The Canine Heartworm Guidelines by the American Heartworm Society (AHS) has been newly revised. These published guidelines, which address heartworm prevention, diagnosis, and treatment, were last updated in 2020. The revised version also includes a new section on spectrum of care.

The latest update was completed after a thorough scientific review by a team of authors, which included experts in parasitology, cardiology, and clinical practice. They based the revisions on the latest research and understanding of heartworm management and addressed questions that are frequently posed by veterinary practitioners.

“The goal of this update was to ensure that our recommendations continue to be both scientifically grounded and practical for veterinarians to implement,” said Jennifer Rizzo, DVM, president of the AHS, in a news release. “The update includes changes to our guidance as well as reinforcement of key points that remained unchanged.” In addition, she noted, the guidelines update includes spectrum-of-care guidance for veterinarians treating dogs under less-than-optimal circumstances.

The updated canine heartworm guidelines are available on the society’s website at 

. Highlights from these guidelines are as follows:

The AHS continues to recommend year-round administration of macrocyclic lactone heartworm preventives as the cornerstone of heartworm management. Additionally, the document now recommends both FDA-approved isoxazolines and EPA-approved mosquito repellent products to kill mosquitoes and help prevent the spread of heartworms (previously only EPA-approved products were recommended).

The AHS recommends annual antigen and microfilaria testing when screening canine patients, with microfilaria testing considered especially important when the dog’s prevention history is unknown or when the veterinarian suspects the dog is infected. In addition, dogs older than 7 months should be tested for heartworms prior to starting a heartworm preventive to ensure that untested and heartworm-positive dogs are not inadvertently administered 

 treatment. In cases where a dog is known to have missed a dose of preventive, the patient should be tested 7 months after the lapse.

Noting that 1 of the more common questions posed to the AHS relates to disagreement between antigen and microfilaria test results, the guidelines emphasize the importance of repeating heartworm tests when the results are unexpected. (For example, when a dog is microfilaria-positive with no antigen detected.) If blocked antigen caused by an antigen-antibody complex has led to such a result, repeating the antigen test with a new blood sample that has been heat treated can unmask the blocked antigen and yield a more accurate result.

Patient evaluation and heartworm treatment

Depending on whether the dog is symptomatic, veterinarians can consider additional patient evaluations, including thoracic radiographs, ultrasonography, and echocardiography. The updated guidelines include a section with detailed advice for using point-of-care ultrasonography.

Meanwhile, the AHS treatment protocol remains largely unchanged in the latest guidelines and includes administration of an ML medication on Day 0, followed by 4 weeks of doxycycline administration to eliminate 

; another month of macrocyclic lactone on Day 30, 60 and 90; and a series of three injections of melarsomine administered on Days 60, 90 and 91. Activity restriction is recommended throughout the treatment period and for at least 6-8 weeks after treatment has been completed.

Spectrum-of-care principles in treating heartworm disease

The guidelines now also include a spectrum-of-care section intended for use in clinical situations when a practitioner is unable to follow the optimal treatment protocol for heartworm-positive patients and needs access to information on efficacy and complication rates. This new section includes a discussion of alternative treatment protocols, including protocols with fewer melarsomine injections, alternatives to melarsomine treatment, and guidance when heartworm treatment is interrupted.

“Heartworm disease in dogs continues to be far too common, despite the availability of highly effective medications to prevent and treat it,” Rizzo said, in the release. “Our hope is that the updated AHS guidelines can provide the practical and proven support veterinarians need to significantly reduce the rate of heartworm disease.”

The current update was spearheaded by a committee of AHS board members, including Tom Nelson, DVM; John McCall, PhD; Andrew Moorhead, DVM, MS, PhD, DACVM (Parasitology); Lindsay Starkey, DVM, PhD, DACVM (Parasitology); and Marisa Ames, DVM, DACVIM (Cardiology).

American Heartworm Society announces updated guidelines on canine heartworm disease. News release. American Heartworm Society. April 9, 2024. Accessed April 9, 2024. 

https://heartwormsociety.org/in-the-news/864-american-heartworm-society-announces-updated-guidelines-on-management-of-canine-heartworm-disease

Articles

The American Heartworm Society is providing new practice guidance for the prevention, diagnosis and treatment of parasitic infection in dogs

Guidelines for canine heartworm disease are updated

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“The diet trial [is currently] the only way to fully diagnose a dog as a food-allergic dog,” said Julia E. Miller, DVM, DACVD. On a recent episode of VetXChange, Miller joined Adam Christman, DVM, MBA, to discuss diet trials as a treatment plan for canines experiencing allergic reactions.

