"It's easy to prevent but hard and expensive to treat."
That's the message from Mitchell Edwards of Macleay Valley Veterinary Services after a heartworm case was diagnosed on the Mid North Coast.
Heartworm disease is caused by a parasite called Dirofilaria Immitis with the disease spread between dogs via mosquitoes.
When a dog is bitten the mosquito injects heartworm larvae into the dog with the larvae developing into adults over a 4-7 month period.
The adult worms then lodge themselves in the heart and can result in serious heart and lung complications if left untreated.
"The biggest problem we have with it is because it's called heartworm a lot of people make the assumption that an all-wormer covers it but that's not the case," Mr Edwards explained.
"It's killed by a different drug than a lot of ordinary all-wormers kill so some people just aren't covering their dogs out of pure naivety."
The symptoms of heartworm don't show up until late in the disease, making it even more important for regular prevention.
Coughing, exercise intolerance and lethargy can occur in an infected dog, essentially when they're in heart failure.
The case from the last two weeks in Kempsey has followed from other recent diagnoses on the coast.
"Recently the eastern seaboard has had a lot more cases and it's starting to ramp up again because it's been quiet for so many years," Mr Edwards said.
"18 months ago there were a few cases in Port Macquarie and quite a lot in Newcastle recently as well as a few in Sydney.
"It's that kind of alarm moment to say hey we've had one here [in Kempsey], it's time to start making sure your dog is prevented."
In the past few decades the disease has been fairly quiet throughout NSW with Mr Edwards stating the situation was far more contrasting during his childhood.
"It's a disease that is unfortunately rebounding," he said.
"When I was a kid about 30 years ago it was rife, it was everywhere and the only preventative we had was a daily tablet so therefore if you missed a day or the dog vomited up a tablet they got heartworm, it was really common and vets were diagnosing dogs all the time.
"As preventatives got better in that decade they started with monthly prevention which was more effective and people were better at it, cases went from 100s to 10s and 5s and it's been that way for probably twenty years.
"When I was a kid everyone heard about heartworm but now people haven't heard of it.
"It's like polio, everyone knew someone who had polio and everyone knew someone whose dog had heartworm and now because we've got so good at preventing it no one has heard of it."
Dog owners have two options when it comes to protecting your pet against heartworm.
"Everyone generally does the annual injection, of the dogs we vaccinate, 50% get the annual heartworm preventative injection," Mr Edwards explained.
"The good thing about it is it lasts 12 months and you don't have to remember it every month.
It's also got a three month reach back where although we do it yearly you've actually got 15 months incase you stuff up and forget to do it.
"The monthly one is good and people still do it but the protection period is not as perfect.
"Often it's 28 days so if people do it by the calendar month on the first day of every month there's the possibility your dog can get bitten during the gap and become infected.
"In Queensland where they still see stacks of it, around 50% of the animals detected with heartworm have been on monthly vaccinations and have missed a dose or done it late."
Mr Edwards also stated the fear of the disease spreading has arisen due to flooding throughout the Mid North Coast.
"The Macleay as an area should have higher cases than anywhere else because of flooding and with heaps of water comes stacks of mosquitoes," he said.
"We've also got a big population of dogs that'll never get prevented - there's wild dogs, foxes and stray dogs that don't get anything.
"There's a lot more people travelling with dogs so people coming from Qld can then transmit it around and I believe that's starting to happen.
"One of our vets comes from Mackay and they're basically treating it every week up there."
While parvovirus is an issue throughout the area he added that heartworm can cause serious concerns if left untreated.
"Parvovirus is a much bigger problem in Kempsey but I certainly see the potential if people get slack that heartworm will come back," Mr Edwards said.
"To treat the dog it actually takes 270 days so it's very long, you've got all these worms in their heart that you've got to kill but if you kill them immediately they form a clog and go into the lungs and cause a massive problem."
To test for heartworm a simple blood test can be performed on a dog in the veterinary clinic which will confirm or deny a diagnosis within 5-10 minutes.