Standard Heartworm protocol vs. “slow kill”
The American Heartworm society protocol for treatment of heart worm can be expensive for clients.
“Aren’t there alternative protocols that don’t include adulticide administration?”
Treatment regimens that utilize heartworm preventives with or with out doxycycline instead of an adulticide are called “slow kill” protocols. Here is why they are not recommended by the AHS.
1) Slow kill requires up to a year—and sometimes much longer—to achieve results, during which time there is progression of pathology and resultant damage.
2) Slow kill is less effective in eliminating adult worms than melarsomine, and the timing of worm death is unpredictable.
3) Slow kill requires strict compliance and exercise restriction throughout the many months—or years—of treatment.
“Could a protocol like this be an alternative for my patients?”
This author stresses that any “slow kill” protocol is a salvage procedure, not a treatment of choice. The longer adult worms take to die, the more damage caused to the dog’s pulmonary vasculature— and that damage can be permanent.
WSAVMA Clin Brf, Jun 2018