Heartworms in Dogs
Heartworms in Dogs - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost
What are Heartworms?
Canine heartworms were first reported by Dr. T. C. Osborne in Erie, Alabama (1847), who described a dog with a massive number of white worms in the heart and its vessels. This disease is caused by parasitic worm called Dirofilaria immitis, which lives in the lungs, heart and associated vasculature of an infected animal where they may cause serious damage and, in some cases, the animal’s death. In 2009, there were approximately 300,000 dogs that tested positive to heartworm disease in the United States (American Heartworm Society). It is present in in all 50 states, Puerto Rico, U.S. Virgin Islands, and Guam. Heartworm disease is most common along the Atlantic and Gulf coasts from the Gulf of Mexico to New Jersey and along the Mississippi River and its major tributaries, as well as, in the Caribbean islands. The dog is the definitive host but cats and ferrets are also susceptible to infection. Heartworms also live in other mammal species, including wolves, coyotes, foxes and sea lions. Heartworm disease is a serious disease that results in severe lung disease, heart failure, other organ damage, and death in pets, mainly dogs, cats, and ferrets. It is caused by a parasitic worm called Dirofilaria immitis. The worms are spread through the bite of a mosquito.
Heartworms Average Cost
From 52 quotes ranging from $1,200 - $3,000
Average Cost
$1,800
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Symptoms of Heartworms in Dogs
Many dogs show few or no symptoms in the early stages of the disease. Heavily infected and active animals usually show more pronounced clinical signs. The clinical signs of heartworm disease include:
  • Mild persistent cough
  • Reluctance to exercise
  • Fatigue after moderate activity
  • Decreased appetite
  • Weight loss
Types
There are four classes, or stages, of heartworm disease:
  • Class 1: No symptoms or mild symptoms (e.g. occasional cough).
  • Class 2: Mild to moderate symptoms (e.g. occasional cough and fatigue moderate activity). Heart and lung changes are usually seen on chest x-rays.
  • Class 3: General loss of body condition, a persistent cough, and fatigue after mild activity. Heart and lung changes are usually seen on chest x-rays.
  • Class 4: A large mass of heartworms prevents blood from flowing back to the heart causing a cardiovascular collapse known as Caval syndrome.
Dogs with a severe infection may develop:
  • Heart failure and the appearance of a swollen belly (due to excess of fluid in the abdominal cavity).
  • Sudden blockages of blood flow within the heart (Caval syndrome), characterized by:
    • Labored breathing
    • Pale gums
    • Dark bloody or coffee-colored urine.
Causes of Heartworms in Dogs
Heartworm disease is a vector borne disease caused by a worm called Dirofilaria immitis and spread by mosquitoes. When a mosquito bites an infected dog, it becomes infected with the microfilariae (the offspring of adult worms). Microfilariae become infective larvae inside the mosquito and when the infected mosquito bites another dog transmission occur. Inside the infected dogs larvae become adults, reproduce and the offspring go to the blood. The worm’s lifespan is five to seven years and adult males measure 4 to 6 inches in length while females measure 10 to 12 inches in length.
Diagnosis of Heartworms in Dogs
There are two types of heartworm tests: the antigen detection test and the microfilariae detection test. Antigens are proteins released into the bloodstream by adult worms, thus the antigen detection test can only diagnose animals that are infected with one or more adult female worms (seven to eight months old. Similarly, the microfilariae detection test can diagnose animals infected with adult heartworms, which mate and produce offspring. Dogs should be tested for heartworm disease annually. The American Heartworm Society recommends the following testing schedule:
Puppies under 7 months of age
Heartworm prevention can be initiated without a heartworm test, and they should be tested 6 months after the initial treatment. These patients should be retested 6 months later and yearly thereafter.
Dogs over 7 months of age
The test should be conducted before starting heartworm prevention. These patients should be retested 6 months later and yearly thereafter.
If there has been a lapse in prevention
Dogs should be tested immediately, and then tested again six months later and annually after that.
Treatment of Heartworms in Dogs
  • Ivermectin: this is the main ingredient of many heartworm preventive products and it is capable of killing microfilariae. Usually, infected dogs are administered a microfilariae-killing drug to prevent them from developing into adults and then an adult-killing drug is administered.
  • Milbemycin: is also found on heartworm preventive products (e.g. Sentinel and Interceptor) and can kill the microfilariae much faster than ivermectin. This can be disadvantageous because large numbers of microfilariae dying at the same time can cause a circulatory shock.
  • Melarsomine dihydrochloride (Immiticide® by Merial): is the only FDA approved drug to kill adult worms. Treatment consists of two or three deep injections into the back muscles. These injections are very painful so your dog may also need pain medication.
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Recovery of Heartworms in Dogs
Dogs receiving heartworm treatment should be confined because physical activity can cause embolism-related problems. Heartworm treatment is potentially toxic, can cause serious complications and is expensive; therefore, prevention is the best option for your pet. There are various FDA-approved heartworm prevention products that can be prescribed by an veterinarian.
