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Andy Moorhead
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Sep 7, 2026
Treating Heartworm When the Ideal Protocol Isn't Possible | VETgirl Veterinary Continuing Education Podcasts
6:13
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6:56
7:13
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6:04Justine LeeHOST
So could you please just, you know, kind of catch us all up to speed and briefly walk us through the steps in the AHS protocol for managing heartworm disease?

Andy MoorheadGUEST
Yes, so basically our protocol has had a few tweaks over the years, but what's consistently been the same is the dose of three doses of melarsomine, the use of a prolonged course of doxycycline, steroids, and macrocyclic lactones.

Andy MoorheadGUEST
The first part of that is, of course, starting the animal on doxycycline and a macrocyclic lactone because we don't want the good that we're about to do with getting rid of heartworms for new heartworms coming in.

Andy MoorheadGUEST
And then we take a month-long wait period, which during that time, doxycycline, which of course eliminates Wolbachia, is there's further elimination of Wolbachia during that extra month.

Andy MoorheadGUEST
Then we give one dose of melarsomine 30 days later give a second and third dose with during especially during melarsomine steroids being administered you are destroying bags of antigens so they're you know these worms and it's they're huge so there's going to be a lot of reactivity there and then at the beginning You also, if the animal is symptomatic, you will use steroids as well to minimize those symptoms.
11 MINS LATER
J
18:18Justine LeeHOST
So how can a practitioner do what's best for the patient within the means of the client?