Dr. Christina Chambreau is a veterinary homeopath about whom I’ve written before (1,2) because she is both an advocate for magical, pseudoscientific nonsense and against science-based medicine. I have also written about the dangerous advice alternative practitioners, especially homeopaths, often give about the prevention and treatment of heartworm disease, a potentially fatal parasitic infection (3). I recently came across an article which brings these two subjects together, and reminds us why no one who believes in homeopathy should ever be trusted with the healthcare of your pet no matter how much they protest that they are really believers in science or scientific medicine.
Scientific Heartworm Prevention and Treatment
As is the case with vaccines, it is ironic that alternative practitioners try to sow fear and mistrust about the very therapies that have been so successful at preventing and treating a disease which so-called “natural,” pre-scientific practices like homeopathy and herbal medicine were never able to successfully control. They are, of course, correct on the basic point that these agents can have side-effects. Nothing with any effect at all is without side-effects in medicine. That is just the reality of tinkering with systems as complex as living beings. However, the frequency and severity of the risks are consistently less than alternative vets claim, and they ignore the very substantial benefits that offset these.
The best source of science-based information concerning prevention and treatment of heartworm disease is the American Heartworm Society (AHS). Yes, this organization has ties and sponsorship from companies that produce heartworm medications (as one small part of their often multi-billion dollar business) as well as companies that provide heartworm testing and unrelated veterinary products. Does that mean there is some potential for bias? Of course. Does that mean that none of the controlled scientific research done by or referred to by the AHS in making its recommendations is valid and it should all be ignored in favor of the haphazard personal experiences of a few alternative vets? Of course not!
Financial bias can have a subtle influence on both scientific data and the opinions of individuals. But there is nothing unique about the relationship between the AHS and pharmaceutical companies or other industries. Disclosure helps doctors and pet owners be aware of the risks of such relationships, but it is not an excuse to ignore good quality scientific evidence, which contains mechanisms to limit the influence of financial bias. And the alternative veterinary community has exactly the same sort of sponsorships and other financial arrangements with herbal medicine companies, homeopathy manufacturers, makers of other products used in alternative medicine, and schools teaching alternative therapies. These folks are no less under the influence of financial and other forms of bias than anyone else, they simply choose to claim they are and that their opinions and experiences are somehow more reliable than scientific research.
The AHS guidelines for preventing and treating heartworm disease have proven to be very successful at maximizing benefits and minimizing risk, and they are continuously updated and improved as new research is done. The opinions, experiences, and faith of “holistic” vets in pseudoscientific nonsense like homeopathy or unproven hypotheses like herbal remedies are not a trustworthy substitute for science-based guidelines.
Chambreau on Science-based Methods
Of course, in order to promote her own alternative to scientific medicine, Dr. Chambreau has to begin by attacking conventional practices, as alternative vets so often do.
The drugs adversely affect many dogs. Any symptoms can become worse (weakened vital force produces many symptoms).
And her evidence for this is?
Over the years at holistic and homeopathic conferences, various veterinarians have reported problems with each of the preventatives.
[I] have seen few problems. One was a Boston Terrier who tried to re-landscape the yard, moving heavy boulders until we stopped the preventative.
From the AHVMA conferences, many holistic veterinarians feel that dogs do fine [without preventatives]. We all agree that the drug companies are suggesting doses too high and too often.
Hmmm. So despite the scientific research that shows the incidence of adverse effects form heartworm preventatives to be extremely low, a few CAVM vets at a conference think they’ve seen problems, including the obvious side-effect of dogs pushing rocks around because of the toxic meds they were taking. What could be more convincing evidence?
Chambreau on Preventing Heartworm Disease
Keep you dog as healthy as possible using homeopathic principles. A healthy dog will kill those migrating larvae…The solution is to make your dog as healthy as possible by vaccinating the least, feeding the best diet (probably a raw meat…and treat the energy problem…Homeopathy is great for this. A healthy dog will be very unlikely to be ill from heartworms.
In high mosquito hours of the day stay in or use an herbal repellent.
Your dog could become infected…yet not be ill from the infection at all…. A healthy body should tolerate a low level of parasites. Therefore, many clients choose to use no preventative and I support them in that choice.
