Scary info from the vet re heartworms/roundworms.

[TNDemo]

During the course of the conversation with the vet today she mentioned that the number one cause of blindness in children in the US is roundworms that they get from their dog. She said roundworms are eliminated through heartworm medicine and she always shudders when people are in with small children and don't have their dog on heartworm prevention. She said after Katrina they started seeing a lot of dogs on heartworm medicine get heartworms up the Mississippi River and that area is spreading. Apparently those are mosquitos on steroids that got blown north. Anyway, she said she had a couple of dogs last year that got heartworms despite treatment. If you buy the medicine from the vet (ours will match any price, even the petmed one), then the drug supplier will pay for the heartworm treatment ($500-700) if your dog gets it and their records show you have them on it year-round. I said I took mine off during the winter and she said it really needs to be year-round here because it needs to be given for two months after mosquitos are gone and one month before they come back. So in TN that is basically year-round. She also said the drug company is emphasizing dosing as every four weeks, not monthly. She said she had to change her routine of giving it to them on the 1st of the month. Guess I'm going to be more diligent with the heartworm medicine.

[xchrom]

1. If it wouldn't be too much trouble - some spaces in all that? Nt

[Myrina]

3. type type type panic must hit enter type type type

... oops, forgot to breathe :rofl:

[hlthe2b]

2. Leading cause of childhood blindness has NOTHING to do with roundworms..

though they can rarely impact the eyes. I suspect you misunderstood much of what you quote your veterinarian as having said, but I only have a couple of minutes to post. So, as to the childhood blindness issue:

**Vitamin A deficiency is the leading cause of childhood blindness worldwide. Waterborne (not roundworms) parasites are important in some parts of the third world but still pale in prevalence to the impact of vitamin A deficiencies and congenital impairments.

In the US, low birth weight is a major risk factor

Causes of Childhood Blindness: U.S Only

Amblyopia and Strabismus

It is estimated that between 1 and 4% of the childhood population is affected by strabismus, and 1 to 2% suffer from amblyopia (National Eye Institute, 1993).

Congenital Cataracts

Among children under 5 years of age, prenatal cataract is the leading cause of legal blindness, accounting for 16% of all cases (National Society to Prevent Blindness, 1980). However, in the developed world, congenital cataract, when appropriately managed, is the only cause of visual impairment to have recently shown a decrease in prevalence (Taylor, 1994).

Cortical Visual Impairment (CVI)

Cortical visual impairment is defined as a temporary or permanent visual loss caused by disturbances of the posterior visual pathways and/or occipital lobes. The vast majority of children with CVI have residual vision (Jan & Wong, 1991).

In developed countries, CVI has become more frequent (Johnson-Kuhn, 1995) and can be considered one of the major causes of visual handicap in children of developed regions (Good, et al., 1994).

Glaucoma

Infantile glaucoma occurs in 1 out of 10,000 live births (Teplin, 1995).

Optic Nerve Atrophy

Optic nerve atrophy accounts for 12% of all cases of legal blindness in children (National Society to Prevent Blindness, 1980).

Retinopathy of Prematurity (ROP)

Retinopathy of prematurity (ROP) is characterized by the abnormal growth of blood vessels in the retina of premature infants. Infants in whom ROP is diagnosed during the perinatal period are at risk for ocular abnormalities and for deficits in visual function.




************************************
The following estimates are based on data collected for children from birth to 36 months of age, from the PRISM Project Registry of Early Childhood Visual Impairment Collaborative Group (PRISM Project Newsletter, 1996). It should be noted that these figures include only those individuals registered with this project.

The following presents the most frequently reported visual impairments among PRISM children (N=165):

ROP

33 (20%)

Optic nerve hypoplasia

27 (16.4%)

Cortical visual impairment

22 (13.3%)

Albinism

14 (8.5%)

Coloboma

6 (3.6%)

Glaucoma

5 (3.0%)

Microphthalmos

5 (3.0%)

Aniridia

4 (2.4%)

Leber's Congenital Amaurosis

3 (1.8%)

Cataracts

3 (1.8%)

Anophthalmos

2 (1.2%)

Bilateral detached retina glaucoma

2 (1.2%)

Cytomegalo virus (CMV)

2 (1.2%)

Septic optic hypoplasia

2 (1.2%)

Optic atrophy

2 (1.2%)

Others

33 (20%)

[TNDemo]

4. Here's an article from a vet about it:

http://www.medscape.com/viewarticle/573090

Will research it further when I get back.

[medeak]

5. sounds like pharma rep just paid vet visit? n/t

[undeterred]

6. My dog is on Interceptor all year round.

Covers other species of worms which can be picked up if he eats other animals. I think this has become standard practice for vets to recommend.

[cutlassmama]

11. mine too. It's expensive for us, but worth it because I love my babies.

