#preventatives

vet-and-wild here.

I'll give a little caveat that I'm most familiar with Heartgard, because that's what my clinic uses. Heartworm medication basically works by back-treating infections before the larvae can grow and cause disease. This is different than how most flea/tick meds work, because those are providing forward prevention. Meaning, when you give heartworm medication you're basically treating for the previous 30 days (or whatever the product is labeled for). Conversely, flea/tick meds are treating for the following 30 (or whatever) days. So heartworm meds aren't really in the system for very long.

In my opinion, yes. Heartworm disease has been diagnosed in all 50 states in the US, and the American Heartworm Society recommends having your dog on a year-round preventative regardless of where you live. Here’s an incidence map for heartworm disease diagnosed in 2013, if you’re interested.

My reasoning is this:

1) Heartworm disease can be fatal, and can also cause permanent damage to your dog’s heart and lungs even after successful treatment.

2) Treating heartworm disease is very expensive (often around $1,000), painful, and requires your dog to have little or no physical activity during the time he is being treated. Some dogs have to be crated or caged for the majority of their treatment, which can last for several months.

3) Heartworm preventatives aren’t very expensive, especially compared to treatment. You can get a 12 month supply for around $100, depending on the brand. Many heartworm preventatives also work for multiple parasites, so you get more for your money; fleas and intestinal parasites are the most common.

Ultimately the choice is up to you, but I personally prefer to err on the side of caution.

I literally cannot stress enough how influential cystitis or a UTI can be to someones dementia. It exasperates everything, all normal symptoms are heightened and it can be very stressful for all parties. My Nan is incredibly prone to cystitis and has been throughout her life, this is now more common due to her lack of willingness to drink fluids and my Grandpas resistance to push the person he loves to do something she doesn't want to do, regardless of how important it is to keep her hydrated.

We now make sure she drinks cranberry juice diluted with water everyday and she drinks out of a 'sippy cup' as this makes her more independent and we can monitor how much she is drinking. Here's a link from Alzheimer's Society (http://www.alzheimers.org.uk/factsheet/528) explaining an outcome called 'delirium'. This can cause 'agitation or restlessness, increased difficulty with concentrating, hallucinations or delusions, or becoming unusually sleepy or withdrawn.' Obviously anyone caring for a person with dementia will know that these symptoms are difficult to distinguish as they are so similar to their usual behaviours, so be sure to ask if they are in pain, having trouble going to the toilet or if they feel like they need to go more regularly than usual. If you think they have a UTI or infection then contact their doctor immediately.