Are common clinical protocols prioritizing detection over prevention in canine Dirofilaria immitis?

Prioritize improving owner compliance with monthly preventives over relying solely on annual heartworm testing.

This viewpoint article challenges the prevailing emphasis on annual heartworm testing in canine Dirofilaria immitis management, arguing that owner noncompliance with preventive medication is the primary driver of infection in established patients rather than true preventive product failure. The author highlights that only 24.4% of dogs under veterinary care achieve full-year purchase compliance with monthly macrocyclic lactone preventives, representing a significant gap in continuous chemical protection. The article further notes that anecdotal practice data suggest annual testing reminders are issued far more consistently than monthly dosing reminders, potentially misaligning clinical priorities. The author contends that the fundamental goal of heartworm management should be maintaining uninterrupted chemoprevention rather than detecting infections that result from prior adherence failures. To address this gap, the viewpoint advocates for practices to actively track patient adherence rates, implement routine adherence counseling as a standard component of heartworm-related appointments, and prospectively evaluate adherence-first clinical protocols within prescription-renewal workflows. While heartworm antigen testing remains an important diagnostic tool, this article argues it should be integrated within a broader prevention-centered framework that places equal or greater emphasis on ensuring clients consistently administer preventives throughout the year. This perspective has practical implications for how veterinary teams structure client communications, reminder systems, and annual wellness visit priorities.

This summary was distilled by AI and may occasionally misinterpret data. Confirm critical details with the primary literature before clinical application.