Improving heartworm preventative compliance

Heartworm preventative dispensing is down seven percent in 2024 compared to last year.1 Among clients who purchase heartworm preventatives, they give less than 75 percent of doses.2 Weak compliance hurts patient and practice health. Here are eight steps your team can take to sell more doses and get clients to give them.

1) Recommend 12 doses first. Denise G. Cisco, DVM, owner of Friendship Veterinary Hospital in Norfolk, Va., has client service representatives (CSRs) check preventative purchase history at checkout. They explain why year-round protection is medically necessary and how to save the most with instant rebates that are greatest for 12 doses.

Start with 12 doses, and then go to six if clients cannot afford it, advises Dr. Cisco. Ideally, single doses should only be sold to clients with puppies and kittens whose weight will change and need different dose sizes during growth stages.

2) Autoship through your online pharmacy. Distributors offer monthly delivery of single doses of preventatives with free shipping. Monthly shipments of single doses may help clients on limited budgets as well as multi-pet families, where clients may not be able to buy 12 doses of preventatives for all pets at the same time. Heartworm medication dispensing went from an average of 5.5 doses when sold at hospitals, to 11 doses when auto shipped.3

3) Localize heartworm risk. Connie Capps, DVM, owner of Bayview Veterinary Clinic in Norfolk, Va., is treating four dogs for heartworm disease this month. Noncompliant clients own two of the dogs. The third was a local dog adopted from a shelter. The fourth dog had been heartworm-positive for one year before its owner sought treatment as a new client. “Obviously, this just affirms the risk here,” says Dr. Capps. Post signs with a running total of the number of dogs your veterinarians have diagnosed with heartworm disease. Hang a city map and put red map tacks on areas where heartworm-positive dogs live.

4) Have a consistent message. “Our staff is comfortable discussing heartworm prevention,” says Ashley Swain, office manager at Shirlington Animal Hospital in Arlington, Va. “Have one to two sentences you are comfortable saying. Practice your speech.” Employees use role playing to gain confidence. When asking clients about giving doses, technicians and assistants say, “This is a judgment-free zone. Are you honestly giving the dose on the same day every month?”

Explain the annual cost of preventatives is typically less than 10 percent of the cost of treatment, but damage from heartworm disease is often permanent, even when treatment is administered,4 explains Chris Rehm, DVM, co-owner of four Rehm Animal Clinics in Alabama, and former president of the American Heartworm Society.

Share that heartworm disease can be fatal, and there is no treatment for cats. Clients must understand the need and urgency for heartworm prevention. Dr. Rehm advises using a compelling message of, “Here’s what I do for my pets.”

5) Repeat the message at every point of contact. An American Animal Hospital Association (AAHA) study found compliance improved as exposure to pet-owner education increased.5 Reinforce heartworm preventative dispensing during scheduling calls, which is the first point of contact, advises Kristen Melita, a manager with Community Veterinary Partners, who oversees Great Falls Animal Hospital in Great Falls, Va., and Shirlington Animal Hospital.

“You have many points of contact with clients,” says Melita. CSRs, technicians, assistants, and veterinarians need to echo the same message about heartworm prevention. Great Falls Animal Hospital has 80 percent compliance for heartworm preventative dispensing.

6) Ask clients to shop local. Value-based spending is strong among millennial consumers, who also are the largest pet-owning segment.6 Talk about how long your veterinary hospital has served the community and how many team members you employ. Share how you give back to your community, such as providing veterinary care for police dogs. Put framed photos of officers with their dogs in your lobby alongside a plaque stating your hospital proudly provides complimentary veterinary care to police dogs in your town. Share your small business story in a short video on your website and social media.

7) Promote the quality of your drugs. Your veterinary hospital is a reputable source for pet medications. Frequently counterfeited pet medications include preventatives and non-steroidal anti-inflammatory drugs.7 Let clients know your medications come straight from manufacturers with manufacturers’ guarantees. If clients have questions about medications, you will support them with answers. Let pet owners know your veterinarians will provide treatments and work with drug makers to cover costs if patients test positive for heartworm disease.

8) Remind clients to consistently give doses. To help busy clients remember to give timely medications, text them dosing reminders on the day of the month to give preventatives. Automate these reminders through your practice-management software or third-party reminder service. Text this: “Give today to protect from heartworms. We will remind you again in 30 days to give the next dose. To make changes to this reminder, click here. Thanks for taking good care of [pet name]!”

Suggest clients pick an easy recurring date to remember such as giving preventatives on the same day they pay monthly bills. Clients can set alerts on smart watches, cell phones, and digital calendars. Most boxed medications include reminder stickers clients can use on paper calendars.

Dr. Rehm warns against using the term “monthly” when referring to heartworm preventatives. Use the phrase “every 30 days” to avoid confusing them about dosing frequency. “The simple act of administering on-time heartworm preventatives can help ensure a lifetime of patient health,” Dr. Rehm says.

Wendy S. Myers, CVJ, has taught communication and client service skills for more than two decades. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, onsite coaching, and conferences. Myers was a partner in an AAHA-accredited specialty and emergency practice. Visit to learn more.


1. Veterinary Industry Tracker. VetSource and American Veterinary Medical Association. Accessed May 15, 2024.
2. Walther C. Pet Owner Compliance a Barrier to Heartworm Prevention. AAHA NEWStat. Accessed May 14, 2024.
3. Garrison G. No Place Like Home (Delivery). VetAdvantage. Accessed May 16, 2024.
4. Rehm C. Successful Heartworm Prevention: Cracking the Compliance Conundrum. Accessed May 16, 2024.
5. Six Steps to Higher-Quality Patient Care, American Animal Hospital Association, 2009:20.
6. Community Engagement Through Shop Local, Shop Small Campaigns. MWI Animal Health. Accessed May 16, 2024.
7. Counterfeit Caution: Buying Pet Medication Online. Caring Hands Animal Hospital. Accessed May 15, 2024.