[Ellie May]

Stuff happens. Ellie has been late before too. Maybe put it as an alert to give once a month in your cell phone? Then the alarm will go off on that day...

ON is pretty close to MI and the protocol has changed her. Medicating for only part of the year is no longer considered acceptable here because there is no guarantee that all mosquitoes die off. There have been positive cases when owners didn't medicate in the winter. So it should be once a month, every month, year-round, with at least annual testing, and watch that they don't throw it up.

All of them fail at one time or another. There are some serious concerns about Revolution having a fairly high failure rate. Personally, I would not trust it.

The new strain is probably isolated around MS right now, but there could also be other afftected areas. There are concerns about the current heartworm meds not working against it, but in the lab, they were all still 99+% effective as long as they were given once a month for three months after the dog was infected. However, there are still a ton of reported cases of heartworm positive dogs down South where the owners are compliant. It's a hard one. All you can do it give a good product year-round.

For almost all dogs, standard of care is Immitcide therapy (arsenic based injections). Slow kill is generally not recommended. The disease can progress during that two year period. Chest xrays will help the vet stage the disease to see how far things have progressed. Prior to treatment, it is becoming very common and a very good idea to give Doxy to kill the wolbachia (some type of nasty that heartworms carry). This makes the Immiticide easier on the pup.

The American Heartworm Society is the authority on all things heartworm and it's a great site to go look around and study.