HW+ and possibly pregnant (what to do?)

I have no idea but I wanted to give you my support. Thank you for giving this girl a chance. I hope everyone comes through it fine.

Man, I would have a long talk with the vet.  An x-ray may not tell you anything quite yet

Much depends on how heartworm positive she is (there ARE degrees) -- and I'd talk to the vet about giving her a dose of Interceptor just to kill microfilaria *BEFORE* (like days before) the spay.  You'd have to keep her very quiet, b/c the body has to filter out the dead parasites from the blood.  But on the other hand ...

I'd also want to know what the immiticide might do to any developing pups if they want to give her the HW treatment before they spay.  You wouldn't want to kill any fetus and then have her body retain it - that would be pyometra the hard way and she doesn't need more.

Typically I would say the heartworm treatment would be the one that could wait as long as it's not impairing her breathing *now* (and if it is, she's not a candidate for the immiticide anyway). 

 Logically, to spit this out chronologically -- typically they want to wait 3 weeks after heat for the tissues to return to normal and they should know *then* if she's pregnant or not.  If she's not pregnant then that gives you leeway to treat her for heartworm and *then* spay her before her next heat??

In short -- heartworm treatment doesn't have to be done this minute -- you will want to exercise real caution with your others to make sure you give them their 'preventive' because this dog is a heartworm "factory" right now.  but waitng a couple of weeks isn't going to make a huge difference -- you want her to be in the best shape for whichever procedure. 

fwiw -- they should not need to "put her under" for heartworm treatment.  It's not surgery.  It simply requires her to be extremely sedentary.  Or did I misunderstand what you said up there -- were you talking about the hw positive being a concern during *spay* surgery?

Am I making sense (I hope?)

Is the vet going with the Imiticide?  Because you can treat the heartworm the "slow" way, with Doxicycline and Heartgard.  It does work and is less expensive.

I don't know that I'd put her through the Imiticide treatment and spay her too close together since the die-off of heartworm carries the risk of blood clots.

If she is already pregnant, I'd think the Imiticide would present a risk to the pups.

Do you feel comfortable asking the vet all these questions, or possibly getting a 2nd opinion?  I definitely wouldn't do anything without medical guidance, but do trust your gut feelings, too.

 I definitely want to talk to the vet some more.  I missed his call yesterday so I didn't get to ask too many questions.  I'm definitely trying to prepare a list for him for when I bring her in early next week. He was wanting to do imiticide, not the slow kill.  I want to ask why he wants to do that method.  I do trust my vet, he's treated all our dogs in the past, and there was a reason he wanted to go with imiticide, but like I said, I didn't speak to him directly. 

 IF she's pregnant, which we don't know at this point, she's only been out of heat for 2 weeks. So if she's pregnant, she's not very far along.  How long before we can know one way or another if she is pregnant?  If she's not then we can wait some time and just do the HW treatment and spay once she's recovered.  That would simplify things a lot.

 She is not very far along HW wise either.  She has no outward symptoms of HW infection at the present.  No issues breathing or any of that.  She is extremely active and healthy looking. 

 Poor little girl.  Someone dropped the ball for her. 

You can know within 30-40 days, if she is in whelp by doing either a Relaxin pregnancy test (you can uy these online but you need blood so vets typically do the test...or your vet can order it direct) or an u/s at that time. If you see no heartbeats on Uu/s at 30-40 days you can be reasonably sure she is not preggers. DO NOT go by simple visual signs because false pregnancies are very common.

I would go ahead with the treatment now...the sooner the better, if it were me and she is carrying a LIGHT load of worms I would simply do the monthly preventative method to wait out the adults and kill the baby worms much cheaper and IMO works just as well PROVIDED the load is light to barely moderate.

IMO if she is pregnant she is JUST barely pregnant and the drugs from the heavier duty treatment plan she might be on will obviously most likely keep it from sticking and solve the issue for you. That is just what I would do. If she were not hw+ I'd have already spayed her, pregnant or not tho so there you have it. The bitch and her health comes first...pups that may or may not have grown to viable age...may or may not survive a birth...and may or may not survive long enough to be adopted, are always secondary to any bitch of mine's...health.

 The original plan was to get her spayed this week or next week but that was prior to finding out she was HW+.

I wanted to wait a couple weeks just in case an owner showed up but no one has.  Not surprising but I was kind of hoping they would. 

 Thanks for all the suggestions.  Got a lot to think about, but either way we're starting treatment beginning next week for sure.  Her health definitely comes first.   I think I will hold off on the spay for now at least until we know if she is for sure pregnant.

Laurelin_429

He was wanting to do imiticide, not the slow kill.  I want to ask why he wants to do that method.  I do trust my vet, he's treated all our dogs in the past, and there was a reason he wanted to go with imiticide, but like I said, I didn't speak to him directly. 

And before I say *anything* I agree with Gina 100%.  I was just plain giving you some logic cos it's hard to know how "urgent" heartworm might be otherwise.

