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Table 1 Protocol developed and adopted by Animal Medical Centers of Northeast Alabama for heartworm treatment

From: Clinical benefits of incorporating doxycycline into a canine heartworm treatment protocol

Day

Treatment

0

Dog is diagnosed and verified as heartworm positive.

If the dog is symptomatic, attempt to stabilize the dog with ACE inhibitors, furosemide, and if severely ascitic, abdominal drainage. Prednisone at 0.5 mg/kg twice daily 1st week, 0.5 mg/kg once daily 2nd week, 0.5 mg/kg every other day 3rd & 4th week.

Administer ivermectin heartworm preventive (If microfilariae are present, pre-treat with antihistamine and glucocorticosteroids if not already on prednisone.)

Begin exercise restriction. The more pronounced the symptoms, the stricter the exercise restriction.

1–28

Doxycycline 10 mg/kg BID for 4 weeks.

30

Administer ivermectin heartworm preventive.

60

Administer ivermectin heartworm preventive.

First melarsomine injection 2.5 mg/kg IM (Day 61).

Prescribe prednisone 0.5 mg/kg twice daily 1st week, 0.5 mg/kg once daily 2nd week, 0.5 mg/kg every other day 3rd & 4th week.

Decrease activity level even further. Cage rest in more severe cases.

90

Administer ivermectin heartworm preventive.

Second and third melarsomine injections 2.5 mg/kg IM (Day 90 & 91).

Prescribe prednisone 0.5 mg/kg twice daily 1st week, 0.5 mg/kg once daily 2nd week, 0.5 mg/kg every other day 3rd & 4th week.

Continue exercise restriction for 6 to 8 weeks after last melarsomine injections.

Antigen test 6 months after completion.

  1. ACE angiotensin converting enzyme inhibitor