Heartworms Average Cost
From 52 quotes ranging from $1,200 - $3,000
Average Cost
$1,800
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Heartworms Questions and Advice from Veterinary Professionals
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Alaskan Malamute
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Sebastian
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11 Years
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My pet has the following symptoms:
Cough
Just received horrible news today that my 11yo malamute has heartworms. Something isn't sitting right with me in regards to treatment. Everything I've read mentions doxycycline & a round of preventative before treatment; however, my vet is ready to treat in next few days. He seemed confident & mentioned Sebastian isn't showing signs of serious infestation, but I disagree. I know my dog & he'll do everything in his power to appear fine- probably in effort to make us happy. He hasn't felt well for a while & is quickly worsening. He may not have expressed "normal" symptoms aduringas other dogs may do, but he's sick. I don't want to come across as insulting by mentioning the doxy & preventative round I've read to be standard part of treatment, but at same time; something just doesn't feel right. Any advice would be greatly appreciated
Aug. 7, 2018
0 Recommendations
Any treatment given is down to your Veterinarian as they are the prescribing Veterinarian however doxycycline administration has become increasingly used before commencing heartworm treatment; you should think about discussing this with your Veterinarian to hear their treatment plan. Regards Dr Callum Turner DVM www.ncbi.nlm.nih.gov/pmc/articles/PMC5688473/
Aug. 7, 2018
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Hound
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Rollins
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6 Years
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My pet has the following symptoms:
Heartworm
we just got Rollins a 6yr old rescue dog. His papers say he tested positive for heart worms but he is only on tri heart for a year before he will be rechecked at the shelter. My question is will the adult heart worms continue to grow while on tri heart? I don't mind taking him to a vet and paying for treatment if that is the best option for him.
July 24, 2018
Answered by Dr. Michele K. DVM
3 Recommendations
The adult worms will continue to live in his heart until they die, or he has actual treatment for the heartworm disease. Having him treated is a better option for him, and will prevent ongoing damage to his heart. Once you have him seen by a veterinarian, they'll be able to give you an idea as to cost and what to expect with treatment.
July 24, 2018
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Basenji-mix
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Sable
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12 Years
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My pet has the following symptoms:
Very Infrequent Dry Cough
My 12 y/o Basenji has been healthy, but began a dry cough, taken to vet and diagnosed with heartworms. She has been on 3 meds for 2 weeks, returns to vet Friday to begin treatment that was not explained to me. Why 3 meds and then more treatment? She had been given 9-in-1 injections that I was told covered everything dogs might be subject to contracting. What have I done wrong? Thank you.
June 27, 2018
2 Recommendations
The 9in1 vaccines which are given to dogs cover the common bacterial and viral diseases which dogs are likely to be exposed to; however they don’t cover heartworm or other parasites which need to be managed separately with another product like Interceptor Plus (milbemycin oxime/praziquantel) which covers heartworm, hookworm, roundworm, whipworm and tapeworms. Treatment for heartworm is done in stages as the adults and the microfilaria need to be treated separately and need to be treated at specific stages of their lifecycle, it isn’t like a bacterial infection where a simple course of antibiotics would do the trick. Regards Dr Callum Turner DVM www.interceptorplus.com
June 28, 2018
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Labrador Retriever
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Jazzy
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3
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I have a 3 year old lab, a rescue with heartworm. We are past the dyxcycolmine and other pre med, and will begin the shots next week. This dog is my service dog. I know that activity is restricted during the treatment but will I be able to take her in her working role to places that are familiar to her all ready. Most of our outings are to resturants. I am concerned that if we do not continue with her training she will forget what she has learned (she is also in Canine Good Citizenship training). My challenge is her health while keeping her a sound working dog. Your advice, suggestions most appreciated
Sept. 27, 2017
0 Recommendations
It is true that rest is best whilst under treatment for heartworm which I know can cause trouble for training of service dogs. The severity of the heartworm would be an indicator for the amount of activity she could endure, small outings which are not stressful may be alright but I would recommend you speak with the Veterinarian treating Jazzy as she isn’t under my duty of care and I cannot determine if she needs strict rest (which is ideal anyway) or mild infrequent training is good or not. Regards Dr Callum Turner DVM
Sept. 28, 2017
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Chihuahua Jack Russel Mix
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Moxie
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4 Years
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My pet has the following symptoms:
None. Diagnosed During Regular Check
My dog is HW+ but shows no signs, it was just found in a test. About how much will it cost to get her hw free? Of course I will do the treatment, but as someone who really is struggling financially at the moment I'd like to make a savings plan.
Aug. 30, 2017
2 Recommendations
Cost of treatment for heartworm varies widely on your location, medicines used and response to initial treatment; I would budget between $1,000 to $1,500 as treatment and follow up testing should come in lower than that figure. It would be best to ask your Veterinarian for their opinion on cost based on their pharmacy prices. Regards Dr Callum Turner DVM
Aug. 30, 2017
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Heartworms Average Cost
From 52 quotes ranging from $1,200 - $3,000
Average Cost
$1,800
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