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Can You Remove Heartworms?

Posted 12.15.19 by Kassie Newton, DVM

A Case Study on Caval Syndrome

Dr. Newton and Toby

This is Tobi. Look at this adorable face. I mean, how can you not love him immediately? From the outside Tobi looks so happy and healthy, but this is the story of how we almost lost Tobi due to heartworms.  

Tobi had been adopted through a local shelter a few months ago by his new owners. He very suddenly and rapidly declined in July, and we initially thought it may be due to an autoimmune disease. However, after a blood transfusion and lots of medications Tobi was not improving. He continued to become very weak, barely wanting to walk, would not eat very much, and was coughing…a lot. His mom was extremely worried that he wasn’t going to make it – and honestly so were we.

Heartworms taking up space in the chambers of the heart.

We ran some more tests on Tobi, and found via an echocardiogram (aka ultrasound of the heart) that Tobi had a condition called Caval Syndrome. This can mimic many of the symptoms of autoimmune disease but is a much rarer situation for us to see in our patients. In most dogs this is a terminal condition, so we knew we had to act fast.

Jar of heartworms
Jar of heartworms.

Wait a second, let’s back up. You said…heartworms? Yep, I sure did. Heartworms are a small parasite transmitted by mosquitos that your dog can contract if not properly protected. Over time these microscopic worms grow to be big and strong – up to 18 inches long in some dogs! They make their way to the heart most commonly and set up residence. Over time these worms can reproduce and make more worms, which then makes it harder and harder for the heart to beat. Left untreated and unchecked heartworms will eventually lead to heart failure and death. Caval Syndrome is when there are so many worms they are in heart failure and the worms are literally shredding their own blood cells. 

Okay, back to Tobi. When a dog has terminal heartworm disease they cannot undergo the traditional heartworm treatment called Immiticide as this is commonly fatal. The only treatment options is to decrease the amount of worms causing the issue with surgery. This is an extremely risky surgery as there is so much stress and strain going on with the patient and their heart cannot always tolerate being under anesthesia. However, if we do nothing they will pass away.

Removing heartworms from an anesthetized dog.
Live heartworms pulled from Tobi’s heart!

We are happy to report that Tobi was a rock star! He was perfect for his surgery and Dr. Newton successfully removed 33 worms from this little man. Yep, that is 33 worms ranging from 8-18 inches in length out of a small dog. Tobi has recovered well from this, but he definitely still has a road. He will need to recover and then go through the traditional Immiticide treatment to kill any remaining worms. But we hope this little man continues to beat this horrible disease and show us how tough he can be.

Dr. Newton and Tobi post-surgery.

Being in the south, we have a lot of mosquitoes – so we see a lot of heartworms. Toby’s case is one of success and happiness, but we sadly see dogs pass away from this disease every year. Thankfully this disease is preventable with correct medications and, if caught early, is absolutely treatable. Give us a call if you have any questions!

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