[Updated August 10, 2017]
The heartworm goes through a number of astonishing changes in order to complete its life cycle. It must start out in one dog, get carried away by a mosquito that’s bitten the dog, and return to another dog (through another mosquito bite) to grow, reproduce, and finish its business in life.
Given the intricacy of the heartworm vector, the difficulty of keeping your dog safe from this insidious killer is understandable. The most commonly prescribed drugs for heartworm prevention and treatment are fairly toxic, and capable of causing health complications and even death.
Of course, so can heartworms.
Fortunately, when both a disease and its conventional treatments are objectionable, complementary and alternative medical practitioners can be of tremendous value. As with practitioners who treat humans, veterinary practitioners offer a range of helpful adjuncts to, and replacements for conventional treatments. For instance, in the case of heartworm, a conservative adjunctive therapy may consist of herbal and nutritional support for dogs that are also undergoing conventional drug treatments for heartworm. On the more radical end of the scale, some holistic practitioners offer a complete alternative to drugs that prevent or treat heartworm infections.
Is Heartworm A Man-Made Problem?
Whichever end of the scale holistic veterinarians place themselves on, they all agree about the first step toward heartworm prevention and treatment: A dog must be essentially healthy in order to resist succumbing to heartworm (or its treatments). This is more than an idle observation – it is the principle that ensures the survival of wild canines, who suffer far greater exposure to heartworm-carrying mosquitoes but succumb from the parasites in far lesser numbers than domestic dogs.
“More and more I’m coming to think that heartworm is really a man-made disease,” states Dr. William Falconer, a veterinarian with a homeopathic practice in Austin, Texas. “The heartworm has been out there forever as far as we know, but we don’t read reports of wolves and coyotes being wiped out by heartworm, and yet domestic dogs are falling prey to it. It speaks volumes to what we’re doing wrong in raising these animals.”
Dr. Falconer, a veterinarian for 18 years (the last 12 with an exclusively holistic practice), thinks it comes down to three common dog-keeping practices: “We’re vaccinating our dogs too much, we’re feeding them poorly, and we’re using too many pesticides to kill their fleas. It all helps weaken their immune systems, and their immunity is really what’s going to save them.” Foxes, coyotes, and wolves, on the other hand, go unvaccinated, eat only raw meat, bones, and a few plants, and are never exposed to the dozens of toxic chemicals we use to kill fleas on our dogs and in our homes. Some seem to be able to “fight off” heartworm infestations; many others host the parasite, but in small enough numbers that the heartworms don’t threaten their hosts’ lives. That’s nature’s plan for parasites,” says Falconer.
“Parasites were never intended to kill their hosts. Something is very out of balance when that happens. A parasite’s whole evolutionary thrust is to continue its life cycle; if it kills its host, there’s a dead end. The fact that our domestic dogs are dying of this disease in greater and greater numbers indicates that something is way out of whack,” Falconer says. Holistic veterinarian Dr. Carolyn Blakey, of Westside Animal Clinic in Richmond, Indiana, concurs with that view, and adds another concern.
“A really healthy animal won’t get parasites that overwhelm them, but there are so few really healthy dogs out there. On the other hand, insects are getting stronger every day, due to their rapid adaptation to our heavy use of insecticides. We may be getting superparasites because of our reliance on insecticides.”
Given the wild canines’ efficiency in dealing with heartworm, both of these veterinarians, and virtually all other holistic practitioners, recommend utilizing as many aspects of the wild canines’ lifestyle as is practical for domestic dogs, including, most importantly, a natural diet of raw meat, bones, and some plants, minimal vaccination, and severely curtailed exposure to flea-killing pesticides. “Animals who are healthy are not in need of a specific preventive; their lifestyle is their preventative,” Falconer asserts.
Immune System Defense Against Heartworm
Researchers have noted that a certain percentage of domestic dogs are able to mount a decent defense against heartworm. They’ve seen dogs whose immune systems are able to seek out and destroy heartworm microfilariae in their blood. They’ve also observed dogs who outlive their heartworm population with no appreciable symptoms of heartworm disease. Scientists speculate that when these dogs were originally infected with heartworm larvae, their bodies organized an immunological defense against new larval attacks, and though a few larvae were able to develop into adult heartworms, no further infestation could occur.
This line of thought is behind the research by a company called Wyoming DnaVaccine, into a heartworm “vaccine.” The company hopes to develop a vaccine that would trigger the dog’s body to produce an antibody-based immune response that would wipe out heartworm larvae. While Wyoming DnaVaccine researchers claim to have developed products that use this approach to successfully vaccinate dogs against other parasites such as hookworm, pinworm, whipworm, and roundworm, the complexity of the heartworm life cycle has proven to make development of this product more difficult.
