# heartgard efficacy



## lizbethc38 (Sep 13, 2007)

First, I'm so sorry to ultrarunner for her loss. Reading the story, I was shocked to learn about Heartgard not being as effective as I thought. Out of ultrarunner's loss, hopefully learning this will prevent others from just blindly trusting in the medication.
I don't use topicals or any kind of pest control on or in Muggsy with the exception of Heartgard. We are cancer survivors & eat organically, no pesticides, herbicides etc etc. You know, one of the crunchy people  I have a natural system in place for fleas & ticks & it works just fine.
The one area I can't find a way around is heartworm medication. Living in FL, the risk is too high, and so I give Muggsy Heartgard, monthly & year round. I test him once or twice a year & his tests have always been negative. 
So, my questions are.. is there a heartworm preventative that is better? One that is ONLY for heartworm? I will not put any pesticides in Muggsy that I absolutely don't have to. I also never really asked what kind of test is done, just asked that the heartworm test be done. Is there a particular kind of test that I should be asking for that gives the most accurate results?
Tomorrow is Muggsy's 8th birthday!! Gonna make him 8 mini meatballs....with organic grass fed beef of course :rockon:


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## Pai (Apr 23, 2008)

No, I don't think there are any better (or organic) options for preventing Heartworms. It's one of those things like vaccines, where there never was another way of doing it before it was invented aside from being naturally resistant (a rare thing).

The best you could do, would be to make your property (or Muggsy himself) as mosquito-unfriendly as possible to avoid getting any infected bites in the first place, on top of continuing your usual medication regimen.


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## ultrarunner (Nov 22, 2011)

Interceptor by novartis is heartworm only. I don't know if they claim 100% efficacy like Heartgard (and speaking with Rebecca at Merial who makes Heartgard, she still says 100%) but really is anything like this absolutely 100%? Why would Merial offer to pay for treatments if heartworm positive? I felt like I was really vigilant with my dogs but obviously not enough. In retrospect, maybe there was a sign a week prior so I definitely feel like I failed him. 
As far as heartworm tests, there is the occult heartworm test which to my understanding tests for microfilariae vs the snap test which tests for adult heartworm and specifically females which grow larger and result in the most damage.

I am switching vets on Monday and having all of my dogs retested for heartworm including one that was just tested in October. From what I read, heartworm a lot of the time if present are there for years before exhibiting in dogs. I don't know how he had repeated negative results including January 26, 2011 and less than 10 months later has what my vet called one of the worst cases ever.

Here I am another sleepless night watching, monitoring my dogs.


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## hamandeggs (Aug 11, 2011)

ultrarunner said:


> Interceptor by novartis is heartworm only.


Nope, Interceptor also prevents roundworms, hookworms, and whipworms. I've had good personal experience with it, though.

Ultrarunner, I am so sorry for your loss.


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## ultrarunner (Nov 22, 2011)

I just got back from the new vet, someone I hope I'll like and be able to stay with. I went to her when she first moved to town and had a slightly disheartening experience with her, but she was a young vet and we talked about this past history (which was in 2003). I told her I really just needed to find a vet I absolutely loved. 

They send out blood samples for an official heartworm test but they did look at the blood under the microscope. Two of my dogs had no microfilariae in their blood but one of them did. Tomorrow I will get the official result. She is one who shares the same lots of Heartgard plus with my dog who died of heartworm last week!!


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## ultrarunner (Nov 22, 2011)

Update: Two of my dogs came back for positive for Heartworm on the antigen test. So 3 out of my 5 dogs on Heartgard plus are Heartworm positive without ever having missed a dosage all with Heartworm negative tests within the last 10 months with one of my dogs deceased already last week which started my transfer of vets and all new tests. 

This would mean that all of these three dogs would have not chewed and repeatedly passed the Heartgard plus or repeatedly vomited the Heartgard plus or maybe there's a problem with Heartgard effficacy!!!


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## Xeph (May 7, 2007)

Ultrarunner, SO very sorry for your loss. Good on you for switching vets and testing everybody again.

I am gobsmacked that 3 out of 5 of your crew are infected when they were supposedly being protected


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## sassafras (Jun 22, 2010)

3/5 dogs in one household all on preventative is just... just extremely weird and incredibly improbable. Like, something is wrong with that lot weird. It's true that ivermectin is not 100%, but the legal wrangling was really just over labeling as I understand it (no drug is 100% effective). Anyway, I would urge your vet to report it to Merial and there is also a veterinary drug reporting hotline that I don't have where I am right now.


