Feline heartworm disease has been
diagnosed in all 50 states. Wherever dogs are considered to be at risk for
heartworms, cats are at risk as well. This is why it is so important for all
cats to receive heartworm prevention. You should discuss prevention with your
veterinarian at your annual preventive care examination.
Research has shown that signs
such as coughing and difficulty breathing, which are often diagnosed as feline
asthma or allergic bronchitis, can be caused by the presence of heartworms in
either larval or adult stages. Heartworm associated respiratory disease, or
HARD, is the term for this condition.
Heartworm infection occurs when a
mosquito carrying microscopic heartworm larvae takes a blood meal from a cat.
The larvae enter through the bite wound and develop in the cat’s tissues. The
immature worms then enter a blood vessel and are carried to the arteries in the
lung where they cause an inflammatory reaction. Most worms die at this stage,
causing even more inflammation. The worms that progress to the adult stage can
live undetected for a couple of years, but when the adult worms die the
inflammation can be severe enough to cause death.
Symptoms
Associated with HARD
·
Coughing
·
Difficulty
breathing
·
Lethargy
·
Rapid
heart rate
·
Decreased
appetite
·
Weight
loss
·
Vomiting
·
Diarrhea
·
Blindness
·
Collapse
·
Convulsions
·
Sudden
death
Online
Resources
KNOW Heartworms
KNOW Heartworms is an awareness campaign cosponsored by the American
Association of Feline Practitioners (AAFP) and the American Heartworm Society
and funded by an educational grant from Pfizer Animal Health. The campaign was
created to raise awareness of feline heartworm disease and HARD. The website
focuses on the "Five Myths and Misunderstandings" of feline heartworm
disease.
The Companion Animal Parasite Council
(CAPC)
CAPC fosters animal and human health, while preserving the human-animal bond,
through recommendations for the diagnosis, treatment, prevention and control of
parasitic infections.
The American Heartworm Society (AHS)
AHS has the most comprehensive and up-to-date information about heartworm
disease, includingguidelines for diagnosing, treating, and
preventing heartworms in cats, a feline heartworm animation, a glossary of
heartworm-related terms, and a "Just for Kids"
page.
Heartworm disease is a serious and potentially fatal disease in pets in the
United States and many other parts of the world. It is caused by foot-long
worms (heartworms) that live in the heart, lungs and associated blood vessels
of affected pets, causing severe lung disease, heart failure and damage to
other organs in the body. Heartworm disease affects dogs, cats and ferrets, but
heartworms also live in other mammal species, including wolves, coyotes, foxes,
sea lions and—in rare instances—humans. Because wild species such as foxes and
coyotes live in proximity to many urban areas, they are considered important
carriers of the disease.
Dogs. The
dog is a natural host for heartworms, which means that heartworms that live
inside the dog mature into adults, mate and produce offspring. If untreated,
their numbers can increase, and dogs have been known to harbor several hundred
worms in their bodies. Heartworm disease causes lasting damage to the heart,
lungs and arteries, and can affect the dog’s health and quality of life long
after the parasites are gone. For this reason, prevention is by far the best
option, and treatment—when needed—should be administered as early in the course
of the disease as possible.
Cats. Heartworm
disease in cats is very different from heartworm disease in dogs. The cat is an
atypical host for heartworms, and most worms in cats do not survive to the
adult stage. Cats with adult heartworms typically have just one to three worms,
and many cats affected by heartworms have no adult worms. While this means
heartworm disease often goes undiagnosed in cats, it’s important to understand
that even immature worms cause real damage in the form of a condition known as
heartworm associated respiratory disease (HARD). Moreover, the medication used
to treat heartworm infections in dogs cannot be used in cats, so prevention is
the only means of protecting cats from the effects of heartworm disease.
How is heartworm disease
transmitted from one pet to another?
The
mosquito plays an essential role in the heartworm life cycle. Adult female
heartworms living in an infected dog, fox, coyote, or wolf produce microscopic
baby worms called microfilaria that circulate in the bloodstream. When a
mosquito bites and takes a blood meal from an infected animal, it picks up these
baby worms, which develop and mature into “infective stage” larvae over a
period of 10 to 14 days. Then, when the infected mosquito bites another dog,
cat, or susceptible wild animal, the infective larvae are deposited onto the
surface of the animal's skin and enter the new host through the mosquito’s bite
wound. Once inside a new host, it takes approximately 6 months for the larvae
to mature into adult heartworms. Once mature, heartworms can live for 5 to 7
years in dogs and up to 2 or 3 years in cats. Because of the longevity of these
worms, each mosquito season can lead to an increasing number of worms in an
infected pet.