Homeopathic Approach to Heartworm
Dr. Falconer uses homeopathy to accomplish the same ends as this high-tech approach. He seeks to boost the dog’s level of health and immune readiness with homeopathic remedies custom-prescribed for each individual. This is accomplished by conducting a thorough intake of the dog’s health history and lifestyle. Then the dog is given the remedy, and the owner is asked to closely observe the dog for a few weeks. Sometimes, the symptoms indicate the need for another remedy, and the procedure is repeated.
This protocol is known as the “classical method of homeopathy,” explains Dr. Falconer. “I choose one remedy chosen on the totality of symptoms the dog is showing, and then carefully evaluate the dog after two or three weeks have gone by, to see how the symptoms are doing. Sometimes I may have to switch remedies, but each remedy is followed by an evaluation period.”
Falconer says he has had almost perfect success with his clients’ heartworm cases, using nothing but homeopathy and healthy dog-keeping practices. “I’ve gotten to the point now where I am very confident treating heartworm. If someone calls and says they have a heartworm positive dog, I tell them not to panic; the prognosis is good,” he says. His only failure came with a very old, weak dog with a very bad heartworm infection and advanced symptoms of heartworm disease, including a constant cough.
Homeopathy does not offer an overnight cure, says Falconer, but it is effective. “It takes three to six months, but what I’m doing is making the dog healthy; that takes time,” he explains. “Once they are healthy, they throw off the heartworm just like they should, just like the wolves, foxes, and coyotes have been doing for generations.”
Falconer supports the homeopathy with good dog-keeping practices. As mentioned above, he suggests the dog be kept from immune-compromising vaccines and chemicals. And he recommends a healthier diet, based on recipes utilizing raw meat and whole foods. He also recommends supplementation with vitamin C, and might also suggest vitamin E supplements if there is evidence of a heart problem. While he believes these supplements can be very helpful, he’s cautious about making the dog’s treatment regimen too complex for the owner. “I like to keep it simple so that people do it. If it’s too complicated, it will be too hard for the average person to get it done,” he says.
While Falconer says he is willing to work with clients who are interested in the benefits of homeopathy, but who also want to give their dogs traditional heartworm preventives or treatments, he’s less enthusiastic about this approach. “Homeopathy can help these dogs, but it’s picking up the pieces. The drugs kill the worms, but you’re still left with a dog that’s in poor health. We know he was in poor health because he got the heartworms in the first place; now he’s even worse off because of the assault on his entire system. So we have to rebuild this dog’s health from the ground up,” he says.
Supporting Your Dog’s Heart Health
Dr. Blakey, a veterinarian for 31 years, the last three spent in an all-holistic practice, takes a very different approach to treating heartworm-positive dogs. She has clients who use traditional drugs and others who take a completely alternative approach to prevention and treatment, and has seen success with both approaches. The secret to her success, she says, is attributable to the homeopathic and herbal remedies and nutritional supplements she administers to improve the dogs’ circulatory function.
“Heart support is as important, if not more important, than killing all the worms,” Blakey says. “As long as the heart is strong and capable of working thorough the challenges presented by the worms and the dog’s overall health is good, he will be able to outlive his wormy burden, or survive the conventional drug treatment, whichever route the owner chooses to take.”
Blakey’s treatment is multi-pronged, and includes an herbal treatment of black walnut to weaken or even kill the heartworms, homeopathic support of Arsenicum album for the heart energy, and a nutritional supplement for supporting the heart function.
Blakey’s two favorite nutritional supplements for the heart are CoQ10 and CardioPlus. CoQ10 is an anti-oxidant and an enzyme that seems to offer special benefits to the circulatory system. The body can produce the enzyme, but people and dogs seem to produce less of it as they age. Supplementation with the enzyme has been credited with lowering blood cholesterol levels and preventing heart attack and stroke. The other supplement is Quantum Inc.’s CardioPlus, which contains CoQ10, as well as a number of other nutrients thought to be beneficial for the heart.
Perhaps most exciting is the black walnut treatment, which Blakey swears is capable of killing adult heartworms. “It often, but doesn’t always kill the adults, but it weakens them considerably,” says Blakey. The herbal treatment’s effect on the worms, and subsequent improvement in their host, is astonishing, says Blakey. “It’s incredible. The dogs start feeling better within days, because their circulation is improved and their heart can function better.”
Veterinary Assistance is Important
While the herbal extract Blakey uses is commonly available in health food stores, Blakey maintains that dog owners must work with a holistic veterinarian when planning and executing the treatment protocol. The veterinarian will adjust the dog’s dosage of the extract according to his weight and condition. The extract comes in a liquid that the owner can squirt into the dog’s mouth daily for about 30 days. The dose is reduced if the dog experiences nausea.