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## ultrarunner (Nov 22, 2011)

I am upset and disappointed by the results. These two positive were not sharing the same lot of Heartgard as they are different weights. My other dog that was sharing lots was negative but she isn't outside as much, not that that should matter since everyone was on monthly Heartgard. Prognosis for treatment for both is good but it will be a long few months.


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## ultrarunner (Nov 22, 2011)

Link to class action suit vs Merial for lack of Heartgard efficacy and non-compliance with FDA to disclose (but also makes claim Interceptor has failed as well)

http://freepdfhosting.com/bef8e85b35.pdf


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## Mr. V (Jan 28, 2010)

Ultra - when did you get your dogs (the ones that are HW +) and how long have they been on monthly heartworm preventative? When was their last negative test?


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## ultrarunner (Nov 22, 2011)

Mr V: The one deceased I had since the end of 2008. He had been on monthly Heartgard plus every month since. He had a negative tests in 08, again at the end of 09, again at the start of 2011. November 21, 2011 he tested positive and died within hours.

Another I've had since August 09. She was estimated under 4 months at the time so did not have a heartworm test. She had mange and was on daily ivermectin therapy for 3 months and I started her on Heartgard plus and ever since she finished that treatment. She had a negative test in sept 2010. She has positive test as of nov 2011.

My other dog was acquired January 2010. He had a negative heartworm test then and was started on Heartgard plus. He had a negative heartworm test in January 2011. He has a positive test as of November 2011.


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## ultrarunner (Nov 22, 2011)

In my lengthy online reading about Heartgard plus efficacy and heartworm treatment, I have come across many articles and studies done by the American heartworm society which have found a lack of efficacy in heartworm preventatives especially in the Mississippi delta region and especially since 2009. Resistant heartworm strains have been identified. This is troubling to me.


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## Normandy36 (Dec 26, 2011)

ultrarunner, I am having the same problem.. My 2 Labs were/are on heartgard they both tested negative at the beginning, then the first annual one tested positive then the second annual the other tested positive, Merial will not stand by their product on the first because the vet prescribed for up to 100 lbs and the dog grew over that with in a couple of months. The second the vet said they will send the results and records to Merial because everything was in order and the product failed. I have probably done the same research that you have and have run into the question of is it really drug resistant heart worms? Plus two court documents claiming a coverup by Merial, Plus FDA Warning Letters about overstating efficacy. I can't find anything like those complaints on any other heartworm drug. Even Bayer that claims 100 % has not been warned about overstating just failure to disclose possible side effects. All the vets at the animal hospital aren't bad.. the first one I went to helped me save buddy from parvo, and sassyfras from red mange. I just wish my vet would have given me more choices than heartgard and talked to me about it. 

I am going to try the slow kill method using doxycycline, and anything but heartgard. I would be too worried that as I try to kill the current adults more would reach maturity because of the efficacy. I would be interested in finding out how many other heartworm preventatives that dogs are coming out positive. I talked to another vet and they said that they have not hand any that developed heartworms that were taking interceptor or the 6 month injections.

My hope is to find data on other meds if anyone knows where I can find that let me know. Thanks


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## DobermanGuy (Dec 16, 2011)

ultrarunner said:


> In my lengthy online reading about Heartgard plus efficacy and heartworm treatment, I have come across many articles and studies done by the American heartworm society which have found a lack of efficacy in heartworm preventatives especially in the Mississippi delta region and especially since 2009. Resistant heartworm strains have been identified. This is troubling to me.


Heartworms can and DO evolve into new strains. The strain you likely read about is the MP3 strain and Heartgard is not 100% effective against it. It will still greatly reduce the chances of getting and the number of adult worms that may be found but not 100%.

The ONLY product tested so far against the MP3 strain (and proven to be 100% effective) has been the Advantage by Bayer. It was proven 100% against that particular strain but...

The Bayer product has NO warranty like the heartgard does and strains DO evolve.

Merial is the ONLY product on the market that will pay for any and all treatment if used as directed and IF you are doing the yearly testing as required - You will not likely be in any real danger or ever have to pay for any treatments. You are not going to have a major worm infestation if you are using the Heartgard as directed and they WILL pay for any treatment should a new strain show up on your yearly test.

