Evidence-based Options When There Are Barriers to the 3-injection Melarsomine Protocol for Treatment of Canine HWD

Presentation Description / Summary: The American Heartworm Society released updated guidelines in 2024 that incorporate Spectrum of Care (SOC) options for the treatment of canine heartworm disease (HWD), particularly when barriers exist to the standard 3-injection melarsomine protocol. This presentation will review evidence-based treatment alternatives, explore barriers to care that extend beyond financial constraints, and illustrate several scenarios where a SOC approach can be beneficial.

Canine heartworm disease represents a significant access-to-care challenge, particularly impacting dogs in underserved communities (Wang, 2014; Jacobson, 2021). Despite the availability of a growing number of products, including diverse formulations (topical, oral, and injectable) and various dosing regimens (monthly, bi-annual, or annual), the trend shows an increasing number of pets leaving clinics without heartworm prevention, alongside a rising incidence of this preventable disease (American Heartworm Society Guidelines, 2024; Vetsource Industry Summary, 2025). By enhancing practitioners’ familiarity and comfort with a range of evidence-based treatment options for canine HWD, we aim to improve patient outcomes and foster better information sharing among specialists, general practitioners, and clients.