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Sunday, June 28, 2015

Recommendations For Flea, Tick, And Heartworm Prevention.....2015 Update

The last time I specifically wrote about my personal recommendations in parasite prevention was several years ago.  In fact, it was about four years ago!  A few things have changed since then, so I thought it would be a good time to update what I recommend to clients.  While I stand by every one of my recommendations, realize that they are my opinions and I know vets who might disagree.

Heartworm Prevention
Personally, I really love ProHeart.  This is an injectable heartworm prevention for dogs that lasts for six months with a single shot.  From what I understand, outside of the US it is frequently used at a higher dose and lasts for a full year.  I wish we had that here!  I love this prevention because you only have to worry about it twice a year.  It's so easy for people to forget a monthly pill, and this keeps that from happening.  Veterinarians can include this in their preventative care reminders, easily contacting clients when another dose is due.  This is the preventative I give to my own dogs. 

If ProHeart wasn't available I would use Trifexis.  I think this is a very safe product, despite the unwarranted media and internet hype about it.  I like the fact that it covers heartworms, fleas, hookworms, roundworms, and whipworms.  It's the only product on the market to do all of that (Sentinel doesn't prevents flea eggs from hatching but doesn't actually kill adult fleas...and it has the same heartworm preventative found in Trifexis!).

There are a plethora of monthly pills similar to Heartgard.  Iverhart, Tri-Heart, and several others use the exact same combination of ivermectin and pyrantel to protect against heartworms, roundworms, and hookworms.  All of them are equally effective, only differing in cost and brand name.  There is nothing wrong with any of them, and they are still an important staple of heartworm prevention.

I'm not huge fan of Advantage Multi and Revolution because they are topical and therefore have the potential to be less effective with frequent bathing.  But for people who don't bathe their dogs more than 1-2 times per month they can still work well.  I just think that there are better options.  However, for cats I love both!  Revolution is my choice for my cats but I think that Advantage Multi works just as well.  These are the best options for heartworm prevention in cats because you don't have to give a pill orally.  These two products are also great for ferrets, who do get heartworm disease, though neither are officially approved for this species.

The bottom line is that no matter which product you chose, please use an approved heartworm preventative year-round in all dogs, cats and ferrets!  This is a completely preventable disease so there is no reason why any pet should ever have to suffer from it.

Flea & Tick Prevention
There are many more choices in this category, and it can get very overwhelming.  Do a search on my blog for "fleas" and you will get lots of details that I've written over the years on proper flea control.  This time I'm focusing on specific products.  But PLEASE read some of my other posts, as no product will be 100% effective, and there are many, many things that can lead to a persistent flea problem even if the product is working well.

As I mentioned above, I'm a big fan of Trifexis.  In my case since I'm using ProHeart for heartworms, I use other products to control fleas and ticks.  I really like Comfortis, which is the same flea control ingredient found in Trifexis.  Dermatology specialists tend to like this product for dogs allergic to fleas since it kills so fast and so thoroughly.  The only downside to Comfortis is that it doesn't do anything for ticks (neither does Trifexis).  If your dog really doesn't go near places with ticks, this is an excellent choice.  If you worry about ticks as well, I'd recommend something else.

My favorite topical products are Advantage (fleas only), K9 Advantix (fleas and ticks), and Vectra 3D (fleas and ticks.....sold under the brand name FirstShield Trio in the Banfield Pet Hospital chain, but is the same product).  Currently I'm using Vectra on my dogs, but I think that the Bayer products work as well and am happy to recommend them to clients.  Advantage has been shown to be safe in most small animals, so it can actually be used on rabbits, ferrets, and guinea pigs (though this is "off-label" and not officially approved for these species).  The products combined with heartworm prevention (Advantage Multi and Revolution) are just as effective against fleas as the non-heartworm equivalents.

A newer product is the Seresto collar, made by Bayer.  I have not personally used this, but I have been hearing many good things about it.  Several of my clients use it and have been extremely happy.  I've also spoken to some veterinary colleagues who use it and recommend it.  The technology behind Seresto is very unique and is unlike any other flea and tick collar ever made.  Do not think this is just another collar!  In fact, I haven't recommended flea collars at any point during my career (18 years at this writing) until Seresto came around.  It is supposed to last for eight months, which if true is a huge advantage for it.  Do NOT buy other collars!  They are simply not effective and are a waste of money.

Frontline is an old reliable topical product, and since the patent ran out you can find cheaper brands containing the same active ingredient (fipronil).  When it first came out it was a huge benefit in the fight against fleas and ticks.  However, I've seen it fail more than other products over the years, and there is anecdotal evidence that there may be some resistance developing to it.  I don't think it's a bad product overall, and many people are still using fipronil products with good success.  However, because there are much more effective products on the market I don't generally recommend it.

I would never use any other topical products currently on the market!  I just don't think that the Hartz and Sergeants products are effective and I've seen some cases of toxicity with them.  Please stay away from them.  Yes, they're cheaper, but in this case you're going to get what you pay for.  Don't throw your money away on them.

Also stay away from flea shampoos.  Yes, they will kill fleas, but they give you no residual protection.  Within a day of you rinsing off the shampoo any new fleas in the environment will be right back on your pet.  Use a product that lasts at least a month in order to get good flea control.

Capstar is a great product for what it does.  There really isn't anything else that kills fleas as quickly!  Within 30 minutes of giving it the fleas will start falling off!  I've seen it happen in my own clinic.  If you want a rapid flea kill, this is a great choice.  The big downside is that it doesn't last for more than a day.  For spot control, such as if you're bringing a new pet home, I love it.  But you won't get lasting control.

There are a couple of newer products on the market this year, Nexgard and Bravecto.  Honestly I don't know anything about them other than what I've read in journals and veterinary forums.  I have no personal experience with them so I can't attest to their effectiveness.  I'm eager to try out Bravecto, as it controls fleas and ticks for three months, and there is growing anecdotal evidence that it can treat demodex mites with a single tablet.  But for now I'll leave those recommendations to other vets who have actually used them.

Okay, I think that covers most of the current products!  As always, check with your own veterinarian if you have questions about anything I write.