Yearly testing is the most important thing to do here.

I stick with Merial for my dogs.


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## juliemule (Dec 10, 2011)

Sorry for your loss. I went through the same thing. three out of five tested positive. I am in TN. two dogs have been on heartgard since pups. They are now eleven and twelve. One has a heavy infestation. the third dog was an eight month old pup, tested negative from the humane society. A year later she too was positive!

Never missed a dose. I was a vet tech and know how important it is to stay on prevention year round especially in the south!
After talking with my vets and doing research, we find that the Mississippi valley area, dogs are coming up positive. not just on heartgard. Also other preventatives. So we decide it may not be an ivermectin resistance.

One was treated with the new treatment of advantage multi and doxycycline twice, still positive, and very symptomatic. Now has an enlarged heart, and stays on temaril p. Vet says this may take awhile to come back negative? The next dog we are debating on which treatment. Third dog tested negative after being put on the new prevention.

None of the treatment was covered by merial. My country vet did not keep records on everything, you could drop in pick up and be billed. So frustrating, but now everything is kept and on new computers to boot. They also began yearly testing as of two years ago.

I now use ivomec injectable, given orally. Though this is not recommended by most vets, and you must know the exact weights every month, it has worked well so far. The dogs live with a heartworm positive dog and are all still negative. I am in a heavily infested mosquito area. The vet recommends advantage multi and heartgard now. I chose not to use this for two reasons. One the heartgard is NOT working, and the advantage multi caused vomiting in one dog, and a large open sore on the back of another dog of mine. Then considering the advantage 'treatment' did not work either, I decided against it.

Good luck finding a prevention, and I hope your other dogs stay healthy and recover with treatment.


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## ultrarunner (Nov 22, 2011)

Normandy, I am sorry that you have to endure this as well. My dogs actually had their first treatment of immiticide on Wednesday. I picked them up yesterday and so far they don't seem to have any residual pain from the injection site. They will go back in 4 weeks for two consecutive injections. 
One of my dogs showed heart englargement on x-ray but not overly worrisome. My other did not but she has visible microfilariae in her blood.

Since you have been researching all of the information, I am sure you have also read that immiticide (the only FDA approved treatment for heartworm) is only manufactured by Merial. There is also a shortage and it is only being distributed on a case by case basis. My current vet has stockpiled immiticide but Merial also said they would provide the immiticide for my dogs/ treatment as a courtesy. My vet has not yet received it.

Merial has also offered to pay $500 towards the treatment of one of my dogs. While it is not strictly a financial issue, I will dispute with Merial further because of the principle. This will only cover about 1/3 of the treatment cost for my one dog. I had 3 dogs all same weight class and I have very consistent purchase history of Heartgard plus every 4 months. 
They are disputing any reimbursement towards my other dog because he was 92lbs in January 2011. In June 2011 a 6-month supply of Heartgard plus was purchased for him. Now his weight is 104lbs. They are saying he was dosed incorrectly as well but as the heartworm life cycle works, it takes 6-months for a larva to mature into an adult and he tested positive less than 5 months later which means their was a failure prior to June.
I am also requesting reimbursements for the purchase of Heartgard plus over the past year.

Many veterinary website still have the Merial Heartgard Guarantee posted which reads "Heartgard Plus is 100% effective against heartworms...Dogs will accept Heartgard Plus Chewables, and the full dose will be consumed every time." 

I have not found much information on other product failures. However, there is/was a class action lawsuit based out of Greenville, MS vs Merial that talks about dogs that were switched from Interceptor/Sentinel to Heartgard Plus because of a failure with Interceptor and then subsequent failure of Heartgard plus.
My vet has told me that especially in the Mississippi delta, that there is evidence that all heartworm preventatives have seemed to have a failure to a heartworm strain that has been found here since 2009. All heartworm preventatives are based on the same chemical structure, a macrocyclic lactone. 

The doxycycline is supposed to kill the Wolbachia bacteria which have a symbiotic relationship with the heartworm. There is evidence that without Wolbachia, the female heartworms become sterile so they would not be able to produce the microfilariae which would mature into adult heartworms. Ivermectin (Heartgard plus) seems to be the only one that has evidence that it kills adult heartworm...However, there are new studies which show that moxidectin (Advantage multi and also what is in the 6-month injectable) has been effective in the slow kill method. 

