Monday, June 10, 2019

Canine Heartworm Disease

Heartworm Disease – What Is It and What Causes It?

Heartworm disease is a serious disease that results in severe lung disease, heart failure, other organ damage, and death in pets, mainly dogs, cats, and ferrets. It is caused by a parasitic worm called Dirofilaria immitis. The worms are spread through the bite of a mosquito.  The dog is the definitive host, meaning that the worms mature into adults, mate, and produce offspring while living inside a dog.  The mosquito is the intermediate host, meaning that the worms live inside a mosquito for a short transition period in order to become infective (able to cause heartworm disease).  The worms are called “heartworms” because the adults live in the heart, lungs, and associated blood vessels of an infected animal.  


heartwormsIn the United States, heartworm disease is most common along the Atlantic and Gulf coasts from the Gulf of Mexico to New Jersey and along the Mississippi River and its major tributaries, but it has been reported in dogs in all 50 states.

The Heartworm Lifecycle in Dogs

In an infected dog, adult female heartworms release their offspring, called microfilariae, into the dog’s bloodstream.  When a mosquito bites the infected dog, the mosquito becomes infected with the microfilariae.  Over the next 10 to 14 days and under the right environmental conditions, the microfilariae become infective larvae while living inside the mosquito.  Microfilariae cannot become infective larvae without first passing through a mosquito.  When the infected mosquito bites another dog, the mosquito spreads the infective larvae to the dog through the bite wound.  In the newly infected dog, it takes about 5 to 7 months for the infective larvae to mature into adult heartworms.  The adult heartworms mate and the females release their offspring into the dog’s bloodstream, completing the lifecycle.

Heartworm disease is not contagious, meaning that a dog cannot catch the disease from being near an infected dog.  Heartworm disease is only spread through the bite of a mosquito.

Inside a dog, a heartworm’s lifespan is 5 to 7 years.  Adult heartworms look like strands of cooked spaghetti, with males reaching about 4 to 6 inches in length and females reaching about 10 to 12 inches in length.  The number of worms living inside an infected dog is called the worm burden.  The average worm burden in dogs is 15 worms, but that number can range from 1 to 350 worms.

How is a Dog Tested for Heartworms?

A veterinarian uses blood tests to check a dog for heartworms. An antigen test detects specific heartworm proteins, called antigens, which are released by adult female heartworms into the dog’s bloodstream.  In most cases, antigen tests can accurately detect infections with one or more adult female heartworms. The earliest that the heartworm proteins can be detected in a dog’s bloodstream is about 5 months after it is bitten by an infected mosquito.

Another test detects microfilariae in a dog’s bloodstream.  Microfilariae in the bloodstream indicate that the dog is infected with adult heartworms (because only adult heartworms can mate and produce microfilariae).  The earliest that microfilariae can be detected in a dog’s bloodstream is about 5 months after it is bitten by an infected mosquito (because it takes about that long for the heartworms to develop from infective larvae into adults that mate and produce microfilariae).

What are the Symptoms of Heartworm Disease in a Dog?

The severity of heartworm disease is related to how many worms are living inside the dog (the worm burden), how long the dog has been infected, and how the dog’s body is responding to the presence of the heartworms.  The dog’s activity level also plays a role in the severity of the disease and in when symptoms are first seen.  Symptoms of heartworm disease may not be obvious in dogs that have low worm burdens, have been recently infected, or are not very active.  Dogs that have heavy worm burdens, have been infected for a long time, or are very active often show obvious symptoms of heartworm disease.
There are four classes, or stages, of heartworm disease.  The higher the class, the worse the disease and the more obvious the symptoms.

  • Class 1:  No symptoms or mild symptoms such as an occasional cough.
  • Class 2:  Mild to moderate symptoms such as an occasional cough and tiredness after moderate activity.
  • Class 3:  General loss of body condition, a persistent cough, and tiredness after mild activity.  Trouble breathing and signs of heart failure are common. For class 2 and 3 heartworm disease, heart and lung changes are usually seen on chest x-rays.
  • Class 4:  Also called caval syndrome.  There is such a heavy worm burden that blood flowing back to the heart is physically blocked by a large mass of worms.  Caval syndrome is life-threatening and quick surgical removal of the heartworms is the only treatment option.  The surgery is risky, and even with surgery, most dogs with caval syndrome die. 
Not all dogs with heartworm disease develop caval syndrome.  However, if left untreated, heartworm disease will progress and damage the dog’s heart, lungs, liver, and kidneys, eventually causing death. 

Is There a Treatment for Heartworm Disease in Dogs?

