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When dead worms are numerous and arterial injury is acute, widespread obstruction of arteries can happen. Clinical signs most commonly observed include fever, cough, hemoptysis (blood in the sputum) and possibly sudden death. It is extremely important not to allow exercise in any dog being treated for heartworms. Often dogs with severe infections will also require the administration of anti-inflammatory doses of corticosteroids.Elimination of MicrofilariaeThe best drugs for this function are the macrocyclic lactone (ML) anthelmintics, i.e.,milbemycin oxime, selamectin, moxidectin and ivermectin. These medications are the ingredients in commonly used heartworm preventives. Though their usage as microfilaricides has not yet been accepted by the FDA, they are widely used by veterinarians as there are no approved microfilaricidal drugs now available. It is encouraged that microfilariae positive dogs being treated using such macrocyclic lactones be screened for at least eight hours following treatment for observation of potential adverse reactions, such as those resulting from rapid departure of the microfilariae.
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