[REP]

7. Scary - and wrong. It's two other roundworms that can infect the eyes

In humans - as in dogs and cats - heartworm infests the lungs, only in humans, it does little harm.

[kestrel91316]

8. If I told my clients to put all their cats on monthly meds just for roundworms,

they'd just laugh at me, because THEY know better. Of course they'd be wrong, but they'd laugh just the same. Compliance with such a recommendation, even before they stopped providing medical care for their cats in this recession, approached zero.

Don't get me started on teh stoopid.

[REP]

9. Cats can die pretty quickly from HARD and are less likely to survive

Four treatments a year for indoor-only cats in areas without heavy mosquito infestation is sufficient, but it really needs to taken seriously. Horrible way to die.

And it's not the nematode that causes human blindness/eye infestation.

[kestrel91316]

10. Ummm, I'm not sure how to break this to you. I'm a

veterinarian. Actually, a cat veterinarian.

:rofl:

Oh, and I have a particular interest in feline zoonoses. So, um, yeah. I kinda sorta know a bit about heartworm. And roundworm. And a whole buncha other stuff, too.

And I wish this was an endemic heartworm area here. Then I could use that to scare my clients into controlling them, and then they'd also control the roundworms. But NO WAY they would do monthly control of something that didn't make their own cat sick. Most Angelenos care only about themselves, and most definitely not about OTHER people and their children (who might not have as much money and STUFF as they do so they are subhuman).

[juajen]

12. WOW, talk about shutting down a discussion, Kestrel, you worm!

[REP]

13. I know, right? Agree with someone and provide more info; get treated like an attacker

That's the DU way! Yay!

[kestrel91316]

17. How did I treat you like an attacker, lol? I just thought maybe you'd like to know

that I already know quite a bit about feline HWD and roundworms.

You're reading way too much into my post.

[REP]

22. The sarcasm.

EVERYONE knows you're a vet. You've mentioned it. A lot.

Don't most vets call it HARD? All the vets I have ever spoken to in real life call it that, not HWD.

[kestrel91316]

26. HWD is an accepted acronym for heartworm disease when typing on the internet.

And no, EVERYONE doesn't know I am a vet. I rarely mention it here other than to correct misinformation or add to a discussion about animal health or zoonoses. I mention it repeatedly to avoid nasty responses asking why the hell I think I know so much.

Where was my "sarcasm" you are referencing?? You have an overactive imagination. It is far to easy to misread tone in posts, which you have to be aware of. You can stop picking this fight ANY TIME NOW.

[REP]

14. Wow, a cat who's a veterinarian! Can you drive a car, too?

So you know it's Dirofilaria tenuis that causes eye problems in humans, not Dirofilaria immitis, and we're cool.

[kestrel91316]

18. Actually, the eye problem in human children we need to be worried about is ocular larva migrans

caused by Toxocara canis and Toxascaris leonina.

But what the heck do I know about feline zoonoses?? I've only been paid to write about that in ONE periodical so far.

I'd send you a link or post it here but I am anonymous on DU except to a few friendly types.

[REP]

23. Toxocara, not Dirofilaria immitis. Different parasites. In other words, the OP is wrong, as I said

[kestrel91316]

28. I bet you read about D. tenuis on the intertubes, huh?

I never said D. immitis caused eye problems in humans. Perhaps you have me confused with someone else.

Because OLM is not a reportable condition, its true incidence is unknown.I did find this:
http://www.medsci.org/v06p0129.htm
"The incidence of ocular toxocariasis is undetermined and it may vary according to different Authors and in different countries. It is more frequent in children and it constitutes 1-2% of uveitis in children. Toxocara should be considered as a possible causative agent of posterior and diffuse uveitis and always in the differential diagnosis of retinoblastoma."

Judging by the fact that in vet school we spent a fair bit of time learning about zoonoses caused by Toxacara and Toxascaris, and none at all on D. tenuis, I have to assume that the former is more common. But I can't prove it to YOU at the moment.

[pitohui]

15. it's scary that a vet would lie to sell pills, all right

i would handle it by getting another vet

i love the part about mosquitoes on steroids getting blown north after katrina though, you have to ask how much acid your vet dropped before she hallucinated that one

i've lived in new orleans an embarrassing number of decades, there are ZERO blind children from not having their dogs on the magical heartworm medicine, if they don't give the dogs heartworm medicine, the dogs get worms, the children don't go blind and the mosquitoes don't go the gym and start giving bj's to get steroids

i hope this post is a gentle spoof of some other post, otherwise, you have an extremely dishonest vet who i presume must be getting kickbacks from the drug company

[REP]

16. Things that rarely happen: I'm in an accident, and agreeing with you

Both things happened today :-)

[kestrel91316]

19. Vets don't get kickbacks from drug companies. We used to get a token

teensy bag of M&Ms to share among staff when the Bayer rep came in but they can't even do THAT anymore. Now they give us notepads.

