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In this episode, host Alyssa Watson, DVM, welcomes Andrew R. Moorhead, DVM, MS, PhD, DACVM (Parasitology), to talk about his recent Clinician’s Brief article, “Pathogen Profile: Dirofilaria immitis.” Dr. Moorhead provides more than just a refresher about foundational heartworm care. He covers updated recommendations and novel ideas, including testing guidelines, melarsomine protocols, and mechanisms of heartworm preventives, which might surprise you.
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Key Takeaways
Heartworm has a complicated lifecycle centered around those “flying syringes” known as mosquitoes, with climate change causing spread into new areas and new species being found that are capable of carrying the parasite.
Testing for the adult female uterine antigen remains the mainstay, but there are several scenarios in which false negative results can occur.
Remember that heartworm prevention does not proactively prevent infections—it gets the larval worms that are already there—and macrocyclic lactones may not even be directly killing the worms but rather shutting down their defense mechanisms, thereby making them vulnerable to host immune responses.
Mosquito repellency is never a replacement for heartworm prevention; isoxazolines and repellants do, however, reduce the spread of heartworms to new hosts.
When treating infections, targeting Wolbachia with doxycycline makes worm die-off less inflammatory, and a 3-dose melarsomine protocol is superior to either a 2-dose or slow-kill protocol, with antigen retesting 9 months afterward.
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The Team:
Alyssa Watson, DVM - Host
Alexis Ussery - Producer & Multimedia Specialist