You may recall that I posted previously on my concerns about our heartworm preventive medicines becoming less than 100% effective. There seems to be no difference in efficacy between the different medications, nor does it appear to be dose-related (i.e. giving a 100-pound dose to a 51 pound dog doesn't guarantee effectiveness). I even tried dosing my own dog twice monthly, using different preventive medicines (she got heartworms anyway — not bad, but she has them).
So what if they were taking preventive medicine constantly? That's what we used to do with daily preventive medicine, but we had trouble getting all the dogs medicated every day, year round. We had compliance problems from both the dog and the owner.
We also used to have continuous daily heartworm preventive medication that was pretty much trouble-free. ProHeart-6 was given by injection once every six months. It was a timed-release medication — basically, you injected a blob of medicine under the skin and it slowly leached into the bloodstream for the next six months. I didn't have a lot of clients on the product, as it didn't control the intestinal worms like Heartgard-30 or Interceptor, and it didn't control fleas like Revolution. Also, we had occasional problems with people coming in a month or two late for the next injection (not good). We had no medical problems with the product, though.
That's why I was flabbergasted when (with no warning from the manufacturer, Fort Dodge Animal Health) the product was pulled from the market. It was all over CNN after I went to bed, and I didn't look at Veterinary Information Network until after clients began calling on the Saturday morning in September 2004. The FDA mandated its removal, citing many adverse reactions, including patient death (which I admit is a bad thing).
The funny thing (funny-strange, not funny-haha) was that the product continued to be used in other countries around the world with no apparent problems. No explanation there, just the FDA "looking out for us" ( I guess Fort Dodge didn't slip them as much cash as Eli Lilly, whose psychotropic drugs list everything they are prescribed for as potential side effects, including suicide. I don't feel like the FDA is looking out for us so well, there.).
Well, ProHeart-6 is coming back, but I can't buy it until I complete my one-hour web seminar this week. It will only be available through a "restricted distribution program", whatever that means. Not only will we not be using it in sick or debilitated animals, we also won't be using it in animals that are underweight, or who have history of weight loss (this being America, there won't be many of those). AND we can't give it within one month of vaccinations. What that says to me is that they don't want to get blamed for any vaccine reactions. Fort Dodge doesn't want to take any lumps for somebody else's lumps. I can certainly understand that, since it took them four years to get the stuff back on the market. On the other hand, I know that my clients won't exactly be happy about having to schedule extra visits.
On the other hand (is that three hands?), if ProHeart-6's daily continuous release of medication makes it 100% effective in those big outside dogs, they will be picking up more market share with my big, outside dog patients. I'd sure like to be able to give people back the confidence they used to have in their heartworm preventive.