Treatment FAQ

"why do you need to test for heart worms before you begin treatment"

by Dr. Alaina Schimmel DVM Published 2 years ago Updated 2 years ago

The second reason to conduct confirmatory heartworm testing is to document heartworm prevention failure. Many pharmaceutical companies will pay for the treatment of heartworms, but require an outside, independent laboratory to confirm a positive heartworm test.

For instance, if a heartworm-infected dog is started on a monthly preventative without testing, immature heartworms (called microfilariae which circulate in the bloodstream) are susceptible to the medication and may die suddenly, causing a serious, shock-type reaction, called anaphylaxis This anaphylactic reaction may ...

Full Answer

Why do I need a heartworm test if I have prevention?

Many clients ask why they still need a heartworm test even if they have given prevention. The FDA who licensed the heartworm prevention require the veterinarian to confirm that the pet is negative for heartworms before prescribing the drug. The only way a veterinarian can confirm that a pet is indeed heartworm negative is with a blood test.

When to test for heartworm in dogs and cats?

Testing procedures and timing differ somewhat between dogs and cats. Dogs. 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:

Is a heartworm test more comprehensive than a blood test?

Clients sometimes think that drawing blood for a heartworm test is a more comprehensive test than it really is. A heartworm test is only a test for heartworms. It is not to be confused with other diagnostic testing, like serum chemistry testing or blood sugar evaluation.

What is an in-clinic heartworm test?

An in-clinic heartworm test is a kit that utilizes similar science as a human pregnancy test. Human pregnancy can be confirmed by the presence of certain hormones only produced in pregnancy. In a comparable fashion, the test kits can detect the presence of antigen to Dirofilaria Immitis (heartworm). If there is antigen, there are adult worms.

Why is heartworm test required before medication?

This means heartworm preventives must be purchased from your veterinarian or with a prescription through a pet pharmacy Prior to prescribing a heartworm preventive, the veterinarian typically performs a heartworm test to make sure your pet doesn't already have adult heartworms, as giving preventives can lead to rare ...

Can I start my dog on heartworm medicine without testing?

If a heartworm-positive dog is not tested before starting a preventive, the dog will remain infected with adult heartworms until it gets sick enough to show symptoms. Heartworm preventives do not kill adult heartworms. Also, giving a heartworm preventive to a dog infected with adult heartworms may be harmful or deadly.

When should a heartworm test be done?

Any dog of any age can, and should, be tested annually. Since it takes 6 months for a pet to develop a positive response on a heartworm test, we recommend that annual testing begin no earlier than 6 months after the end of the heartworm season of the previous year which is usually considered to be October 15th.

Can I give my cat heartworm medicine without testing?

Cats should be tested before being put on prevention and re-tested as the veterinarian deems appropriate to document continued exposure and risk. Because there is no approved treatment for heartworm infection in cats, prevention is critical.

What are the first signs of heartworms in dogs?

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.

Can a dog fully recover from heartworms?

It is crucial to take your dog to the veterinarian as soon as you notice any symptoms at all. Routine veterinary appointments are also always a must, even if your pet seems to be in perfect health. Dogs can indeed recover completely from heartworm, although the degree of the ailment has a lot to do with outcome.

What happens if you give a dog heartworm prevention that already has heartworms?

It doesn't kill adult heartworms. An infected dog has microfilariae, or baby heartworms produced by the adults, circulating in his bloodstream. Giving him a preventative can cause a sudden microfilariae die-off, which can result in a dog going into shock and dying.

What do they do for a heartworm test?

In order to perform the test, a small amount of blood is drawn from the dog's forearm or neck vein. This test detects the presence of the adult heartworm in the pulmonary arteries and / or the dog's heart. The heartworm antigen test is extremely accurate and is a very reliable method for diagnosing heartworm disease.

What is the success rate of heartworm treatment?

There is some risk involved in treating dogs with heartworms, although fatalities are rare. "A new drug is available that does not have as many side effects, allowing successful treatment of more than 95% of dogs with heartworms."

What are the first signs of heartworms in cats?

The most common clinical signs of heartworm infection include: intermittent vomiting (sometimes of blood as well as of food); diarrhea; rapid and difficult breathing, coughing and gagging, all of which may be confused with feline asthma or some other bronchial disease; loss of appetite; lethargy and weight loss.

Can a cat survive heartworms?

Less common signs of heartworm infection include vomiting, neurologic signs, collapse and sudden death. Many cats are able to overcome this phase of the disease process – and in some cases completely clear the heartworm infection – but not without damaging the small blood vessels in the lungs during the process.

What percentage of cats get heartworms?

Studies have shown that up to 15% of all cats in certain locations, regardless of whether they are indoor or outdoor cats, have been exposed to heartworms. 3. There Is No Good Treatment. There is simply no good treatment for heartworm-infected cats.

How long does it take for a dog to test positive for heartworm?

It takes months before a dog with heartworm will test positive on a heartworm test, so testing annually—usually at the time the prescription for his heartworm medication is being renewed—makes sense. As with many diseases, the earlier heartworm can be diagnosed, the better the chances he will recover. If heartworm disease in a dog goes undetected ...

