Changes

===Prevention===  

===Prevention===  

Heartworm prophylaxis should be implemented in all cats and dogs living in or visiting areas in which ''Dirofilaria immitis'' is endemic. In the UK, milbemycin oxime and selamectin are licensed for the prevention of heartworm disease and should be administered on a monthly basis as they are capable of killing migrating larvae up to week six post-infection. In the event of non-compliance or a missed dose, it may be necessary to test the animal for ''Dirofilaria immitis'' six months later if indicated by the risk of infection. Drugs that persist in the long term, such as injectable moxidectin, can help overcome this issue.

Heartworm prophylaxis should be implemented in all cats and dogs living in or visiting areas in which ''Dirofilaria immitis'' is endemic. In the UK, milbemycin oxime and selamectin are licensed for the prevention of heartworm disease and should be administered on a monthly basis as they are capable of killing migrating larvae up to week six post-infection. In the event of non-compliance or a missed dose, it may be necessary to test the animal for ''Dirofilaria immitis'' six months later if they are likely to have been exposed to infection during the time they were unprotected. Drugs that persist in the long term, such as injectable moxidectin, can help overcome this issue.

==Prognosis==

==Prognosis==