My dog's heartworm meds are excreted fast. How do they work monthly?
Hi there. Most heartworm preventatives, including milbemycin oxime (Sentinel), do not work by staying in the dog's body the entire month. Instead, they are active for a few days, and kill any heartworm larvae and/or intestinal parasites that are present at that time.
As long as you give the product monthly, it will prevent heartworm disease from developing because any larvae that the dog is exposed to will never have a chance to develop beyond one month of age. For intestinal parasites, you can think of it as doing a routine deworming once monthly.
Revolution (selamectin) and Advantage Multi (moxidectin) are the exceptions to this rule. They do stay active in the body for the entire month, and kill larvae continuously as the pet becomes exposed. However, in practice this difference really doesn't matter one way or the other - all of these products are effective at preventing heartworm disease and keeping dogs from picking up intestinal parasite infestations.
Updated on September 23rd, 2025