Get

In Your Inbox

Dogster is reader-supported. When you buy via links on our site, we may earn an affiliate commission at no cost to you. Learn more.

Heartworm in Dogs: Our Vet Discusses Causes, Signs, Treatment & Prevention

Share

heartworm removed from dog

Most of us know that regular worming treatments are an important part of canine preventive healthcare, but how much do we know about the worms we are trying to prevent? And more importantly, what happens if our dogs are infected with worms?

Heartworm is a potentially devastating and deadly parasite affecting dogs around the world, and the first step in keeping your dog safe is understanding the importance of the heartworm life cycle in treatment and prevention.

Fortunately, heartworm prevention is readily available and effective, so keep reading to learn more about this potentially devastating disease and why, when it comes to protecting your pets, timing is everything.

divider dog paws 3 oct 2024

What Is Heartworm Disease?

Canine heartworm disease is caused by the parasitic worm, Dirofilaria immitis. Dogs are the natural host, but other mammalian species can also be affected, including cats, ferrets, wolves and other canids, bears, and (rarely) humans. The parasite is transmitted through the bite of mosquitoes that pick up microfilariae (neonatal larvae) by feeding on infected dogs. The microfilariae go through several molts inside the mosquito until they develop into the infective larval stage (L3), which is transmitted into the bloodstream of another host when the mosquito feeds on them.

Over the next 1–2 weeks, the larvae molt into a fourth stage (L4) and remain in the soft tissue for another 2 months before undergoing a final molt into young adults, gradually migrating their way toward the pulmonary vessels (those that supply the heart and lungs) around 3–4 months after infection.

These young worms are around 1–2 inches long when they reach the heart, growing rapidly over the next few months, with adult males reaching around 6 inches and females a whopping 10 inches long! Females start producing microfilariae as early as 6 months after initial infection, continuing the life cycle, and can live in a dog for up to 7 years.

dog sad sick sleeping bored
Image Credit: Przemek Iciak, Shutterstock

What Are the Signs of Heartworm Disease in Dogs?

There are four stages of heartworm infection in dogs, depending on how many worms are present (worm burden) and what life stage they are at.

Stage 1 No signs or mild signs only (e.g., occasional cough)
Stage 2 Mild to moderate signs (occasional cough, increased tiredness after activity)
Stage 3 Signs include ill-thrift appearance, persistent cough, and exercise intolerance.

Trouble breathing and signs of heart failure are common. Changes to the heart and lungs are visible on X-rays.

Stage 4 Also called caval syndrome, worm burden prevents blood flow to the heart.

Emergency surgical removal is the only possible treatment but is high risk. Most dogs with this syndrome do not survive.

Not all dogs with heartworm will develop caval syndrome, but the damage caused by the infection will eventually cause fatal damage to the heart, liver, lungs, and kidneys if left untreated.

If your dog is showing these signs, we suggest you speak to a vet.

If you need to speak with a vet but can't get to one, head over to PangoVet. It's our online service where you can talk to a vet online and get the advice you need for your dog — all at an affordable price!

PangoVet_Mention-in-Content Savings V1

How Is Heartworm Diagnosed?

Heartworm infection is diagnosed via a blood test for proteins produced by the parasites (heartworm antigen test), and chest X-rays or echocardiography may be used to assess the extent of the worm burden and any possible damage caused to the heart. There are additional tests that can detect microfilariae in the blood, but the antigen test is now the main form of diagnosis.

Detection, Prevention, and Treatment: Why Timing Is Important

When our dogs have intestinal worms, we can just give them a worming tablet, but using the same approach in a dog with heartworm disease can be ineffective or even have fatal consequences.

Heartworm prevention medications will not kill adult heartworms, only stop their reproduction; it will not stop the progression of heartworm disease. If the worm burden is low, medication may keep the infection stable until there is a break in worming treatment or if the worm size or health of the dog causes the disease to progress. If the worm burden is high, heartworm disease will still develop.

If mature heartworms are present and have been reproducing, most heartworm treatments will cause any microfilariae to die suddenly, releasing a rush of antigen into the bloodstream. This can result in a severe, even fatal, anaphylactic reaction.

border collie breed old tricolor dog tired or sick at rest attitude
Image Credit: Nora Claudia Mazzini, Shutterstock

Heartworm Treatment

If your dog has been diagnosed with heartworm disease, the next step will be to ascertain the extent of the infection and prepare them for treatment with a drug that will kill adult worms and reduce the risk of anaphylaxis.

