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The onset and severity of disease in the dog is mainly a manifestation of the amount of mature heartworms present, the era of the infection and the level of activity of the dog. Dogs with high numbers of worms are usually found to have more severe heart and lung disease affects. Until the number of adult heartworms exceeds 50 in a 25-kg dog (approximately 55 pounds), almost all the heartworms reside in the reduced caudal pulmonary arteries (the arteries of the lower lung lobes). Higher numbers of heartworms lead to their existence in the right chambers of the heart. In such ailments, the most common early pathological changes brought on by heartworms are due to inflammatory processes that exist in and around the arteries of the lower part of the lungs in response to the presence of heartworms. Later, the center may enlarge and become weakened because of an increased workload and congestive heart failure may occur. A very active dog (e.g., working dog) is more likely to develop serious disease with a comparatively small number of heartworms compared to an inactive one (e.g., a lap dog or couch potato). Occasionally, a dog with a large number of heartworms might not just have worms in the heart, but also in the caudal vena cava (large main vein of the lower body) involving the liver and the heart. If the heartworms aren't removed surgically, this syndrome causes abrupt collapse and death within two to three days.Canine heartworm disease is widely distributed throughout the United States. Heartworm disease was found in dogs indigenous to all 50 states. All dogs, irrespective of their age, sex, or habitat, are susceptible to heartworm infection. The maximum infection rates (up to 45%) in dogs (not maintained on heartworm preventive) are observed in 150 miles of the Atlantic and Gulf coasts from the Gulf of Mexico into New Jersey and across the Mississippi River and its major tributaries. Additional regions of the United States may have lower prevalence rates (5% or less) of canine heartworm disease, while some areas have ecological, mosquito population and dog population factors that allow a greater local incidence of heartworm infection. Regions where heartworm disease is prevalent have diagnosed infections in dogs as young as one year of age, with the majority of regions diagnosing infections chiefly between the ages of three and eight years. Even though there are differences in frequency of infection for a variety of groups of dogs, all dogs in all areas should be considered in danger, placed on prevention programs and also often examined by a veterinarian.
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