الكاتب: Multiple References

Heartworm disease classification is used to categorize patients based on the severity of the disease. The treatment protocol is based on this classification.{R-1; 2} Class 1: Asymptomatic to mild heartworm disease. General loss of condition, fatigue on exercise, or occasional cough may be present; however, radiographic and other laboratory tests are normal.{R-1; 2} Class 2: Moderate heartworm disease. Abnormal radiographic signs or abnormal hematologic test results, such as anemia, are present. Radiographic signs include right ventricular enlargement, slight pulmonary artery enlargement, or circumscribed perivascular densities with mixed alveolar or interstitial lesions. For dogs in this class, anemia is defined as a packed cell volume (PCV) between 20 and 30%. Mild proteinuria (2+) may be present. General loss of condition, fatigue on exercise, or occasional cough may be present. Patients may need to be stabilized prior to treatment.{R-1; 2} Class 3: Severe heartworm disease. Cardiac cachexia, constant fatigue, persistent cough, dyspnea, or other signs associated with right heart failure such as ascites or jugular pulse may be present. Radiographic signs may include right ventricular enlargement or right ventricular and right atrial enlargement, severe pulmonary artery enlargement, circumscribed to chronic mixed patterns and diffuse patterns of pulmonary densities or radiographic signs of thromboembolism. Significant anemia (PCV < 20%) or other hematologic abnormalitites may be present. Proteinuria (> 2+) may be present. Patients may have moderate clinical signs and significant laboratory or radiographic alterations or they may have significant clinical signs with only moderate laboratory and radiographic signs to be categorized as Class 3. Patients in Class 3 should be stabilized prior to treatment and then given the alternate dosing regimen. Patients in this class have a guarded prognosis.{R-1; 2} Class 4: Severe heartworm disease. D. immitis is present in the venae cavae and right atrium (caval syndrome). Patients in this class should not be treated with melarsomine.