On Fleas and Ticks
With the (over) abundance of flea and tick products available these days, and new ones seemingly coming out every month, it can be challenging to provide guidance for our clients as to the best choices for their individual situations. We have come a long way from the bad old days of sprays, powders, and toxic malathion dips.
First off, speaking of dogs, one current chart we use to explain the choices compares:
Advantage II, Advantage Muti, Advantus, K9 Advantix II, Seresto Collars, Provecta, Vectra, Vectra 3D, Combiva, Comfortis, Credelio, Parastar, Trifexis, Activyl, Activyl Tick, Scalibor, Certifect, Frontline Plus, Frontline Tritak, (beats me), Nexgard, Bravecto, Capstar, Effipro, Effitix, Sentinel, Sentinel Spectrum, Preventic Collars, Simparica and Revolution.
whew!!! So rather than a comprehensive review we shall discuss flea control and the situations we encounter, talk about the product choices which we generally recommend, and why.
First, some overall observations about fleas and flea control:
1) Fleas do not infest animals. Fleas infest environments. If your dog goes walking in the park in August and a flea jumps on her and bites her that is not a problem. If the flea is carried home, feeds on your dog, then starts to lay eggs in your house, then that is a problem. So products, which kill the fleas after they bite, but before they lay eggs, are quite satisfactory. Similarly, if your dog is in a back yard with fleas, and you bring the dog in and give him a wonderful bath and 50 fleas fall off dead, then you rinse off the shampoo and put the dog back in the infested yard, you have accomplished very little. In an hour he will have fleas again.
This is a key point. Products like Nexgard and Seresto DO work. If you are using these and still have a flea problem then almost certainly some specific area in the animal's environment is severely infested. There are not enough fleas in the grass of your backyard, nor in your living room where you are not getting bitten by fleas, to overwhelm good protection. The classic example is the old German Shepherd who has dug a sandpit against the foundation of your house in the back yard. That pit has about a gazillion fleas in it and until you target that area any flea control used on the dog will be overwhelmed. That infested area can be a garage or a cellar, (both common), a closet or a laundry room. Sometimes it takes some detective work, with flea traps and such, and we can help you with that. For these reasons, "treating the lawn" or"bombing the house" are generally unproductive.
2) Fleas cause two different problems: Flea bite dermatitis, and Flea allergy dermatitis. Flea bite dermatitis is obvious - your dog has fleas, they are biting her, she is itching and scratching, you see fleas running around on her. Pretty simple. However many dogs have an allergy to flea saliva, so that when a single flea bites them they break out in a large, nasty, hive like rash. These dogs can have four or five flea bites a week, and be tearing themselves up as if they had a major infestation. In these cases the owners often refuse to believe that fleas are a problem, because they have not seen any fleas on the animal. Remember our dog walking in the park in August, and we said that one flea- bite is not a big problem? If the dog is severely allergic, then actually that IS a big problem.
3)’Flea Season’
In areas like Rhode Island, flea infestations are not, as generally believed, a ‘heat of the summer’ problem. They are an early Fall problem. Flea cases start to dominate our caseload on August 10, and peak in September and October. The reason for this is that fleas have a life cycle that is about two months long. So if your dog picks up a couple of fleas in June, and your house gets infested, the big problem will start when those fleas’ eggs hatch. You want to be on flea prevention by May the latest.
Recommendations
Understanding the basics of flea control, we can now move on to specific recommendations. The basic question is which form of administration you wish to use- spot product, tablet, or collar. (As discussed above baths do have their uses but only for specific situations, as they provide no residual action if the animal is returning to the infested environment. However if your dog spent the weekend in the shelter, or picked up fleas at a kennel, or simply has a heavy infestation, a flea bath is very useful. This is the best way to quickly eliminate all fleas, larvae, and flea eggs from your pet. Still, they are useless as a method of flea prevention.)
