Heartworm Vs. Flea Prevention: Weighing Costs In Tough Financial Times

Recently I received an email from a reader, and it's a rather timely one.  People often have to make financial decisions about the health of their pets, giving things up because they simply don't have the funds.  So this situation is one that many pet owners can understand.

I recently fell down a flight of stairs & did horrible damage - breaking my hip, smashing tailbone & disks.  I am in a horrible place financially now.

I had my 4 yr 100 lb black lab on Triflexis.  We live outside Houston & have bad flea issues.  I can't afford the Triflexis anymore.  What cost effective combo would you recommend for heartworm & flee control?  What about ticks?  Do I need to worry about missing treatment for that?

I've spent hours reading blogs- including yours - and I just need some definitive advice.  Every penny counts right now & I'm desperate to find a solution.  We - my two kiddos & I - love our crazy lab & I want him to be as healthy as he can for his life - but I'm really in a bad spot financially.  My vet doesn't seem to understand that - and thinks Triflexis is the only way to go.

Any help would be greatly appreciated.

First, I'm so sorry that you hurt yourself that badly!  I sincerely hope that you are being treated and are on the road to recovery.

I do think that Trifexis is an excellent product, and we carry it in my practice.  I'm very aware of how expensive it is, but I think that given what it covers this is not an unreasonable cost for a product like this.  It is a unique product, and currently is the only oral product that will prevent heartworms, kill fleas, and protect against three intestinal parasites.  I don't doubt that other companies are trying to develop similarly all-inclusive products, but they haven't released them yet.

In a situation like this my first recommendation is to cover the heartworms.  Yes, the fleas are very visible and in Texas are a real problem.  However, they are mostly a great nuisance and rarely carry anything fatal to the pet.  Heartworms, on the other hand, are a "hidden" and potentially fatal disease.  Only a blood test can detect a dog with heartworms in the early stages, so by the time you see clinical signs of heartworms your dog is in a more advanced state of the disease.  Treatment is possible, but can cost $800-1000 in an uncomplicated case.  If it goes untreated it will lead to congestive heart failure and eventually a slow, lingering death.  Obviously, you don't want this!  If you have to make tough financial choices, pick an inexpensive heartworm prevention.  There are several on the market in the US that are equivalent to Heartgard and can cost around $50 or even less for a six month supply for a dog the size of yours.  Many of these are available online with a veterinarian's prescription (which all vets are legally required to provide you if you ask).

But what about combination products?  Trifexis is probably the most expensive of thembut none are going to be cheap.  Sentinel has the same heartworm preventative found in Trifexis, but it doesn't kill fleas, only prevents the eggs from hatching.  Advantage Multi and Revolution are topical preventatives that will prevent heartworms and kill fleas, but they aren't inexpensive.  You can shop around and see what the price of each might be for your dog.

That brings us to flea prevention.  Obviously you want to use some in your area!  Many good flea preventatives are now over-the-counter.  Frontline and its generic equivalents can be found in almost any store that carries pet supplies.  While I don't think it's the best product, I think it's better than just about any of the cheaper ones.  Personally I like the Advantage products (found over-the-counter), Vectra (sold through vets), or Seresto collars (found through pet supply stores).  I think each of these is very effective, though they aren't inexpensive.  Some flea prevention is better than none, so you may have to sacrifice in this area and risk having fleas.  Though treating an existing flea problem is much harder and more expensive than preventing one.

You should compare the costs of separate heartworm and flea preventatives to the combination products and see which is going to fit in your budget the best.  If you simply can't afford both, then I would absolutely focus on the heartworm prevention, as this is a much more severe disease. 

What about ticks?  I think it depends on the risks in your area, and that's something that a local vet can answer better than I can.  It also depends on your dog's lifestyle.  Even in an area with ticks, if your dog is only in your house and fenced yard there will be a much lower risk than if that same dog was running through woods or fields.  Not every flea preventative will also cover ticks, and there is nothing currently on the market that gets fleas, ticks, and heartworms.  Products will cover fleas and heartworms or fleas and ticks, but not all three.  If your dog is going to be at very low risk for ticks based on location and lifestyle, I would pick something without tick prevention to help costs down.

I really do hope that this helps at least a little!