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Split dose (3 injections), melarsomine and doxycycline; thoracic radiographs, CBC, UA, chemistry panel, coagulation profile
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↑ efficacy, ↓ risk of PTE, safety of phased worm kill, no resistance concern
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Cost $$$$; exercise restriction for 2 months
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Appropriate for all; best approach for severe HW disease
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Standard dose (2 injections), melarsomine and doxycycline; thoracic radiographs, CBC, UA, chemistry panel, coagulation profile
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↓ cost, ↓ risk of PTE (vs standard dose), exercise restriction only 1 month, no resistance concern
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Cost $$$; ↑ risk of PTE (vs split dose); ↓ kill efficacy (vs split dose)
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Appropriate when financial constraints and mild to moderate HW disease
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Standard dose (2 injections), melarsomine
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↓ cost; exercise restriction only 1 mo, no resistance concern, easier for shelters
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Cost $$; ↑ risk of PTE (vs standard dose); ↓ kill efficacy (vs split dose); cage rest imperative
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Appropriate when financial constraints and mild HW disease
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Non-arsenical adulticidal therapy: oral ivermectin, topical moxidectin/imidacloprid, or oral moxidectin, at preventive dosage, with doxycycline
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↓ cost, no injections, no hospitalization, shorter treatment duration than slow kill protocol
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Cost $; ↑ risk of resistance, not approved by AHS, ~12-month course, lung disease progression, time of HW death unknown
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Appropriate when there are severe financial or other constraints, lack of melarsomine availability, or failure of melarsomine treatment to clear dog previously
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Slow kill non-arsenical adulticidal therapy with ivermectin, topical moxidectin/imidacloprid, or oral moxidectin, at preventive dosage
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Inexpensive; no injections
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↑ risk of resistance, 30-month course, lung disease progression, time of HW death unknown
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Should be avoided; MUST clear microfilariae
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