Why do dogs spit out heartworm pills?

Some dogs spit out their heartworm pills when their owners aren’t looking. Others may vomit their pills or rub off a topical heartworm medication. Whatever the cause of missing or delaying a dose, any of these mishaps can put your dog at risk of heartworm infection. I have several cats as well as a dog.

Can cats get heartworms?

Like dogs, cats get heartworm disease. And while cats are not as easily infected as dogs, it only takes one or two heartworms to make a cat very sick. That’s why the American Heartworm Society recommends year-round protection for both dogs and cats. Because

Can heartworms cause death in dogs?

As with many diseases, the earlier heartworm can be diagnosed, the better the chances he will recover. If heartworm disease in a dog goes undetected and untreated, the worms can cause progressive and potentially fatal damage to his arteries, heart and lungs.

Can heartworms be detected in cats?

Because. heartworm disease in cats may or may not involve infection with adult worms, the diagnosis can be challenging. Veterinarians typically run heartworm blood tests on cats before putting them on medication the first time, but later rely on procedures such as chest x-ray or ultrasound to confirm diagnoses.

Why do we need a confirmatory heartworm test?

The second reason to conduct confirmatory heartworm testing is to document heartworm prevention failure. Many pharmaceutical companies will pay for the treatment of heartworms, but require an outside, independent laboratory to confirm a positive heartworm test.

Why do you need to confirm a dog is positive for heartworms?

Confirmatory testing is typically performed for one of two reasons. The first reason is to confirm a dog is positive for heartworms prior to undergoing treatment. The drug used in the treatment of heartworms can have severe negative side effects and shouldn’t be used unless adult heartworms are present. Unfortunately, there is no adult heartworm treatment approved for cats – cats can only be treated for their symptoms.

How many heartworm tests are done in 2019?

TVMDL performed over 500 heartworm tests in 2019 for both canine and feline species. For feline patients, TVMDL suggests veterinarians use radiographs as an additional diagnostic tool. It’s difficult to diagnose feline heartworm disease solely through blood testing, and radiographs may provide useful information.

What is the second test for heartworms in dogs?

The second testing approach is using an enzyme-linked immunosorbent assay, ELISA.

How long do heartworms live in dogs?

Mature heartworms can live within dogs for up to seven years and up to three years in cats. Once infected, dogs and cats experience heartworm disease differently. Clinical signs in dogs are generally based ...

What does a cat's heartworm test detect?

The feline heartworm antibody test detects antibodies the cat makes to the larval stage mosquitos inject when they feed ; however, these larval stages may die en route to the heart and never actually develop into adult heartworms.

What is the second method of testing for heartworms?

The second testing approach is using an enzyme-linked immunosorbent assay, ELISA. Technicians in the serology section use the ELISA test to detect antigens that are associated with pregnant female heartworms. A positive result indicates adult female heartworms are present. This is the primary testing method used to detect heartworms.

Why do I need a heartworm test when I know I have been giving the heartworm prevention?

The FDA who licensed the heartworm prevention require the veterinarian to confirm that the pet is negative for heartworms before prescribing the drug. The only way a veterinarian can confirm that a pet is indeed heartworm negative is with a blood test. This is not saying that you the client did not give the prevention as directed. But, because the veterinarian did not give the prevention or wittiness the prevention being given, the veterinarian cannot certify that the pet is indeed negative for heartworms.

How do you test for heartworm infection?

Heartworm testing requires a simple blood test and is necessary prior to starting a pet on heartworm prevention.

What does a heartworm test show?

The heartworm test in dogs confirms that there are heartworms in the the major vessels feeding the lungs. Heartworm positive dogs progress to heartworm treatment, while heartworm positive cats progress to more diagnostic tests.

Can a veterinarian certify a dog is negative for heartworms?

This is not saying that you the client did not give the prevention as directed. But, because the veterinarian did not give the prevention or wittiness the prevention being given, the veterinarian cannot certify that the pet is indeed negative for heartworms.

How to diagnose heartworm disease?

Heartworm disease is usually diagnosed with a simple blood test. There are two main tests for detecting heartworm infection; one test detects adult worms and the other detects microfilariae.

What other methods are used to detect heartworm infection?

In some infected dogs, the blood tests are negative even though there are heartworms in the heart.

What is heartworm disease? How does a dog become infected?

Dogs become infected when they are bitten by an infected mosquito that is carrying immature, infective heartworm larvae.

What are the clinical signs of heartworm disease?

In the early stages of disease, dogs often have no clinical signs, especially if they are carrying only a small number of worms.

How is heartworm disease diagnosed in the dog?

Heartworm disease is usually diagnosed with a simple blood test. There are two main tests for detecting heartworm infection; one test detects adult worms and the other detects microfilariae.

What about the DNA-PCR test?

This test, which detects the DNA of the heartworm, is not yet sensitive enough to screen dogs for heartworm infection. However, if microfilariae are found and there is any doubt about their identity, then the DNA-PCR is helpful to confirm that they are Dirofilaria immitis and not another kind of blood parasite.