Melarsomine dihydrochloride (available under the trade names Immiticide and Diroban) is an arsenic-containing drug that is FDA-approved to kill adult heartworms in dogs. It's given by deep injection into the back muscles to treat dogs with stabilized class 1, 2, and 3 heartworm disease. Another drug, Advantage Multi for Dogs (imidacloprid and moxidectin), is FDA-approved to get rid of microfilariae in the dog’s bloodstream. Advantage Multi for Dogs is a topical solution applied to the dog’s skin.

The treatment for heartworm disease is not easy on the dog or on the owner’s pocket book.  Treatment can be potentially toxic to the dog’s body and can cause serious complications, such as life-threatening blood clots to the dog’s lungs.  Treatment is expensive because it requires multiple visits to the veterinarian, blood work, x-rays, hospitalization, and a series of injections.     

The Best Treatment is Prevention!

Many products are FDA-approved to prevent heartworms in dogs.  All require a veterinarian’s prescription.  Most products are given monthly, either as a topical liquid applied on the skin or as an oral tablet.  Both chewable and non-chewable oral tablets are available.   Some heartworm preventives contain other ingredients that are effective against certain intestinal worms (such as roundworms and hookworms) and other parasites (such as fleas, ticks, and ear mites). Year-round prevention is best!  Talk to your dog’s veterinarian to decide which preventive is best for your dog.

A dog MUST be tested within 12 months to get heartworm preventive.

The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at 









Monday, October 22, 2018

Providence Veterinary Hospital: Halloween Safety Tips for your Pet

Providence Veterinary Hospital: Halloween Safety Tips for your Pet: Halloween is almost here!  While Halloween is a joyous and thrilling time of year for us, it can create a lot of stress and anxiety fo...

Halloween Safety Tips for your Pet

Halloween is almost here! 
While Halloween is a joyous and thrilling time of year for us, it can create a lot of stress and anxiety for our pets. The constant doorbell ringing and strangely dressed people, with lots of scary costumes and elevated and unusual noises, can stress out many dogs and cats. It’s not unusual for pets, especially dogs, to exhibit physical signs of stress through vomiting, diarrhea, barking and unexpected fearful aggression. Some will even bite when stressed.
 Cats may also vomit or have diarrhea although they are more likely to run and hide.

Veterinarians treat more dogs during this time than usual. These costly and unwelcome visits to the animal hospital emergency room can be lessened if a few precautions are put in place prior to this holiday.

Here are some Halloween safety tips for your pets:

·         Keep them indoors. Halloween pranks can be vicious, especially if you have a black cat. Keep pest in a quiet room with music and a toy, away from activities of the trick or treaters. A synthetic hormone product called Feliway can be sprayed on the pets and around the room to help relieve their anxiety. You might also provide your pets with a long-lasting, treat-dispensing toy to keep them entertained during the height of the trick-or-treat activities. You can buy these products at most pet supply stores. For pets with severe anxiety levels, it may be necessary to consult your veterinarian about anti-anxiety or tranquilizing medications. Visit Providence Veterinary Hospital before the festivities begin to maximize the effects of calming medications.

·         Watch them closely. Be careful that your pet does not dart out the door when trick or treaters appear. 

·         Be sure they have proper identification. In case they do escape the confides of the house, a permanent, implanted microchip and inclusion into the lost pet registry is best. Collars with identification will work too.

·         Don’t take your dog trick or treating. Dogs inside the house you visit may be protective of their territory and charge out of the house to fight with a visiting dog. It’s difficult to break up a dog fight under any circumstances, and almost impossible when dressed in costumes and masks.

·         Keep candles out of reach. An overturned candle can burn a pet’s nose, or even start a fire by catching on papers or curtains. The vapors off a candle may harm pet birds.

·         Don’t let pets have candy. Both the candy and wrappers can be a threat to your pet’s health. Chocolate can be toxic to dogs. Candy may contain the artificial sweetener, xylitol, which is toxic to dogs and cats. Baked products that contain raisins, currents, grapes and chocolate can result in kidney failure in dogs. Candy wrappers and popsicle sticks are often the cause of intestinal blockage that may require surgery to remove.  Dogs cannot unwrap candy, so they eat it wrapper and all. Aluminum foil especially can cause severe intestinal blockage.

·         Keep drugs and alcohol out of reach. It’s never a good idea to allow dogs to access marijuana or baked goods that include marijuana. With the recent legalization of marijuana in many states, the incidence of marijuana toxicity has increased significantly in those areas. Also, alcohol left in glasses or other containers can be toxic to dogs and cats. Keep these substances out of the pet’s reach. If you think your pet may have ingested a toxic substance, call the Pet Poison Helpline at (855) 764-7661 or the ASPCA Poison Line at (888) 426-4435

·         Watch out for garbage. Don’t allow your dog to access garbage containers. Spoiled food containing bacteria and toxic substances such as coffee grounds and chocolate can make them sick. If you suspect your dog has gotten into a potentially poisonous substance, call your veterinarian immediately, as well as the Pet Poison Helpline.