If you are very afraid of your dog getting heartworms, give the preventative
carefully. Observing your dog will give you clues that you need to try one of the other preventatives or use none at all….Learn how to ask yes/no questions of the universe B dowsing, pendulum, intuition, applied kinesiology talks of checking with nature for all your decisions in life and teaching a yes/no finger method)….You can certainly do energy healing after giving a preventative such as Reiki or Healing Touch which you can learn top [sic] do yourself or go to a practitioner.
Ok, so the best option is to use magic and untested alternative dietary strategies to keep your dog health, and then just don’t worry about it. Your dog might not get heartworms, and if he or she does, all the magic will make it just a minor problem. This is ignorant and dangerous nonsense, of course. There is no evidence raw diets help ward off parasites, homeopathy is completely useless voodoo, and “energy medicine” is just religion masquerading as healthcare. Heartworm disease, on the other hand, is a serious and often fatal malady that can easily kill your pet if appropriate prevention and treatment are not used. This kind of willful blindness to facts and wishful thinking substituting for medical advice is deeply unethical.
As for herbal mosquito repellants, this is at least a suggestion that could be effective if particular remedies were tested to see if they effectively repel fleas, but so far there is no such evidence, so it’s just more wishful thinking. None of the suggestions Dr. Chambreau makes for heartworm prevention have any basis in reality except the use of conventional preventatives, which she presents with unjustified fear-mongering and then suggests be accompanied by several varieties of quackery: Dowsing is superstitious nonsense, Reiki is more faith healing, and applied kinesiology is a delusion or a scam.
Dr. Chambreau on Heartworm Treatment
Treatment of heartworm disease is risky. While the medications used to kill heartworms do have some potential risks, the benefits of treating the disease far outweigh these. And the most significant risk is from the death of the heartworms themselves, which is going to apply to any therapy that is effective, “natural” or not. However, Dr. Chambreau leaps into recommendations that are pure fantasy with no hesitation, as usual.
Herbs and homeopathic treatment for adult heartworms are about 75% effective.
Most dogs seem to recover from heartworm infection without the conventional drugs and without serious heart problems. There is, of course, a risk that your dog has an energy weakness for heart problems and if infected, will have serious problems. A healthy dog will usually have no heart problems and the worms will die in a year or so on their own.
So despite the overwhelming evidence that homeopathy is nothing but a placebo, she claims a high success rate for it as a heartworm treatment. She also suggests herbal remedies are effective, and while this is more plausible, it has not yet been demonstrated that any herbal treatments are as safe or effective as conventional treatment. Of course, she makes the even more ridiculous claim that a healthy dog won’t need treatment, and then tries to weasel out of responsibility for any dogs who suffer from heartworm infestation by claiming they have an “energy weakness for heart problems,” which is a meaningless bit of misdirection to justify the failure of ineffective or unproven treatments.
Bottom Line
The sort of nonsense Dr. Chambreau recommends is often dismissed even by skeptics as fundamentally harmless because homeopathy, Reiki, and many other such interventions don’t actually do anything at all, so they can’t directly harm patients. But the danger of telling pet owners to avoid safe and effective preventatives and treatments for serious disease is great, and substituting magic and wishful thinking for medicine is both dangerous and unethical. It is hard to understand why vets who put pets in unnecessary danger in this way can get away with doing so, but the best those of us committed to science-based medicine can do about it is expose their bad advice for what it is and hope pet owners will be skeptical and wary of this kind of quackery.
This is so frightening to me that there are people out there making these types of recommendations. Living in Texas, giving heartworm preventative is not an option. I am seeing more and more of this on the internet where dog owners are opting out of heartworm treatment in areas similar to where I live. I saw one owner comment on Facebook that since she was not getting bitten by mosquitoes, she knew her dogs were not either and, therefore, she didn’t need to give heartworm preventative. Others, even in areas of high likelihood of infection year round, only give heartworm treatment a few months out of the year, typically spring and summer. All our poodles get monthly treatment year round, even our standard who has IMT. Despite the fact that mosquitoes are not typically going to be active during the winter months in Texas, I just think it is too much of a risk to not treat year round.