What are the signs of heartworm
disease in dogs?
In the early stages of the disease, many dogs show few
symptoms or no symptoms at all. The longer the infection persists, the more
likely symptoms will develop. Active dogs, dogs heavily infected with
heartworms, or those with other health problems often show pronounced clinical
signs.
Signs of heartworm disease may include a mild persistent
cough, reluctance to exercise, fatigue after moderate activity, decreased
appetite, and weight loss. As heartworm disease progresses, pets may develop
heart failure and the appearance of a swollen belly due to excess fluid in the
abdomen. Dogs with large numbers of heartworms can develop a sudden blockages
of blood flow within the heart leading to a life-threatening form of
cardiovascular collapse. This is called caval syndrome, and is marked by a
sudden onset of labored breathing, pale gums, and dark bloody or coffee-colored
urine. Without prompt surgical removal of the heartworm blockage, few dogs
survive.
What are the signs of heartworm
disease in cats?
Signs of heartworm disease in cats can be very subtle
or very dramatic. Symptoms may include coughing, asthma-like attacks, periodic
vomiting, lack of appetite, or weight loss. Occasionally an affected cat may
have difficulty walking, experience fainting or seizures, or suffer from fluid
accumulation in the abdomen. Unfortunately, the first sign in some cases is
sudden collapse of the cat, or sudden death.
How significant is my pet's risk
for heartworm infection?
Many factors must be considered, even if heartworms do
not seem to be a problem in your local area. Your community may have a greater
incidence of heartworm disease than you realize—or you may unknowingly travel
with your pet to an area where heartworms are more common. Heartworm disease is
also spreading to new regions of the country each year. Stray and neglected
dogs and certain wildlife such as coyotes, wolves, and foxes can be carriers of
heartworms. Mosquitoes blown great distances by the wind and the relocation of
infected pets to previously uninfected areas also contribute to the spread of
heartworm disease (this happened following Hurricane Katrina when 250,000 pets,
many of them infected with heartworms, were “adopted” and shipped throughout
the country).
The fact is that heartworm disease has been diagnosed
in all 50 states, and risk factors are impossible to predict. Multiple
variables, from climate variations to the presence of wildlife carriers, cause
rates of infections to vary dramatically from year to year—even within
communities. And because infected mosquitoes can come inside, both outdoor and
indoor pets are at risk.
For that reason, the American Heartworm Society
recommends that you “think 12:” (1) get your pet tested every 12 months for
heartworm and (2) give your pet heartworm preventive 12 months a year.
What do I need to know about
heartworm testing?
Heartworm disease is a serious, progressive disease.
The earlier it is detected, the better the chances the pet will recover. There
are few, if any, early signs of disease when a dog or cat is infected with
heartworms, so detecting their presence with a heartworm test administered by a
veterinarian is important. The test requires just a small blood sample from
your pet, and it works by detecting the presence of heartworm proteins. Some
veterinarians process heartworm tests right in their hospitals while others
send the samples to a diagnostic laboratory. In either case, results are
obtained quickly. If your pet tests positive, further tests may be ordered.
When should my pet be tested?
Testing procedures and timing differ somewhat between
dogs and cats.
Dogs. All
dogs should be tested annually for heartworm infection, and this can usually be
done during a routine visit for preventive care. Following are guidelines on testing and timing:
·
Puppies under 7
months of age can be started on heartworm prevention without a heartworm test
(it takes at least 6 months for a dog to test positive after it has been
infected), but should be tested 6 months after your initial visit, tested again
6 months later and yearly after that to ensure they are heartworm-free.
·
Adult dogs over 7
months of age and previously not on a preventive need to be tested prior to
starting heartworm prevention. They, too, need to be tested 6 months and
12 months later and annually after that.
·
If there has been a
lapse in prevention (one or more late or missed doses), dogs should be tested
immediately, then tested again six months later and annually after that.
Annual testing is necessary, even when dogs are on
heartworm prevention year-round, to ensure that the prevention program is
working. Heartworm medications are highly effective, but dogs can still become
infected. If you miss just one dose of a monthly medication—or give it late—it
can leave your dog unprotected. Even if you give the medication as recommended,
your dog may spit out or vomit a heartworm pill—or rub off a topical
medication. Heartworm preventives are highly effective, but not 100 percent
effective. If you don’t get your dog test, you won’t know your dog needs
treatment.
