# At my wits end with heartworm meds



## CarolynAnn (Apr 14, 2009)

I don't know where to go from here with heart worm meds, and was hoping someone else on the forum has experienced something like this. Rocky is 3 years old and weighs 4.9 to 5 pounds. Since I got him at 12 weeks, he was been on Interceptor for heartworms, with no problem. When Interceptor went off the market, my vet gave him Iverhart Plus. I gave it to him 7-8-12 and as far as I know, he kept it down, though he could have thrown up outside without my knowledge. When I gave it to him on 8-8-12, he threw up within 2 hours. I next tried Heart Shield capsules on 8-12-12. He threw up about 10 hours later, and the vet said it would be unusual for the Heart Shield to have caused that after so many hours. Today I gave him another Heart Shield. I stayed with him for about 3 hours, and nothing happened. Then I had to be out of the house for 4 hours, and when I got back, he had thrown up several times - sort of a white frothy liquid, mixed with the undigested cheese that I had used to give him the Heart Shield. He's also had a semi-solid accident in the house. He seems to feel fine, is playful & ate his dinner ok. His vet has suggested Advantage Multi for heartworms & fleas, but I've heard some bad things about that product, too, but don't know anything else to give him. I'm worried sick that he may have been exposed to heart worms in the last couple of months since we don't know for sure how much of the medicine he's kept down, and right now we have so many mosquitoes in Texas. He did have his annual heart worm test on 8-14-12 which was negative. Sorry about the long post....but does anyone have any advice? Thanks, Carolyn


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## Patsy Heck (Jun 10, 2011)

I think it sounds like you need to go to a topical like your vet recommended. I use advantage multi since we too have mosquitos bad here in KY. The girls are 5lbs. and have done fine. Sometimes you have to weigh the risks. My vet said heartworm in these small dogs could be fatal.


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## MalteseJane (Nov 21, 2004)

It is difficult for some one else to advise you. When I was in Houston I used Sentinel during the summer months and at one point Heartgard. Never gave anything from October to about May. I am 99.9% sure my dog had recurrent staph infection from those products. So even tho vets say it cannot be, my experience tells me it can be. 
How much is your little one outside ? With everything you have experienced with those products I personally would take the risk and not medicate. But that's me. Topical Advantage can also cause problems. It's a chemical after all. I would try to spray him with a natural repellent when you let him go outside.


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## Ladysmom (Oct 19, 2004)

Oh, dear. Texas is at an extreme risk for heartworms, so skipping it is not an option.

http://spoiledmaltese.com/forum/52-maltese-health-behavior/120981-2012-heartworm-map.html

I have never used anything but Interceptor. It was the only safe heartworm preventative for Lady with all her health issues and Bailey has always gotten it. Thankfully I stocked up last year when they closed the plant, but my stockpile won't last forever. 

Have you tried Heartguard? It's been around for a long time although I have heard stories of dogs throwing it up. Maybe you could try one treatment of Advantage Multi? Like you I hate to combine flea and heartworm treatments. I always space them apart by about two weeks. In this case you may not have a choice, though.


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## jmm (Nov 23, 2004)

I believe the active ingredient in all of those vomited meds is ivermectin. Some dogs are more sensitive to that drug than others. If I were to use a topical heartworm med I would select Revolution.


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## sassy's mommy (Aug 29, 2005)

I have always used Sentinel. I like it because it has a dosage for dogs under 10 lbs.


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## pippersmom (May 21, 2012)

I've been using Revolution since April and have had no problems so far. You could ask your vet about this topical. I like the topical because you don't have to worry about trying to get it down them.


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## Ladysmom (Oct 19, 2004)

sassy's mommy said:


> I have always used Sentinel. I like it because it has a dosage for dogs under 10 lbs.


Sentinel, like Interceptor, is no longer being produced by Novartis. It was manufactured in the same North Dakota plant that was shut down almost a year ago.


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## edelweiss (Apr 23, 2010)

Revolution. . . I use it in Europe called Stronghold. No issues & have allergic dogs.


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## lmillette (Apr 23, 2012)

I really liked Interceptor and am still upset that it is gone. Opey has been on Trifexis since Interceptor went away and he hasn't had any issues with it. It doesn't appear that this product has ivermectin in it, the ingredient Jackie mentioned. It does have the same ingredient as Interceptor had, milbemycin oxime. So maybe you could give that a try or try one of the topicals.


