Dirofilaria immitis is a nematode that infects canids worldwide as well as other mammalian species, including humans. Worms and dogs are well adapted to one another, making dogs the best urban host for the parasite. Nevertheless, 30% of dogs do not sufficiently present microfilaremia, that is, the low larval load impairs transmission by mosquitoes and diagnosis by its detection in the blood samples. Therefore, the canine diagnosis must always include a microfilaria test and serological tests to detect adult worm antigens. To describe the clinical findings in naturally infected dogs in Rio de Janeiro, 34 dogs were included in the study. All dogs were evaluated for history, anamnesis, physical examination, complete blood count (CBC), D. immitis testing for antigens (ELISA test SNAP 4Dx Plus®), and microfilarial burden. The most frequent complaint from the owners was coughing (14.7%, 5/34). The most common CBC finding was eosinophilia (29.4%), followed by thrombocytopenia (26.5%) and neutrophilia (14.7%). Of the 34 animals, 91.2% were microfilaremic, with a mean count of 11.939 microfilaria/mL. Veterinarians working in areas endemic to D. immitis should always undergo screening tests and pulmonary auscultation, and increased expiratory sounds, even in the absence of coughing, can be considered a sign of the disease, along with eosinophilia, thrombocytopenia, and neutrophilia.