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The objective of this paper is to describe two cases of heartworm disease in dogs presented with ascites and dyspnea. A diagnosis of mixed infection with both Dirofilaria immitis (D. immitis) and Dirofilaria repens (D. repens) was established in the first case, while D. immitis was detected in the other dog. Based on clinical, parasitological, laboratory and radiographic examinations, the diagnosis of severe stage heartworm disease (HWD) was established because both dogs were in heart failure due to HWD. An alternative therapeutic protocol with combined doxycycline and ivermectin was used as an antiparasitic treatment in both cases. No microfilariae were detected after 30 and 60 days, and no antigen to D. immitis was detected after 8 and 12 months in the first and second case, respectively. Based on the clinical examinations and parasitological testing performed, the two dogs were considered cured of HWD by this alternative therapy.
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