A new partnership introduced at the NAVC last week is intended to educate pet owners – and veterinary professionals – about the growing need to protect cats from heartworm disease. While the American Heartworm Society (AHS) has worked to raise awareness about the disease in dogs, this year the American Association of Feline Practitioners (AAFP) has thrown its hat into the ring with new data about how heartworm affects cats.

“We are looking at heartworm within a prevention context,” said James Richards, DVM, past president of the AAFP. “We want to add it to wellness discussions – along with behavior issues – and talk with owners about risks. We have a tendency to put out fires rather than prevent fires. [Now we realize that] emphasizing preventative medicine is really the way to go.

Tom Nelson, DVM, president of the AHS, and Richards tag-teamed the presentation on Jan. 14, 2007, and introduced a consumer campaign titled “KNOW More Heartworms” as well as an in-clinic veterinary kit.

Dispelling the myth that indoor cats are not at risk for heartworm disease, Richards noted that one half to one-third of the cats with heartworms do not roam outdoors and told audience members that they should look for heartworms in cats wherever they see the disease in dogs.

Paul Pion, DVM, DACVIM, president of Veterinary Information Network (VIN), raised the issue of how programs such as this can be presented in ways that help practitioners make rational recommendations to clients rather than simply adding to the “overwhelming number of recommendations that similar program and product promotions encourage.” In other words, he asked, how do we refine the message so that doctors can know which recommendations rationally apply to their practice location and patient demographics?

In response, several AAFP board members raised the issue of informed consent. “Let the client make that decision,” Nelson said. “It’s always better to give the information upfront than to “have a client come back and say, ‘why didn’t you tell me about this?’”

John McCall, DVM, who had a personal experience with feline heartworm prevention or the lack thereof, said, “I think it’s better to over-prescribe here.”

After the press conference, Pion clarified, “We need to take responsibility for making recommendations that are rational, not just give clients all of their options and hope they make the best choices. Offering everything to everyone indiscriminately is not good medicine and ultimately risks degrading the public’s trust in our recommendations.”

McCall told a story about a family cat that died of heartworm disease. He had advised his brother, who lives in southern Georgia to put his dog on heartworm prevention but wasn’t aware that he had a cat. When he asked his sister-in-law why she hadn’t put the cat on prevention as well, she told him that their veterinarian told her that it wasn’t important for cats.”

Pathology
Feline pathology of heartworm disease is different than dogs, and may manifest with wheezing or coughing, according to new studies that show a significant respiratory pathology at all heartworm stages, including larvae. Research indicates that fast breathing, feline asthma, or bronchitis may be caused by the presence of heartworms.

“We have some ground to gain even in our own community,” Richards said, acknowledging the fact that many veterinarians fail to broach the issue of heartworm disease with their clients. Part of the problem is that cats with heartworm disease do not show clinical signs, because they are not normally active.

“You don’t see cat races,” Nelson joked. To illustrate the lack of awareness among practitioners, Nelson pointed to the fact that only 3.9 percent of cats are on heartworm prevention compared to about 50 percent of dogs. “Why is it so hard for the veterinary profession to acknowledge that heartworm occurs in cats,” he asked the audience. “Because we don’t recognize it!