“…However, there have been reports of loss of efficacy (LOE) of these MLs against heartworm in the USA, especially in those areas where heartworm challenge is high (Hampshire, 2005). Recent studies have confirmed, using in vivo efficacy studies and genetic analysis, actual ML resistance in D. immitis (Bourguinat et al., 2011a, Bourguinat et al., 2015, Pulaski et al., 2014). There also exists some evidence of ML resistance in the human parasite, Onchocerca volvulus (Osei-Atweneboana et al., 2007, Osei-Atweneboana et al., 2011, Nana-Djeunga et al., 2012, Nana-Djeunga et al., 2014, Pion et al., 2013), a filarial nematode which is closely related to D. immitis .…”