Heartworm In dogs?

[tempus vernum]

So, our dog tested positive for heartworm . We’ve had her on heartworm preventative for two years. Honestly I’m still in denial it’s very “rare”
To have heartworm prevention and test positive. We didn’t buy enough at one time for her treatment to be free () . Ironically we were told THIS year the day of the test that if we buy 12 at once they guarantee and pay for treatment.

Any tips? Thoughts? Ideas?

We see the vet without her tomorrow to discuss treatment options, cost, risk factors, etc.

I’ve read a bit and already have some concerns about discussing treatment without figuring out what stage the disease is. I’ve done some reading and understand a bit already. Enough I’m concerned w discussing treatment without xrays and/or ultrasound.

Here are my questions— any other questions we r missing?
1 what stage is our pup?
2 I’ve heard it’s vital To do xrays and potentially an ultrasound before discussing treatment if that’s not true and vet ready w treatments , why?
3 how many dogs have u treated?

Does anyone think after the first appointment discussing treatment we should get a second opinion?