Changes

==Treatment==

==Treatment==

Animals with right-sided congestive heart failure require stablisation with diuretics, ACE inhibitors and cage rest before treatment for heartworm disease is implemented. Animals with severe respiratory signs also require stabilisation with oxygen supplementation, anti-inflammatory doses of corticosteroid and anti-thrombotic drugs. The specific adulticidal treatment for ''Dirofilaria immitis'' is melarsomine dihydrochoride, a new generation arsenical compound. Melarsomine is injected

Animals with right-sided congestive heart failure require stablisation with diuretics, ACE inhibitors and cage rest before treatment for heartworm disease is implemented. Animals with severe respiratory signs also require stabilisation with oxygen supplementation, anti-inflammatory doses of corticosteroid and anti-thrombotic drugs. The specific adulticidal treatment for ''Dirofilaria immitis'' is melarsomine dihydrochoride, a new generation arsenical compound. Melarsomine is administered

intramuscularly into the lumbar muscles at a recommended

intramuscularly into the epaxial, and pressure should be applied during and after needle withdrawal³. A "graded-kill" protocol is recommended: an initial injection is followed one month later with two injections at an interval of 24 hours, given on opposite sides^1-4. This spreads the killing effects over two treatments, with an aim to reducing the occurence of thromboembolism after parasite death. Cage rest and anti-inflammatory doses of corticosteroids in the week following melarsomine treatment can also reducce the likelihood of pulmonary thromboembolism. Adulticidal treatment may be declined by the owner, owing to the risk of thromboembolism. Alternatively, it may not be possible to implement adulticidal treatment if the patient is suffering renal or hepatic failure³. In these cases, is declined by the owner,

dose of 2-5 mg/kg, repeated after 24 hours. However,

only a single dose should be administered to class 3 dogs,

the risk of pulmonary thromboembolism. If the patient

administered one month later. In the week following the

administration of melarsomine, the likelihood of pulmonary

thromboembolism can be minimised with cage

rest and corticosteroids at anti-inflammatory doses.

If adulticidal treatment is declined by the owner,

monthly administration of prophylactic doses of ivermectin

monthly administration of prophylactic doses of ivermectin

may represent a reasonable option because it will prevent

may represent a reasonable option because it will prevent