·         Dress them in safe costumes. If you dress your pet in a Halloween costume, be sure that it doesn’t interfere with the pet’s ability to breathe, see, hear, move or bark. Strings and tassels on costumes can become play toys for cats and puppies. These costumes can become hazardous to your pet if not managed properly.  Cats especially like to chew on these items and they can absorb the dyes in the cloth or swallow the material causing intestinal blockage. Glow sticks, if chewed through, can be caustic and burn your pet’s mouth. It’s important to keep these items out of reach of your pets.

Halloween can be a fun and enjoyable time for all family members, including pets, if certain precautions are taken. Plan and take necessary precautions to protect your pets from the hazards of Halloween. Your pets will appreciate it if stress is minimized!

Thank you Dr. Bruce Little for writing the majority of this article. 
The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester,PA. Contact Dr. Herman at 610-872-4000 or visit us at 

Tuesday, December 12, 2017

Anxiety Signs in Dogs and Cats

Providence Veterinary Hospital Newsletter

Common Signs of Anxiety or Fear in Dogs and Cats 

There are common behavioral positions for dogs and cats that are demonstrate anxiety. Particularly around the holidays, it is helpful to know your dog or cat is 1 inch away from a nervous breakdown or freak out. To recognize these signs is to be aware of your pet’s condition and puts you in a position to act to avoid further distress.
Excessive barking



Ears lowered or flattened, or highly erect

Tight lips

Tucked tail



Lifting on front paw

Disinterested in play




Dilated pupils

Flattened ears


Nails extended

Crouching low



Hair standing on end

Inappropriate elimination


Inter-cat aggression

Loss of appetite

The above signs are the most common ones for dogs and cats. Keep them in mind during the holidays. Your pet will thank you!

Have a most Happy Holiday Season

Providence Veterinary Hospital

 The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at 

Monday, February 6, 2017

PetDesk App

Providence Veterinary Hospital is about to launch our own PetDesk app.
The go-live date is February 12th.
If you want to: 
  • Request appointments
  • Receive reminders for everything
  • Save notes and tasks
  • Know when your pet is ready for discharge
  • Access your pets medical history and vaccinations
  • Manage your recurring pet tasks
  • or just ask a general question
  • plus many more functions and information. Download the app!

We need your email to be current, and for you to find us for free in the App Store or Play Store.
Make sure to use your e mail on record with us and with your provider during the sign up.
You may download the app by going to:

The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at 


Friday, November 11, 2016

Cervical Disc Disease

Canine Cervical Disc Disease

You are petting your dog for something he or she did that was good and your dog yelps out in pain for no good reason. Your pet just stands there with a stiff neck, afraid to move. When it turns its head it seems to be in a huge amount of discomfort. We could be looking at a dog with cervical disc disease.

stiff neck and painful
A more common term for cervical disc disease is a ‘slipped disc’ in the neck. The discs are the structures between the bones of the spine (vertebrae) that act as shock absorbers. As in people, discs in dogs degenerate as they get older.
This process results in the discs becoming dehydrated and losing their cushioning effect. They may then ‘slip’ in one of two ways. Firstly, the material in the center of the disc can come out of the fibrous ring and injure the spinal cord. Secondly, the fibrous ring may thicken and compress the spinal cord. Either type of ‘slipped disc’ may cause neck pain and nerve injury.
The Clinical Signs:

Neck pain
Signs of neck pain may be obvious e.g. yelping and crying or rigidity of the neck. More subtle signs include reluctance to jump or climb and low head carriage. Difficulty lowering the head to eat from the floor may be evident.
The Diagnosis

A neurological examination is necessary to detect evidence of spinal cord injury and neck pain. There are many other causes of neck pain and nerve injury in addition to cervical disc disease. As a result investigations are necessary to confirm a ‘slipped disc’ and exclude these other conditions.

