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===Prevention===  
 
===Prevention===  
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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.
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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.
 
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Preventive drugs kill migrating
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larvae of D immitis up to the sixth week of infection.
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Therefore, they all provide a high degree of protection
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when administered on a monthly basis. If a patient misses
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one or more doses in the prophylactic schedule, it
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should be tested for heartworm disease after six months.
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The risk of incomplete protection due to owner noncompliance
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can be eliminated with a recently introduced
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sustained-release injectable formulation of moxidectin
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(Proheart 6; Fort Dodge).
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High doses of ivermectin and milbemycin oxime are
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potentially toxic in approximately one-third of collies.
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However, side effects are not observed in these breeds
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when prophylactic drugs are administered at the recommended
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doses.
      
==Prognosis==
 
==Prognosis==
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