We used to do dog rescue, and we had two dogs with heartworm. Both dogs were mixed breed adults. Both dogs lived for many years after their treatment and died of unrelated causes.
The first dog had the full treatment, had to be kept in a crate, and had to go to the ER twice. It was expensive and really unpleasant.
The second dog had a very different experience. It was a female with liver problems so the regular heartworm treatment was contraindicated. So the veterinarian said we should just keep her on heartworm medicine and that eventually the heartworms wold die off, just more slowly, and there would be less risk and no new heartworms would be born. We did that because we had no choice, but it was actually much easier on us and on the dog. It was cheaper, no visits to the ER, and we didn't have to keep her in a crate. Her case may have been less severe than the first dog's case.
Good luck.
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