Dog heartworm: What slow kill treatment is best with doxycycline?

Question

My dog tested positive for heartworm antigens, but our vet thinks a slow kill treatment plan should work well. My question is about the efficacy of the different treatment options. Which of the 3 following would be most recommended in combination with doxycycline (for 30 days followed by 90 days without doxycycline, then repeat until negative for heartworms)? 1) Moxidectin Injection (ProHeart 6) 2) Ivermectin (Heartgard) 3) Moxidectin Topical (Advantage Multi). Pet's info: Dog | Boxer | Male | unneutered | 3 years and 8 months old | 66 lbs

Dr. Heidi DVM, CVA, CCRT, CVTP, CVSMT, CVCH · Accepted Answer

I am so sorry that Tucker has tested heartworm positive. I adopted a dog that was heartworm positive, so I certainly understand how difficult it is to make a decision on treatment. I am attaching a link below to the American Heartworm Society (AHS) which has a lot of good information for you. https://www.heartwormsociety.org/ The AHS does not recommend the "slow kill" method as it's treatment of choice, but does recommend the following for an alternative treatment if needed. They recommend Doxycycline and either ivermectin or topical Moxidextin. ("Topical moxidectin is now FDA-approved for use in heartworm-positive dogs.") They do not list ivermectin or topical Moxidextin as being better than the other, so they should have the same efficacy. Injectible Moxidectin (Proheart) is not listed by the AHS as recommended and the company that manufactures Proheart lists that it "should be used with caution in heartworm positive dogs". I am attaching the exact recommendation from the AHS below. " In cases where arsenical therapy is not possible or is contraindicated, the use of a monthly heartworm preventive along with doxycycline at 10 mg/kg BID for a 4-week period might be considered. An antigen test should be performed every 6 months and the dog not considered cleared until two consecutive NAD (no antigen detected) heartworm antigen tests, 6 months apart, have been obtained. If the dog is still antigen positive after one year, repeat the doxycycline therapy. Exercise should be rigidly restricted for the duration of the treatment process." So, I would recommend reviewing the AHS website, then discussing it further with your vet. Good luck! I hope that was helpful. Thanks for using PetCoach.

Dog heartworm: What slow kill treatment is best with doxycycline?

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