We had an eventful visit with Bobby Sue at Parkside last week – she was heartworm positive but had a severe complication called caval syndrome, where the heartworms actually jam up the heart, preventing proper blood flow and causing the destruction of the red blood cells as they try to move past the worms. Bobby Sue’s heartworm disease was so bad we decided the best option was actually heartworm removal surgery!
Bobby Sue was from a fabulous local rescue, Denver Dachshund Rescue and Transport, and needed emergency care for this condition. This wonderful rescue group took on the care for Bobby Sue so that they could adopt her out as a happy healthy dog. When we found out about Bobby Sue and her heartworms we were happy to help!
How Did Bobby Sue Get Heartworms?
Bobby Sue was brought up from the southern part of the US where heartworm disease is much more prevalent. Heartworms are transmitted by mosquitoes. When a mosquito bites an animal that has live adult heartworms, the mosquito also collects small (microscopic!) baby worms that are called microfilaria. These baby worms actually mature into larvae that can infect a new host. The mosquito goes on doing his mosquito thing and bites a dog like Bobby Sue. The larvae are released onto the skin during this process and the larvae use the bite wound as a way to infect the dog.
To make things more complicated, it takes 6 months for the heartworms to reach adult stages which means you’re not likely to see any symptoms for quite a while after infection!
Would you rather watch than read?
So How Did We Know Bobby Sue Had Heartworms?
Bobby Sue had actually already found her forever home but her new parents noticed that her urine was red. Notice we didn’t say she had bloody urine or blood tinged urine. She had red urine. That’s because when we looked at her urine we didn’t see any red blood cells like we would expect from bloody urine. The urine was actually dyed red from the hemoglobin (the protein that carries oxygen in the blood) which means that for some reason the blood cells were breaking apart and making their way into the urine.
The reason? Bobby Sue had such a severe case of heartworms that when the blood was pumped through her heart, the cells were actually being ripped apart as a result of all the worms. This put extra strain on her kidneys which had the job of trying to filter out these fragments. Not to mention the extra strain on her overall health since her blood was less oxygen rich.
When we put together the big picture of the case and discovered how severe her heartworm disease was we decided the best option was to perform heartworm removal surgery. Bobby Sue had started to decline over the last few days as well, and the strain of the heartworms was clearly starting to catch up to this normally happy and bouncy dog.
How Does Heartworm Removal Surgery Work?
It may not be what you think! We actually went in through the jugular vein, which is a large vein on the side of your neck. Once Bobby Sue was prepped and ready for surgery, we laid her on her side and opened part of her neck in order to have access to her jugular. From there, we used an instrument called alligator forceps (check out the video to see them in action) to slowly remove the worms from the right side of the heart. The forceps entered the jugular and made their way all the way into the heart.
These forceps only open at the very tip that so instead of having the entire instrument open and close. This lets us get into hard to reach places, like the right side of the heart via the jugular vein to be specific.
In case you were wondering- it is as gross as it sounds!
These are the heartworms in water, after surgery – all of these were blocking Bobby Sue’s blood flow!
How Many Worms Did The Surgery Pull Out?
We pulled out 27 worms from little Bobby Sue’s heart! As you can see below, some of these worms were 13 inches long! We aren’t kidding when we say that Bobby Sue is little either. She weighs less than 20 pounds!
Whoa, Scary (And Gross)! What Can I Do To Avoid This?
This is why we spend so much time talking with everyone about heartworm disease and preventative! First off, if you ever adopt a dog from the southern parts of the US or your dog spends time there without preventative we highly recommend visiting our veterinary clinic for a wellness exam. But why would you not have your dog on a monthly preventative?! Because we live in Colorado?
Okay, let’s talk about risk management. We already know that this disease comes from mosquitoes. Luckily, Colorado doesn’t have a lot of mosquitos. While that means the risk is decreased as compared with areas of the south, it doesn’t mean there isn’t a risk! And most people want to be able to take their dog into the mountains or other areas that are more likely to have mosquitos without fear. That’s why we urge everyone to start monthly heartworm preventative on their dogs. This simple precaution can protect the health of your dog and give you peace of mind! The best part is, the preventative also helps with common intestinal parasites!
Okay, that ends our public service announcement so let’s back to Bobby Sue and the question everyone needs to have answered!
Will Bobby Sue Be Okay?
Heartworm removal surgery only removes the live worms. It doesn’t fix the damage that has been done as a result of having so many worms living in her heart for so long. Even in cases that don’t require surgical removal of heartworms, the treatment involves that use of a toxic drug that kills the worms. No matter how many worms are present, worms dying in the heart can cause problems and the overall treatment protocol is long.
Although Bobby Sue will have some irreversible damage to her heart, she is feeling much better now! In fact, she was eagerly awaiting treats pretty soon after surgery. Here she is more worried about treats than recovery from her heartworm removal surgery!
This is Bobby Sue, begging for treats just after recovery from her surgical heartworm removal at Parkside.
February Update: Bobby Sue Is Loving Life!
Bobby Sue came back to see us yesterday (although she now goes by Luna) and she looked great! Just in time for Valentine’s Day!
After she had many of her heartworms surgically removed, Bobby Sue received an injection of a drug called Immiticide. Immiticide is used to kill the adult heartworms that we didn’t remove with the surgery or to take care of heartworms that have grown up since the removal surgery. While not as a tough as a surgery, especially one related to the heart, Immiticide carries its own dangers. The drug actually contains arsenic! Remember, these heartworms are living creatures and so many of the same things that are poisonous to them can be poisonous to other living creatures too.
But Bobby Sue wasn’t letting it slow her down! She was happy to see everyone and was still (and always) hoping for a treat or two. The first time we saw this little pup she had a heart murmur, pale gum color (remember, her blood had poor oxygen levels) and low energy. Not today! Between the surgical heartworm removal and the use of the more standard Immiticide Bobby Sue’s worm burden had greatly decreased and as a result, she had no murmur and excellent color!
Bobby Sue spent most of the day with us so we could monitor for any adverse reactions to the injection. In addition to Immiticide, she also has to start a monthly preventative in order to kill any immature worms. Remember, the heartworm removal surgery handled adult worms and the injections take care of the remaining worms but that leaves the earliest life cycle worms. That’s where the monthly preventative comes in.
Most disappointing to Bobby Sue though is the fact that she still has to be on exercise restriction. Even though she is feeling much better, her heart still isn’t 100% healthy (and may never be with how many worms she had!). But more importantly, as adult worms die they can cause a lot of heart problems. That means Bobby Sue’s family has the difficult job of trying to keep her from getting too excited or being too active during her Immiticide treatment.