Depending on the magnitude of infection, the treatment of heartworm disease may involve:

  • Stabilization of any clinical signs present
  • Medical treatment with an adulticide to kill adult worms present
  • Surgical removal of worms from the heart and pulmonary vessels (uncommon)
  • Monitoring and treatment of reactions to treatment
  • Long-term treatment for damage to organs
  • Management of congestive heart failure
  • Follow-up blood tests
Owner giving medicine in a pill to his dog
Image Credit: Creative Cat Studio, Shutterstock

Heartworm Prevention

The best way to keep your dog safe from heartworm disease is through year-round protection. Breaks in treatment are an opportunity for larvae to mature into adults and reproduce, putting your pup at risk.

To ensure your dog is effectively and safely protected against heartworm infection, your vet will make recommendations based on their age and risk factors. Although heartworm prevalence is greatest wherever there are mosquitoes, cases have been seen in all 50 states, so heartworm prevention should be part of every dog’s healthcare plan.

There are a number of different options available, including monthly tablets, flavored chews, and even a yearly injection.

The American Heartworm Society recommends yearly heartworm antigen testing of all dogs, even those that have been on constant heartworm medication, to ensure that treatment protocols are effective. An antigen test should also be performed before administering treatment if there has been a break in heartworm prevention longer than 4 weeks.

person giving tick and flea medicine to a white maltese dog
Image Credit: Tanya Dol, Shutterstock
Dog’s Age Treatment protocol Antigen testing
< 8 weeks Start heartworm prevention as early as the label allows Annually
8 weeks – 7 months Start heartworm prevention immediately 6 months and 12 months after treatment, annually thereafter
> 7 months Antigen test before treatment Repeat antigen test 6 months after treatment, annually thereafter

divider dog paws 3 oct 2024

Frequently Asked Questions (FAQ)

Is Heartworm Contagious?

Not directly. Dogs cannot spread the parasite to each other, but if dogs live in an area where heartworm is present, it is easily spread from dog to dog by mosquitos.

Can Cats Get Heartworm?

Yes. The significance of feline heartworm disease is often underestimated, although worm burdens are not often severe enough to cause caval syndrome. Cats are not a natural host for Dirofilaria, so infection doesn’t happen as easily or last as long.

Ideally, cats should follow a similar test and treatment protocol to dogs, but the antigen detection test is less reliable in cats. Talk to your vet about the best way to keep your cat safe from heartworm.

vet holding papillon dog
Image Credit: Di Studio, Shutterstock

Can Humans Get Heartworm?

There have been cases of humans becoming infected with heartworm from mosquitoes, but these are rare. Humans are not a natural host, and the worms do not tend to survive to adulthood.

Is Heartworm Prevention Safe?

Like with any medication, there are always risks that some individuals may have an adverse reaction to heartworm prevention drugs, but generally, these risks are low. Some collie breeds have a genetic mutation that makes them more sensitive to certain medications, including ivermectin, which is used in some heartworm prevention medications, so we recommend talking to your vet about which product is best for you.

divider dog paws 3 oct 2024

Final Thoughts

Heartworm disease is a potentially deadly disease that can affect dogs of all ages, breeds, shapes, and sizes. Fortunately, it is completely preventable, but prevention isn’t always as simple as giving your dog a pill. If you’re worried that your dog could be at risk of heartworm disease or you’re not sure they have been fully protected, talk to your vet about getting them on track safely. Remember, prevention is always better than cure.

See also:


Featured Image Credit: vitrolphoto, Shutterstock

Want content like this delivered to you?

Sign Up For Our Newsletter

News, insights, expert advice, and everything dog

* By submitting, you agree to our Terms & Conditions and Privacy & Cookies Policy.




How useful was this post?

Click on a star to rate (you can leave written feedback after clicking submit)

Help us improve Dogster for pet parents!

Your feedback really matters.

What did you like about this post? Also how can we improve it?

Join the conversation

Leave a Reply

You’re very welcome to leave a comment or question. Please know that all comments must meet our community guidelines, and your email address will NOT be published. Let’s have a positive and constructive conversation.


