Lewis Moon Posted January 24, 2012 Report Share Posted January 24, 2012 Cerb just had his annual and was negative for heartworm. Over the last two years he has been on a "generic" compounded by Roadrunner Pharmacy here in AZ. My Vet no longer "works with" them and now wants to sell me the meds herself, at double the price I paid the two previous years. Can someone suggest a good, less expensive alternative to the mainstream meds out there? Cerb takes pills like a champ with a swipe of peanut butter so "chewable" really doesn't make it any better, especially it the price is higher. I'm also not a fan of Big Pharma so would rather go with generic if possible. I know veterinary medicine is a business. Hell, I was married to a vet for 12 years (and I'd take Cerb to her if it wasn't...you know...icky), but I hate being viewed as a cash cow when I walk through the door and having everyone in complete salesman mode, all the time. Link to comment Share on other sites More sharing options...
Mark Billadeau Posted January 24, 2012 Report Share Posted January 24, 2012 Ivermectin + Pyrantel Pamoate = Heartgard Plus Link to comment Share on other sites More sharing options...
gcv-border Posted January 24, 2012 Report Share Posted January 24, 2012 Ivomec + strongid paste = heartgard plus Dosages please!? Ivomec: do you use the oral or injectable? (or use the injectable as an oral?) Thanks, Jovi Link to comment Share on other sites More sharing options...
Lewis Moon Posted January 24, 2012 Author Report Share Posted January 24, 2012 Ivomec + strongid paste = heartgard plus I read the compound info on Cerb's meds last year and ivermectin was one of the main ingrediants. Forgive a no0b, but can you get that OTC? I was an analytical chemist in a former life and am now working as an environmental toxicologist, so I know why and how to get the dose right. Link to comment Share on other sites More sharing options...
Mark Billadeau Posted January 24, 2012 Report Share Posted January 24, 2012 “Give a man a fish and he eats for a day teach a man to fish and he can feed himself for life” If you are going to do this I feel you should really understand the amounts you are giving; therefore, I'd prefer to not tell you what to do (give you a fish) but will show you how to figure it out for yourself (teach you to fish). The product insert for Heartgard Plus indicates the minimum effective dose of ivermectin is 2.72 mcg/lb of body weight and up to 10x of the minimum dose is safe (no adverse effects even in dogs with the MDR1 mutation). The dose of pyrantel pamoate is 2.27mg/lb body weight. The product information of all drugs indicates the amount of drug per weight or volume of the product. Ivomec comes as 1%, or 0.08% solutions, that is 0.01 g/mL or 0.0008 g/mL of ivermectin. Link to comment Share on other sites More sharing options...
Lewis Moon Posted January 24, 2012 Author Report Share Posted January 24, 2012 I found THIS: dosage is: Ivomec 1% solution - 1/10 cc per 10 lbs. of dog weight Would love to get a second nod on this. Looks like the 1% 50ml bottle can be had for as low as $30. Link to comment Share on other sites More sharing options...
Mark Billadeau Posted January 24, 2012 Report Share Posted January 24, 2012 I was an analytical chemist in a former life and am now working as an environmental toxicologist, so I know why and how to get the dose right. I updated my first post to include links to an online store (from one chemist to another). Link to comment Share on other sites More sharing options...
Lewis Moon Posted January 24, 2012 Author Report Share Posted January 24, 2012 “Give a man a fish and he eats for a day teach a man to fish and he can feed himself for life” If you are going to do this I feel you should really understand the amounts you are giving; therefore, I'd prefer to not tell you what to do (give you a fish) but will show you how to figure it out for yourself (teach you to fish). The product insert for Heartgard Plus indicates the minimum effective dose of ivermectin is 2.72 mcg/lb of body weight and up to 10x of the minimum dose is safe (no adverse effects even in dogs with the MDR1 mutation). The dose of pyrantel pamoate is 2.27mg/lb body weight. The product information of all drugs indicates the amount of drug per weight or volume of the product. Ivomec comes as 1%, or 0.08% solutions, that is 0.01 g/mL or 0.0008 g/mL of ivermectin. Mr. Billadeau, you rock. If you drink beer, I owe you one. Link to comment Share on other sites More sharing options...
Mark Billadeau Posted January 24, 2012 Report Share Posted January 24, 2012 I found THIS: Would love to get a second nod on this. Looks like the 1% 50ml bottle can be had for as low as $30. I would check the math on this. Also, be sure to account for the accuracy of what you are using to measure out the OTC drugs; you do not want to underdose. Link to comment Share on other sites More sharing options...
Lewis Moon Posted January 24, 2012 Author Report Share Posted January 24, 2012 I would check the math on this. Also, be sure to account for the accuracy of what you are using to measure out the OTC drugs; you do not want to underdose. Will do. Link to comment Share on other sites More sharing options...
bc friend Posted January 24, 2012 Report Share Posted January 24, 2012 I'm aware this may not be a popular opinion on the Board but I'm not a big fan of not using commercial hw preventatives, especially when you live in a climate where heartworm disease is rampant. The rescue I work with (and me personally as a foster) have lost dogs either as a result from the HW treatment or whose disease was so advanced it couldn't be treated w/o fatal complications - all because their prior owners didn't give the dogs monthly preventatives. It's a horrible way for a dog to die. While the treatment is much easier than it used to be, it is still a harsh insult to the dog's system and is time-consuming (I currently have a very high hw+ foster getting ready to go through a 2 month treatment). None of of us want to be seen as "cash cows" but their are cheaper alternatives to buying commercial hw preventatives, such as mail order, and it is my understanding that Krogers, HEB and Target are now selling prescription pet meds at a reduced prices including hw preventative. While some people are experienced enough to mix their own formulas, IMO, most people aren't. I'm not willing to risk my dogs' health or subject them to the risk of a harsh medical treatment or death. I know hw preventatives are a big expense if you have several dogs but it's a lot cheaper than treating the dog for hw or watching it die. Link to comment Share on other sites More sharing options...
