The American Heartworm Society offers heartworm disease treatment guidelines that consist of combination therapy with melarsomine, doxycycline and a macrocyclic lactone. Brian Herrin, DVM, PhD, recently shared treatment tactics recommended by veterinary experts and gave an overview of less extensive and less expensive alternatives.
Source: Veterinary Medicine, July 26, 2019. Link. Early diagnosis and early elimination of heartworms with adulticidal therapy give affected dogs the best chance at a healthy life but there are consequences to consider.