Meet Miss Starly.  Starly is an Anatolian Shepherd who was pulled from a
shelter by a rescue group. Starly was extremely underweight, had a skin
condition, and had a mammary tumor along with being heartworm positive.
Because she was an older dog with many health problems, Starly was not a
candidate for the traditional heartworm treatment. It was decided that
Starly would be taken through the “soft heartworm treatment.”

The traditional treatment for heartworms is two fold: 1) adulticide is used
to kill the adult heartworms; and 2) microfilaricide is used to kill the
microfilaria  (baby heartworms).  
With the adulticide, the dog is injected by an intramuscular injection into the lumbar muscles with an
arsenical compound called Immiticide. Although this is supposedly a safer procedure than in years past,
there are still many complications that can arise, including pulmonary thromboembolism or blood clots
after the treatment. This is condition is caused from the dead worms clogging the lungs and restricting the
blood flow through the arteries.  Death from adulticide is not uncommon.  Most veterinarians agree that
the dog must remain quiet and still for about a month after the adulticide injection is administered or
serious complications or possibly death can occur.

The rescue group decided traditional heartworm treatment with an adulticide was not what Starly needed.  
I worked with the foster mom and outlined a program starting with Ivermectin, which is a microfilaricide,
meaning that it kills the microfilaria (baby heartworms).   By starting Starly on Ivermectin, this would
eliminate the existing microfiliaria as well as protect her from being further infected with heartworms
which are passed by the mosquito.  Another important part of the treatment is a good nutritious diet – with
as many fresh, foods as possible. Ideally, I like to see the dogs on a raw food diet supplemented with a
high quality kibble.  Nutritional supplements were prescribed to help build up Starly’s immune system to
make her stronger overall to combat the parasite infection. The supplements were chosen to meet Starly’s
specific needs.

The idea of the “soft treatment” is to slowly and gently weaken the adult heartworms and wait for them to
die naturally.  Heartworms themselves have a life span – female heartworms are known to live longer than
the males. In my experience, they may live for a period of 6 months to 2 years. An advantage to this
treatment is that a large number of heartworms are not killed at one time, which can cause serious
complications. With the heartworms dying slowly, the dog’s system is able to reabsorb the parasite without
side effects.

Starly was put on Ivermectin and natural supplements and received a lot of tender loving care. As you can
see from her pictures, she is now a healthy, beautiful dog who plays and carries on with her younger
housemates.   Fortunately, Starly became heartworm negative within one year and continues to thrive

In my opinion, the “soft treatment” makes good sense for any heartworm positive dog – severe or mild –
young or old. I have seen too many complications with the traditional method – many times the
complications have resulted in death. Additionally, I have seen health problems appear further down the
road as the animal ages – mostly involving immune problems. Keeping the welfare of the patient in mind, I
strongly recommend the soft treatment for any dog who tests to be heartworm positive.

Patricia A. Cooper, DVM
211 Kleinbrook Drive
Houston, Texas 7706
Cooper Animal Clinic
5211 Kleinbrook Dr
Houston Tx 7706