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TDK conference 2020

New approaches in the complex therapy of canine heartworm disease
Kónya Réka - year 6
University of Veterinary Medicine Budapest, Department of Internal Medicine
Supervisors: Dr. Károly Vörös, Dr. Zsolt Becker


At the Small Animal Clinic of the University of Veterinary Medicine Budapest we performed the complex therapy on 44 dogs as recommended by the American Heartworm Society with additional, developmental modifications. Of these patients, 19 dogs belonged to the 1st, 18 animals to the 2nd, and 7 to the 3rd clinical categories of the disease.

Microfilariae were destroyed with moxidectin (Advocate spot-on solution A.U.V), applied on the 1st, 30th, 60th and 90th therapeutic days, whilst in the literature there are only publications on the ivermectin as the part of the complex therapy. On the 1st-28th days, 10 mg/bwkg/12h doxycycline (Doxycyclin 100 mg tabl. A.U.V.) was given per os against the symbiotic Wolbachia pipientis bacterium, complemented with probiotics, not yet published in the literature. Adult heartworms were eliminated with 2.5 mg/bwkg melarsomine (Immiticide Merial injection A.U.V.), on the 60th, 90th and 91st days, im., injected deeply into the lumbar musculature. The depth of the injection site was measured during ultrasound- (US-) examination of the lumbar muscles, being the first internationally as to our knowledge. We also observed the local side effects with this method, together with the physical examination. The patients received 0.3-0.4 mg/bwkg butorphanol (Alvegesic 10 mg/ml inj. A.U.V.) injection im., before the melarsomine injection, to decrease the local pain and to provide immobilization. The injection needle was held in place for 5 minutes, to prevent the backflow of the melarsomine after pulling out the needle. From the 60th day, we gave dalteparin (Fragmin injection) sc., for 10 days, to mitigate the chance of pulmonary thromboembolism.

All of the 44 dogs recovered clinically after one month from the time of the 3rd melarsomine injection. At the 120th day, there were no detectable microfilariae in the peripheral blood of any patients. The Ag-test was performed in 37/44 animals at the 271st day, being negative in all cases. The moxidectin did not cause any signs of an adverse reaction, not even in microfilaraemic dogs. The side effects of doxycycline (anorexia, vomitus, diarrhea) occurred in 3 (6%) dogs, that recovered after symptomatic therapy and by lowering the dose. From the systemic side effects of melarsomine, temporary anorexia and diarrhea occurred in one (2%), as well as coughing and mild respiratory distress also in one (2%) animal. These problems resolved in a few days after symptomatic therapy. Mild local side effects of melarsomine occurred in 29 (65%) patients, and severe local swelling and pain were observed in two (4%) cases, which greatly decreased within a month. The grades of the local signs were consistent with the degrees of the US findings.

Our therapeutic results proved to be more favorable compared to the previously published results, which can be mainly due to the new, additional procedures introduced by us within the procedure of the complex therapy.

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