Heartworm Disease and Prevention

Heartworm Disease and Prevention

What are heartworms?

The heartworm (or Dirofilaria immitis) is a variation of roundworm, transferred by mosquitoes and one of the more dangerous parasites found in pets. Heartworms can reach up to a foot in length and can affect dogs, cats, ferrets, and wildlife, such as coyotes, wolves, foxes, mountain lions, bobcats, etc. These parasites are transmitted from one animal to another by mosquitoes. After a mosquito bites an infected animal, they can transmit the larva to other animals when they take a blood meal. As mosquitoes can get inside your home, both indoor and outdoor pets are at risk for heartworm disease. After being bitten by an infected mosquito, the heartworms migrate to the right side of the heart where they grow into adults and are capable of causing substantial permanent damage to the heart and lungs before your pet shows any signs of disease.

What are the symptoms of heartworms?

In the early stages of the disease, many dogs show few symptoms or no symptoms at all. The longer the infection persists, the more likely symptoms will develop. Active dogs, dogs heavily infected with heartworms, or those with other health problems often show pronounced clinical signs. Signs of heartworm disease may include a mild persistent cough, reluctance to exercise, fatigue after moderate activity, decreased appetite, and weight loss. As heartworm disease progresses, pets may develop heart failure and the appearance of a swollen belly due to excess fluid in the abdomen. Dogs with large numbers of heartworms can develop sudden blockages of blood flow within the heart leading to a life-threatening form of cardiovascular collapse.

What do I need to know about heartworm testing?

All dogs should be tested annually for heartworm infection, and this can usually be done during a routine visit for preventive care. Following are guidelines on testing and timing:

  • Puppies under 7 months of age can be started on heartworm prevention without a heartworm test (it takes at least 6 months for a dog to test positive after it has been infected), but should be tested 6 months after your initial visit, tested again 6 months later and yearly after that to ensure they are heartworm-free.
  • Adult dogs over 7 months of age and previously not on a preventive need to be tested prior to starting heartworm prevention. They, too, need to be tested 6 months and 12 months later and annually after that.
  • If there has been a lapse in prevention (one or more late or missed doses), dogs should be tested immediately, then tested again six months later and annually after that.

Annual testing is necessary, even when dogs are on heartworm prevention year-round, to ensure that the prevention program is working. Heartworm medications are highly effective, but dogs can still become infected. If you miss just one dose of a monthly medication—or give it late—it can leave your dog unprotected. Even if you give the medication as recommended, your dog may spit out or vomit a heartworm pill—or rub off a topical medication. Heartworm preventives are highly effective, but not 100 percent effective. If you don’t get your dog tested, you won’t know your dog needs treatment.

How do monthly preventives work?

Whether the preventive you choose is given as a pill, a spot-on topical medication or as an injection, all approved heartworm medications work by eliminating the immature (larval) stages of the heartworm parasite. This includes the infective heartworm larvae deposited by the mosquito as well as the following larval stage that develops inside the animal. Unfortunately, in as little as 51 days, immature heartworm larvae can molt into an adult stage, which cannot be effectively eliminated by preventives. Because heartworms must be eliminated before they reach this adult stage, it is extremely important that heartworm preventives be administered strictly on schedule (monthly for oral and topical products and every 6 months for the injectable). Administering prevention late can allow immature larvae to molt into the adult stage, which is poorly prevented.

What happens if my dog tests positive for heartworms?

No one wants to hear that their dog has heartworm, but the good news is that most infected dogs can be successfully treated. The goal is to first stabilize your dog if he is showing signs of disease, then kill all adult and immature worms while keeping the side effects of treatment to a minimum. Here’s what you should expect if your dog tests positive:

  • Once a dog tests positive on an antigen test, the diagnosis should be confirmed with an additional—and different—test. Because the treatment regimen for heartworm is both expensive and complex, your veterinarian will want to be absolutely sure that treatment is necessary.
  • Restrict exercise might be difficult to adhere to, especially if your dog is accustomed to being active. But your dog’s normal physical activities must be restricted as soon as the diagnosis is confirmed, because physical exertion increases the rate at which the heartworms cause damage in the heart and lungs. The more severe the symptoms, the less activity your dog should have.
  • Before actual heartworm treatment can begin, your dog’s condition may need to be stabilized with appropriate therapy. In severe cases of heartworm disease, or when a dog has another serious condition, the process can take several months.
  • Once your veterinarian has determined your dog is stable and ready for heartworm treatment, he or she will recommend a treatment protocol involving several steps. Dogs with no signs or mild signs of heartworm disease, such as cough or exercise intolerance, have a high success rate with treatment. More severe disease can also be successfully treated, but the possibility of complications is greater. The severity of heartworm disease does not always correlate with the severity of symptoms, and dogs with many worms may have few or no symptoms early in the course of the disease.
  • Approximately 6 months after treatment is completed, your veterinarian will perform a heartworm test to confirm that all heartworms have been eliminated. To avoid the possibility of your dog contracting heartworm disease again, you will want to administer heartworm prevention year-round for the rest of his life.

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