I think it’s to much of a risk not to treat year round>>>
I’m not a supporter of the American heartworm society. Like the Avma money is funneled from pet drug companies to support year round Heartworm medication along with annual checkups. Neither annual “preventative ” is evidenced based. Heartworm cannot be completed inside the body of the mosquito if the temperature stays above 57 degrees for at least 45 days straight, both day and night. If the temperature drops below 57 degrees even once during that 45-day period, the lifecycle of the heartworm is broken, and heartworm cannot be transmitted to your dog. What this means, in simple terms, is that a year-round program of “preventative” medicine is NOT needed in most of the country outside of Florida, the Rio Grande Valley of Texas.
Art, thanks for the information. I do know most (all?) vets here recommend monthly in large part due to making sure the client has a regular schedule to administer the preventative to their dogs versus every X number of weeks or X months in the year. I have also read that there was at least one study that showed heartworms are now showing resistance to the medication. Am I actually doing our poodles a disservice by treating them all 12 months of the year?
To me, this kind of insanity is malpractice. Why are people like this allowed to practice? If a veterinarian can have a license suspended for negligence, how is this any different?
The transmission does depend on the ambient temperature, Art. However, that is unpredictable from year to year. We just had the warmest year ever on record in CA, with temperatures well above seasonal norms. So seasonal use of preventatives requires owners to know how hot for how long the temperature has to be in order to know when transmission is possible and then to keep track of the temperature and remember to start and stop preventatives accordingly. That is wildly unrealistic given the data on patient and client compliance with much simpler medication regimes. Year-round prevention in areas with significant transmission risk during some portion of the year is much more practicable for most owners, and there is absolutely no evidence that it has serious risks or that it is riskier than seasonal prevention. There may very well be financial reasons for some to recommend year-round preventatives, but there are also perfectly sound reasons that have nothing to do with money.
And just to be clear, since I know the ad hominem attacks will start any minute, in my local practice area, we don’t have the vector mosquito, so I tell clients that heartworm prevention is probably not necessary at all unless they travel to areas where cases are regularly reported. Some of these areas are quite close by, and I actually do give year-round preventatives to my own dogs since I sometimes take them places outside my immediate area. So far, my large breed mutts have all lived into their mid to late teens and been quite healthy.
So just to head off the inevitable, no one should bother providing anecdotes of dogs injured by heartworm prevention, since I have plenty of my own of dogs who took it their entire lives and thrived, and dueling anecdotes is a waste of time. And no one should bother accusing me of being a heartworm industry shill since I don’t actually recommend the stuff in my own business for most clients.
Dr. Cottrell,
I’ve been asking that question for years. I think what it comes down to, is that the client, if wronged, must be the one to forge a complaint. We never hear about those complaints – and of course the internet, the all-knowing go-to place for all your pet health questions – is so inundated with nonsense and increasingly difficult for owners to find quality information.
I personally think websites from quacks should be proof in a court of law (willfully and negligently practicing malpractice by way of media and dispensing advice without a valid doctor-patient-client relationship).
Here is a guide study on using Heartworm “prevention” seasonal.
http://www.terrierman.com/heartworm-seasonality-knight-LOK.pdf
You should also be aware that once a month labels got FDA grandfathered in for parasite prevention in the 1950. Seargents once a month wormer my dad bought for my first is dog at the supermarket did not do much good in the middle of winter with snow on the ground. If you look at efficacy studies for many Hw “preventions ” results are the same at 30 and 60 days. That may not be true for effectiveness studies. The fda does not require a 60 day effectiveness study to compare for its once a month label.
Some vets say it is okay to give the heartworm pill every 45 days or 6 weeks instead of every month. I have been doing it this way for years without problems. I usually stop for a month or two in winter (frozen ground). Yearly testing.
What’s your opinion?
It might be effective or it might not to extend the dosing interval. The testing used to license the products used 30 days as the interval, so we know it works for that long. In the absence of controlled testing for longer intervals, nobody really knows. The risk of extending the interval without this data depends on the risk of heartworm locally. I would do it in South Carolina or Florida, for example, without being sure it works. Where I work, however, the risk is quite low so it would probably be pretty low risk to try this.