Do all dogs need to be tested?

No. Puppies less than 6-7 months of age do not need to be tested. Adult worms are not present at this age and both antigen tests and microfilariae tests will be negative.

How does heartworm prevent disease?

Heartworm Preventive medication stops infection by killing the worms before they mature , reproduce and cause damage . There is no drug that can stop the mosquito from carrying the larvae to your dog, so we have to stop them before they become damaging adults and make the infection worse with their offspring.

What to do if a dog has heartworm?

For a long time, if someone came in with a heartworm positive dog and did not want to treat the adult infection, veterinarians would put that infected dog on preventive medications. The rationale for this choice was that we could at least keep the infection from getting worse (by killing new larvae as they reached susceptible stages) and maybe eventually the existing adults would die off. This “slow kill” was considered a valid option in the face of a positive test when adulticide treatment was not an option.

Do heartworms have a guarantee?

Heartworm manufacturers offer product guarantees. If their product was purchased from a veterinarian (that knows you and your pet and was prescribed for your dog), your record shows that you have purchased doses without lapse, and you have done the recommended yearly testing, then any heartworm infection in your dog will be paid for by the company. But you have to have the negative test on record each year for the guarantee to apply.

Can you give a dog preventatives for heartworms?

It is no longer recommended to give preventatives to infected dogs. The presence of our heartworm preventative compounds where there are already adult heartworms is what has caused the worms to adapt and develop resistance, much like inadequate dosing with antibiotics has encouraged resistance among bacteria, endangering us all. As a responsible pet owner, you must KNOW (with testing) if your dog has become infected with adults for his safety and the safety of everyone’s beloved dogs. We have to test before filling or refilling a preventative prescription.

Can heartworms be detected in dogs?

No commercially available test will detect the babies until they become adults, so there is a limbo period where the heartworms are neither susceptible nor detectable. If we are giving the pills and running the tests every year, we have a chance to catch any larvae that break through before they cause extensive damage to the vessels of the heart and lungs, but if we skip testing entirely as a routine preventive test, we will not realize our dog has heartworm disease until he is showing clinical signs of cardiac impairment. Once signs of heart failure show themselves, irreversible damage has occurred.

Can dogs get heartworms from the Mississippi Delta?

Researchers have identified heartworms from the Mississippi Delta area that can even develop in dogs that are receiving heartworm preventatives. Because the preventatives are our best hope (and are still effective against the strains outside the Delta region… for now) we MUST continue to give them exactly as directed, only we have to be sure that we are doing the suggested testing too, so that we will know if and when these resistant worms are moving into our area.

What happens if my dog tests positive for heartworms?

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.

How significant is my pet's risk for heartworm infection?

Your community may have a greater incidence of heartworm disease than you realize—or you may unknowingly travel with your pet to an area where heartworms are more common. Heartworm disease is also spreading to new regions of the country each year. Stray and neglected dogs and certain wildlife such as coyotes, wolves, and foxes can be carriers of heartworms. Mosquitoes blown great distances by the wind and the relocation of infected pets to previously uninfected areas also contribute to the spread of heartworm disease (this happened following Hurricane Katrina when 250,000 pets, many of them infected with heartworms, were “adopted” and shipped throughout the country).

What is heartworm disease?

Heartworm disease is a serious and potentially fatal disease in pets in the United States and many other parts of the world. It is caused by foot-long worms (heartworms) that live in the heart, lungs and associated blood vessels of affected pets, causing severe lung disease, heart failure and damage to other organs in the body. Heartworm disease affects dogs, cats and ferrets, but heartworms also live in other mammal species, including wolves, coyotes, foxes, sea lions and—in rare instances—humans. Because wild species such as foxes and coyotes live in proximity to many urban areas, they are considered important carriers of the disease.

How is heartworm disease transmitted from one pet to another?

The mosquito plays an essential role in the heartworm life cycle. Adult female heartworms living in an infected dog, fox, coyote, or wolf produce microscopic baby worms called microfilaria that circulate in the bloodstream. When a mosquito bites and takes a blood meal from an infected animal, it picks up these baby worms, which develop and mature into “infective stage” larvae over a period of 10 to 14 days. Then, when the infected mosquito bites another dog, cat, or susceptible wild animal, the infective larvae are deposited onto the surface of the animal's skin and enter the new host through the mosquito’s bite wound. Once inside a new host, it takes approximately 6 months for the larvae to develop into sexually mature adult heartworms. Once mature, heartworms can live for 5 to 7 years in dogs and up to 2 or 3 years in cats. Because of the longevity of these worms, each mosquito season can lead to an increasing number of worms in an infected pet.

What are the signs of heartworm disease in dogs?

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.

When should my pet be tested?

Testing procedures and timing differ somewhat between dogs, cats and ferrets.

What are the symptoms of heartworm in dogs?

Signs of heartworm disease may include a mild persistent cough, reluctance to exercise, fatigue after moderate activity, decreased appetite, and weight loss.

How many pets have heartworms?

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Is heartworm a serious disease?

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