Good luck with your dogs. I hope they are well. 
If I find any data on other meds, I will let you know.


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## ultrarunner (Nov 22, 2011)

DobermanGuy said:


> Heartworms can and DO evolve into new strains. The strain you likely read about is the MP3 strain and Heartgard is not 100% effective against it. It will still greatly reduce the chances of getting and the number of adult worms that may be found but not 100%.
> 
> The ONLY product tested so far against the MP3 strain (and proven to be 100% effective) has been the Advantage by Bayer. It was proven 100% against that particular strain but...
> 
> ...





I was informed that the MP3 strain has only been isolated once and outside of Atlanta. It has never been isolated again and it is not the seemingly heartworm resistant strain that has appeared in the Mississippi delta region. 
I have to disagree with you and Merial as far as reimbursement for diagnosis and treatment. I have a copy of the Merial Heartgard Guarantee which states that "If a pet tests positive for heartworms...while taking Heartgard plus on a monthly basis, according to label directions, Merial will refund the purchase price and will assume responsibility for reasonable costs related to diagnosis and treatment."

I have all of the supporting documentation of annual heartworm testing and purchase history and Merial has only agreed to compensate the immiticide plus $500 for one of my dogs and has refused to reimburse for the diagnosis of my dog who died because he did not have an autopsy. That is not "any and all treatment" as you say, Dobermanguy.

Also, Advantage Multi (Bayer) does have a 100% guarantee.


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## sassafras (Jun 22, 2010)

Well honestly I can't blame them for wanting an autopsy. Otherwise just anyone could claim that their dog died of heartworm and ask for money from them.

They are SUPER strict about the terms of their guarantee as far as your purchase history of Heartguard, correct size, etc. Sometimes, I think, too strict, but then again on the other hand I do understand wanting to protect themselves against false claims.


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## ultrarunner (Nov 22, 2011)

juliemule said:


> Sorry for your loss. I went through the same thing. three out of five tested positive. I am in TN. two dogs have been on heartgard since pups. They are now eleven and twelve. One has a heavy infestation. the third dog was an eight month old pup, tested negative from the humane society. A year later she too was positive!
> 
> Never missed a dose. I was a vet tech and know how important it is to stay on prevention year round especially in the south!
> After talking with my vets and doing research, we find that the Mississippi valley area, dogs are coming up positive. not just on heartgard. Also other preventatives. So we decide it may not be an ivermectin resistance.
> ...




Juliemule, I wish you the best with your dogs. It takes a while (up to a year) for a dog to come back negative even with immiticide treatment. This is the result of the heartworm breaking up and depending on the severity of the heartworm, the dog's body has to absorb all the fragments and so if enough fragments in the body, then the test will be positive even if no live heartworm. That is how I understand it. 

Please expand on the third dog and his negative test after new prevention. No other treatment was used?


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## juliemule (Dec 10, 2011)

There was no treatment. I began her on a high dose of ivermectin, three months later her test was negative. This is NOT recommended by vets. However. What was recommended did not work. She is still heartworm free.


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## DobermanGuy (Dec 16, 2011)

ultrarunner said:


> I was informed that the MP3 strain has only been isolated once and outside of Atlanta. It has never been isolated again and it is not the seemingly heartworm resistant strain that has appeared in the Mississippi delta region.
> I have to disagree with you and Merial as far as reimbursement for diagnosis and treatment. I have a copy of the Merial Heartgard Guarantee which states that "If a pet tests positive for heartworms...while taking Heartgard plus on a monthly basis, according to label directions, Merial will refund the purchase price and will assume responsibility for reasonable costs related to diagnosis and treatment."
> 
> I have all of the supporting documentation of annual heartworm testing and purchase history and Merial has only agreed to compensate the immiticide plus $500 for one of my dogs and has refused to reimburse for the diagnosis of my dog who died because he did not have an autopsy. That is not "any and all treatment" as you say, Dobermanguy.
> ...


Please post a link to the Bayer 100% guarantee. Neither I nor ANY of the Vets that I contacted previously could every find one. 