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## Ladysmom (Oct 19, 2004)

lmillette said:


> I really liked Interceptor and am still upset that it is gone. Opey has been on Trifexis since Interceptor went away and he hasn't had any issues with it. It doesn't appear that this product has ivermectin in it, the ingredient Jackie mentioned. It does have the same ingredient as Interceptor had, milbemycin oxime. So maybe you could give that a try or try one of the topicals.


Trifexis contains Spinosad which can cause vomiting so Rocky might not do well on it.

Trifexis | Flea & Heartworm Control - 1800PetMeds


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## TLR (Nov 13, 2011)

I used sentinel until I ran out last month and switched to revolution. I know the weight on revolution is 5.1 lbs. Ben weights 5.1 pounds and tolerated it well. I was very nervous as he seems to have sensitivities to must all chemicals but he did fine. He just had his second dose of revelation on the first without any problems.


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## lmillette (Apr 23, 2012)

Ladysmom said:


> Trifexis contains Spinosad which can cause vomiting so Rocky might not do well on it.
> 
> Trifexis | Flea & Heartworm Control - 1800PetMeds


Just a thought. I feel like all medications out there list vomiting as a possible side effect. Was thinking it may not be too bad on his tummy if he tolerated Interceptor and this does have the same ingredient in addition to Spinosad.


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## sassy's mommy (Aug 29, 2005)

Ladysmom said:


> Sentinel, like Interceptor, is no longer being produced by Novartis. It was manufactured in the same North Dakota plant that was shut down almost a year ago.


 Marj who is manufacturing the Sentinel now? I just purchased 6 months at my vet's office 2 weeks ago. The exp date is 2014.


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## jmm (Nov 23, 2004)

Spinosad commonly causes vomiting the first time you give it. It is such a common reaction your vet should caution you about it. Most dogs are fine with follow up doses.


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## bailey02 (May 1, 2009)

CarolynAnn said:


> I don't know where to go from here with heart worm meds, and was hoping someone else on the forum has experienced something like this. Rocky is 3 years old and weighs 4.9 to 5 pounds. Since I got him at 12 weeks, he was been on Interceptor for heartworms, with no problem. When Interceptor went off the market, my vet gave him Iverhart Plus. I gave it to him 7-8-12 and as far as I know, he kept it down, though he could have thrown up outside without my knowledge. When I gave it to him on 8-8-12, he threw up within 2 hours. I next tried Heart Shield capsules on 8-12-12. He threw up about 10 hours later, and the vet said it would be unusual for the Heart Shield to have caused that after so many hours. Today I gave him another Heart Shield. I stayed with him for about 3 hours, and nothing happened. Then I had to be out of the house for 4 hours, and when I got back, he had thrown up several times - sort of a white frothy liquid, mixed with the undigested cheese that I had used to give him the Heart Shield. He's also had a semi-solid accident in the house. He seems to feel fine, is playful & ate his dinner ok. His vet has suggested Advantage Multi for heartworms & fleas, but I've heard some bad things about that product, too, but don't know anything else to give him. I'm worried sick that he may have been exposed to heart worms in the last couple of months since we don't know for sure how much of the medicine he's kept down, and right now we have so many mosquitoes in Texas. He did have his annual heart worm test on 8-14-12 which was negative. Sorry about the long post....but does anyone have any advice? Thanks, Carolyn


I use heartguard for heartworms and Confortis for the fleas..trust me i know texas mosquitoes are killer...


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## Ladysmom (Oct 19, 2004)

sassy's mommy said:


> Marj who is manufacturing the Sentinel now? I just purchased 6 months at my vet's office 2 weeks ago. The exp date is 2014.


Sentinel has not been manufactured since late last Fall when Novartis shut down the plant. You are lucky that your vet still had it in stock. My vet had a run on Interceptor when word got out and sold out of it early this year.


