Saturday, October 15, 2011, seemed like a pretty nice day. I took Star (our other dog, a “LabraPit”) and JoLee into the vet clinic for nail trims, and, for Jo, his routine vaccinations. As part of JoLee’s first annual exam, Dr. Grosch took a blood sample to test for heartworms. As she drew his blood, I laughed and said, “It’s not like he lives outside or anything - you’re just wasting your time.” And, I thought, wasting my money. I couldn’t have been more wrong.
After the vet appointment, the dogs and I continued on to Pioneers Park, where we had a nice, leisurely Saturday morning walk in the beautiful fall sunshine. I threw the frisbee for JoLee, and he and Star played until they were worn out.
There were two phone messages waiting when I got home. The first was from one of the vet techs at Animal Haven, who informed me that JoLee’s rabies tag was still there at the clinic - I could come by and pick it up any time. The second message was also from Animal Haven. It was from Dr. Grosch, who said, “There’s a problem with JoLee’s heartworm test. It came back positive.”
No way, I thought. It must be a mistake. I called the clinic back immediately. It couldn’t be positive. JoLee had been on heartworm preventative since he was six months old - it had to be a false positive.
After she answered the phone, Dr. Grosch said, grimly, “Can you come down? We need to talk.”
I literally dropped everything and drove to the clinic. When I got there, the other vet in the two-vet practice was in the back room, and when he saw me, he shook his head regretfully, said, “I’m so sorry,” and clapped me on the shoulder. Dr. Grosch offered to show me the slide with a smear of Jo’s blood that was still under the microscope. She said she saw “swimmers” (something highly desired in semen samples, but not so much in blood samples), and when she couldn’t find them right away (“they don’t last long outside the body”), she showed me the test device used for the initial sample; a small white plastic holder with a receptacle for a drop of blood - very much like the diabetes tests used to keep track of blood sugar levels. “See here?” Dr. Grosch pointed to a small panel below the blood receptacle. “This is where it shows the results. If a blue dot appears, the test is positive.” Sure enough, a pale blue dot was unmistakably visible. “I couldn’t believe it, myself,” Dr. Grosch continued, “So I looked at a sample under the microscope, and there they were.”
I trailed after her into the exam room.
“He was on preventative,” I said, shaking my head, confused. “It was the generic kind, but he was on it the whole time! How could this happen?”
“Well,” she said, “It could be that you got a bad batch, or that an infected mosquito got to him at just the right time, if you were a day late giving him the heartworm pill.” She studied the ceiling for a moment and then took a breath. “I don’t want this to sound judgmental, but I know it will. If you had been getting your heartworm preventative through us, Merial would have paid for the treatment. Unfortunately, the treatment for heartworms costs between $600 and $800.”
Looking me in the eye, she continued. “Heartworm is a fatal disease,” she said, “But the treatment is nearly as bad.”
Dr. Grosch went on to explain that the treatment for heartworms is derived from arsenic, and consists of two extremely painful injections given to the dog deep in the lumbar muscles in the small of his back.
“He could die from the complications of those injections,” she said. “There is the chance of anaphylaxis, serious breathing issues or verminous pneumonia. He would have to stay here at the clinic for two or three days, and after that, you would have to keep him as quiet as possible for two months.” She paused a minute to let that soak in, and then continued. “He could also die at any time during that period if a large piece of a worm broke off and migrated outside his lungs and blocked a blood vessel.”
I got tears in my eyes as I thought of my bouncing baby boy, who loves frisbee-catching and wrestling; who lives to chase balls and go for long walks.
“And it gets worse,” she continued. “The manufacturers of the treatment are having problems making it, so there’s a shortage. I only have one dose here right now, and it takes two.”
She patted the table with one hand. “So, you have several decisions to make. First of all, dying from heartworms is a terrible thing. What happens is that the worms multiply and fill up the arteries. The dog loses weight, because the worms derive all their sustenance from the nutrients in the dog’s blood. They keep multiplying and growing, and eventually, the dog starts coughing, has trouble getting around, and then his back legs stop working. It’s a horrible way to go.”
I stared at Dr. Grosch in disbelief. Could she be suggesting that I might let JoLee die from heartworm disease? “Well, there’s no doubt that I want to treat him!”
She looked relieved. “Okay. Then you have two options.” She leaned against the table.
“Option A is the two-shot approach, where he would stay here for a couple of days while the majority of the worms die, and then you’d have to keep him quiet so they didn’t clot up and move outside his lungs.”
“Option B would be to put him on preventative, knowing that it kills only the babies, and just wait until the adults die.”
My brows knit as I considered. “Well, it almost seems to me that Option B would be the way to go - it seems much less traumatic for the dog.”
Dr. Grosch looked unhappy. “Honestly, I would recommend Option A - we may have no other alternative, with the shortage and all - but I think that would be the best way to go.”
“Then, that’s the way I will go,” I stated flatly. “I trust your judgment.”
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