Lewis Moon Posted January 24, 2012 Author Report Share Posted January 24, 2012 I would check the math on this. Also, be sure to account for the accuracy of what you are using to measure out the OTC drugs; you do not want to underdose. A 1 in 1/100 disposable serlogical pipete should work for measuring. Link to comment Share on other sites More sharing options...
Mark Billadeau Posted January 24, 2012 Report Share Posted January 24, 2012 A 1 in 1/100 disposable serlogical pipete should work for measuring. Yes, but what volume will you need and how accurate can you be at delivering (vs. "to contain") that volume with this syringe? These are the questions that I asked when I started, and my answers altered what dose I was targeting knowing the dogs must receive the minimum effective dose (or they run the risk of getting HW). Link to comment Share on other sites More sharing options...
Lewis Moon Posted January 24, 2012 Author Report Share Posted January 24, 2012 Yes, but what volume will you need and how accurate can you be at delivering (vs. "to contain") that volume with this syringe? These are the questions that I asked when I started, and my answers altered what dose I was targeting knowing the dogs must receive the minimum effective dose (or they run the risk of getting HW). Accuracy of measurement does NOT equal accuracy of delivery, especially if you have to deliver it oraly. Understood. Link to comment Share on other sites More sharing options...
nancy in AZ Posted January 24, 2012 Report Share Posted January 24, 2012 Sam, why can't you ask your vet to write you the prescription and get it filled at the compounding pharmacy or wherever you choose? That's what I used to do. Link to comment Share on other sites More sharing options...
juliepoudrier Posted January 24, 2012 Report Share Posted January 24, 2012 Mark has provided good information. Here's a website that explains some things as well, especially the difference between using the injectable vs. the drench formulations of ivermectin. Just remember that if you go this route you are responsible for making sure you get the doses right so that you are not leaving your dog at risk with too low a dose or putting the dog at risk with too high a dose. DogAware Ivermectin page Please don't just look at dosages and pick what's right for you--read the entire page so that you're aware of issues, etc., involved with off-lable use of parasiticides. J. Link to comment Share on other sites More sharing options...
Lewis Moon Posted January 24, 2012 Author Report Share Posted January 24, 2012 Sam, why can't you ask your vet to write you the prescription and get it filled at the compounding pharmacy or wherever you choose? That's what I used to do. I got the message pretty loud and clear that it was her way or the highway. She wouldn't even write me a scrip to buy heartguard elsewhere. The vet tech whispered "1800petmeds" to me as I paid the bill . My mom-in-law's vet in Indiana is the same way. Link to comment Share on other sites More sharing options...
Mark Billadeau Posted January 24, 2012 Report Share Posted January 24, 2012 Julie, The case filing is VERY revealing and disturbing. We are still left wondering if the reduced effectiveness is related to true resistance or under dosing for an increased monthly exposure to microfilaria above what was used to determine the minimum effective dose. Mark Link to comment Share on other sites More sharing options...
gcv-border Posted January 24, 2012 Report Share Posted January 24, 2012 I got the message pretty loud and clear that it was her way or the highway. She wouldn't even write me a scrip to buy heartguard elsewhere. The vet tech whispered "1800petmeds" to me as I paid the bill . My mom-in-law's vet in Indiana is the same way. Yes, I have left a vet over the issue of not allowing me to give medication to my own dog. Not quite the same situation as you have though. (i.e. wanting to sell you higher priced meds) My previous vet would provide a monthly dose of Adequan only if I brought my dog in and paid $40. My rehab vet sold me a year's supply of Adequan for ~$100 (can't remember exact #). The vet I used in NJ said "she didn't want to be a pharmacy". She would sell you meds (at market prices) or she would write you a scrip if you wanted to get it elsewhere. But, she did have pretty high prices for visits, treatments, etc. so she made her $$ elsewhere. Jovi Link to comment Share on other sites More sharing options...
Mark Billadeau Posted January 24, 2012 Report Share Posted January 24, 2012 This discussion has prompted me to review the recent scientific literature on the possible resistance of current HW preventatives. I'm still reviewing but did find this study which stated.... ....The results of the study as reported herein indicate that the FDA-CVM-approved ML, IVM, and MBO, originally approved 19 or more years ago, as tested in this study by current testing guidelines and with a recent HW field isolate would now fail to be approved for single treatment effectiveness at their currently registered dose bands. ML are safe, effective, and convenient drugs for prevention of HW disease in virtually all dogs when used as instructed.4 While 100% prevention was not obtained for either ML with this recent HW field isolate, it should be emphasized that these products are not intended to be used for just 1 month during the HW transmission season. While the finding of a single female worm in a dog in each of the treated groups would not be a patent infection, the presence of these worms suggests that effectiveness can be influenced by the actual isolate used in the testing, and the relative lack of susceptibility of some HW isolates to the ML could be a contributing factor to the LOE reports arising from use of these products. Additionally, a "treatment dilemma" for the clinician would occur for a dog that is presented that harbors a single female worm that would be amicrofilaremic yet could be shown to be HW positive by currently available HW antigen tests. Ivermectin and Milbemycin Oxime in Experimental Adult Heartworm Infection of Dogs So why is this relavent for this discussion? The report indicates that even with using the prescription HW preventatives a dog could still become HW infected. The reason(s) for this are still not known but could be due to developing resistance in a subpopulation of HWs to macrocyclic lactones (the class of drugs for all HW preventatives) or an increase in the monthly infection of microfilaria that a dog sees which would require an increase in HW preventative. Link to comment Share on other sites More sharing options...
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