Talk With A Vet Online

Peace of mind,
anywhere, anytime

Affordable vet advice

Dogster’s Weekly Photo Contest Winners: My Best Trick (April 16, 2026)

Every week our team gets the privilege of sorting through our readers photos to choose what dogs will win this weeks contest! See...

From Grief to Gratitude: How One “Potato” and a Road Trip Changed Everything

The “COVID Puppy” phenomenon is a well-known chapter of the pandemic, but for Alexis Walling, the arrival of a tiny, wrinkled English Bulldog...

Why Dogs Play Too Rough — And the Simple Fixes That Prevent It From Becoming a Problem

A dog that plays too rough with others is a problem that builds fast. One minute, the dogs are running and chasing, the...

Ricky Gervais Says: It’s Time to Release The Dogs

As activists prepare to carry out the biggest Open Rescue in the history of animal welfare, Ricky Gervais says, “it’s time to release...

More related

7 Great Off-Leash Dog Parks in Lexington, KY (2026 Update)

If you’re looking for a dog-friendly place to visit or live with your dog, then Lexington, Kentucky may be exactly what you’re hoping...

10 Surprising Canada Cat & Dog Neutering Statistics to Know in 2026

Note: This article’s statistics come from third-party sources and do not represent the opinions of this website. Neutering is considered a part of...

287 Popular & Unique Pekingese Dog Names

Congratulations! You’ve just adopted a precious Pekingese, which is one of the sweetest, smartest, and most outgoing dogs on Earth! You have everything...

ESA Doctors Letter Service Review 2026: Our Expert’s Breakdown

Your pet is your family. They love you unconditionally and are there for you through the ups and downs of life. As a...

Keep reading

10 Best Dog Foods for Akitas in 2026: Reviews & Top Picks

Akitas are large, powerful dogs that require high-quality nutrition to help them maintain a healthy body weight and good muscle mass. The right food can make all the difference in your Akita’s health, but it can be confusing to know...

Akita puppies eating food_New Africa_Shutterstock

10 Best Puppy Foods for Goldendoodles in 2026 – Reviews & Top Picks

Welcoming a Goldendoodle puppy into your home is fun and exciting! The right toys, beds, leashes, bowls, and food are all important things to acquire when you get a new dog. When it comes to puppies, they need different nutrition...

female goldendoodle puppy

Can Dogs Eat Seafood? Vet-Reviewed Health Facts, Benefits & Risks

Seafood is a delicacy and is loved by many people, but what about humans’ best friends? Can dogs also indulge in the delights of the ocean? The short answer is yes, dogs can eat seafood – but not all seafood,...

Can Dogs Eat Seafood

Green Lipped Mussels for Dogs: Vet-Verified Facts & FAQ

You may have never heard of green-lipped mussels (GLMs), but these particular shellfish are nutrient-rich mollusks that have many health benefits. They are great for humans, but what about dogs? Are GLMs healthy for dogs? Yes, and they can even...

mussels on a plate

Can Dogs Eat Chayote? Vet-Verified Facts & FAQ

Chayote (or mirliton/choko) is a fruit that belongs to the gourd family and was first cultivated in Mexico and Honduras. These fruits are a great snack for dogs; they can eat them without any issues. Chayote is nutritious and versatile,...

Can Dogs Eat_chayote

Emergency Dog Food: What To Keep In a Survival Kit

Disasters are unpredictable, and the safety of our beloved canine companions is paramount during these critical times. Thankfully, preparedness goes a long way in ensuring the well-being of our furry friends. So, if you’re wondering what to put in a...

pug dog eating from feeding bowl

10 Best Stainless-Steel Dog Bowls in 2026 – Reviews & Top Picks

There are many different dog food bowls, but stainless-steel bowls are some of the best options for many dogs. They’re more durable than other materials and can also be more hygienic. There isn’t much variety in stainless steel bowls, but...

two fluffy dogs eating from the triple stainless steel feeders

Annamaet Dog Food Review 2026: Pros, Cons & Final Verdict

Review Summary With healthy, natural ingredients, great research, and different options to meet your dog’s needs, Annamaet definitely stands out. This premium food company has over thirty years of experience in making dry food, and it has consistently given us...

Dogster_Annamaet Dog Food Review

Love Dogs? So Do We! Join the Dogster Community

Stay informed with expert pet care insights delivered straight to your inbox! Discover professional guidance on animal behavior, feeding tips, trusted product picks, and much more.




Sign up for the Dogster Email Newsletter