2mo 100% efficacy 3 mo 98% efficacy 4 mo with 95% efficacy
Prevention of experimentally induced heartworm (Dirofilaria immitis) infections in dogs and cats with a single topical application of selamectin.
Vet Parasitol 91[3-4]:259-68 2000 Aug 23
McTier TL, Shanks DJ, Watson P, McCall JW, Genchi C, Six RH, Thomas CA, Dickin SK, Pengo G, Rowan TG, Jernigan AD
In a series of six controlled studies (four in dogs, two in cats), heartworm-free dogs and cats were inoculated with Dirofilaria immitis larvae (L(3)) prior to topical treatment with the novel avermectin selamectin or a negative control containing inert formulation ingredients (vehicle). Selamectin and negative-control treatments were administered topically to the skin at the base of the neck in front of the scapulae. In dogs, selamectin was applied topically at dosages of 3 or 6mgkg(-1) at 30 days post-inoculation (PI), or of 3 or 6mgkg(-1) at 45 days PI, or of 6mgkg(-1) at 60 days PI. Cats were treated topically with unit doses providing a minimum dosage of 6mgkg(-1) selamectin at 30 days PI. Of the animals that were treated 30 days PI, some dogs were bathed with water or shampoo between 2 and 96h after treatment, and some cats were bathed with shampoo at 24h after treatment. Between 140 and 199 days PI, the animals were euthanized and examined for adult D. immitis. Adult heartworms developed in all control dogs (geometric mean count, 18.7 worms) and in 88% of control cats (geometric mean count, 2.1 worms). Selamectin was 100% effective in preventing heartworm development in dogs when administered as a single topical dose of 3 or 6mgkg(-1) at 30 days after infection, 3 or 6mgkg(-1) at 45 days after infection, or 6mgkg(-1) at 60 days after infection. Selamectin was 100% effective against heartworm infections in cats when administered as a single topical unit dose of 6mgkg(-1). Bathing with water or shampoo between 2 and 96h after treatment did not reduce the efficacy of selamectin as a heartworm prophylactic in dogs. Likewise, bathing with shampoo at 24h after treatment did not reduce the efficacy of selamectin in cats. These studies demonstrated that, at the recommended dosage and treatment interval, a single topical administration of selamectin was 100% effective in preventing the development of D. immitis in dogs and cats.
Skeptvet, I think you meant to say in your last post comment, regarding extending the dosing interval:
“I wouldn’t do it in South Carolina or Florida, for example, without being sure it works.”
I suppose it’s a risk (dose every 6 weeks). I wasn’t being cheap, just wanted to give them a break from the chemicals…
“I wouldn’t do it in South Carolina or Florida, for example, without being sure it works.”>>>>
The problem with that is that this is promoted as a “preventative” not a wormer. Preventatives according to David Sackett should require a different higher level of evidence than a treatment. And the last time I checked there were 100% effective efficacy studies for all the macrolid monthly Heartworm medications at 60 days. It’s against the law to sell frontline off label because it’s a epa regulated product. All you can do is tell the client in England it has a give every three month label. But the FDA regulates our “monthly” Heartworm medication so we can legally direct clients to use it more often or less often than once a month if we choose not to promote monthly preventative medicine without a rct to support its usage. Personally I think “monthly” is economically not medically conceived.
The other thing a lot of people don’t realize is that the heartworm pill works backwards, meaning that it kills the worms from the month prior, not the month ahead. Something to keep in mind if you stop it in the winter. Correct me if I’m wrong.
Excellent reference, Art, thank you.
I don’t see any information about the efficacy at 3 months or 4 months as you state, however. The study showed 100% efficacy when the preventative was given as much as 60 days after inoculation with heartworms. This makes some sense in that we know the preventatives work by killing larvae dogs have already been exposed to. This would mean that a regular monthly dose would protect dogs exposed 30 days prior from developing adult heartworms. This study simply shows that if an owner is 2-4 weeks late in giving a dose, there is still 100% protection with this agent. That would justify giving this preventative every 2 months rather than monthly, but it doesn’t address the level of protection when given every 4-6 months. Did you find this info in another study somewhere?
Yes, that’s what I meant. Thanks!
