Yorkie has ALT level of 680+ and Dehydrated... Help please!

[Madraga]

Hi, I have a Yorkie Mix that's been infected with heartworm. The vet said she's in stage 3 coz when he took a drop of her blood to see if there are any larvae, they found a few under the microscope. So we opted to treat her coz the vet said she had a fighting chance. She's very skinny though and she's a rescue dog so she's probably had heartworm all her life and was never treated nor cared for by her previous owners.

She was put through doxycycline for 2 weeks (1/4 of the pill twice a day). A few days before the end of the 2 week period she received her Ivermectin shots. But on the same day she was also given shots for rabies, distemper, hepatitis and leptospyrosis. Her ALT was within the normal range at 47. The rest of her bloodwork was also normal. This was Sept 21, 2010. Then last night (Sept 23) she showed signs of severe dehydration. She's already been avoiding water for a few days. She just won't drink water so we had to force feed her water. She would eat very little as well. So i took her to the vet and she had to undergo IV drips of Ringer solution for her hydration. They had to keep her overnight at the hospital to check if she vomits again. This afternoon (sept 24) she appeared to be well hydrated and the vet opted to test her blood again to check her liver. Her ALT level was at 680+. It went that high in less than 4 days. Now she's still in the hospital and they gave her dextrose instead of the ringer's solution.

Has anyone ever had this experience before? It's depressing really coz she's so well behaved. She's scared of everything and this was brought about by being caged most of her life and not really being cared for by her owners.

Please advice as to how long she should stay at the vet's. They want to keep her till Sunday or Monday but I'm hoping she'll get better by tomorrow afternoon.

Thanks.

[Ladymom]

Why in the world did your vet bombard her with all vaccines the same day she had an Ivermectin treatment for heartworm?????

Lepto especially can cause serious reactions and should only be given in areas where there are a high numbers of cases. Then it should be given separately from all other vaccines.

Rabies should also be given 2-3 weeks separately from other vaccines.

No wonder her ALT soared to 680! Her poor liver couldn't handle all the toxins that were put into her body at the same time. I pray she recovers.

[Madraga]

Originally Posted by Ladymom

Why in the world did your vet bombard her with all vaccines the same day she had an Ivermectin treatment for heartworm?????

Lepto especially can cause serious reactions and should only be given in areas where there are a high numbers of cases. Then it should be given separately from all other vaccines.

Rabies should also be given 2-3 weeks separately from other vaccines.

No wonder her ALT soared to 680! Her poor liver couldn't handle all the toxins that were put into her body at the same time. I pray she recovers.

I don't know really. i think they're used to doing these things like a 5-in-1 shot. I didn't know it was dangerous coz he said it was ok. I mean he could've told me to wait. I'm just relying on his judgment. And he checked her bloodwork before giving her those vaccines and he said it was all normal. He came so highly recommended too. Should I consider seeing another vet now?

You think she'll ever recover? What do you think are her chances? Oh my god, I don't think I could live with myself now knowing that I did this to her. It's all my fault really for not being smart enough to disallow it.

[yorkielady06]

I would be having a serious discussion with that vet.
Just giving a rabies shot and a 5 way shot in one visit should be avoided. Rabies should be at least 2 weeks later. But add to that the Ivermectin!! and in a dog that is already compromised with weight? what was this vet thinking???
Most will not do the heartworm treatment until they have put on some weight. Then it is slow and not all that together....I am shocked that a vet would do that.
I think my first thing would be to ask this vet why? And are they planning on helping you with the cost of all this? I would be furious actually.
I hope your baby makes it though this, as it sounds like she has already had a hard life
I would leave your baby at the vets until her alt comes down and she is plenty hydrated and eating...it is in her best interest and yours...
Sorry this happened to you.

[143julz]

So soory you are going through this. I hope she makes a full recovery and you give the vet a piece of your mind, that is way too much of an overload on her liver.

[Patti]

I am so sorry your baby and you are going through this. You were just following your vets advice so don't blame yourself. You will learn so much on here so you will be able to question your vet. I had Yorkies all my life and learned so much from YT. Since she is so scared maybe you can see if it is safe to bring her home at night bring her back during the day for treatment. I will keep your baby in my prayers.

