Why So Much?

---> Immiticide Unavailability!<---

Before we talked about the cost of treatment versus the cost of prevention.

We said you could buy 7 years of monthly medicines for the same price as one heartworm treatment.

Definitely a bargain there. But treatment is necessary, and well worth the price to get rid of the heartworms and stop the attack on the dog's heart, lungs, kidneys and liver. As we said before, the only choice you do not have is not to treat. So this is definitely not a message of save money, don't treat! Treat, treat! But better, know what the costs are and prevent, prevent!

When we said $700, we were using our local prices, from vets we have worked with.

So we are asking readers: do you know how much it costs for heartworm treatment where you live?

Right now it's a theoretical exercise without the Immiticide. But if you can find out, you can figure out how many months of heartworm meds you can buy with the cost of treatment.

What goes into the cost of heartworm treatment? This information will help you to get an estimate.

SNAP test to diagnose $__________
Physical exam $__________
Blood panel $__________
Urinalysis  $__________
Microfillaria smear (Knott's test) $__________
X-rays (generally 2 views) $__________
Some will do an Echocardiogram $__________
1 month doxycycline $__________
1 month probiotics  $__________ (probably not provided through veterinary office)
Immiticide - treatment 1, injection 1 $__________
Possible pain management $__________
Possible Prednisilone $__________
Day boarding, injection fees as applicable $__________
Possible overnight board and observation $__________
Physical exam recheck prior to second treatment $__________
Immiticide - treatment 2, injection 2 $__________
Day boarding, injection fees as applicable $__________
Possible overnight board and observation $__________
Immiticide - treatment 2, injection 3 $__________
Day boarding, injection fees as applicable $__________
Possible overnight board and observation $__________
Possible pain management $__________
Possible Prednisilone $__________
Plus any additional fees your vet office may have $__________
Total estimate: $__________

Cost of heartworm medication every month?  $__________

How many month of heartworm medicines could you buy for the cost of treatment?

Why do we do all those extra things? Heartworm Society helps us again with our summary in (  ): 

PREADULTICIDE EVALUATION

The extent of the preadulticide evaluation will vary depending on the clinical status of the patient and the likelihood of coexisting diseases that may affect treatment outcome. (So how the dog looks, feels, acts, and any other health issues that they may have.)

Clinical laboratory data should be collected selectively to complement information obtained from a thorough history, physical examination, antigen test and usually thoracic radiography. (So those are the minimum things - history, exam, HW test, x-rays.)

The most important variables influencing the probability of post-adulticide thromboembolic complications and the outcome of treatment are the extent of concurrent pulmonary vascular disease, the severity of infection and the activity level of the dog. (The things that make it more likely the dog will have clot complications: 1. How much HW or other disease is impacting the blood circulation in the lungs  2. How bad their HW infection is 3. AGAIN [CAPS AGAIN] the activity of the dog AGAIN - please, if you have a HW + dog or a dog going through treatment, keep them quiet)

Assessment of cardiopulmonary status is indispensable for evaluating a patient’s prognosis. Post-adulticide pulmonary thromboembolic complications are most likely to occur in heavily infected dogs already exhibiting clinical and radiographic signs of severe pulmonary arterial vascular obstruction, especially if congestive heart failure is present. (Assessing heart and lungs is huge.)

Although a very crude method of assessing the severity of infection, the strength of ELISA-based antigen test reactions may provide an indication of whether an infection is light or heavy (see Antigen Tests - that's their ( ) but that is a good section in the link above).

Since radiographic signs of advanced pulmonary vascular disease may persist long after an infection has run its course, some of the most severely diseased dogs may have disproportionately low levels of circulating antigen by the time they are tested. Also some inactive dogs can have large worm burdens and be clinically asymptomatic with minimal radiographic changes. (So your vet needs to look at the whole picture - which is why they do all those tests)

Most expensive part of treatment? Anyone want to guess? That's right, the Immiticide.

 AKA Melarsomine (made by Merial)

• Melarsomine is the drug of choice for the first stage and is effective for killing adult heartworms living in the arteries of the lungs.
• Melarsomine is an arsenic-based drug. Although these drugs are known to kill adult heartworms, the exact method of the killing action is unknown.
• Melarsomine is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.   
• http://www.petplace.com/drug-library/melarsomine-immiticide/page1.aspx

Next time you will meet Mila's personal doctor.