Today, that's an increasingly important gap. Tick-borne pathogen testing detects more positives than heartworm in 49 of 50 U.S. states, making comprehensive vector-borne disease (VBD) screening a practical evolution of annual wellness testing rather than an additional service.

The good news is that implementing comprehensive screening is largely a workflow change—not a clinical overhaul. The same blood sample collected during the wellness visit can provide significantly broader pathogen coverage without requiring another appointment or another sample.

What does comprehensive VBD screening add?

A heartworm-only test detects a single pathogen using antigen detection. A comprehensive canine VBD screening detects:

• Heartworm (Dirofilaria immitis) by antigen testing

• Three Ehrlichia species (E. canis, E. ewingii, E. chaffeensis) by antibody detection

• Borrelia burgdorfeouri (Lyme disease) by antibody detection

• Two Anaplasma species (A. phagocytophilum and A. platys) by antibody detection

That means a single blood sample can screen for seven vector-borne pathogens rather than heartworm alone.

This broader coverage is particularly valuable because many tick-borne diseases produce nonspecific signs—including fever, lethargy, anorexia, lameness, and polyarthritis—that may not develop until weeks or months after infection. Annual screening identifies exposure to an infected tick before disease is necessarily suspected clinically, supporting earlier investigation and monitoring where appropriate.

Importantly, the sample collection process doesn't change. Only the assay performed on that sample changes.

Converting your protocol: A step-by-step approach

Successfully switching from heartworm-only testing to comprehensive screening depends less on training your team to perform a new procedure than on changing the practice's default workflow.

1. Update your default order sets

Begin by reviewing annual wellness protocols within your practice management system. Many hospitals still have "heartworm test" embedded as the default annual preventive screening order simply because it has remained unchanged for years.

Replace that default with the comprehensive VBD screening panel. The goal is for the team to order the comprehensive screen automatically rather than presenting it as an option.

When comprehensive screening becomes the standard recommendation, consistency improves throughout the practice.

2. Confirm sample collection remains the same

Team members sometime assume broader testing requires additional blood collection.

It doesn't.

The same whole-blood sample supports testing for all pathogens included in the panel, so technicians and assistants don't need to explain an additional blood draw or obtain another sample.

Keeping this message simple helps reduce hesitation from both your team and clients.

3. Decide on in-house or reference lab testing

Choose the workflow that best suits your practice needs. Running testing in-house allows results to be available during the same appointment, supporting immediate clinical discussions and follow-up planning.

Submitting the sample to your reference lab remains an effective alternative, particularly for practices that routinely bundle diagnostics or submit fecal antigen testing together with wellness samples.

Either approach supports the same preventive screening protocol; the decision depends on turnaround time and your workflow preferences.

4. Update client communications

A common source of inconsistency can be outdated client-facing language. Appointment reminders, recall notices, estimates, and phone scripts often continue referring to a "heartworm test" even after clinical protocols have changed.

Review all templates and revise terminology to reflect comprehensive vector-borne disease screening. Consistent messaging helps clients understand what they're receiving and prevents confusion during appointments, matching their expectations with what's actually being run.

Assign clear ownership across the practice

Protocol changes are most successful when responsibilities are clearly assigned.

• Practice managers or office leaders should oversee one-time system updates, including default order sets, reminder templates, and client communications.

• Veterinarians establish the clinical standard by recommending comprehensive screening as routine preventive care rather than as an elective upgrade. They should also determine follow-up pathways for both heartworm antigen–positive and tick-borne antibody–positive results.

• Veterinary technicians and assistants continue collecting the same blood sample while performing or submitting the test.

• Front desk and client care teams play an important role by updating estimates, reminder language, and appointment scripts so they accurately reflect the current protocol.

Common pitfalls during implementation

Several predictable issues can undermine implementation of a change in protocol.

Treating comprehensive screening as an upsell

If your team continues presenting comprehensive testing as an optional addition to heartworm testing, many clients will decline it and the practice will naturally drift back toward heartworm-only screening. Instead, comprehensive screening should be positioned as the standard annual recommendation.

Misinterpreting antibody results

Positive antibody results for Ehrlichia, Lyme disease, or Anaplasma indicate exposure to an infected tick, not necessarily active clinical disease. An apparently healthy antibody-positive dog with normal lab findings may reflect previous exposure rather than current illness.

Clinical interpretation should incorporate history, physical examination, CBC with blood film, serum chemistry, and urinalysis when clinically indicated before diagnosing active disease or initiating treatment.

Decision-support resources can help guide interpretation, particularly for less commonly encountered pathogens.

Skipping heartworm confirmation

Unexpected positive heartworm antigen results still require confirmatory testing before initiating adulticide therapy, regardless of whether they were identified through a comprehensive screening panel or a heartworm-only assay.

Maintaining this step remains essential.

Assuming previous infection prevents future risk

Dogs previously exposed to or treated for Ehrlichia or Anaplasma remain susceptible to reinfection, and persistent infections may occur.

Annual screening therefore remains appropriate even in dogs with previous positive results.

Underestimating exposure risk

Indoor housing or fenced yards do not eliminate exposure to mosquitoes or ticks. Your team should avoid reassuring owners that lifestyle alone protects dogs from vector-borne disease, as mosquitoes and ticks readily enter residential environments.

Finally, avoid combining canine and feline screening recommendations. Canine comprehensive VBD screening protocols differ substantially from feline heartworm and retrovirus screening recommendations and should be discussed separately.

Measuring success after the change

Once the protocol has been implemented, it’s worthwhile monitoring whether adoption is actually occurring.

Useful indicators include:

• Pulling a monthly report from the practice management system comparing comprehensive-panel orders versus heartworm-only orders during annual wellness visits. The ratio should be trending upward.

• Tracking whether positive results receive the appropriate follow-up diagnostics before treatment decisions are made.

• Auditing a sample of reminder cards, emails, and appointment scripts quarterly to confirm client-facing language matches the panel actually being run.

• Reviewing regional Companion Animal Parasite Council (CAPC) parasite prevalence data annually so recommendations are up-to-date. Tick-borne disease prevalence relative to heartworm shifts by region and year, so the protocol's clinical rationale should stay current rather than citing a static figure indefinitely.

These metrics help ensure the protocol becomes routine practice rather than a temporary initiative.

The bottom line

Switching from heartworm-only testing to comprehensive canine VBD screening doesn't require another appointment, another blood draw, or significantly more labor time. Instead, it expands annual preventive screening to include five additional clinically important tick-borne pathogens using the same sample already being collected.

Practices that successfully make the transition treat comprehensive screening as the default—not an optional upgrade—and pair that workflow change with consistent interpretation of antibody results and appropriate confirmatory testing. Together, those changes create a more complete preventive screening protocol, while maintaining an efficient wellness visit.

 

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