Right, which gets to the other side of the risk/benefit analysis. We know the preventatives work if given monthly. There is some evidence that some may work equally well given less often, though it isn’t entirely clear how little you can get away with for each preventative, and it depends on the local conditions, and so on.
However, the other side of this is what benefit is there to giving less? There is also zero evidence that “a break from the chemicals” has any beneficial health effects. I am certainly in favor of not giving unnecessary treatments, which is why I don’t recommend heartworm prevention in my area. However, I am also in favor of not avoiding necessary treatments if there is no evidence that they are harmful. If the risk is low in your area, it’s perfectly reasonable to give heartworm preventatives only as seasonally indicated, or not at all. However, if the risk is high, I wouldn’t reduce the amount you give in order to avoid a health risk that there is no evidence to suggest really exists.
This is the same reason people argue for curtailed vaccine schedules or giving less than a “full dose” of a vaccine to small animals, and in that area the evidence is clear that these are choices which increase, rather than decrease, health risks. It is not as clear in the case of heartworm prevention how much risk there is to giving less, since it depend on amny factors, but it also isn’t clear that giving less has any benefits.
Again, it’s about risk vs benefit. The risks of giving less depend on the local incidence of heartworm, the season, and the efficacy of the agents. If there is good evidence that they are just as effective given every 2 months instead of monthly, as you’ve shown for selamectin, then that is a perfectly reasonable thing to do (though, again, I think you are ignoring the risk introduced by the lack of compliance with this more complicated dosing schedule). However, if there is no reason to think that monthly dosing safer than less frequent dosing, then the appropriate thing to do is present clients with the evidence and let them decide. Plenty of clients may choose monthly dosing since they recognize they are unlikely to remember an every-other-month regime and the difference in cost is less important to them. Even if financial bias encourages a recommendation of monthly rather than every other month from the AHS, that doesn’t automatically mean we should tell people to give the preventatives every other month if this isn’t going to make the risk/benefit ration better for the patient.
Can we at least agree that the AHS recommendation makes more sense than Dr. Chambreau’s, which is, after all, what this post was about? 🙂
Doctors that sell homeopathic medicine in my opinion need to go to jail but those who control the Avma support allowing the vet hospital down the street from me to advertise homeopathic medicine on their website within Avma ethical guidelines.
*****
Canine Heartworm Disease: Current Treatment and Prevention Approaches
Clarke Atkins, DVM, Diplomate ACVIM (Cardiology, Internal Medicine)
North Carolina State University
Prevention
The introduction of the macrolide agents ivermectin (HeartgardR), milbemycin oxime (InterceptorR), moxidectin (ProHeartR and ProHeartR 6) and selamectin (RevolutionTM) has provided the veterinary profession with effective heartworm (HW) preventatives in a variety of formulations. Such agents, because they interrupt larval development during the first 2 months after infection, have a large window of efficacy and are administered monthly or less frequently. These agents are superior to diethylcarbamazine (DEC) in: convenience; producing less severe reactions when inadvertently given to microfilaremic dogs; allowing a grace period for inadvertent lapses in administration; efficacy with treatment lapses of up to 2-3 months when used continuously for the next 12 months1; and lastly, having a dual role as microfilaricides.2-4
Ivermectin, a chemical derivative of avermectin B1 which is obtained from Streptomyces sp. is effective against a range of endo- and ectoparasites and is marketed as a once monthly heartworm preventative. It is marketed in a form with pyrantel pamoate to improve efficacy against intestinal parasites (Table 1). Macrolides offer a wide window of efficacy and provide some protection when treatment lapses (of up to two months) occur. This is extended with continuous 12-month administration post-exposure to 3 months with 98% efficacy and to 4 months with 95% efficacy.1 As stated above, ivermectin is microfilaricidal at preventative doses (6-12 µg/kg/month), resulting in a gradual decline in microfilarial numbers. Despite this gradual microfilarial destruction, generally mild, adverse reactions (transient diarrhea) can occur if administered to microfilaremic dogs.5,6 Collies have been identified as a breed in which certain individuals are at increased risk of central nervous system signs and even death due to increased concentrations of ivermectin in the central nervous system. It is important to note that such adverse reactions have not been identified at preventative or even microfilaricidal doses of ivermectin. When used appropriately, ivermectin is virtually 100% effective in preventing HWI. Additionally, recent studies have shown ivermectin to have partial adulticidal properties when used continuously for 16 months.7
I’m so disheartened to see quacks are convincing caring dog owners to forgo HW prevention. This advice has real consequences. What happens when the HW+ dogs under this quack’s “care” go “Caval”? Do the scammed owners believe that kind of disease progression is due to problems with “energy fields”? Or do they then finally turn to good surgeons at the end, who then have to try to pull the mass of worms out of the chest manually in a last-ditch effort to save a dying dog?
