A six-year-old Coonhound mix is presented with a two-week history of coughing, exercise intolerance and lethargy.
He presents with labored breathing, tachycardia, ascites, hepatomegaly and crackles on lung auscultation.
These are signs of right-heart failure. Heartworm antigen test is positive and the dog is stabilized in hospital.
What is the best treatment going forward from here?
A - Metformin two doses IM 24 hrs apart followed by strict cage rest and low-dose furosemide diuresis
B - Initiate HW preventative therapy and predisone, then go to surgery to resolve caval syndrome
C - Monthly macrocyclic lactone, four weeks doxycycline, three-dose melarsomine protocol at day 60
D - Ivermectin now, two doses thiacetarsamide sodium at least three months later with concurrent prednisone
E - Milbemycin now, two doses thiacetarsamide sodium at least five months later
answer/c
