to be retested before starting again.

It was so much easier to monitor when we were the only ones to supply the preventive (you knew if they only purchased a 60 day supply the dog didn't get the required medication). I see real potential for problems:

Vet: gave script for 12 months of meds

Client: I got it filled online and gave all of it when in fact they didn't.

Restart medication:

Results: dead dog.
Doug & Sandy
Kaylee
Winnie 6 1/2 year old golden
2008 Southwind 2009 Honda CRV

Pawz4me
Explorer
Explorer
Ahh . . . I remember Filaribits! My dogs always liked them. Would that really be an acceptable/more effective alternative? I'm fuzzy, but I seem to remember there was more risk in giving them to an already infected dog than there is with the current preventatives? And wasn't testing recommended every six months for dogs on Filaribits? That seems like such a long time ago . . .
Me, DH and Yogi (Shih Tzu)
2017 Winnebago Travato 59K

magnusfide
Explorer II
Explorer II
dturm wrote:

Seriously, this is a real problem that is being studied. Our best defense right now is to get every dog on preventive all year long.

Because of the potential, it is VERY important to get an annual heartworm test even if being given medication.


We've been getting the 1x/year injections for our dogs. Much easier to keep track than 1x/month for us.
"The only time you should fear cast iron is if your wife is fixin' to hit you with it."-Kent Rollins
First law of science: don't spit into the wind.

Magnus

dturm
Moderator
Moderator
I see Filaribits coming back on the market :B

Seriously, this is a real problem that is being studied. Our best defense right now is to get every dog on preventive all year long.

Because of the potential, it is VERY important to get an annual heartworm test even if being given medication.
Doug & Sandy
Kaylee
Winnie 6 1/2 year old golden
2008 Southwind 2009 Honda CRV