In the German Shepherd rescue I volunteer with, about 60% of the purebred dogs we pull from Louisiana shelters are HW+ upon rescue. Even the ones who test negative are very likely to turn positive positive 6 months later, so the real infection rate is closer to 75-80% I think. It’s staggering. I’ve seen what dogs go through in the final stages of HW disease in public shelters, and it’s not a “good” death. It’s a slow, very miserable way to die. The idea of one of these “professionals” allowing a dog to die that way by not treating is unconscionable– even treating with “slow kill,” which has plenty of issues, is better than NO treatment. The idiocy of arguing that a HW+ dog showing no clinical signs is in no danger really pisses me off — I’ve had a good dog, barely a year old, die in my foster care during treatment when she threw a pulmonary embolism. She had to be rushed to LSU’s ICU in the middle of the night, and passed anyway, despite pred, strict crate rest, completely lockdown on all physical activity, and doing everything according AHWS protocol for treatment. To lose a good dog to a totally preventable disease really, really hits hard.
The bitter reality is that immiticide treatment is expensive, and very painful for the dog, followed by months of frustrating crate rest. It’s ghastly, and I hate it. Anyone who thinks HW is worth the risk because it’s “treatable” (something I’ve seen holistic people argue on message boards) fails to realize this arsenic-based treatment is many, many times more toxic to the dog than a wee-little dose of ivermectin in a Heartguard pill. The alternative of allowing the disease to progress is worse though.
The cost argument against HW prevention is also nonsensical. Most vets in my region will gladly write a RX for Pet Trust (generic equivalent of Heartguard) to be filled at Walmart’s pharmacy for under $30/6 pills — less than $5 month! Some will even price match with Iverhart or TriHeart (more generic equivalents) to keep the sale in-house and monitor compliance — I know of many good vets who would rather sell that stuff at near-cost to keep owners using it than see patients turn up HW+. A few even sell it one dose at a time to financially strapped clients, who come in each month to buy one pill or tube. These are good vets who care about their patients and do everything they can to keep clients using prevention. Not every client has to have Trifexis or Revolution — cheaper, older products are better than sending them home empty-handed.
As for the “every other month” argument? Not in the Land of Ivermectin Resistance! (See the Auburn study on ivermectin resistance, linked below.) It apparently takes MULTIPLE, CONSECUTIVE doses for many products to work against the resistant strain (with the exception of Advantage Multi, which works in 1 dose). Those of you up north that don’t have the resistance strain need only wait a few years — at the rates that southern HW+ shelter dogs are transported up North for adoption, it’s just a matter of time until it spreads nationwide. It sucks…but the writing is on the wall. Some of those every-other-month clients will then probably wish they’d dosed more often, unfortunately.
Veterinary Parasitology 176 (2011) 189-194:
http://www.bayerdvm.com/show.aspx/blagburn-study-vet-parositol
See p. 193: “Results of this study indicate that prevention of experimental infection in dogs infected with the MP3 laboratory strain of D. immitis in dogs may not be possible with single doses of all ML heartworm preventive products.”
see p. 194: “Results reported herein indicate that not all available
heartworm preventive products are effective against the
MP3 strain of D. immitis when applied as a single treatment
30 days after experimental infection”
So wait does this mean that food grade diatomaceous earth is not a healthy safe way to provide heartworm preventative for my cats and dog? Is it still ok for fleas, tapeworms, roundworms, hookworms, and whipworms. It seems to be working so well so far. Although haven’t been on it very long yet. This is suppose to be helping their over all health also. I’ve been seriously thinking about starting it myself. Didn’t get idea from Dr Christina but her name did come up and I saw your discussion here seeming to down all homeopathic solutions. What is your view on this one that has been used by farmer’s for decades? And Does it prevent heartworms??? So far I haven’t used on my dog at all because I felt with her trifexis it would kinda be double medicating. The cats(which are all spoiled and kept indoors at all times) are doing so well and last flea battle won victoriously. Litterbox smells good, hair looks great, and overall looking very healthy. I thought my dog could use this stuff….hmmm. Could it replace her meds too???? So here I am asking a skeptic because she’s my baby and heart worms are way too serious to just try and see.