When a patient comes into the clinic because it is experiencing itchiness, clinicians usually consider 3 types of allergies: flea, food, and environment. Once ectoparasites are ruled out as the cause, the clinician should ask the client follow-up questions to determine whether the allergen is environmental or related to food.

Allergies caused by environment typically affect dogs aged 1 to 4 years, though certain breeds, like French bulldog, American bully, and doodle, can experience effects at just 6 months of age.

“If I’m getting a dog that’s itchy before 6 months of age, [I’m implementing a] diet trial,” said Miller. “That’s the first thing on my list every single time.” Similarly, if a dog has never had allergic reactions but becomes itchy at an older age, environmental allergens are an unlikely cause.

“Once you’ve decided that your patient is the right patient for a diet trial, then you have to decide if your client [is] the right client for a diet trial,” said Miller. She stressed that communication between the clinician and the pet parent is crucial in ensuring the trial’s success. If the client has any stipulations about strictly adhering to their pet’s food plan, then a diet trial may not be the best option. If the client can commit to a few weeks, however, then the next step is choosing a trial that is compatible with that pet and pet parent’s lifestyles.

Highly digestible, low-residue gastrointestinal diets, fiber-enriched diets, elimination diets, and low-fat diets are a few of the trials available and can be broken down into 2 primary diet types: hydrolyzed diets and novel protein diets. Clinicians should determine the patient’s diet history before deciding which trial to try first. “If that dog has eaten a ton of chicken-based products, I am less likely to reach for hydrolyzed chicken-based food,” said Miller.

No matter which diet is tested, it should be prescription. Over-the-counter (OTC) diets can be cross-contaminated with chicken, beef, and pork, which are common allergens and can complicate the diagnosis. Although they are not suitable as a diagnostic tool, OTC diets can later be used for allergy maintenance.

Miller also noted that communication between the client and clinician does not end after the diet plan is implemented. The clinician may have to check in with the client to ensure the dog is not consuming food outside the diet plan.

“That kibble should be the only thing that goes in that dog’s mouth,” said Miller. Flavored toys, chews, capsules, dental treats, and food from the table can affect trial success. After ensuring the trial has been started, clinicians should check in after 4 to 6 weeks. If there is no change in the patient after the trial is complete, it can be determined that the patient is not allergic to that food, or the patient is not a food-allergic dog.

If a patient is a food-allergic dog, diet trials can be used to determine the allergen and develop a diet plan. 

Diet trials for canine allergic reactions

The Janice K. Hobbs UC Davis Veterinary Medical Center Southern California. (Photo credit: Blake O'Brien)

The University of California, Davis has purchased a new building at 5040 Shoreham Place in San Diego, California to become the Janice K. Hobbs UC Davis Veterinary Medical Center Southern California. The veterinary hospital is scheduled to open in fall 2025 after renovations are completed. According to a news release from UC Davis,

 the center’s namesake, Jan Hobbs, is a Southern California philanthropist, animal lover, and UC Davis donor who helped make the building purchase possible.

“The Janice K. Hobbs UC Davis Veterinary Medical Center Southern California will be an even greater hub of innovation and treatment for this region’s pets and veterinary community,” said Brett Feder, DVM, DACVIM (SAIM), the center’s chief veterinary medical officer, in the release.

The Janice K. Hobbs UC Davis Veterinary Medical Center Southern California will provide 24/7 veterinary emergency and critical care and allow the university to expand its veterinary specialty services to now include cardiology, clinical pharmacy, hemodialysis, nephrology and advanced urology, internal medicine, oncology, surgery, and radiology/diagnostic imaging. It will become one of the few locations in the country to offer hemodialysis for kidney failure and other advanced therapies for toxicities and immune-mediated diseases, a treatment option that UC Davis has been offering at its current teaching hospital.

Along with companion animals, the new medical center capabilities will also extend to exotic animals and wildlife, and it will become a service provider for animals being cared for by the San Diego Zoo Wildlife Alliance.

The new center is 23,000 square feet and a single-story structure, which UC Davis finds is ideal for emergency needs.

 The university is hopeful this new facility will only enhance their expertise and offer students a wider range of knowledge and training opportunities.

