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Diagnostic Tests, Clinical Signs, and Treatment for Dirofilariasis in Dogs, Cats, and Ferrets

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Host	–-–----------------Diagnosis (Test Utility)--------------------				Clinical Signs	Preventatives	------------Treatment------------
	Microfilaria	Ag or Ab Test	Thoracic Radiography	Echocardiography			Adults	Microfilariae
Dog	****	***** (Ag)	*** MPA, PA, RHE, PTE, PIE	**	Respiratory, exercise intolerance, heart failure, weight loss	Ivermectin, milbemycin, selamectin, or moxidectin	Melarsomine, doxycycline, supportive treatment	Moxidectin,^a ivermectin, milbemycin, or selamectin + doxycycline
Cat	*	(Ag) * (Ab)^b	** PA, PIE	****	Respiratory, vomiting, sudden death, heart failure	Ivermectin, milbemycin, selamectin, moxidectin, or eprinomectin^c	Supportive treatment, doxycycline, heartworm extraction	—
Ferret	*	*** (Ag)	* RHE	***	Heart failure, respiratory, sudden death	Ivermectin, milbemycin, selamectin, or moxidectin^d	Supportive treatment (including corticosteroids)	—
Abbreviations: * = rarely useful; = somewhat useful; * = moderately useful; ** = often useful; *** = excellent test.; Ab, antibody; Ag, antigen; ML, macrocyclic lactone (macrolide); MPA, main pulmonary artery enlargement; PA, pulmonary artery enlargement; PIE, pulmonary infiltrate with eosinophils; PTE, pulmonary thrombosis or embolism; RHE, right heart enlargement. Adapted from McCall, JW. Clin Tech Small Anim Pract. 1998;13(2):112. ^aMoxidectin-imidacloprid is the only FDA-approved microfilaricide. ^bAb-positive result does not prove mature infection, only exposure/abbreviated infection. ^cDo not use in cats with the feline MDR1 mutation. ^dMoxidectin (in a formulation with the insecticide imidacloprid) is the only FDA-approved preventative in ferrets.