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## CrystalAndZoe (Jul 11, 2006)

For what it's worth, if I did not have my stock pile of Interceptor I would most likely use Revolution. As much as I hate using something that is a combo med (flea & heartworm), I tend to go with a product that is dosed for a dog as close to my dog's weight as possible. You can get one that is dosed for dogs up to 5 lbs and one that's dosed for dogs from 5.1 lbs to 10 lbs. On a topically applied product like Revolution, for a dog that is most likely bathed weekly, I would use monthly as prescribed. For me, after the study, research, and putting 2 traditional vets and 1 holistic vet in a flat out, no way of giving the 'accepted and trained' answer situation, I'm giving my 3 their Interceptor every 80 days. I use my iPhone (Seri) to remind me every 80 days. Technically you could go 90 days, but I'm ok overlapping by 10 days.

Still no conclusive word as to when Interceptor will be available again.

Excedrin & Interceptor – Back By Mid-Year? eFoodAlert


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## sassy's mommy (Aug 29, 2005)

Ladysmom said:


> Sentinel has not been manufactured since late last Fall when Novartis shut down the plant. You are lucky that your vet still had it in stock. My vet had a run on Interceptor when word got out and sold out of it early this year.


 Marj I called my vet and was assured that the product I have is in fact a Novartis product. They just had a stock pile and only allowing patients to purchase 6 months at a time is the only reason they still had some Sentinel.


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## Ladysmom (Oct 19, 2004)

sassy's mommy said:


> Marj I called my vet and was assured that the product I have is in fact a Novartis product. They just had a stock pile and only allowing patients to purchase 6 months at a time is the only reason they still had some Sentinel.


Yup, that's what I said, that your vet had stock. 

My vet allowed clients to purchase a year's supply at a time and it went quickly. Fortunately I had four pills left in a six month supply and I give it every 45 days so I am all set for awhile.

From what I have read, Novartis' problems with the FDA went back for years. It sounds like there is a strong possibility that the plant won't reopen. I have no idea what I'll do then.

Veterinarians frustrated by Novartis backorders - VIN

http://skewnews.com/excedrin-shortag.../#.T-cg4NUSHxE

Novartis Consumer Health


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## sassy's mommy (Aug 29, 2005)

Ladysmom said:


> Yup, that's what I said, that your vet had stock.
> 
> My vet allowed clients to purchase a year's supply at a time and it went quickly. Fortunately I had four pills left in a six month supply and I give it every 45 days so I am all set for awhile.
> 
> ...


 
I am also giving Sassy her pill every 45 days....but don't know what I will use if Novartis doesn't reopen. Guess I should start thinking about it.


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## Ladysmom (Oct 19, 2004)

sassy's mommy said:


> I am also giving Sassy her pill every 45 days....but don't know what I will use if Novartis doesn't reopen. Guess I should start thinking about it.


I'm in denial. :hiding:


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## ffalcon (Sep 30, 2008)

MalteseJane said:


> It is difficult for some one else to advise you. When I was in Houston I used Sentinel during the summer months and at one point Heartgard. Never gave anything from October to about May. I am 99.9% sure my dog had recurrent staph infection from those products. So even tho vets say it cannot be, my experience tells me it can be.
> How much is your little one outside ? With everything you have experienced with those products I personally would take the risk and not medicate. But that's me. Topical Advantage can also cause problems. It's a chemical after all. I would try to spray him with a natural repellent when you let him go outside.


Hello! I'm new to this forum even though I registered years (when I first got my adorable little maltese) and lurk around for information. I've been having issues with my Daisy having fleas jump on her when she goes into the yard, and even if I catch them right away it still makes me really nervous as they could have already bit her. She has MVD, so I don't like to give her any unnecessary toxins like the flea pesticides in Advantix, frontline, etc. I saw you said you spray with a natural repellent when your maltese goes outside. What do you use if you don't mind me asking? I"m interested in finding a safer natural alternative to flea spot on products. thanks in advance.

