How much does heartworm treatment cost?
Ashburn, VA

How much does heartworm treatment cost?

Ashburn, VA

How much does heartworm treatment cost?

$600 – $2,000 cost of heartworm treatment
$5 – $15 cost per month for heartworm prevention medication

Get free estimates for your project or view our cost guide below:

$600 – $2,000 cost of heartworm treatment

$5 – $15 cost per month for heartworm prevention medication


Get free estimates for your project or view our cost guide below:
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Kristen Cramer
Written by
Kristen Cramer
Edited by
Tara Farmer
Fact-checked by
Jennifer Carlson

Heartworm treatment cost

Heartworm treatment costs $600 to $2,000, depending on your pet's size, the stage of the disease, and the blood tests, X-rays, and medications needed. In comparison, heartworm prevention costs $5 to $15 per month to help your pet avoid this potentially fatal disease.

Average cost of heartworm treatment vs. prevention
Heartworm management type Average cost
Heartworm treatment $600 – $2,000
Heartworm prevention medication $5 – $15 per month

  • Heartworm disease can cause anemia, difficulty breathing, fatigue, decreased appetite, heart failure, lung, damage, and even death.

  • Monthly heartworm prevention is more cost-effective and provides your pet with a better quality of life. Heartworm treatment costs about 10 times more than the total annual cost of heartworm prevention.

  • Treating heartworms is not just expensive but also requires multiple vet visits and several months of exercise restriction and strict rest.

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What affects the cost of heartworm treatment?

Though heartworm prevention medication is available for both dogs and cats, the FDA has only approved heartworm treatment for dogs, as the drug used for treatment—called melarsomine dihydrochloride—is toxic to cats.

Several factors impact the cost of the treatment:

  • Dog's size: Larger dogs require higher doses of medication, increasing costs.

  • Disease stage: The severity of the disease depends on how many heartworms are present and how much damage they've caused. The more severe a dog's condition, the more additional medications and melarsomine injections may be needed, resulting in higher costs.

  • Diagnostic fees:

    • An antigen heartworm test costs $40 to $75 and detects proteins in the bloodstream that are produced by adult heartworms. Results are typically available within 10 to 20 minutes.

    • If your dog's antigen test is positive, your vet will confirm the diagnosis with a microfilaria test. This test costs $20 to $40 and detects immature heartworms or larvae called microfilariae.

    • Your dog may also need X-rays to evaluate the extent of the heart and lung damage before beginning treatment. Dog X-rays cost $150 to $250 per image.

  • Additional medications: As part of the heartworm treatment protocol, your dog will need several other medications:

    • Heartworm preventative to kill the larvae

    • Doxycycline, an antibiotic, to weaken the heartworms before the melarsomine injections

    • Sedation before each injection

    • Prednisone or other steroid medications to reduce the inflammation caused by dying heartworms

  • Follow-up testing:

    • One month after the third melarsomine injection, your vet will perform another microfilaria test to determine if any heartworm larvae are still present, at an additional $20 to $40 cost.

    • Three months after the third injection, your vet will perform another antigen test for an additional $40 to $75. If the test is positive, your dog may need additional melarsomine injections and doxycycline.

Does pet insurance cover heartworm treatment?

Most comprehensive pet insurance plans cover heartworm treatment if the dog is first diagnosed with the disease after you've enrolled them in the plan. However, plans vary by provider, and some companies charge extra for illness coverage.

Pet insurance typically does not cover heartworm preventatives unless you purchase an add-on wellness package. Standard accident-and-illness pet insurance costs $35 to $75 per month for dogs and $15 to $50 per month for cats. A wellness plan adds $10 to $25+ per month to that cost.

Heartworm symptoms

The symptoms of heartworm disease include:

  • Mild, persistent cough

  • Fatigue after moderate activity

  • Low energy & reluctance to exercise

  • Decreased appetite

  • Weight loss

As the disease progresses, other symptoms may include a swollen abdomen, difficulty breathing, pale gums, and heart failure.

How do dogs get heartworm?

Dogs get heartworms through mosquito bites. After an infected mosquito bites a dog and injects the heartworm larvae, the larvae enter the dog's bloodstream and move into the heart, arteries, and lungs. Once inside the dog's body, the larvae grow into adult worms that range from 4 to 12 inches in length and continue to reproduce.

Microscopic view of heartworm microfilariae and a growing adult heartworm in a dog's heart
Microscopic view of heartworm microfilariae and a growing adult heartworm in a dog's heart

Heartworm prevention

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Heartworm preventatives cost $5 to $15 per month on average, depending on the brand, your pet's weight, and whether you choose chewable tablets or a topical product. It's important not to miss a monthly dose of heartworm preventative as skipping a month can lead to a dangerous infection later.

What is the treatment for heartworms?

Melarsomine dihydrochloride is the only FDA-approved drug to treat heartworms. The drug also goes by the brand names Immiticide and Diroban.

Heartworm treatment involves a minimum of three melarsomine injections spread out over several months, along with antibiotics, anti-inflammatory steroids, and heartworm preventatives to ensure all adult heartworms and immature larvae are killed.

How long does heartworm treatment take?

Heartworm treatment takes 4 to 6 months on average. Spreading out the treatment over several months puts less stress on your dog's body. The total treatment time will vary depending on your dog's condition and the stage of the disease, but the typical treatment timeline is:

  • Doxycycline for 30 days, and heartworm preventative throughout the treatment

  • First melarsomine injection 30 days after beginning the doxycycline

  • Second melarsomine injection 30 days after the first injection

  • Third melarsomine injection 24 hours after the second injection

  • Follow-up testing 30 days and 90 days after the third injection to determine if the dog requires additional treatment

How long after heartworm treatment can a dog be active?

It is crucial that you limit your dog's activity to strict rest and short walks on a leash until at least 1 month after the final injection, or longer if your vet recommends it. As adult heartworms die, the body slowly absorbs them, and these clumps can obstruct circulation and cause a stroke or sudden death during exercise.

Keep your dog as quiet as possible during this time, and make sure they avoid strenuous activities like swimming, jogging, wrestling with other dogs, chasing other animals, or visiting the dog park. Provide stimulation with chew toys or food-dispensing puzzle toys instead.

Is heartworm treatment painful?

The injections for heartworm treatment can be painful, but the inflammation that occurs during the days following each injection causes the most discomfort. However, the disease itself is painful and usually deadly if left untreated.

How long can a dog live with heartworms without treatment?

If left untreated, heartworm disease is usually fatal for dogs. An infected dog's life expectancy depends on their size and general health before the infection and how many worms they have.

Dogs with severe heartworm disease may develop caval syndrome, a life-threatening condition caused by a mass of heartworms that fill so much of the heart they block normal blood flow. Surgical removal is the only treatment option, with costs ranging from $3,500 to $6,000+.

A veterinarian listening to a dog's heart with a stethoscope
A veterinarian listening to a dog's heart with a stethoscope

Questions to ask your vet about heartworm treatment

Heartworm treatment is a long process and comes with some risks. Ask your veterinarian these important questions to help you better understand the treatment and other key details:

  • What outcome should I expect from the treatment?

  • What are the negatives in pursuing this treatment plan?

  • How long will the heartworm treatment take?

  • Will it be uncomfortable or painful for my dog?

  • What do I need to do to prepare my dog for the treatment?

  • What special care will my dog need during and after the treatment?

  • What are the possible side effects, and what should I look for?

  • How can I help my dog if side effects occur?


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