Heartworm Treatment at CHEW
If your dog was diagnosed with heartworms at another facility, we require those records to be sent in advance for review. All dogs must have completed 28–30 days of doxycycline and at least one month of heartworm prevention before starting the first injection.
If your regular veterinarian prescribed prednisone or gabapentin, please administer the morning of the first treatment. If you were not provided with these medications, notify the nurse at drop-off so they can be given at the clinic.
If your dog is showing any signs of advanced heartworm disease (such as coughing or wheezing), an exam will be required prior to the first injection. Dogs over 7 years old must also have an exam before starting treatment.
CHEW’s heartworm treatment includes:
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3 injections
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Gabapentin and prednisone (after injections)
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All-day monitoring after each injection
CHEW’s heartworm treatment does not include:
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Trazodone: Recommended to help keep your dog calm
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Radiographs: Required only if your dog is showing signs of advanced disease, but recommended for all heartworm-positive dogs
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Radiographs: Recommended for all heartworm-positive dogs because they show the extent of heart and lung damage caused by the disease. While only required if a dog is showing signs of advanced disease (such as coughing or difficulty breathing), they are encouraged for all patients to help us assess disease severity, guide treatment, and monitor for potential complications.
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Bloodwork Bloodwork is recommended for all heartworm-positive dogs because it checks liver and kidney function, screens for anemia or infection, and provides a baseline before treatment begins. While only required if a dog is showing signs of advanced disease, it is strongly encouraged for all patients to help ensure treatment can be carried out as safely as possible.
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Intramuscular sedation: May be needed if your dog is overly anxious or difficult to keep still, since the injection is given deep into the back muscles near the spine and must be administered precisely for safety)
Pricing: -
0–20 lbs: $450
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20.1–40 lbs: $540
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40.1–60 lbs: $630
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60.1–85 lbs: $720
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85 LBS and over - CALL FOR PRICING
Day 0 – Diagnosis & Start of Treatment
Your dog tested positive for heartworms today
What to do now:
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Start monthly prevention (Heartgard or Iverhart)
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Start Doxycycline twice daily for 30 days (this targets bacteria that live with the heartworms)
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Begin strict activity restriction (leash-only bathroom breaks, calm environment)
Medications Sent Home Today:
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Doxycycline – Start now, twice daily for 30 days
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Heartworm prevention – Give now, repeat monthly
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Gabapentin + Prednisone + Benadryl – To be given on injection days between 7:00–8:00 AM
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Trazodone (if included) – Use as needed to help keep your dog calm
Day 60 – First Heartworm Injection or Day 30 if early treatment was approved and consent signed
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Give Gabapentin + Prednisone between 7:00–8:00 AM
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Drop off at CHEW by 8:30 AM
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Your dog will receive the first melarsomine injection to kill adult heartworms
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You will go home with more Prednisone and Gabapentin
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Continue strict activity restriction
Day 90 & Day 91 – Final Injections
Your dog will receive two additional melarsomine injections, 24 hours apart
For both days:
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Give Gabapentin + Prednisone between 7:00–8:00 AM
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Drop off at CHEW by 8:30 AM
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Start Prednisone and Gabapentin again that evening
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Maintain strict leash-only restriction throughout
Retest: 9 Months After Final Injection - this is not included in cost
What is Heartworm Disease?
Heartworms are dangerous, mosquito-borne parasites that live in a dog’s heart and lungs. Left untreated, they can cause severe heart and lung damage or even death — but preventable with monthly medication.
How Do I Know If My Dog Has It?
Heartworm disease is detected through a blood test. Dogs may not show signs until the disease is advanced. Advanced symptoms include: Coughing, Lethargy, Loss of appetite, Difficulty breathing
Can It Be Prevented?
Yes! Give monthly prevention every 30 days, year-round, and test annually. This protects both dogs and cats from heartworm disease.
Watch Closely After Treatment
Common side effects:
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Mild coughing
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Tiredness
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Reduced appetite
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Soreness at injection site
Call your vet right away if you notice:
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Heavy coughing
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Breathing trouble
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Vomiting
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Swelling
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Weakness or pale gums
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Sudden collapse
These may be signs of a dangerous reaction from dying heartworms.