Not too long ago I took my dog Joy to the vet for a check up. She had heartworms and hookworms. They gave us a panacure to mix in with her food to treat the hookworms. Before long the hookworms were gone. Within the next few days we then gave her her first heartgard to get rid of the microfilariae and the L3 and the L4 larvae first. Then we would go back to get her tests done to determine the class of her heartworms. Her class was the beginning stage of class 2, which is pretty good for a five year old dog that had never been treated with a heartworm preventive. They also gave us some pills for her to start taking a month before her first deworming shot. Today is the day we start giving her the pills. And on Feb. 12 she will have her first deworming shot. Its a long and expensive process...But its worth a happy and healthy dog.