~Daisys Mom


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## MalteseJane (Nov 21, 2004)

ffalcon said:


> Hello! I'm new to this forum even though I registered years (when I first got my adorable little maltese) and lurk around for information. I've been having issues with my Daisy having fleas jump on her when she goes into the yard, and even if I catch them right away it still makes me really nervous as they could have already bit her. She has MVD, so I don't like to give her any unnecessary toxins like the flea pesticides in Advantix, frontline, etc. I saw you said you spray with a natural repellent when your maltese goes outside. What do you use if you don't mind me asking? I"m interested in finding a safer natural alternative to flea spot on products. thanks in advance.
> 
> ~Daisys Mom


I already replied in your other post. I don't know if you are in an apartment or a house. If you are in a house and have a yard you need to spray your yard periodically to kill the fleas. You can buy a spray at Home Depot or Lowe's that hooks up to your water hose. That's the easiest way to do it. If you don't treat the environment you won't be able to get rid of the fleas. Those products also _help_ with the mosquitoe problem. Don't let the dog out before the product is completely dry. If you treat the environment there is a good chance you won't have to put anything on your dog. When you start seeing one or 2 fleas on your dog, you know it's time again to treat the yard. Here is a recipe for your dog :
1/2 oz (15 ml) base oil (hazelnut or sweet almond)
4 drops Clary Sage
1 drop Citronella
7 drops Peppermint
3 drops Lemon
Store in a dark glass bottle. Apply 2-4 drops topically to the neck, chest, legs and tail of the dog. You can also add the drops to a bandanna or cotton collar.
*Make sure to use pure essential oils not synthetic oils.
*Here is a recipe for a Spritz :
Makes 8 oz (240 ml)
1 teaspoon vegetable glycerin
1/2 oz (15 ml) Grain Alcohol or Vodka
1 teaspoon Sulfated Castor oil
10 drops Grapefruit Seed Extract
7 oz Distilled or Spring Water
4 drops Clary Sage
1 drop Citronella
7 drops Peppermint
3 drops Lemon
If you don't find the glycerin, just forget about it. 

Hope this helps. But the important thing is to treat the environment before treating the dog.


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## hoaloha (Jan 27, 2012)

I know lots of people have had no issues with Interceptor... but can I ask a question to those of you using Novartis products (sorry, if I'm being naive :blush- Do you not feel nervous that the Novartis plant was actually shut-down by the FDA due to patient safety issues? I'm guessing you guys like it for your fluffs because of the prior good responses. I don't think I would want to take meds from Novartis that have been recalled (ie. the human over-the-counter ones). Do you ladies feel that it is safe and the 'lesser of two evils' by not switching to something else? I am trying to decide for Obi and all this heartworm med recall stuff and side effects etc makes me scared honestly! I've been using topical frontline for fleas and then essential oils for ticks/mosquitos if we go out. And my vet didn't strongly recommend any one particular product for Obi since we live in a low-risk heartworm area. This stuff makes my head spin :smpullhair:


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## Ladysmom (Oct 19, 2004)

hoaloha said:


> I know lots of people have had no issues with Interceptor... but can I ask a question to those of you using Novartis products (sorry, if I'm being naive :blush- Do you not feel nervous that the Novartis plant was actually shut-down by the FDA due to patient safety issues? I'm guessing you guys like it for your fluffs because of the prior good responses. I don't think I would want to take meds from Novartis that have been recalled (ie. the human over-the-counter ones). Do you ladies feel that it is safe and the 'lesser of two evils' by not switching to something else? I am trying to decide for Obi and all this heartworm med recall stuff and side effects etc makes me scared honestly! I've been using topical frontline for fleas and then essential oils for ticks/mosquitos if we go out. And my vet didn't strongly recommend any one particular product for Obi since we live in a low-risk heartworm area. This stuff makes my head spin :smpullhair:


Marissa, I am nervous that the Novartis plant was "voluntarily" shut down one step ahead of the FDA. I ran to my vet's office and picked up a year supply of Interceptor the day I heard about the recall, before I knew the whole story. 

If you read the inspection reports (I posted the link), medications were mixed up, etc. I have never had an issue with Interceptor for over ten years, but knowing that makes me really nervous.

I suspect Novartis' reputation is so damaged that these products will never come back on the market. The same thing happened with DVM Pharmaceuticals a few years ago.


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## jmm (Nov 23, 2004)

If you are going to do an oral heartworm medication right now, I think Iverheart is the best alternative. It has ivermectin (just like heartgard and any other generic heartworm med), but it is a small pill instead of the big beef chew. They make a plus with dewormer in it. I've been using it for a while and am happy with it.