[ladyjane]

I am stunned...that is all I can say.

I honestly would be at another vet now! I would not trust them again...no way, no how.

I hope she recovers .. what a scary thing.

Keep us posted, please.

Welcome to YT!

[Rhetts_mama]

Ivermectin has listed potential side effects of elevated liver enzymes and hepatitis. So it's possible this would have occured even if she hadn't been given the vaccines concurrently. This little girl is a rescue, so who knows what else might be lurking in the background with her.

As for her getting better by tomorrow, I wouldn't rush it. She's better off where they can continue to give her the IV's and monitor her more closely for signs of liver failure.

[ladyjane]

I don't care what the side effects of Ivermectin are. I remain stunned that any vet would give anything along with heartworm treatment.

As for taking her home sooner than recommended...I agree, I would not do that. This pup needs IV fluids to try and get the toxins out of her body. Poor baby.

[Ellie May]

I don't even know why Ivermection was given to begin with.
Slow kill is Heartgard daily, not by injection.
Injections would be Immidicide.
Perhaps I have to go read up on heartworm treatment again.

And all vets know better than this. Time to find a new one...

[Rhetts_mama]

The OP is in the Phillipines. They may have different treatment protocols there than we do in the U.S.

[ladyjane]

I am sure they used Immiticide.
And, I have never heard of Heartgard daily? That dog is stage 3 and does need the Immiticide treatments. Interesting that they use the Doxy which is fairly new......I just wonder why they did not give Heartgard for a couple of months first which really is a slower safer treatment and the recommended way now.

[ladyjane]

I have had many fosters go through heartworm treatment and I have never, ever heard of giving any other shots or treatments smack in the middle of heartworm treatment!
The newest protocol calls for Doxy daily for two months; and also two months of Heartgard before the treatment.

[Madraga]

Hi guys, thank you so much for all your replies. I'm so scared right now that maybe things won't go back to normal.

I've been reading up on heartworm treatment prior to the Ivermectin shots. When I found out she had heartworm, I started reading on it. And I guess protocol here is different. She was given doxycycline for 2 weeks. We visited the doctor before the 2 week period was up. So I asked if things are getting better with her. She got tested and there were signs of improvement. So I asked if she can be given the medicine for heartworm coz doxycycline is merely an antibiotic and it doesn't kill or stop heartworm larvae from growing in number. So the vet told me she could coz her bloodwork had improvements. She was given a shot of ivermectin and it's supposed to last for the year. So her next shot is next year Sept 21. I was also surprised of this coz I've been reading that dogs get ivermectin at a weekly rate. But he didn't really explain why he was doing the yearly ivermectin shots.

He was asking for her vaccine records which I don't have so I just said she's not showing any signs of rabies or anything that should concern me. He said he was afraid she might get parvo or the other diseases like distemper, etc coz she's a bit frail. So i asked if she can get vaccines for those and he just said that it's fine and it's better to get everything in 1 day so i don't miss it the following year.

I know it's stupid of me to not think of this like I would if it was me but I really didn't know it would go this way. I've had a dog before that had heartworm but seemed very normal and could take anything. She's been with the vet for 2 days and i'm hoping things will get better this afternoon.

I hate to see her like this, she's got bruising from where they took blood. I know that doesn't really hurt but it's like she's gone through enough and now I'm doing the same thing to her. She ripped her IV out yesterday when I left the hospital and she's got a wound on her arm and her fur around the area is bald. That alone made me want to bring her home but I can't really do anything. They don't do one-on-one with the dogs.

[ladyjane]

As Ellie May said: Ivermectin does not kill adult heartworms. The injection you are referring to, I am quite sure, is Immiticide.

Here is a link that explains heartworm treatment clearly:

Heartworm Treatment

I have never heard of weekly treatments for heartworms...and I have never heard of treatments being spread out over an entire year.

I don't see how the protocol could be any different in any country. I think you really need to ask your vet for more details about what protocol he is following. Her bloodwork would have nothing to do with heartworm treatment unless it was altered from the beginning in which case she would be considered high risk for treatment with Immiticide.