The advantage of the imiticide is it's faster.  typically they do a couple of shots -- spaced 3 weeks to 2 months apart.  It can be painful -- more for some dogs than others.  (I suspect it's the drug that is used that causes a lot of muscle soreness in some dogs but I don't know that for a medical fact - just observation)

Usually vets want to do the imiticide because it's vet-controlled.  They aren't at the mercy of an owner (or potentially an adopter) who "says they'll do it" but they just plain don't.  Now you, Gina and I??  If we say we're GONNA we **are** gonna.  But the average Joe Adopter isn't.  So if there's a possiblity she will be placed they aren't going to want to do the slow kill because likely it won't get done!  AND if you do it with weekly or monthly administrations of ivermectin there's a period of time where they still can manufacture microfilaria and pass it on to other dogs (by getting bitten by a mosquito) AND every single time the ivermectin is administered you have to be uber careful that she doesn't get at all riled up because whatever parasites die then have to be re-absorbed by the body and they can be at risk of stroke/embolism.

That said -- Gina and I are both on the same page -- the slow method is much easier on the dog and it's much much cheaper.

I'm glad you're going to talk to your vet -- often just by asking what *their* logic is you'll find the answer to the whole question.  Good luck for sure!!

Another factor to throw in here is has she had a litter before? 

Factors that increase the chances of hemorrhaging are
(1)  spaying soon after a heat (uterus is still engored)
(2)  spaying when the bitch is pregnant
(3)  spaying when the bitch has had previous litters.

Especially if #3 you want to check her clotting ability and you want her monitored for 24-hours after the spay.  The latter means having her overnight in a manned facility.  I have heard enough stories about hemorrhaging after a spay to be extra cautious with a female that has had pups.

If #3 I would also want a board-certified surgeon, but that gets expensive. 

Spaying soon after a heat can also throw a female into a false pregancy.  Found that one out the hard way.  My little terrier was whimpering and wandering around with a squeek toy in her mouth.  I took her back in to the vet because I thought something had gone wrong with the spay and that she was in pain.  Nope - she just felt like she was missing some puppies. 

janet_rose

If #3 I would also want a board-certified surgeon, but that gets expensive. 

Spaying soon after a heat can also throw a female into a false pregancy

I have MANY breeder friends that retire bitches that have had 1-3 litters. Never have I heard of this causing extra problems on the table.

False pregnancies are COMMON in bitches spaying them or not, you cannot possibly know she would have not had one, anyways. Almost every girl I have had has had at least one, ranging from merely "looking" preggers for 2 months, to full blown moody acting "where are my babies" nonsense.

YES it is riskier to spay a bitch close after a season and yes it is riskier to spay a bitch carrying a litter/abort a litter.

rwbeagles

I have MANY breeder friends that retire bitches that have had 1-3 litters. Never have I heard of this causing extra problems on the table.

Glad you and your friends have never run into this issue.  Not everyone is so lucky! 

Below is a quote from the story (2003) of someone that nearly lost her Basenji.   Clotting tests were done before the spay surgery, so that was not the problem.

The info in red below came from the ER staff that saved her dog.  ER clinics would be in the best position to determine which females were at the greatest risk during spay surgery since their business is emergencies. 

http://www.newworldbasenjis.net/Mirrie's%20Spay.htm
"IN THE END:   I will never again spay an older bitch who doesn't REQUIIRE spay surgery for some reason (pathology, etc.). I sent a healthy, happy 8 yr. old girl to surgery, and a few hours later, she was literally at death's door. I realize that there is no such thing as routine surgery - however, what I did NOT KNOW and what I know now (from my conversations with the ER clinic staff) is that these kinds of life threatening complications are NOT as uncommon as we might like to think... And that spay surgery on an older bitch who has had litters is a FAR MORE risky surgery than spaying a puppy or a young bitch who has not had litters. Apparently the vascularity of the entire area of the uterine horns and ovaries makes hemorrhaging a FAR greater risk for matron bitches. The ER vet told me that a "surprising number" of older bitches are lost during/immediately after spay surgery every year. If I'd known this, I  would never have made the decision to have Mirrie spayed. I simply thought it was "the right thing to do" since I no longer intended to breed her (turning the reigns over to her daughter, who is five).  Famous last words... 

In case anyone is wondering, nothing in Mirrie's blood work up indicated any kind of clotting or bleeding problem. Her pre-surgery blood panel was (per my vet) "text book perfect".... Her platelets were normal and per the ER vets, her clotting time was completely normal.  It was the somewhat mysterious tear into the soft tissue near the site of her left ovary that caused the bleeding -- and very nearly took her life."

Another interesting spay issue is ovariohysterectomy (OVH) vs ovariectomy (OVE).  The latter does not remove the uterus, but pyometra is not an issue because that disease requires progesterone, a hormone produced by the ovaries.   

OVE is popular in many other countries and is much less invasive a surgery than OVH. 

http://speakingforspot.com/blog/?p=1931
http://www.petconnection.com/blog/2011/03/15/a-better-way-to-spay-your-dog-that-you-probably-never-heard-about/

Read the comments, too - very interesting discussions!

rwbeagles

False pregnancies are COMMON in bitches spaying them or not, you cannot possibly know she would have not had one, anyways.

I just believed what the vet told me.    He blamed it on spaying too soon, but I bet that you know more about false pregnancies than he did.