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## Furbabies mom (Jul 25, 2011)

jmm said:


> If you are going to do an oral heartworm medication right now, I think Iverheart is the best alternative. It has ivermectin (just like heartgard and any other generic heartworm med), but it is a small pill instead of the big beef chew. They make a plus with dewormer in it. I've been using it for a while and am happy with it.


I use Iverheart also. No problems!


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## jmm (Nov 23, 2004)

BTW, if you research just about any pharmaceutical company, you'll find similar things in their history. Just sayin'


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## shellbeme (Mar 1, 2011)

Originally we used revolution, then the year of the tick came. Now we use tri heart plus and frontline for fleas and ticks.


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## Ladysmom (Oct 19, 2004)

jmm said:


> If you are going to do an oral heartworm medication right now, I think Iverheart is the best alternative. It has ivermectin (just like heartgard and any other generic heartworm med), but it is a small pill instead of the big beef chew. They make a plus with dewormer in it. I've been using it for a while and am happy with it.


Earlier in this thread you suggested Revolution so now I'm confused. Which would you recommend? I am trying to research alternatives just in case Interceptor is gone forever.


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## jmm (Nov 23, 2004)

Marj, that was for a dog that does not tolerate Ivermectin. Pretty much every Heartgard-like product is ivermectin based, including Iverheart. Revolution contains a "cousin" selemectin which works differently and hence is well tolerated by dogs that don't tolerate ivermectin. My personal dogs do fine with ivermectin so get Iverheart.


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## Ladysmom (Oct 19, 2004)

jmm said:


> Marj, that was for a dog that does not tolerate Ivermectin. Pretty much every Heartgard-like product is ivermectin based, including Iverheart. Revolution contains a "cousin" selemectin which works differently and hence is well tolerated by dogs that don't tolerate ivermectin. My personal dogs do fine with ivermectin so get Iverheart.


Thanks! So you've had no issues with combinations meds? I am so paranoid because of Lady's health issues. I always separated her Advantage and Interceptor by two weeks. Bailey is a healthy boy from a great breeder so I know I shouldn't worry, but I can't help it.

Would I better just switching to Heartguard and then doing Frontline Plus two weeks later?


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## jmm (Nov 23, 2004)

I really don't pay any attention to separating meds. 
Just be sure if you use Heartgard that the dog will chew up the entire chew. If they won't you need a different product.


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## allheart (Oct 3, 2008)

jmm said:


> I really don't pay any attention to separating meds.
> Just be sure if you use Heartgard that the dog will chew up the entire chew. If they won't you need a different product.


 
That is so true with the Hearguard. I have to break it up in little pieces and hand feed Ana with it, to make sure she gets it all. But she does. Mia and Leo gobble it down. 

I wish heartguard came in pill format to, and I could put it in a pill pocket for Ana.


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## jmm (Nov 23, 2004)

It does...its called Iverheart


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## allheart (Oct 3, 2008)

jmm said:


> It does...its called Iverheart


 
Great Jackie, thanks so much. That would be so much better for Ana.

Thank you!!!!!


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## hoaloha (Jan 27, 2012)

Thank you guys for your suggestions and experiences! Discussions like these are so helpful


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## ffalcon (Sep 30, 2008)

MalteseJane said:


> I already replied in your other post. I don't know if you are in an apartment or a house. If you are in a house and have a yard you need to spray your yard periodically to kill the fleas. You can buy a spray at Home Depot or Lowe's that hooks up to your water hose. That's the easiest way to do it. If you don't treat the environment you won't be able to get rid of the fleas. Those products also _help_ with the mosquitoe problem. Don't let the dog out before the product is completely dry. If you treat the environment there is a good chance you won't have to put anything on your dog. When you start seeing one or 2 fleas on your dog, you know it's time again to treat the yard. Here is a recipe for your dog :
> 1/2 oz (15 ml) base oil (hazelnut or sweet almond)
> 4 drops Clary Sage
> 1 drop Citronella
> ...


Wow! Thanks so much for this post. These recipes are super helpful and I'm going to try them out. So far, I've used Diatomaceous earth in the yard and front of the house. It seems to have helped, but I have still seen a couple of fleas. I'm not sure if I just need to add more or go for something stronger. How often do you apply the oil or spritz recipe?