1. There is NO alternative heartworm preventative that has shown to be effective, whereas the conventional products have been tested and we know they work. Even most holistic vets are clear that if heartworms are a risk in your areas, you should be using a conventional heartworm preventative. Diatomaceous earth isn’t going to do anything for heartworms anyway because it stays in the GI tract, and the larvae are injected into the blood directly by mosquitos. It could theoretically have an impact on GI parasites, but this has never been tested in dogs. It has some weak effects on parasites in chickens in a few studies, and can be used environmentally to reduce flea populations, but there is no evidence for it as an internal parasite preventative.
2. Homeopathy does nothing, ever. People will say they have used it and seen things happen that they credit to homeopathy, but in 150 years since it was invented, no good-quality scientific proof of any effect has been developed. There are many studies, most of which full of bias and done by true believers, but an objective review of the literature finds no convincing evidence. The theory behind it is nonsense, and the reality is it should never be used as a substitute for real medical treatment. I have written about his subject many, many times, so if you are truly interested you can look at previous articles in which I have reviewed the theory and the evidence concerning homeopathy in great detail.
“As for herbal mosquito repellants, this is at least a suggestion that could be effective if particular remedies were tested to see if they effectively repel fleas…”
Why did you bring up fleas here? It’s only mosquitoes that transmit heartworm, correct? Did I miss something?
Also, on the note of resistance: I know infrequent dosing of heartworm prev. is being linked to heartworm developing resistance (any comments?)
I’m wondering if dosing every month all the time might not eventually cause the same thing? It seems less problematic than on-and-off dosing, but nonetheless..?
(But then again I don’t see much of a safe alternative here… what, let the heartworms proliferate without the effect of medication so at some point later they’re more sensitive to it, assuming any of them are somehow already that resistant? LOL NO THANKS)
I’m particularly wondering this with the frames of reference of:
1) antibiotics (part of the resistance problem there is overuse directly by people taking them unnecessarily, and indirectly by being fed to all our horribly-raised livestock, correct?
Although yes yes I do know that bad compliance with antibiotic regimens is part of it too :b), as well as
2) flea medications (in my area, frontline has been essentially ineffective for years, at least from what I hear from pet owners. It was a highly popular brand so it seemed like perhaps its year-round usage may have been related, although I’m realizing I really have very little actual data on what caused this. Are you familiar with this?
On that note, do you recommend year-round flea prevention or just treatment once fleas are already there?)
P.s. love your site, as usual. Many hours slip away from me some days perusing and reperusing your very entertaining and thoughtful analyses :b
Although I would note, you’ve stated somewhere on here that your criticisms of alternative vets are always “respectful,” but your tone of them is often quite scalding and mocking. And while this is – arguably – appropriate, (and as much fun as I have to admit it is to read these soundly-reasoned verbal lashings), especially for some of the more egregious cases, I’m not sure I would call it respectful, and I can imagine it might intimidate and alienate some wa/ondering souls trying to find answers. Just a thought 😉
P.s. love your site, as usual. Many hours slip away from me some days perusing and reperusing your very entertaining and thoughtful analyses :b
Although I would note, you’ve stated somewhere on here that your criticisms of alternative vets are always “respectful,” but your tone of them is often quite scalding and mocking. And while this is – arguably – appropriate, (and as much fun as I have to admit it is to read these soundly-reasoned verbal lashings), especially for some of the more egregious cases, I’m not sure I would call it respectful, and I can imagine it might intimidate and alienate some wa/ondering souls trying to find answers. Just a thought 😉
Dammit sorry for the half-duplicated comment :p