Q. Is heartworms painful for dogs ? What to expect in a old dog with heartworms ?

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A. Heartworms are not generally painful, but the treatment can be painful depending on what approach you take. The age of the dog does not matter as much as the health and how long the dog has had heartworms and what type of damage has been done to the heart and other organs. You need x-rays and possibly an echocardiogram to see what the heart looks like and how it is functioning and check some bloodwork to ensure the rest of the organs are ok before you decide how he will do with the treatment.

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