Continuing Ed

So — no doubt about it — Willie has heartworms, and the news is heartbreaking and frightening.  How many worms? How big are they?  There’s no way to know without an expensive echocardiogram – or an autopsy — but one things is certain: Willie needs to be treated, and soon.

I know the Internet will be filled with information and illustrations and likely even videos on the topic (Everything You Never Wanted to Know About Heartworms; Heartworms and You; When Heartworms Attack!) but for most of the first day after Willie’s diagnosis I resist the siren call of the World Wide Web and instead consider the information I received from Doctor Sweeney and from my friend Ann, a retired vet from Texas who hasn’t practiced since 1995.  Finally, as I’m about to take Willie for our afternoon walk, I search for a podcast.  And as the two of us tromp around for an hour in a housing development up on Cherry Hill on a sunny, blue sky day, I am wearing headphones and listening to a production of The American Heartworm Society on the importance of prevention (is there a way to fast forward this thing?) and then finally on the treatment protocols for infected animals and their associated risks.

I’m left with the impression that the standard treatment involves administering a powerful drug to kill the worms.  But then you’re supposed to restrict the dog’s movement for more than a month because as the worms die (do they break apart? Are they reabsorbed somehow?) they create a risk for clots, embolism, stroke, heart attack…But wait — Willie is only a year old!

My vet wants Willie to come in for a day-long treatment; should it matter that I don’t yet fully understand what that treatment is?  “Most dogs do okay with it;” said Doc Sweeney, “we’ll be watching him all day and we’ll call you with updates.  He can probably go home that night.”

I imagine Willie in a cage, sedated, connected to IV lines and monitoring devices – a little doggie ICU.  I call the vet to learn what protocol he plans to follow.  I call another vet for a second opinion.  I fall down the rabbit hole of the Internet.   And by the end of the day I have amassed enough knowledge to pass an exam.

Heartworm is transmitted via mosquito bites.  It takes roughly five or six months for the infection to show up in a test – the time it takes for a worm to grow, take up housekeeping in the lung or the heart, and to sexually mature and reproduce.  A female worm then pumps tiny, wriggling offspring – not much bigger than a blood cell – into the dog’s system.  Untreated, they will continue to grow and reproduce, eventually plugging up the dog’s heart and lungs, interfering with blood and oxygen delivery.  By the time a dog shows any outward signs of infection – coughing, shortness of breath, lack of interest in food or exercise – the disease is very far progressed and the treatment outcomes aren’t very rosy.

How far progressed can the disease possibly be in a one year old dog?