When Blakey uses this treatment protocol, she rechecks the dog at this point, performing a heartworm antigen test to determine whether heartworms are still present. If they are, she will sometimes recommend treatment with the black walnut for another two to three weeks. After that, she says, the herbal extract will have accomplished as much as it can.
If the dog still has heartworms, the dog’s owner has another decision to make: they can decline further treatment and just “get on with the dog’s life,” or go ahead with the conventional treatment with Immiticide to kill the remaining adults. For her part, Blakey feels good about either choice. “Left untreated, many of the adult heartworms will just die out – the black walnut can weaken them that substantially. Or an owner can go ahead with Immiticide; I feel fine about it at that point. After the black walnut treatment, a dog is really ready for the Immiticide; he’s not wiped out, and he can handle the Immiticide much better.”
The black walnut doesn’t seem to affect the microfilariae, but Blakey says they can be wiped out with a dose of Ivermectin later on, once the dog is feeling better. The dog’s improved health will help him cope with the Ivermectin, too.
Homeopathic Preventive to Heartworm
In addition to her treatments for infected dogs, Dr. Blakey also has an alternative for dog owners who prefer not to use any of the preventive drugs at all. “Some dogs have had bad single reactions to the preventives; others have poor liver function, making it difficult for them to clear the toxins from their system every time the drugs are administered,” explains Blakey.
For these dogs, Blakey recommends the use of homeopathic nosodes for heartworm. Nosodes are prepared in the same fashion as other homeopathic remedies. The active ingredient substance is super-diluted, and then shaken vigorously or “potentized,” following dilution, a process which is thought to transfer the medicine’s healing properties to the water.
Most homeopathic remedies consist of plant, mineral, or animal products that are intended to emulate the first, tiny symptoms of a disease, thus triggering the body to mount an offense against the unwanted condition. Nosodes differ in that they are made from a product of the disease, such as pus, or infected blood, that is so diluted that no more of the substance exists. Homeopaths explain that the “energy” of the disease is still present in the nosode preparation, and, properly administered, the nosode will trigger the body to produce an immune response intended to battle the invader. In this case, the heartworm nosode is intended to trigger the dog to produce antibodies that are capable of destroying the larval form of the heartworm.
No studies have ever been conducted on the efficacy of this approach for preventing heartworm infestation, but Blakey claims that she and other homeopathic veterinarians have seen success with it. She cautions dog owners who want to use this methods that they had better be committed to backing up this approach with other immune-system builders such as the best diet, and avoidance of unnecessary vaccines and pesticides.
A Conservative Approach
California veterinarian Nancy Scanlan says that while she agrees in theory with the idea that a person can prevent their dog from getting heartworms by keeping their immune system ship-shape, she doesn’t know of anyone who cares to test the theory on their own dogs. Dr. Scanlan, who has been in veterinary practice for 27 years (the last 10 with an all-holistic practice) characterizes the holistic treatments she recommends for owners concerned about heartworm as “complementary,” rather than “alternative.”
That doesn’t mean she sees this role as less than valuable. Though the preventive and treatment drugs can save dogs’ lives, she says, they can and do have serious effects on dogs’ health. That’s where holistic treatments can really shine, says Scanlan.
First, Dr. Scanlan recommends using the homeopathic remedy called Thuja 6C to help the dog clear his system of toxins, on the day of, and two days following treatment with the monthly preventive drugs.
A big fan of daily antioxidant use, Dr. Scanlan regards the use of antioxidants before and after giving the dog (especially older dogs) preventive drugs as absolutely critical. “Supplementation with vitamin E and C are the absolute minimum in this application,” says Scanlan. “The older the dog is, the more likely it is that I will also prescribe supplementation with superoxide dismutase (SOD, an antioxidant used by the body to counteract harmful free radicals), CoQ10 (an enzyme that has been shown to improve heart and circulatory function), and Pycnogenol (a powerful antioxidant derived from the bark of the French Maritime Pine Tree). These substances help the dog decrease inflammation, and help the liver process toxins and waste products.”
Because vitamin E is a fat-soluble substance, and can cause side effects in doses higher than the maximum amount suggested, Dr. Scanlan advises that dog owners check the total amount of vitamin E a dog receives from his food and other supplements. She recommends the dog receive between 100-400 IUs of vitamin E per day, depending on their size (100 IUs for small dogs, 400 for large dogs).