Normal survey X-rays of the neck under sedation or anesthesia may reveal evidence of cervical disc disease, such as a narrowed disc space or a calcified disc. However, more advanced
closed space between c2-3
investigations are necessary to see which disc has actually slipped and to assess the severity of any spinal cord compression. Of these advanced imaging techniques, an MRI scan provides the best method of investigating cervical disc disease. Instead of X-rays, MRI uses high powered magnets and a computer to generate images of the spine. MRI provides information not only on the health and position of the discs in the neck but also on the nature of any injury to the spinal cord. This makes diagnosis more accurate and assists greatly in deciding the best course of treatment for the individual patient.
Myelography is another imaging technique which can be used for investigating cervical disc disease. This involves injecting a dye (contrast agent) around the spinal cord and obtaining multiple X-rays to assess the flow of the dye to see if it is interrupted at the site of the slipped disc. Injecting around the spinal cord is not without risk of causing further damage to already compromised nerve tissue. MRI is less invasive than myelography with less risk of side-effects, and for most patients MRI provides the best option for investigation. Both MRI and myelography require the dog to have a general anesthetic

Occasionally it is necessary to collect some fluid (cerebrospinal fluid - CSF) from the spine and send it to a laboratory for analysis. This test assists in the diagnosis of inflammatory conditions that affect the spine.

The Treatment
The two principle methods of managing cervical disc disease are (1) conservative treatment and (2) surgery.
  1. Conservative treatment
    When dogs with cervical disc disease are managed conservatively their exercise must be restricted. Short walks on a harness for toileting purposes may be necessary, with strict confinement at other times. The hope is that the ‘slipped disc’ will heal, any neck pain subside and the spinal cord recover from any injury. Painkillers may be necessary and possibly other drugs such as muscle relaxants.
  2. Surgery
    The aims of surgery are to remove any disc material that is compressing the spinal cord and to prevent any more disc material ‘slipping’. Decompressive surgery involves removing a section of bone from the bottom of the spine (ventral slot) to enable retrieval of disc material. Further
    ‘slipping’ is prevented by removing any remaining material in the center of the disc (disc fenestration). Occasionally vertebral stabilization (fusion) procedures are necessary, especially in large dogs.
The Prognosis
The outlook or prognosis with cervical disc disease is generally good.
Conservative management can be successful in cases with neck pain and no evidence of spinal cord injury, such as weakness and incoordination. Unfortunately some dogs continue to deteriorate with this approach or recover only to have a recurrence weeks or months later.
The success rate with surgery is generally high provided that the spinal cord hasn’t been compressed for a long time (chronic spinal cord injury). Chronic cord injuries can be treated successfully with surgery, but the outlook is less favorable than it is for short-term (acute) injuries.

The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at 
Some information was obtained from Willows Veterinary Centre and Referral Service in the UK




Monday, October 3, 2016

Proactive Wellness Exams To Prevent Disease

Preventive Care

Do you change the oil in your car? Why do you do that? If your answer is to prevent car trouble latter on down the road, read on.
Do you have a security system on your computer to prevent viruses? Yes? Read on.
Do you go to the dentist or medical doctor about once a year to prevent a major issue with your teeth or body? Yes?

Then why wouldn’t you go to a veterinarian to prevent disease in your dog or cat? Preventive Care is a proactive approach to your pet’s health. Your pet often will not indicate anything is wrong. He or she does not
say “I am not feeling so hot today”. Unlike humans, animals will often hide pain or discomfort, so there may be no outward signs anything is wrong. Regular wellness visits to your veterinarian to prevent disease allows you to be sure your pet is in good health.
Blood tests, diagnostic procedures, and examinations are performed based on your pet’s age, breed, life style, behavior, diet and history. For example, a five year old unsprayed female Beagle would not get the same examination as a thirteen year old neutered male Labrador.
A typical annual wellness examination on an old patient may consist of a blood health screen, urinalysis, thyroid test, parasite check, glaucoma screen and a heartworm test. Based on the history or findings, further testing may be necessary. All those tests usually don’t add up to one serious disease diagnosis and treatment. Preventive medicine is always less costly than treating a major crisis.

The Benefits of Preventive Care are:

1.     Pets get better, more comprehensive care instead of a hit or miss approach.
2.     Owners can anticipate the cost of preventive care and plan in advance.
3.     Diagnosing a little problem is always more rewarding than treating an emergency.
4.     Regular visit also provide your veterinarian with  better knowledge of your pet’s habits, general health and temperament, and can reduce stress of an office visit for you and your pet.

Health Care Plans

At Providence Veterinary Hospital, we offer several health care plans for your cat or dog.
We have puppy plans, kitten plans, adult cat and dog plans. Please ask the receptionist to review the ones you are interested in studying. All plans have a approximate built in 40% discount on items in the plans.
Pets should receive a veterinary examination at least annually and for some animals, more frequent visits may be appropriate. 
The Providence Veterinary Hospital Blog is a publication of Peter Herman, VMD, at the Providence Veterinary Hospital, 2400 Providence Ave. in Chester, PA. Contact Dr. Herman at 610-872-4000 or visit us at