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An accurate patient historythe comprehension of varied clinical signsthe utilization of several diagnostic procedures that may include: blood (serological) testingmicrofilarial detection and differentiationphysical examination and clinical laboratory tests X-ray (radiology)angiography andultrasound (echocardiography)in the worst case situation, evaluation following death (necropsy).SerologyDiagnostic evaluations for the analysis of antibodies and antigens in blood clots.Antigen TestsAntigen tests detect specific antigens primarily found in mature female heartworms and are used with much success to discover canine heartworm infection. At present, tests are accessible as in-clinic evaluations in addition to at many veterinary reference labs. Most commercial evaluations will correctly detect infections with one or more adult female heartworms that are at least seven or eight months old, but the tests generally do not detect infections of less than five months duration.
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Elimination of MicrofilariaeThe best drugs for this purpose would be the macrocyclic lactone (ML) anthelmintics, i.e.,milbemycin oxime, selamectin, moxidectin and ivermectin. These drugs are the active ingredients in commonly used heartworm preventives. Although their usage as microfilaricides hasn't yet been accepted by the FDA, they are widely used by veterinarians as there are not any approved microfilaricidal drugs now available. It's recommended that microfilariae favorable dogs being treated with such macrocyclic lactones be screened for at least eight hours after treatment for monitoring of potential adverse reactions, including those resulting from accelerated departure of the microfilariae.Circulating microfilariae usually can be removed in a couple of weeks by the management of the ML-type medication mentioned previously. Today however, the most widely used microfilaricidal treatment is to just administer ML preventives as usual, and the microfilariae will be eliminated gradually over a period of approximately six to nine months.
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Radiology (X-ray)Radiographic abnormalities grow early in the course of this disease. X-rays of the lungs and heart are the best tools available to evaluate the severity of the disease and to develop a prognosis. Typical changes observed are enlargement of the following constructions: pulmonary arteries in the lobes (especially the lower lobes) of the lung, main pulmonary artery, and right side of their heart. Blunting and thickening, usually along with tortuosity (abnormal twists or turns), of pulmonary arteries, can be noted. Infection is often located in the lung tissue, especially the tissue that surrounds the pulmonary arteries.Angiography and UltrasonographyThese forms of imaging are rarely utilized in the identification of canine heartworm infection outside referral clinics and teaching associations. Angiography is a technique which allows visualization of blood vessels within your system by taking radiographs within seconds after injecting a contrast material (dye) into those blood vessels. In canine heartworm infection, angiography can be used to study changes to the pulmonary blood vessels. Worms may be visualized on the angiogram as submitting defects. Ultrasonography (echocardiography) was utilized to evaluate enlargement of the heart chamber and also to search for the existence of heartworms in the right ventricle or main pulmonary artery.
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