Changes

===Adulticidal Treatment===

===Adulticidal Treatment===

 

heartworm disease and the relative prognosis depend on

Decisions in the treatment of heartworm disease are dependent on the severity of infection. A scheme exists to classify patients in terms of disease severity². Class one patients have subclinical heartworm disease, and carry an excellent prognosis following treatment wiht adulticidal drugs. Class two animals show mild to moderate clinical signs and similar radiographic changes. These animals may respond positively to treatment. Dogs with class 3 disease have severe clinical signs, such as persistent coughing, dyspnoea, right-sided heart failure or haemoptysis, and these are reflected by severe radiographic signs. These cases have a high risk of pulmonary thromboembolism and so prognosis is guarded and the benefits of adulticidal treatment should be considered carefully.

the severity of the infection. In an attempt to assess this,

 

Even low grade infections in cats may result in pulmonary thromboembolism with adulticidal treatment, and spontaneous remission is seen in some cats. Because of this, symptomatic treatment (cage rest, oxygen supplementation, fluid therapy, bronchodilators and dexamethasone) may be more appropriate in sick cats, and clinically well cats can merely be monitored regularly for remission. Adulticidal treatment should only be considered in cats that fail to respond to supportive treatments but are in a stable condition.

* CLASS 1. Patients with subclinical or no clinical signs;

 

* CLASS 2. Patients with mild to moderate clinical signs

and mild to moderate radiographic changes;

* CLASS 3. Patients with severe clinical signs (eg, persistent

cough, haemoptysis, dyspnoea, right-sided heart

failure) and severe radiographic changes.

may have a positive outcome. Animals in class 3 have a

guarded prognosis due to the high risk of pulmonary

thromboembolism; in these cases, the potential complications

of adulticidal treatment should be thoroughly

In cats, adulticidal treatment may be dangerous even

in patients with low grade infection, and pulmonary

thromboembolism due to premature death of parasites is a common complication. Considering that some cats

die naturally, periodic monitoring of the patient is more

appropriate than adulticidal treatment. Cats with respiratory

as patients with feline asthma. Cage rest, oxygen supplementation,

fluid therapy, bronchodilators and injectable

steroids (eg, dexamethasone) can be used to stabilise

acutely ill cats. Adulticidal treatment should only be considered

for cats in a stable condition that fail to respond to

supportive treatments.

Adulticidal treatment involves the administration of

Adulticidal treatment involves the administration of

a new generation arsenical compound, melarsomine dihydrochloride

a new generation arsenical compound, melarsomine dihydrochloride