[live love laugh]

20. Never heard of such a thing. Signed--skeptical nt

[GeorgeGist]

21. As far as the 4wks vs monthly dosing ...

your Vet has been scammed by the drug company rep.

[kestrel91316]

27. A recommendation to treat every 28 days makes MORE SENSE than

treating every 28-31 days if you are looking at pharmacokinetics. If the drug levels drop right at the end of the month, it is POSSIBLE that could allow HW infection to develop.

A "month" is fungible. 28 days is ALWAYS 28 days.

I don't treat dogs, so I don't keep up on canine HWD issues (and am not in a HW area so we don't see it in cats either). But if I run across any publiished research on this issue I will try to post it here.

[kestrel91316]

24. This thread desperately needs some facts about ocular larva migrans.

Enteric Nematodes of Lower Animals Transmitted to Humans: Zoonoses
http://www.ncbi.nlm.nih.gov/books/NBK8176/

CDC's web page on toxocariasis:
http://www.cdc.gov/parasites/toxocariasis/

CDC's Healthy Pets/Healthy People web page on toxocariasis:
http://www.cdc.gov/healthypets/diseases/toxocariasis.htm

Larva Migrans fact sheet from Iowa State U:
http://www.cfsph.iastate.edu/FastFacts/pdfs/larvamigrans_F.pdf

CAPC recommendations for Toxacara:
http://www.capcvet.org/recommendations/ascarids.html

"Public Health Considerations: Toxocara spp. are well-documented, important zoonotic disease agents. Infection with Toxocara spp. is most common in children and occurs upon ingestion of larvated eggs from a contaminated environment following geophagy or other forms of pica. Although all children are susceptible to infection, some studies have shown that toxocariasis is more common in rural or inner-city areas, and is associated with both poverty and contact with breeding and/or untreated, free-roaming dogs.

"Larvated eggs of Toxocara spp. are commonly found in soil collected from playgrounds or parks, and the eggs survive and remain infective for many years. When these eggs are ingested, the larvae they contain migrate internally in the child, resulting in disease. Syndromes of toxocariasis include visceral larva migrans, which is usually characterized by hepatomegaly, pulmonary disease, and eosinophilia; neural larva migrants, characterized by progressive neurologic disease; ocular larva migrans, characterized by a unilateral granulomatous retinitis; and covert toxocariasis, in which chronic abdominal pain or other nonspecific symptoms develop.

"Baylisascaris procyonis also causes disease in children following ingestion of larvated eggs from a contaminated environment. The larvae of B. procyonis migrate extensively in the central nervous system, commonly resulting in severe neurologic disease in affected individuals; B. procyonis can also produce visceral, ocular, and covert forms of disease.
Prevention of disease caused by infection with zoonotic ascarids requires preventing the ingestion of eggs from the environment. Young children should be closely monitored so that geophagy and other forms of pica can be discouraged, particularly in public areas known to be frequented by dogs and cats or populated with raccoons.

"Early and regular deworming is essential in preventing contamination of the environment with Toxocara eggs. Treating pets to prevent egg shedding is critical because the eggs are very hardy and long-lived in the environment. Once present, the eggs can be removed or destroyed only through extreme measures such as entombment of kennel areas or areas of pet defecation in concrete or asphalt, complete removal of topsoil, prescribed burns, or treatment with steam."

[kestrel91316]

25. Article in Pediatrics for Parents:

http://www.pedsforparents.com/articles/3051.shtml

[Flubadubya]

29. Most confusing thread, so I have a question please...

Sorry, but I'm having a hard time making much sense of this thread as far as real information about treating your pets for heartworm. I'm sure the confusion is strictly my fault. Nonetheless, I love my dogs and want to make sure I'm doing the right thing.

I live in Southwest Arkansas if locale is of any consequence.

I have a Chihuahua who weighs about 6.5 pounds and a miniature dachshund that weighs about 8.5 pounds. My vet provides me with Iverhart Plus Chewables for dogs up to 25 pounds. I give them each one on the first of each month. Do you think this is proper and adequate treatment?

Thanks :hi::)

[kestrel91316]

30. Look, I'm a CAT vet. I haven't practiced on dogs in 20 years, lol.

You are clearly following the label dosing. I just don't know what to make of the 28 days recommendation vs a month (which is 28-31 days). Personally, it doesn't make sense to me that they would have what turns out to be such a narrow margin of safety in the timing.

Ask YOUR vet. And call the manufacturer (phone # is on the package). And maybe suggest that your vet ask a veterinary internist or even parasitologist or pharmacologist if this is a legitimate concern.

[Flubadubya]

31. Thank you...

I will definitely check with my vet. I just didn't realize there was such a controversy over this, lol. :)