“As the number one ranked veterinary school in the nation, UC Davis is proud to be able to serve both Northern and Southern California with its innovative, advanced care,” said Mark Stetter, DVM, DACZM, the dean of the School of Veterinary Medicine. “We are grateful to Jan Hobbs, the veterinary and animal owner communities, and others who have made this expansion possible.”

Warren R. UC Davis expands veterinary services in Southern California. News release. The University of California, Davis School of Veterinary Medicine. March 29, 2024. Accessed April 9, 2024. 

https://www.vetmed.ucdavis.edu/news/uc-davis-expands-veterinary-services-southern-california

About the Center. The University of California, Davis School of Veterinary Medicine. Accessed April 9, 2024. 

https://hobbs.vetmed.ucdavis.edu/about-center

The new building is scheduled to open in fall 2025

UC Davis veterinary hospital expands in San Diego

MetLife Pet Insurance shared the news that it entered a collaboration with the Association of Animal Welfare Advancements (AAWA) to create and produce content that highlights issues pet parents face surrounding access to veterinary care. The partnership will also include the Golden Beagle Award, a MetLife-sponsored award recognizing innovative animal welfare organizations.

“Animal welfare organizations play an essential role in providing care and comfort to every abandoned, neglected, and abused animal and AAWA has been a positive force in supporting these institutions,” said Brian Jorgensen, chief executive officer of Pet Insurance at MetLife, in an organizational release.

“We are proud to be working with such a respected group to address the financial and physical challenges pet parents may experience when trying to obtain medical care. We believe pets are part of the family and are committed to ensuring that they can live full and healthy lives,” he continued.

 this new collaboration will focus on producing blog posts, newsletters, podcasts, and other content mediums to help animal welfare organizations address the challenges pet owners face when it comes to access to veterinary care. The collaboration will highlight innovations, potential legislation, and dispersing news from shelters, local organizations, and countrywide movements.

The collaboration will work with new and potential parents to help animal welfare organizations get a better understanding clients could face when trying to get care for their pets. The challenges could be financial, such as not being able to afford the cost of care their pet needs, or physical distance such as no access to a veterinarian.

“Access to care is a critical issue facing animal welfare organizations and pet parents alike,” said Jim Tedford, president and chief executive officer of AAWA.

 “We are pleased to be working with MetLife Pet Insurance, a market leader, to identify potential obstacles to providing care for pets and spotlighting both potential solutions and actions being taken to address this issue.”

Along with the content development MetLife will sponsor the Golden Beagle Award, which will be awarded to an animal welfare organization for the first time at the upcoming 2024 AAWA conference in November.

 The award will be given to an organization for its innovative approach to addressing the challenges faced when trying to help larger dog breeds find a loving home. The winner of the Golden Beagle Award will win a $20,000 award to continue their work.

MetLife Pet Insurance announces collaboration with the Association of Animal Welfare Advancement. News release. MetLife Pet Insurance. April 9, 2024. Accessed April 9, 2024. 

https://www.metlife.com/about-us/newsroom/2024/april/metlife-pet-insurance-announces-collaboration-with-the-association-of-animal-welfare-advancement/

The collaboration will include the Golden Beagle Award 

Pet insurance company announces partnership with the Association of Animal Welfare 

The American Association of Veterinary Medical Colleges (AAVMC) has announced the first 15 scholarship recipients of a new program that aims to increase the veterinary profession’s representation of underserved groups and communities. In partnership with Chewy Health, the program is distributing a total of $300,000 in education funding to its inaugural cohort.

The goal of the Chewy Veterinary Leaders Program is to help participants develop a solid foundation as they build their practices, according to Mita Malhotra, president of Chewy Health.“We are passionate about fostering a healthy culture in veterinary medicine and our scholarship program uniquely focuses on the opportunity to support veterinarians as they are navigating the transition from being a student to a doctor,” Malhotra said in a news release.

