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The AHS Protocol vs. “Slow Kill”

ANDREW MOORHEAD, DVM, MS, PHD, DIP. ACVM (PARASITOLOGY) ASSOCIATE RESEARCH SCIENTIST COLLEGE OF VETERINARY MEDICINE, UNIVERSITY OF GEORGIA

Heartworm treatment can be time consuming and expensive, causing some clients to balk when presented with a treatment plan. Because heartworm is both serious and progressive, I advise clients that treatment is no place to cut corners.

Q. What is the rationale for the steps involved in the American Heartworm Society (AHS) heartworm treatment protocol?

A. The AHS protocol starts with administration of a macrocyclic lactone (ML) drug on Day 1 and Day 30 of treatment, along with oral doxycycline at 10 mg/kg BID on days 1–30.

■ Giving the ML eliminates any juvenile stages of worms that might be present. Melarsomine is not labelled for treatment of worms less than 4 months or age

■ Administering doxycycline eliminates Wolbachia bacteria. This bacteria plays a key role in heartworm pathogenesis, and eliminating Wolbachia signifi- cantly reduces inflammation and worm mass, thus decreas- ing the severity of pulmonary thromboembolisms (PTE).

■ Glucocorticoids should also be given as needed to control clinical signs of PTE.

Why Don’t Clients Give Heartworm Preventives?

STEPHEN JONES, DVM

While pet numbers in the U.S. are increasing, the number of annual heartworm preventive doses sold in the U.S. is declining. I believe this is a frightening trend, especially considering that the average number of heartworm cases per veterinary clinic rose by 21% between 2013 and 2016.1

I recently researched medication adherence in human patients2 in order to better understand why people don’t take their own medications. In the process, I learned that the reasons my clients don’t give pets heartworm preventives as directed are similar to the reasons they skip their own cholesterol, diabetes and blood pressure medications.

Relocate Dogs—Not Heartworms

BRIAN A DIGANGI, DVM, MS, DABVP

Q. The American heartworm Society (AHS) and the Association of Shelter Veterinarians (ASV) recently released a set of best practices for transporting dogs. Why?

A. The AHS and ASV saw a need for heartworm-specific transport recommendations to guide veterinarians and animal shelters. Heartworm disease has become more widespread in the U.S. over the past several decades, due in part to the increased movement of heartworm-positive dogs to regions where heartworm disease was once uncommon. When mosquitoes feed on a microfilaremic dog, they become heartworm vectors capable of transmitting heartworms to unprotected pets.

Is it Negative or Not? The Role of Heat Pretreatment in Heartworm Testing

BRIAN A DIGANGI, DVM, MS, DABVP

Veterinarians today are fortunate to have several point-of-care heartworm tests. In the majority of cases, these D. immitis antigen tests meet practitioners’ needs for speed and accuracy. However, when test results conflict with clinical expectations, the added step of heat pretreatment(HPT) of the sample should be considered.

AHS Survey Finds Increase In Heartworm Cases

CHRISTOPHER J. REHM, DVM

Is heartworm incidence up or down in your practice area?

The latest American Heartworm Society Heartworm Incidence Survey has uncovered both challenges and opportunities for veterinarians in practice. On one hand, heartworm incidence has inched upwards in the three years since the AHS survey was last conducted. On the other hand, the power to reverse this upward trend is, quite literally, in our hands.

April is Heartworm Awareness Month

CHRISTOPHER J. REHM, DVM

APRIL IS HEARTWORM AWARENESS MONTH and the ideal time to discover the many resources available from the American Heartworm Society (AHS). Our goal: to arm you with the knowledge and tools you need to defeat this serious parasite.

Is There an Echo in Here?

CHRIS DUKE, DVM

Q. I’m a big believer in heartworm prevention, but I find myself repeating my “heartworm 101” lecture over and over to clients. Is it worth it?

Can YOU Outsmart a Mosquito?

TOM NELSON, DVM

Q. While the American Heartworm Society (AHS) recommends year-round heartworm prevention for dogs and cats, many veterinarians and owners take a seasonal approach. What is the AHS’ rationale?

Adulticide Treatment: Minimizing Melarsomine Complications

STEPHEN JONES, DVM

Q. Why is melarsomine recommended by the American Heartworm Society (AHS), given the potential for complications during adulticide treatment?

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