I will try to dig up some old info about the MP3 strain for... :wave:


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## ultrarunner (Nov 22, 2011)

DobermanGuy said:


> Please post a link to the Bayer 100% guarantee. Neither I nor ANY of the Vets that I contacted previously could every find one.
> 
> I will try to dig up some old info about the MP3 strain for... :wave:



http://www.bayerdvm.com/products/advantagemulti/multi-for-dogs.cfm

New prescription-only Advantage Multi for Dogs combines the proven-effective flea control of Advantage®, which has been trusted by veterinarians and their clients for more than 10 years, with a 100-percent effective preventive for heartworm disease and effective treatment and control of intestinal worms (hookworms, roundworms, and whipworms) all in one convenient, monthly topical solution.


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## ultrarunner (Nov 22, 2011)

sassafras said:


> Well honestly I can't blame them for wanting an autopsy. Otherwise just anyone could claim that their dog died of heartworm and ask for money from them.
> 
> They are SUPER strict about the terms of their guarantee as far as your purchase history of Heartguard, correct size, etc. Sometimes, I think, too strict, but then again on the other hand I do understand wanting to protect themselves against false claims.




He had his annuals at the end of January 2011 with a negative heartworm test. Suddenly in October 2011 he is coughing blood. Immediate vet visit and he tested positive for heartworm on the snap 4dx test. X-rays showed heart enlargement, bronchiole blockage etc. Vet said one of the worst cases of heartworm he had seen...He was put on antibiotics and steroids and within 2 hours went into a coughing spasm and died...This was right before Thanksgiving and no one at Merial was available. We buried him at the lake house and the Monday after Thanksgiving Merial requested he be exhumed and an autopsy performed. Wasn't going to subject him or the kids to this.

I had three dogs on the 26-50 lb dosage (31, 38, 44 lbs). My purchase history with vet shows I purchased every 4 months without fail. Merial says that they will not guarantee because my dogs shared lots of Heartgard and they should have all had their own. That is ridiculous.


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## ultrarunner (Nov 22, 2011)

juliemule said:


> There was no treatment. I began her on a high dose of ivermectin, three months later her test was negative. This is NOT recommended by vets. However. What was recommended did not work. She is still heartworm free.


Maybe she had a false positive to start with. Glad she is negative.


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## DobermanGuy (Dec 16, 2011)

ultrarunner said:


> http://www.bayerdvm.com/products/advantagemulti/multi-for-dogs.cfm
> 
> New prescription-only Advantage Multi for Dogs combines the proven-effective flea control of Advantage®, which has been trusted by veterinarians and their clients for more than 10 years, with a 100-percent effective preventive for heartworm disease and effective treatment and control of intestinal worms (hookworms, roundworms, and whipworms) all in one convenient, monthly topical solution.


That does not link me to any written guarantee that they will pay for any treatment 'IF' the dog manages to get heartworms anyway because of a new strain...

I do know that this WAS the only prouduct tested against the MP3 strain that was 100% effective... The study I looked at showed a few of the dogs on Merial developing one or two adult worms (MP3 strain was introduced on purpose to the test dogs)

I would quickly consider switching to the Bayer product IF they had a written guarantee that they would reimburse me for any and all treatments IF a new strain came along. 

Merial does give me that guarantee and my Vet explained it to me very well. If my dog was to get heartworms while using the Merial as directed - I will NOT be having to worry about paying for any treatment to get rid of them. My Vet and I BOTH keep track of all the required paperwork/receipts/proof of yearly testing/proof the medicine was purchased from our 'real vet' and that there is a true client/patient relationship...

Still trying to gather info about the MP3 strain for you. I sent an email to the Vet that showed me the reports about that strain...


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## DobermanGuy (Dec 16, 2011)

ultrarunner said:


> I had three dogs on the 26-50 lb dosage (31, 38, 44 lbs). My purchase history with vet shows I purchased every 4 months without fail. Merial says that they will not guarantee because my dogs shared lots of Heartgard and they should have all had their own. That is ridiculous.


That does sound rediculous and I would be filing a lawsuit if I were in your shoes. ESPECIALLY if you have the proof to support that you followed their instructions. 

If you have the documentation to prove you gave the drug as directed and that you followed Merials' 'rules' they WILL lose any case you file against them. 

If any company is going to offer that kind of guarantee and YOU followed all the rules - You need to hold their feet to the fire and make them honor their promises.