Each of the third-year students in the 2024-2025 Chewy Veterinary Leaders Program Cohort are receiving $20,000 in funding. This cohort of students includes the following individuals:

Alexandra Yiambilis—Cornell University; Ithaca, New York

Breonna Freeman—Louisiana State University; Baton Rouge

Casey Lavender—Mississippi State University; Mississippi

Christina Camson—The Ohio State; Columbus

Christopher Ibarra Gervacio—Washington State University; Pullman

Claudia Vasquez—University of Missouri; Columbia

Dianne Quiroz—Oregon State University; Corvallis

Ester Lam—University of Minnesota; Saint Paul

Hannah Huff—University of Georgia; Athens

Kelsey Birchfield—University of Tennessee; Knoxville

Mariana Martinez—Western University of Health Sciences; Pomona, California

Melanie Narvaez—University of Illinois at Urbana-Champaign

Natalia Sanchez—Colorado State University; Fort Collins

Stephanie Yopp—University of Wisconsin-Madison

Zachary Wriedt—Auburn University; Alabama

Andrew T. Maccabe, DVM, CEO of AAVMC, said the association’s membership was excited to offer the scholarships in partnership with Chewy Health. “This funding will be instrumental in helping us further education and representation in the profession as we champion diversity and inclusion in advancing veterinary medicine,” Maccabe said in a news release.

Through facilitation by MentorVet, a Chewy partner, these students will participate in monthly conversations designed to be supportive and promote camaraderie, as part of the leadership program. Training, networking and other activities are also planned for the scholarship recipients.

After graduation from their respective schools, the scholarship recipients will have opportunities to join a network of Chewy Veterinary Leaders alumni, continue participating in networking, and will be provided with post-graduation sponsorship to join MentorVet Leap, a 6-month professional development program for early-career veterinarians.

 “We hope these new leaders will inspire even more caregivers to enter the profession,” Malhotra added.

AAVMC awards inaugural Chewy Veterinary Leaders Cohort. American Association of Veterinary Medical Colleges. March 27, 2024. Accessed April 8, 2024. 

https://www.aavmc.org/news/aavmc-awards-inaugural-chewy-veterinary-leaders-cohort/

AAVMC partners with Chewy Health to launch new veterinary scholarship. American Association of Veterinary Medical Colleges. November 6, 2023. Accessed April 8, 2024. 

https://www.aavmc.org/news/aavmc-partners-with-chewy-health-to-launch-new-veterinary-scholarship/

2024-2025 Chewy Veterinary Leaders Cohort. American Association of Veterinary Medical Colleges. Accessed April 8, 2024. 

https://www.aavmc.org/wp-content/uploads/2024/03/Chewy-Veterinary-Leaders-Program-Recipients.pdf

Fifteen recipients will each receive $20,000 in funding as the first cohort of a new program created in partnership with Chewy Health

AAVMC awards $300,000 in scholarships to veterinary students

In partnership with payment processor company, Stripe, comes a payment software: Digitail Secure Payments. This new all-in-one cloud-based operating system aims to streamline the billing process and tackle the challenges associated with missed charges. Digitail, veterinary software solution, helps support practice information management for veterinary businesses.

“AAHA estimated that due to manual data entry and human errors, veterinary hospitals lose up to 17% of revenue from diagnostic services alone. This financial gap can accumulate to the equivalent of an annual salary for a full-time veterinarian. Furthermore, a consistent pattern of missed charges may erode client trust and satisfaction,” said Ryan Leech, director of strategic partnerships at Digitail, in a news release.

 “With Digitail Secure Payments, practices can say goodbye to lengthy checkouts and human errors, and say hello to a seamless, efficient, and error-free payment process.”

Digitail Secure Payments system. (Photo credit: Digitail)

Veterinary hospitals utilizing Digitail Secure Payments can effortlessly gather payments via an integrated terminal within their premises or dispatch invoice links through text, email, or the Pet Parent App. Customers have the flexibility to conveniently clear their bills using their chosen payment method, regardless of location. This pioneering solution guarantees precision in payments by automatically transmitting the accurate invoice amount to the terminal, eradicating errors stemming from manual data entry, faulty invoice calculations, and payment discrepancies.

Digitail Secure Payments offers flexible pricing options and its Quick Start plan features a simple pay-as-you-go pricing model, with 2.79% + $0.25 per successful card charge and no setup fees or monthly fees. Additionally, veterinary practices can take advantage of custom pricing options by bringing their current statements, with Digitail committed to matching or beating existing rates.

Say goodbye to missed charges: Digitail announces Digitail Secure Payments. News release. Digitail. Accessed April 8, 2024. 

https://digitail.com/blog/say-goodbye-to-missed-charges-digitail-announces-digitail-secure-payments/

Digitail Secure Payments can ease practice management needs