Other points of view are always welcome, don't worry about starting a war
My issue lies more with the fact that issues regarding Proheart were ignored by the company for so long. It isn't so much that I do not trust moxidectin, I do not trust the company to put forth a truly safe product. Unfortunately, they make a lot of things.
I am not suggesting that people either choose Proheart or not treat their dogs.
Of course the risk of heartworm in an untreated dog outweighs the risk of a Proheart reaction, no one is arguing that.
I'm not ruling it out as a potential preventative. Like I said, if I saw it safe on the market now for a few years, I would consider it effective and safe, but my own knowledge of the hullabaloo surrounding its recall would make me wary of actually recommending it over and above other monthly medications.
Ivermectin toxicity mostly kills animals because owners are uneducated by their veterinarians and go buy bulk ivermectin (like the horse dose and try to do the math for dogs to save money) ad dose it improperly, or dose their own products improperly, and many of those reports are sketchy. Current ivermectin treatments on the market for dogs are not concentrated enough to kill a dog with the average ivermectin sensitivity: that is one of the many reasons why ivermectin based products have been reported to be less effective, the dose is becoming too low.
And vaccine related sarcomas are so ridiculously rare that there is NO reason to stop vaccinating cats...much more rare that proheart reactions or reactions to any other med or vaccine...the risk of acquiring the disease is many, many times higher than the risk of a vaccine related sarcoma.
If we had an alternative to those, then sure, to minimize the already minute risk of sarcoma, I'd use it. But we don't. we DO have alternatives to proheart. it is a matter of continually educating clients to increase compliance, not choosing a riskier drug. Because that is a slippery slope IMO.
It is our job as veterinarians to provide the safest drug to the animal and to educate clients, not to give up on clients as being idiots and give them the easiest alternative that may have more side effects/risks associated.