1) Spot Products- Frontline, Advantage, Advantix and the like. These still work as well as they ever did, (though apparently flea resistance to Frontline may have occurred in Florida), but, frankly, we think they are on their way out and may be only a 'niche' product in a couple of years. Why use a spot product when you can give a pill once a month? Spot products leave that messy splotch and you never know if you got sufficient skin contact, especially in long-haired animals. However, one plus might be affordability. The makers of these products know that the expense is a major consideration in consumer choice, and they are careful to see that all products tend to have about the same monthly cost. Having been around longer and gone generic, you may be able to find these products or their equivalent, (if you pay proper attention to ingredients on the label), at a lower cost. They are still fine products that do the job.
2) Nexgard. Probably our favorite at the current time. A tablet, recommended now by a lot of top experts. Works very well for fleas and ticks, and as a bonus is very good treatment for both of the most common forms of mange. There is also a companion drug, Bravecto, which has seen a lot of advertising. It is very similar to Nexgard, but only needs to be given every three months. Our impression, in a word, 'BZZZZZZZT!' Sorry, we are not comfortable putting any chemical into a dog which can not be taken out for the next three months. If the animal is having a problem tolerating a monthly product, (or much more commonly, the owner THINKS they're having a problem), such as acting depressed, not eating as well as usual, occasional vomiting, then we can just say it will be out of their system in a couple of weeks and we will switch to a different product. With a three month medication, this is problematic.
3) Seresto. While we had our doubts at first, this collar has proven to be a very safe, easy and effective method of control against both fleas and ticks. Swimming and bathing only slightly limits it's duration of effect. Downsides are that you don't want toddlers crawling all over a dog with a collar, or chewing on the collars, and, (as silly as this sounds to point out), in 9 months puppies outgrow them. We have to smile (inwardly) when we see a 10 week old Labrador Retriever puppy with his proud new $70 flea collar.
6) Combination Products. There are also combination flea prevention/ heart worm prevention medications. These are available both as spot products, such as Revolution, and as a tablet, such as Trifexis. The downside there is that for most dogs heart worm and flea season do not coincide, and the combined products are more expensive than the single ingredient product. However, if you use both flea and heart worm prevention year round, (for example should you winter in Florida), or you are on both seasonally from April until December, these combination products can be a good idea. Generally we would choose one product for fleas and another for heart worm, for better control.
It should also be noted that intestinal parasites are not an overwhelming issue in our area, (New England), so we are not dealing here with which flea products deal with which intestinal worms. In much of the country this is an important consideration, and should be discussed with your veterinarian.
Thus- our current recommendations-
Nexgard or Seresto seem to be the state of the art at present. If ticks are a major concern, the collar may be more effective.
Ticks -
Nothing is 100% for ticks. If your pet is on a good flea preventative like Frontline or Nexgard, and he has a flea infestation, something odd is going on and we have to figure out what it is. However, calling us to tell us that the tick prevention did not work because you found a tick on your dog, or believing that a dog on good tick prevention cannot get Lyme is, sadly, optimistic. That being said, good tick prevention can certainly greatly reduce the number of ticks which will infest your pet, and is strongly recommended for dogs with tick exposure.
Also, ticks are not as seasonal as fleas. While they tend to peak in April and May they can be a problem during many months of the year. November has been a terrible month for ticks the last two years. And, oddly, January is often bad if there is no snow cover.
Fortunately, our two recommendations for fleas, Nexgard and Seresto, are also very good choices for tick control. While perhaps slightly less effective, the spot products like Frontline and Advantix are still quite good as well.
Cats
While we have been primarily discussing dogs, the situation is fairly similar for cats, except that Nexgard and Bravecto are not available. Also cats are far more susceptible to 'pyrethrin' (a common ingredient in spot products) poisoning than dogs, so be careful not to expose cats to spot treatments designed for dogs. There is a tablet available called Comforts, and its sister drug, Cheristin, which are very effective for fleas, though not for ticks. Ticks are rarely a problem in cats. So either Frontline or Seresto remain our go to products for flea and tick control in cats.
-Dr. Mac
