When dead rats are numerous and arterial injury is severe, widespread obstruction of arteries may happen. Clinical signs commonly detected include fever, cough, hemoptysis (blood in the sputum) and possibly sudden death. It is very important to not let exercise in almost any dog being treated for heartworms. Often dogs with acute infections will also require the management of anti-inflammatory doses of corticosteroids.Elimination of MicrofilariaeThe best drugs for this function would be the macrocyclic lactone (ML) anthelmintics, i.e.,milbemycin oxime, selamectin, moxidectin and ivermectin. These medications are the active ingredients in commonly used heartworm preventives. Although their usage as microfilaricides hasn't been accepted by the FDA, they are frequently used by veterinarians as there are not any approved microfilaricidal drugs currently available. It's recommended that microfilariae favorable dogs being treated using such macrocyclic lactones be hospitalized for at least eight hours after treatment for monitoring of potential adverse reactions, such as those resulting from accelerated death of the microfilariae.
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