Cats. Heartworm
infection in cats is harder to detect than in dogs, because cats are much less
likely than dogs to have adult heartworms. The preferred method for screening
cats includes the use of both an antigen and an antibody test (the “antibody”
test detects exposure to heartworm larvae). Your veterinarian may also use
x-rays or ultrasound to look for heartworm infection. Cats should be tested
before being put on prevention and re-tested as the veterinarian deems
appropriate to document continued exposure and risk. Because there is no
approved treatment for heartworm infection in cats, prevention is critical.
What happens if my dog tests
positive for heartworms?
No one wants to hear that their dog has heartworm, but
the good news is that most infected dogs can be successfully treated. The goal
is to first stabilize your dog if he is showing signs of disease, then kill all
adult and immature worms while keeping the side effects of treatment to a
minimum.
Here's what you should expect if your dog tests
positive:
·
Confirm
the diagnosis. Once a dog tests positive on an
antigen test, the diagnosis should be confirmed with an additional—and
different—test. Because the treatment regimen for heartworm is both expensive
and complex, your veterinarian will want to be absolutely sure that treatment
is necessary.
·
Restrict
exercise. This requirement might be
difficult to adhere to, especially if your dog is accustomed to being active.
But your dog’s normal physical activities must be restricted as soon as the
diagnosis is confirmed, because physical exertion increases the rate at which
the heartworms cause damage in the heart and lungs. The more severe the
symptoms, the less activity your dog should have.
·
Stabilize
your dog's disease. Before actual heartworm treatment
can begin, your dog’s condition may need to be stabilized with appropriate
therapy. In severe cases of heartworm disease, or when a dog has another
serious condition, the process can take several months.
·
Administer
treatment. Once your veterinarian has
determined your dog is stable and ready for heartworm treatment, he or she will
recommend a treatment protocol involving several steps. The American Heartworm
Society has guidelines for developing this plan of attack. Dogs with no signs
or mild signs of heartworm disease, such as cough or exercise intolerance, have
a high success rate with treatment. More severe disease can also be
successfully treated, but the possibility of complications is greater. The
severity of heartworm disease does not always correlate with the severity of
symptoms, and dogs with many worms may have few or no symptoms early in the
course of the disease.
·
Test
(and prevent) for success. Approximately 6 months after
treatment is completed, your veterinarian will perform a heartworm test to
confirm that all heartworms have been eliminated. To avoid the possibility of
your dog contracting heartworm disease again, you will want to administer
heartworm prevention year-round for the rest of his life.
What if my cat tests positive for
heartworms?
Like dogs, cats can be infected with heartworms. There
are differences, however, in the nature of the disease and how it is diagnosed
and managed. Because a cat is not an ideal host for heartworms, some infections
resolve on their own, although these infections can leave cats with respiratory
system damage. Heartworms in the circulatory system also affect the cat’s
immune system and cause symptoms such as coughing, wheezing and difficulty
breathing. Heartworms in cats may even migrate to other parts of the body, such
as the brain, eye and spinal cord. Severe complications such as blood clots in
the lungs and lung inflammation can result when the adult worms die in the
cat’s body.
Here’s what to expect if your cat tests positive for
heartworm:
·
Diagnosis. While infected dogs may have 30 or more worms in their heart and lungs,
cats usually have 6 or fewer—and may have just one or two. But while the
severity of heartworm disease in dogs is related to the number of worm, in
cats, just one or two worms can make a cat very ill. Diagnosis can be
complicated, requiring a physical exam, an X-ray, a complete blood count and
several kinds of blood test. An ultrasound may also be performed.
·
Treatment. Unfortunately, there is no approved drug therapy for heartworm infection
in cats, and the drug used to treat infections in dogs is not safe for cats.
Nevertheless, cats with heartworm disease can often be helped with good
veterinary care. The goal is to stabilize your cat and determine a long-term
management plan.
·
Monitor
your cat. Heartworm-positive cats may
experience spontaneous clearing of heartworms, but the damage they cause may be
permanent. If your cat is not showing signs of respiratory distress, but worms
have been detected in the lungs, chest X-rays every 6 to 12 months may be
recommended. If mild symptoms are noted, small doses of prednisolone may be
administered to help reduce inflammation.
·
Provide
veterinary care. If the disease is severe,
additional support may be necessary. Your veterinarian my recommend
hospitalization in order to provide therapy, such as intravenous fluids, drugs
to treat lung and heart symptoms, antibiotics, and general nursing care. In
some cases, surgical removal of heartworms may be possible.
·
Maintain
prevention. A cat that has developed
heartworm disease has demonstrated that it is susceptible to heartworm
infection, and both outdoor and indoor cats are at risk. It’s important to give
your cat monthly heartworm preventives, which are available in both spot-on and
pill form. Preventives keep new infections from developing if an infected
mosquito bites your cat again.
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