UPDATE: The FDA has granted Merial approval to import limited quantities of Immiticide from Europe. Click here to read this story.
The American Heartworm Society (AHS) board and scientific committee has released an interim heartworm management plan to help veterinarians deal with heartworm cases in light of Immiticide being unavailable for the time being.
“With Immiticide unavailable, veterinarians will need to take steps to carefully manage their heartworm-positive patients,” said Wallace Graham, DVM, president of AHS. “As the primary source of information on heartworm prevention and treatment for the veterinary practitioner, we have provided veterinarians with recommendations for appropriate patient care.”
The goals of the interim plan endorsed by AHS include reducing potential pathology from the infection, maintaining the health of the heartworm-positive dog until it can be appropriately treated and preventing additional heartworm infection of the patient. Dr. Graham said the goal of this plan is not to eliminate the infection, but to manage the patient until Immiticide is available.
The AHS plan entails pretreatment of heartworm-positive dogs to prevent shock and careful administration of a macrocyclic lactone heartworm preventive, followed by clinical observation for a minimum of eight hours.
AHS’ plan instructs veterinarians to continue administration of a heartworm preventive on the regular dosing schedule and administer doxycycline on a one-month-on/two-months-off schedule.
Activity is to be restricted throughout the management period and medical treatment of symptomatic heartworm infection to relieve signs of respiratory disease, with surgical options weighed for dogs exhibiting cardiovascular compromise.
The society urges veterinarians to visit its website to review the full plan.
AHS recommends retesting for heartworm status before treatment with adulticide treatment once the product is available.
Immiticide (Melarsomine dihydrochloride), the only Food and Drug Administration approved adulticide for treatment of heartworm, will be unavailable for an undetermined amount of time, according to the drug’s manufacturer, Merial.
Merial attributes a shortage of melarsomine due to technical production problems at a plant as cause for the drug’s market absence.