RE: Dirofiliaria in a dog imported from Brazil. Treatment advise?

topaz koch — Wed, 24 Jul 2019 11:48:51 GMT

thank you so much for this, has increased my confidence in using. This dog leads a very sedentary lifestyle anyway so rest is not going to be an issue luckily.

will see how much it costs!

topaz

RE: Dirofiliaria in a dog imported from Brazil. Treatment advise?

Andreia Dias — Wed, 24 Jul 2019 11:34:20 GMT

I can't help regarding how easy it is to get, but Immiticide is a Merial drug so maybe ask them (I guess now it's Boehringer?). It's widely used in South Europe so I figure won't be too difficult to get, but even there is quite expensive and I think you will need to buy a whole box of 10 vials.

Regarding treatment, we also follow the guidelines, but not sure if they mention this...

- We measure D-dimer after starting doxycycline treatment and before adulticide treatment. We tend to use Milbemax before adulticide treatment to control microfilaremia.

- When we give immiticide, it's deep IM injection on the lumbar area and we mark the side to use the other next time. We then keep patient in for 15-30 mins to watch for any reactions

- We often administer a short acting steroid when doing the first immiticide injeciton

- OWNERS MUST KNOW NO EXERCISE at all during the course of treatment! Strict rest, no running, no jumping, no walks off lead

- Owners are explained about thromboembolism. Patients do present with signs of thromboembolism especially if they've been around running. I always explain that we will get the parasites in the lungs but they will hopefully be in the part of the lungs that are not being used, however if they exercise, the blood vessels in the lungs "open up" and the dying parasites can clog them, causing clinical signs. Typically shortness of breath, but sometimes other signs such as not wanting to eat and lethargy. If we are suspicious, we repeat D-dimer.

- We give out prednisolone for owners to administer if they are worried about anaphylatic reaction.

- A patient that has had a reaction will stay at the clinic for the 2nd or 3rd immiticide on cage rest for the day of the injection and the day after

Hope this helps a bit. We don't see too many reactions that require aggressive treatment, but they are more likely when the dogs are running around and exercising. Also with high parasitic loads (of course) or when adulticide treatment is done before doxy/Milbemax.