The heartworm pills sold as preventatives aren't really "preventatives". They contain pesticides that actually kill the heartworms (in early stages) after the dog has it. By giving it at the rate they recommend, it kills them before they grow too large. Until a dog I had was sick with several auto-immune disorders years ago, I always believed it was an actual preventative. If you do end up giving the heartworm pills, you can give a lower dose and stretch it out to every 6 weeks. There is an fda report that shows Interceptor is good for heartworms at 1/5 the recommended dosage but not for other parasites. They list the 1 month dosage period, because they feel it will be easier for people to remember. It was even good at 60 and 90 day intervals in 95% of the cases studied. Going with 6 weeks is recommended as 100%.