Unfortunately, yes, depending on where you live. Let me answer it this way—if you have mosquitoes where you live, then yes. They are how the disease is spread so, if you live, say, in Canada where there are no mosquitoes, it's not going to be a big deal to you guys. But here in South Louisiana, the Gulf Coast, and the majority of the United States, I would say it's a pretty big issue.

Why do they call it heartworm? Because the worms live in the heart. I'm not saying that to be silly, but anything that lives in the heart is obviously going to be detrimental. These worms can get pretty good-sized. Believe it or not, they can reach six to eight inches long, so that's a pretty good size. If you get one or two, it’s probably not a huge deal. If you get 10 or 12, it’s starting to become a big deal now. If you get more than that, well, you can imagine. Common sense would tell you that's going to begin to affect how efficiently and effectively that the heart can pump. Can those valves seal off? Is blood flow going to be impeded in going to the lungs to get oxygenated? All that stuff is a factor, so there are some very significant signs associated with the disease itself. And some of those changes are irreversible if they've been there for long enough, even if the dog is treated.

I get asked that one every now and then as well. The simple answer is, no. I can't really justify a reason for me to say that's better. I've been doing this for over 20 years and I can count maybe not on one hand, but probably on two hands, how many times an animal has died peacefully on their own at home. It just doesn't happen very often. They fight. They hang on. They just don't let go the way that we would want them to let go. So oftentimes it stinks, but we as veterinarians and sometimes you as owners have to make that hard decision for them. I encourage people to think of it not as being cruel because I, too, struggle with that. What gives me the right to do that? What gives me the power and the right to decide if an animal lives or dies? It's a weird power to yield, but I've come to realize that it's the last bit of love that we can give them. It really is. When you know that the end is there, there's nothing else you can offer and there's nothing that's going to make this animal turn around. Isn't it kinder to let them go with dignity, pain-free, in a controlled, loving setting where their owner can be right there with them, holding them, talking to them? I would like to go that way. I hope that that can be done for me one day, and I know it can't, but who wouldn't want to pass that way in that situation. So, yeah. I think it is much more feasible and humane for the animal to ease them in their passing, as opposed to drawing it out and just waiting and waiting and waiting for them to pass at home.

The reality is most of these cats are going to show you much more subtle early signs, and you're probably going to take the cat to your veterinarian to have them checked—to have lab work or x-rays—whatever it takes to diagnose what the underlying problem is. So again, with that information and the advice of your veterinarian and their staff, a group decision will typically be made in reference to what treatment options are. Euthanasia is usually the last thing that we can do to ease their suffering. So once all other treatment options have been exhausted and there is no improvement or the animal continues to decline, that's when the time for euthanasia.