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## sassafras (Jun 22, 2010)

ultrarunner said:


> He had his annuals at the end of January 2011 with a negative heartworm test. Suddenly in October 2011 he is coughing blood. Immediate vet visit and he tested positive for heartworm on the snap 4dx test. X-rays showed heart enlargement, bronchiole blockage etc. Vet said one of the worst cases of heartworm he had seen...He was put on antibiotics and steroids and within 2 hours went into a coughing spasm and died...This was right before Thanksgiving and no one at Merial was available. We buried him at the lake house and the Monday after Thanksgiving Merial requested he be exhumed and an autopsy performed. Wasn't going to subject him or the kids to this.


I'm not saying I disagree with your decision not to do it, I'm just saying I understand why they want objective evidence for a claim (from anyone, not just you) that a dog died of heartworm. You may be honest, but not everyone is. There are plenty of people who would happily try to scam money out of them for something totally unrelated to heartworm. 



> I had three dogs on the 26-50 lb dosage (31, 38, 44 lbs). My purchase history with vet shows I purchased every 4 months without fail. Merial says that they will not guarantee because my dogs shared lots of Heartgard and they should have all had their own. That is ridiculous.


Yea I agree this is pretty silly on Merial's part because it's simply a record keeping issue. I mean, you shouldn't have to make sure there are 2 pills on on dog's record, 2 pills on another dogs's record, and so on. If you purchase sufficient quantities to treat all your dogs over a year's period it shouldn't matter which dog's names the purchases were under. I do wish they would change this but I doubt they will. Again, I get they are trying to protect themselves against fraudulent claims but this seems pretty dumb to me.


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## juliemule (Dec 10, 2011)

Its possible mine had a false negative. Though I don't believe so, two are positive, she lives with them and was on the same failing prevention. Also, as far as I can remember the snap tests are pretty reliable. At least they used to be.

I think medial should cover all the vet expenses related to heartworm disease. I have learned the hard way. I hope my old Guy can recover and hope your others get through treatment ok.


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## juliemule (Dec 10, 2011)

Spellcheck, and I can't edit....... merial not medial


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## ultrarunner (Nov 22, 2011)

Dobermanguy,
*Merial does not pay for any and all treatment...*
You can call and talk to a customer service rep but ultimately one of Merial's vets will make the decision. You will never be allowed to talk to the vet that does and only your vet will be able to. But beware if your vet puts himself/herself in this situation, Merial is also the only manufacturer of immiticide (the treatment for heartworm) and there is a shortage and if your vet happens to need to treat a dog with heartworm (and has not stockpiled immticide), Merial may not be willing to send.

While the Merial guarantee states that it will pay for diagnosis and treatment, my dog Max (heartworm negative 1/26/11) with the purchase of 12 dose Heartgard preventative tested positive for heartworm 11/21/11 and died a few hours later. Merial will not cover the diagnosis expenses because treatment was never provided.

Master P, heartworm negative 9/29/10 with the purchase of 12 dose Heartgard preventative tested positive for heartworm 11/28/11. Merial decided to pay for the immiticide and $500. Total so far for treatment has been $1275.99 less immiticide costs $215.48 and $500 which means I've still been responsible for $560.51.

Jacob, heartworm negative 1/26/11, who had purchase of 12 dose Heartgard in August, 2010 and then 6 dose purchase on 6/23/11, tested heartworm positive 11/28/11. Merial has decided only to pay for the immiticide. Total so far for treatment has been $1521.45 less immiticide costs of $660.84 which means I've still been responsible for $860.61.

Also, Merial guarantee states that you will reimbursed for Heartgard purchases but will not and has sent my vet one 12 month supply. I don't use Heartgard any longer.

Not that I would ever wish this situation on someone, but in the event you find yourself in it, Dobermanguy, no surprises when Merial does not pay for any and all treatment even if all documentation is in check with guarantee and provided.



Merial is the ONLY product on the market that will pay for any and all treatment if used as directed and IF you are doing the yearly testing as required - You will not likely be in any real danger or ever have to pay for any treatments. You are not going to have a major worm infestation if you are using the Heartgard as directed and they WILL pay for any treatment should a new strain show up on your yearly test.

I stick with Merial for my dogs.[/QUOTE]


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## Pawzk9 (Jan 3, 2011)

On using ivermectin (the wormer) if you have a collie type dog (I know the belgians are not) you want to be sure the dog is MDR-1 normal/normal before using. It can kill a dog who is normal/mutant or mutant/mutant


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