Why Test for Heartworm Disease Differently in Dogs and Cats

Heartworm disease acts very differently in dogs and cats. Dogs are the definitive host for
heartworm disease. This means dogs get an immature form of the worms from a mosquito, and the worms
then mature to adults and reproduce in the dog. The cat is an aberrant host of heartworm disease. This
means the worms do not normally mature or reproduce in cats and there are usually less worms present in
cat heartworm disease then dog heartworm disease.
There are three blood tests that are routinely used to detect heartworm disease in small animals.
The first is an occult heartworm test. This test is used in dogs that receive heartworm preventative during
the mosquito season or ideally year round (Heartgard, Interceptor, Sentinel, Revolution, and Pro-Heart 6)
and in dogs that are not on heartworm preventative. The test detects if there are adult heartworms present
in the dogs body by detecting proteins, or antigens, released by mature female heartworms. Since dogs
with adult heartworms usually have lots of mature worms, there is usually a lot of antigen present to be
detected. If a dog has a positive occult test, it has adult heartworms in its heart and/or pulmonary arteries.
If a dog has a negative occult test, it does not have adult heartworms. Cats, on the other hand, rarely have
greater than 6 worms, and the worms are much more likely to be immature or only male in cats. If a cat has
a positive occult heartworm test, it has heartworm disease, but if it has a negative occult test, it may or may
not have heartworm disease.
The second heartworm test is a microfilaria or modified Knotts test. Microfilaria are larval or
immature forms of heartworms. Dogs are much more likely to have microfilaria than cats, since
heartworms readily reproduce in dogs. Microfilarial tests detect larval heartworms that are either given to a
dog from an infected mosquito or produced from adult heartworms living in the dog. Heartworm
preventatives kill or prevent maturing of microfilaria, so this test is not performed on dogs receiving
preventative. However, this test is performed on dogs that have not been on heartworm preventative for 6
months or longer. The test is performed because a dog could have microfilaria without having adult worms
if the dog was bitten by a mosquito carrying heartworm disease and the microfilaria have not had enough
time to mature to adult heartworms.
The third heartworm test is an antibody test. This test determines whether or not an animal has
made antibodies against heartworm antigens. The test only tells veterinarians if the animal has been
exposed to heartworms. It does not tell veterinarians whether or not an animal has a heartworm infection in
its body. This test is not used in dogs because the occult and microfilarial tests are inexpensive and reliable
ways to determine if a heartworm infection is present. However, this is the preferred test in cats, because
the other methods are not sensitive enough to determine if heartworm disease is present in cats. A negative
antibody test means the cat has never been exposed to heartworms and does not have heartworm disease. A
positive antibody test means the cat has been exposed to heartworms, but may or may not have the disease
right now and further tests are needed to determine if the cat has heartworm disease.
It is very important that all cats be kept on heartworm preventative. Cats that are infected with
heartworms may only have a few worms. However, when these worms die, they are much more likely to
be lodged somewhere in the body, which can cause very severe signs in the cat. It is common that the first
sign seen in a cat with a heartworm infection is death. Even indoor only cats may be at risk, if a mosquito
slips in an open door or a torn screen.

Laura Smith