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Alert from Aloha Animal Hospital Associates: Shortage of Heartworm Disease Medicine

There is a growing shortage of heartworm disease medicine. We’re sending this e-mail to remind all dog owners to be sure their dogs are current on heartworm preventatives such as HeartGard, Interceptor, Sentinel or other medications. Why? If your dog contracts the disease, it may be difficult to acquire the medicine to treat it.

The nation’s only heartworm disease medicine, called “Immiticide,” has been out of production in the United States since late 2009. Heartworm can be fatal and is something you never want your dog to contract; but the shortage of the medicine used in treatment makes it especially dangerous for dogs to contract the disease at this time." Imiticide is distributed by Merial. Last December, Merial was notified by the sole supplier for Imiticide’s active ingredient that it was stopping production indefinitely. Merial has no other supplier for this ingredient. As a result, no Imiticide has been manufactured for several months. Merial is rationing out supplies to vets who have the most serious cases of heartworm disease. Vets are being required to phone Merial to make special requests when they have a dog with heartworm disease.

We contacted Merial’s supplier on April 15, 2010. We asked when they plan to be in production again. A representative told us, “We hope to have it by the end of the year, or even by the end of the summer, but no date has been set.” Merial is aggressively searching for another supplier, but until one is secured, the supply of Imiticide will continue to dwindle.

The best course of action is prevention. Keep your dog away from areas where there are mosquitoes and ensure your dog is on heartworm preventives. If your dog is not currently on heartworm preventives, we strongly recommend that you test your dog and initiate a monthly prevention regimen as soon as possible. If you have questions, call 732-2242 or click here to send a message

To order heartworm preventives, go to your favorite supplier (prescription required) or click here to use our free order service.


Q: What are heartworms?
A: Quite honestly, they’re pretty disgusting. Adult Heartworms are round whitish worms about 6-10 inches long that spend their lives inside the heart and blood vessels that connect a dog’s heart to the lungs. They block blood flow to major organs, and can cause anemia, kidney disease, immune mediated disease, and thrombo-emoblic (blood clot) problems.

Q: How do dogs get heartworm disease?

A: Ironically, heartworm is not transmitted by infected dogs. Instead, it is transmitted by mosquitoes that bite infected dogs. Dogs can't get heartworm directly from infected dogs, but rather by mosquitoes that bite infected dogs. When a mosquito bites a dog with heartworms, it ingests the youngest heartworms, which are microscopic in size. Larvae then go through a developmental stage inside the mosquito which the mosquito transmits when it bites other dogs. This new stage of the heartworm microfilaria can develop into an adult heartworm over the course of about six months.

Q: How common are heartworms in Hawaii?
A: Heartworms are found in all 50 states and worldwide. Stray or uncared-for dogs as well as various wildlife can be carriers. In Hawaii, veterinary clinics typically see between 7 and 25 cases per year.

Q: What are the warning signs that my dog might have heartworm?
A: Warning signs are difficult to detect until heartworm has progressed into its later stages. Late stage clinical signs can include the following symptoms:
  • Coughing
  • Difficulty breathing
  • Sluggishness

    Q: What should I do to help protect my dog against heartworm?
    A: Keep your dog on a heartworm-prevention medicine and avoid mosquito-infested areas. You can never totally avoid mosquitoes, but you should try to minimize their exposure to your dog.

    Q: I have a dog and a cat. Can my cat get heartworm disease?
    A: Yes - your cat can get heartworm disease. Cats don't get heartworm as often as dogs, but a single heartworm can kill a cat. Cats can have serious problems even if a heartworm infection partially develops. Cats should be on heartworm preventives as well. Since there is no approved or effective treatment for cats, prevention is critical. We recommend the use of Revolution (a spot-on treatment that also prevents flea problems) or HeartGard for cats.

    Q: How are dogs tested for heartworm infection?
    A: A simple blood test can detect the presence of adult heartworms, whether there are microfilaria or not.

    Q: How can heartworm disease in dogs be prevented?
    A: There are several medications approved in the U.S. for heartworm prevention in dogs including HeartGard, Interceptor, Sentinel, Revolution, Advantage Multi or others. HeartGard is AAHA’s standard recommendation to prevent heartworm in dogs, and it comes as a chewable tablet/treat. It should be given monthly year round. To order, click here.

    Q: What happens if my dog gets heartworm? How is it treated?
    A: There is only one safe and effective medicine approved in the U.S. to treat heartworm disease which is called “Immiticide.” Due to a manufacturing issue, Immiticide is not currently being produced. Even when available, this medicine is not 100 percent effective against heartworm disease. The dog is usually hospitalized when the medicine is administered and then sent home to remain quiet in confinement for four – six weeks. The confinement is required because there is a risk of blood clots and/or heartworm debris blocking the blood flow. Sometimes, an additional series of treatments is required as well as a separate treatment to rid the dog of the tiny, immature larvae (microfilaria) that are circulating throughout the blood stream.

    Q: What happens if my dog does not get treatment for heartworm disease?
    A: In the early stages, heartworm disease typically causes only minor problems, but over time and with heavy heartworm burdens dogs can develop exercise intolerance, heart failure, anemia, and kidney disease; untreated dogs may die from heartworm disease.

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      1616 Liliha Street #101 Honolulu HI
      808.734.2242 |

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