Vitamin C, on the other hand, can be given to the dog in whatever amounts his bowels will tolerate (diarrhea will occur if the dosage gets too high). For dogs receiving heartworm preventive drugs, she recommends giving them 250 mg to 2,000 mg twice a day, depending on their weight. She prefers the Ester C vitamin C products, except for dogs who have overly alkaline urine; those dogs are better off with the ascorbic acid forms of the vitamin.
Support for Immiticide
If a dog has tested positive for heartworms and the owner wishes to treat him with Immiticide, the safest and most effective drug for killing the adult heartworm, Scanlan recommends the use of nutritional supports to help the liver accomplish the huge task of ridding the dead, toxic worms from the body. She prescribes the Silymarin marianum (milk thistle), an herb with a long history of use for liver ailments. Her favorite source of the herb is a product called Oxygenics, which also contains minerals that assist liver function. Depending on the dog’s size, she would administer 1/4 to one tablet per day for the duration of the time the dog is recuperating from the Immiticide treatment.
A lesser-known nutritional supplement to help the dog’s liver is raw, fresh beef liver. Scanlan recommends giving the dog a small piece of fresh liver (one tablespoon for big dogs, one to two teaspoons for smaller dogs) each day while he is dealing with the aftereffects of Immiticide treatment, and for at least 30 days afterward.
There has been some discussion among dog owners about the use of an herbal supplement called Paraway made by Enrich Corp. It contains black walnut, as well as a number of other herbs commonly used against intestinal parasites. These herbs include pumpkin seed, wormwood, clove, sage, garlic, and more. While the product is intended for treating parasitic organisms in humans, some dog owners have tried giving it to their dogs for heartworm infestations. “I’ve never heard of anyone having success with Paraway for heartworms,” says Dr. Scanlan, adding, “It’s really aimed at parasites that live in the gastrointestinal tract; there is no reason to believe it could kill worms living in the cardiovascular system.”
If a dog owner is uncomfortable using any of the above therapies as an alternative to, or an adjunct for, traditional treatment, Dr. Blakey and Dr. Scanlan suggest a number of ways that the conventional treatments can be modified to make them gentler.
If a dog who is hosting heartworms has proved to be sensitive and reactive to medications, if his health is poor, or if he is carrying a particularly high heartworm burden, his veterinarian may choose a modified Immiticide treatment.
The usual protocol (Fighting Cases of Heartworm in Dogs, May 1998) is two injections of the drug, delivered intramuscularly 24 hours apart. The first injection generally kills the weaker worms, and the rest of the population in killed with the second injection. The success of this regimen depends upon the dog’s ability to absorb and “shed” all of the dead worms within a fairly short period of time.
In the modified treatment, a single injection is given to the dog, and he is given four to six weeks to recover before further treatment. In most cases, a veterinarian will run a blood test to make sure that the dog’s liver is functioning properly following the tremendous challenge posed by the disposal of the first batch of dead worms. If the test indicates the liver is functioning well, the veterinarian will proceed with the standard regimen of two doses, 24 hours apart.
Modifications may also be made to the traditional preventative regimen. Unlike the conventional treatment protocol, where only one acceptable drug (Immiticide) is available, dog owners can choose between three conventional preventatives. Fewest side effects have been reported from use of Diethylcarbamazine (DEC), the drug that has been on the market the longest, and this is the choice of many owners of chemically sensitive dogs. Much less convenient to the owner than the other drugs, DEC must be administered every day, and must not be given to any dog that may have circulating microfilariae.
Both Blakey and Scanlan point out that the treatment regimen of both Ivermectin (found in the preventive HeartGard-30) and milbemycin oxime (found in Interceptor and Sentinel) can be safely reduced to lessen the dog’s exposure to the drugs.
The labels of both drugs indicate that for optimum safety, they should be given to the dog every 30 days during the mosquito season. Since both drugs kill all migrating heartworm larvae, and the larvae take 50-70 days to travel from the site of their carrier mosquito’s bite to the circulatory system, theoretically, if the drugs were administered only every 45-50 days, the dog would still be protected. If taking this approach, however, an owner must be organized, since the safety window will be very small.
No matter which approach dog owners decide to take to prevent or treat their dogs for heartworms, all the holistic practitioners consulted agreed on two key issues:
• Use the traditional approach, the alternative approach, or a combination of the two, but use something. Heartworm disease is frightening and serious, and it mustn’t be ignored.
• Testing your dog for heartworm, utilizing the tests for microfilariae and adult heartworms, should be done at least once each year. That recommendation might be stepped up to twice a year if a person is using only alternative methods to prevent heartworm infection. The sooner an infection is treated, the better.
Thanks to Nancy Scanlan, DVM, of Sherman Oaks, CA, William Falconer, DVM, of Austin TX, and Carolyn Blakey, DVM, of Richmond, IN for their help with this article.