Dr. Pizano explains the different heartworm medicines available for your dog.
by Dr. Sara Pizano, Viewpoints Expert Contributor
Heartworm disease is a potentially deadly condition spread by mosquitos. It is often better to provide preventative heartworm medicine to your canine friend than to deal with the effects. Ultimately, the decision of what heartworm medicine is best for you and your pet’s needs is up to you and your veterinarian, but below is a helpful guide to explaining what exactly heartworm disease is and what the differences are between some of the more popular prescription medicines.
Heartworm disease explained
When a mosquito that is infected with heartworm disease bites a dog, microscopic larvae are injected and make their way into the bloodstream. The term ‘heartworm’ is confusing to some pet owners as it is not found in the intestines or feces. Heartworms are only found in the bloodstream, so a blood sample is required yearly, or before starting heartworm prevention. Once the larvae enter the bloodstream of the dog, it takes about six months for them to mature into adults. The commonly used antigen test only detects adults, but the immature or microfilariae stage can be diagnosed with a blood smear under the microscope prior to six months.
If too many adult heartworms mature, they will not be able to pass through the heart, hence the name ‘heartworm disease’. If left untreated, heartworm disease can lead to symptoms like coughing, exercise intolerance, weight loss, heart failure and ultimately death.
The heartworm medicines
The following prescription heartworm medicines are currently on the market, and your veterinarian can help you decide which prevention is best for your pet. All products listed are to be given monthly with the exception of the Proheart. Topical heartworm medicine should be placed on the skin between the shoulder blades so the pet cannot lick the product. Topical products should be placed on your dog when dry and your dog should not swim or be bathed for 48 hours after application. Puppies should start heartworm prevention at 8 weeks of age with the exception of Proheart, which can be given at 6 months of age.
Heartgard Plus heartworm medicine.
Advantage Multi ($45, rated 76/100) is a topical heartworm medicine that also kills fleas, prevents roundworms, hookworms and whipworms. Those worms are all intestinal parasites that can also infect people.
Heartguard Plus ($35, rated 94/100) is a medication that is dispensed in a chewable cube and also prevents roundworm and hookworm infections. Collies sensitive to ivermectin should not take Heartguard.
Iverhart Plus ($27, rating pending) is an oral heartworm medicine that also prevents roundworms, hookworms and tapeworm infections, all of which can be transmitted to people. Collies sensitive to ivermectin should not take Iverhart.
Proheart ($20, rating pending) is an injection given only by your veterinarian every 6 months. In addition to preventing heartworm disease, it treats any existing infection with tapeworms. Proheart should not be given to sick, debilitated dogs, puppies under 6 months, or dogs with allergies.
Revolution ($43, rated 80/100) is the only topical heartworm prevention that also treats ear mites, American Dog Ticks and sarcoptic mange. Revolution also kills fleas and flea eggs.
Sentinel heartworm medicine.
Sentinel ($43, rating pending) is an oral medication that is also effective against flea eggs preventing them from hatching, roundworms, whipworms and some hookworms.
Trifexis ($100, rating pending) is available in a chewable tablet. In addition to preventing heartworm disease, it also kills fleas and controls hookworms, roundworms, and whipworms.
Tri-heart Plus ($30, rating pending) is an oral medication that also treats roundworms and hookworms. Because the active ingredient is ivermectin, it should not be given to sensitive Collies.
It is far easier and more humane to keep your dog on heartworm prevention during the mosquito season than to treat him for a heartworm infection. In warm weather climates that means prevention must be given year-round, so talk to your veterinarian about the best plan for your dog. And be sure to review this heartworm medicine guide before speaking with your veterinarian so you can ask the most informed questions.
Dr. Sara Pizano is a Cornell Veterinary School graduate and has devoted most of her career to shelter medicine. Her passion for homeless animals led to her work in three of our country’s largest animal shelters where she was instrumental in improving the care and life saving measures of hundreds of thousands of animals. Dr. Pizano is now enjoying her work in private practice in South Florida. She lives happily with her two-footed life partner in addition to 3 cats, 2 dogs and 3 horses, all rescues of course! In her spare time Dr. Pizano relaxes with gardening, cake decorating and creating culinary masterpieces.
Editor’s Note: The prices listed above are the lowest prices found for six-month prescriptions. It is important to note that prices and availability will vary. The prices offered are meant only as a general guideline.
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