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## SammieMom (Nov 13, 2010)

jmm said:


> Marj, that was for a dog that does not tolerate Ivermectin. Pretty much every Heartgard-like product is ivermectin based, including Iverheart. Revolution contains a "cousin" selemectin which works differently and hence is well tolerated by dogs that don't tolerate ivermectin. My personal dogs do fine with ivermectin so get Iverheart.


I just found this GREAT thread. I'm out of Inteceptor! Had a yr supply but Penny came along. After reading comments, I am now glad they are gone. Who's to say they are not tainted or mixed up. 
I have a question. mine tolerated Inteceptor fine. Does it contain (IVERMECTIN)?? If so that would mean they prob would not vomit on the Iverheart. Is it a (COMBO) or just HW protection? And do you have to buy it from a Vet? 
Another ? We treat our property, so I've never needed a flea med. but I had to give Sammie FP at HH. Afterward he was super agitated and restless, circling his bed, panting some and seemed (warm (but could been from crappy AC unit) in room. We moved hotels next am but he was fine by then. Anyone know what might cause that reaction. Really scared me. he will get confortis should I need flea control. No ticks, but if he gets one I'll go to vet. 
Thanks!!


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## SammieMom (Nov 13, 2010)

My vet has TRIHEART, a generic Iverheart! What do you think?
It only comes in up to 25 lb. no 5 lb dose. Shoot!!!


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## SammieMom (Nov 13, 2010)

Jackie--sorry, I just realized that the OP used Inteceptor too and vomiting was with iverheart. Dah! I guess that's my answer. He could vomit. Maybe I'll try it and see. 
I wonder if generic is ok? Triheart?? I hate all this med stuff. I'm a "chicken little"... LOL.


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## zooeysmom (Aug 1, 2011)

bailey02 said:


> I use heartguard for heartworms and Confortis for the fleas...


This is what has worked well for my dog family over the years. I give Zooey Heartgard on the 1st of the month and Comfortis on the 16th, and I always feed them with a meal.


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## CrystalAndZoe (Jul 11, 2006)

hoaloha said:


> I know lots of people have had no issues with Interceptor... but can I ask a question to those of you using Novartis products (sorry, if I'm being naive :blush- Do you not feel nervous that the Novartis plant was actually shut-down by the FDA due to patient safety issues? I'm guessing you guys like it for your fluffs because of the prior good responses. I don't think I would want to take meds from Novartis that have been recalled (ie. the human over-the-counter ones). Do you ladies feel that it is safe and the 'lesser of two evils' by not switching to something else? I am trying to decide for Obi and all this heartworm med recall stuff and side effects etc makes me scared honestly! I've been using topical frontline for fleas and then essential oils for ticks/mosquitos if we go out. And my vet didn't strongly recommend any one particular product for Obi since we live in a low-risk heartworm area. This stuff makes my head spin :smpullhair:


Just now seeing this Marissa and I'd like to respond. You know...like Marj said, it does make me nervous. For us, neither Zoe nor Jett can tolerate ivermectin. I've not even tried with Callie. So that would pretty much leave Revolution. But I live in a high risk area for heartworm. Bathing my dogs every week makes me nervous to use a topically applied product. Plus, mine play and mouth joust each other so much that something applied topically is a worry. From my understanding, the different dosed Interceptor pills are different sizes, the 2.3 mg being 6 mm in size, the 5.75 mg being 8 mm in size and the 11.5 mg being 10 mm in size. I know a mm is very small but I'm hoping I would be able to see a difference in sizes if they had the wrong pill in the wrong package. And maybe I don't have an accurate understanding of what was really happening but I thought the problem was wrong products in wrong packages. Was it more than that?

To me, the products I'm giving to my 4 lb Callie and 5 lb Jett, and even my 9 lb Zoe that are dosed for a dog up to 25 lbs is pretty scary. Maybe it's because I don't have an understanding of how meds break down in the body but to me, giving a 5 lb dog the same dose you would give a 25 lb dog (25 lbs being 5 times the weight of a 5 lbs dog) would be the equivalent of giving a 60 lb dog the same dose you would give a 300 lb horse. Would that be right? 300 lbs being 5 times the weight of 60 lbs. Is my thinking correct?? I've been wanting to have a discussion on this for some time now. I'd love to know why this is deemed safe and ok.

I've been really successful in avoiding having to use any flea/tick meds for over 3 years now.


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