OK, thanks. I have no doubt that you are motivated to do what's best for the dog.
I think I can help explain this to you so you can make a good decision on Luke's behalf. I am a cardiac nurse with expertise in severely diseased hearts, so this is right up my alley.
To simplify (cause I've got things to do today! but know how important this is to you guys and Luke!) I am going to put this in my own words and then put some links at the bottom for your further perusal. Everything I am about to say is contained in those links for verification.
I am sorry that's so graphic, but it's really necessary to see exactly what we're talking about when it comes to heartworm. This is an actual dog's heart completely congested with real heartworms. They are like spaghetti in a heart. No doubt this dog died from the disease. You will notice how enlarged the heart is and that's because it worked extra, extra hard in its lifetime trying to do its job working against all that congestion that shouldn't be there. (Think of how lovely it would have been to have free flow without all those worms.)
So sad when prevention is so simple. To be clear, dogs get it from the bite of a mosquito in which larvae is deposited into the dogs blood stream, travels to the heart and begins to grow there. If the dog is on preventative medicine, the larvae cannot grow. If it's not, then they can and will.
So what to do once heartworm is there? That is the question.
Veterinarians spend a LOT of time researching heartworm disease because it is such a very big problem in our pet population. It is probably one of the most studied things there is in veterinary medicine. What that means is that, for many years, they have studied a variety of circumstances and treatments to see what it's all about and what works best for it and what doesn't. Vets are well aware that time, money, and other circumstances, like owners having to confine pets for extended periods, all affect treatment decisions, and they strive to find things that will work best given those considerations.
So there is a ton of evidence based research to support the current heartworm treatment guidelines as recommended by the AMVA.
Standard treatment is considered safe and effective, especially in a younger, healthy dog, and especially when disease is early stage.
However, as with most other things, there are a few caveats. These seem to include your concerns so I will help explain them in simple terms.
Activity Guidelines in Heartworm Treatment
So once treatment is started, it is necessary for the dog to keep its activity level low. Why is that? There are a couple of reasons.
First, as we can see from the picture above, blood flow is impeded in a heartworm diseased heart, so the dog can become short of breath if he significantly increases his activity level. Think of how much more oxygen would be required for a dog running vs walking. This is a supply and demand situation. Running requires higher oxygen demand from blood; but due to congestion, the diseased heart can't supply it. So one cannot add that extra stress to the heart while the worms are there.
Second, there are some concerns as the worms die off. Fragments of dead worms break off and the dog's immune system sends cells there to clean them up. This process can result in thromboemolism, or blood clots, which can then cause changes in the vasculature of the heart and lungs that cause further disease in all of the structures leading to cardiopulmonary disease. The risk of this is small, especially in younger, healthy dogs with early disease, but it is always a concern in treatment.
Please note that with both of these issues, it is a problem regardless of the *type* of treatment one chooses.
The fact that the heartworms are there is the biggest problem of all, *not* whether the dog has traditional treatment or alternative treatment.
With that said (directly from one of the links)
Herbal Therapies
No natural or herbal therapies have been shown to be safe and effective prevention or treatment for heartworm disease.
They have also done research that showed that giving heartworm preventative pills as a treatment takes up to two years to kill all the worms and damage to the cardiopulmonary system in that time can occur.
So I, personally, would feel pretty safe with standard treatment.
And I would NOT undergo alternative treatments that not only that haven't been proven safe or effective, but could actually harm the dog more so than treatment that HAS been proven safe over many years of actual academic based, scientific research.
I am just sad that they're there at all. Yes, the conventional medicine does contain arsenic but it IS necessary to kill the worms and it is in small enough amounts to be safe to the dog. Again, researched up the ying yang. Millions of dogs have successfully undergone this treatment.
I just wanted to say a word about exercise in all of this in order to address your concerns.
One benefit of this is I wouldn't have to keep Luke still/confined for months if we went this route, not to mention he wouldn't be getting these harsh treatments, that I found out includes arsenic
my main reason for wanting to explore the alternative treatment, is they are not required to be confined for that period of time, Not to mention there are negative side effects from that medicine they give for the heartworms.
The word "confined" is sort of a scary word. You've used it and I see it in the literature as well. However, I doubt that the dog has to actually be confined as in kept in a crate all the time. One definition below is "in house or on leash". (Naturally you will get specific instructions from your own vet on exact activity guidelines he or she recommends.)
But yes, his activity level has to be somewhat restricted (i.e. he can't run or play hard) but he should be able to do normal activities like walking and moving about. Remember that part of this is related to the supply and demand issue so you wouldn't want to put extra stress on the heart during his treatment anyway. (The other part being that 1) worms can be pushed out into the lungs during heavy activity and/or 2) blood clots could break loose and cause damage in the lung or brain, etc., though the risk of this is extremely low.) Activity levels also seem to vary by stage of treatment.
Again, activity levels are a concern regardless of the treatment you choose.
So in other words,
even if you go the alternative route, it is NOT ok to let the dog run around and doing so would be irresponsible even with the herbal treatment. BUT, the dog should not have to be completely confined like they might with an orthopedic procedure.
Although treatment involves risk, when we discover heartworms in dogs that are still in reasonably good shape, the risk is small. Its not unusual to have complications, but nearly all dogs survive treatment and are much healthier afterwards.
Restrict activity
The first thing we need to do is restrict your dogs activity (no ball chasing, running, or playing excitedly with the kids). The increased blood circulation from heavy exercise can push heartworms out of the major blood vessels and into the lungs, increasing the chance of developing congestive heart failure and possibly causing sudden collapse and death.
This is important: From the first stage of hospital treatment until 4 weeks after the second (about two months) your dog must be confined in the house or on a leash. After that, only limited activity (no ball chasing, running, or playing excitedly with the kids) is allowed for an additional two months.
During the critical two months, most dogs are going to cough some and have days when they dont feel well.
Links
http://pets.webmd.com/dogs/guide/heartworms-in-dogs-facts-and-myths
http://www.heartwormsociety.org/veterinary-resources/canine-guidelines.html#11
http://www.placervillevet.com/canine heartworm.htm
HTH and give Luke a scratch and a hug for me too!