One of the differences that struck me most between working in the small animal hospital at Tufts and doing an externship down south is the number of canine patients that present to the clinic that test heartworm positive. During the ten months of core rotations up in Massachusetts, I only saw one dog that was treated for heartworms, a tiny Chihuahua on my first ever rotation. I encountered him on what was his 91st day of treatment, the last day he would receive an injection of a specific drug in the epaxial muscles of his back. In stark contrast to this, almost every day that I have been doing the externship in Louisiana have I seen at least one dog positive for heartworm present to the clinic.
I have found it useful to reread my parasitology class notes as well as pay a visit to the online version of the Merck Veterinary Manual and The American Heartworm Society website, the latter of which has an online map showing the incidence of heartworm in the United States from 2001 to 2016. In looking at these resources, I can help explain to pet owners the importance of preventative medicine and ensuring that our beloved pets get their monthly medications (or those given every three or six months, depending on the product). One of the vets used the ultrasound probe to check the thorax of a dog on my first day at the clinic, and it was surreal to see worms undulating as the valves opened and closed.