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Heartworms
Two years ago I took in a stray daschund. He was extremely underweight, was missing alot of his fur, and also had heartworms. Looking at him now, you wouldn't know it was the same dog. However we've gone through two treatments for the heartworms and are testing again tomorrow to see if the last one finally cleared it. I know they can still live a full life for years even with them, but he has "a severe case" as the vet put it; because we don't know how long he's had them and the extent of the damage I don't think this is an option for us. There were complications the second time around (fluid building up in his lungs) so I won't consider putting him through another round and told myself if he still had them I'd have to put him to sleep since I didn't want him to suffer. At the begin of the month I caught him walking around and suddenly whining like he was in pain, and in the last week he's vomited a couple of times. I'm afraid I already know what the results will be and I'm not ready 
Has anyone else had to deal with this?
Re: Heartworms
We had a heartworm positive dog in a few weeks ago and she's doing great after the treatment! I don't understand why she wasn't fully recovered from them the first time. The treatment is constant cage rest and once daily injections. We kept the dog here during treatment and slightly sedated to avoid over-stimulating her. Exercise intolerance is a huge part of heartworm disease so the quieter they are the better. I don't know that I would automatically think that you need to put her down. Talk with your vet if it is a money issue because this dog was treated FOR FREE! The company we purchase most of our heartworm preventatives and products from treated her for free and bought her enough food for a year.
*Some back story, the dog was a stray and her current owner took her in not knowing anything about her. Found out, out of the blue, that the dog was sick and knew she couldn't afford to take care of her properly. We made a few phone calls here at the clinic and our reps were amazing in helping this woman out. The dog is doing great now*
So talk with your vet and see if there is anything they are willing to do. Usually all it takes is for someone to ask and help will be given.