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Hi this is Dr. Evans, are you available to chat?
I've seen so many of these poor little ones. Is your dog clinical?
Coughing is the most common sign. If this is the case slow kill may be "safer'', however, heartworm kills 100% of animals if left untreated. Due to the urgency, I and the majority of my colleagues recommend the treatment using immidicide (melarsamine) which is a series of injections to get the worms taken care of ASAP.
It should also be noted that Immidicide, the injection drug, has been on back order several times recently so many veterinarians that dont have access to it may offer the best the can do - meaning the slow kill...
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