Understanding Flea, Tick, Mite and Worm Control (part 4)

I hope you enjoyed the first 3 articles of the series, and understand why we advise prevention over cure! I

have spent a lot of time considering how best to summarise the current treatments for you. Parasite control is a complicated subject and I

wanted to provide you with as much information as possible without overcomplicating things.

I have given a table below that shows which control products cover for what (please note the numbered key and comments that follow).

Beneath this, is a brief discussion of how treatments are administered (spot-on vs. tablet) and how often they must be given. Bear in mind

the information given in the table is still a slight over-simplification as there are a number of different species of roundworm, tapeworm etc.

and whilst most treatments cover for the ‘main’ ones, there is some variability in exactly which species are killed by what.

The Treatments

Name Fleas Ticks Sarcoptes/

Scabies

Demodex Ear

Mites

Harvest

Mites

Round

worm

Hookworm Tapeworm Whipworm Heartworm Lungworm

(canine)

Nexgard Spectra

(dogs)yes yes yes yes no no yes yes no yes yes yes

Nexgard (dogs) yes yes yes yes no no no no no no no no

Veloxa (dogs) no no no no no no yes yes yes yes yes no

Milbemax/Milpro1

(cats & dogs)no no no no no no yes yes yes yes yes

yes (if given

monthly)

Bravecto (dogs) yes yes no no2 no no no no no no no no

Bravecto (cats) yes yes no n/a no no no no no n/a no n/a

Advocate (dogs) yes no yes yes yes no yes yes no yes yes yes

Name

Advocate (cats)yes no

yes

(Notoedres)n/a yes no yes yes no n/a yes n/a

Stronghold

(dogs)yes no yes no yes no yes no no no yes no

Stronghold (cats)yes no

yes3

(Notoedres)n/a yes no yes yes no n/a yes n/a

Stronghold Plus

(cats)yes yes

yes3

(Notoedres)n/a yes no yes yes no n/a yes n/a

Profender (cats) no no no n/a no no yes yes yes n/a no n/a

Frontline Plus/

Combo (cats &

dogs)

yes4 yes no no no no no no no no no no

Frontline (spray) yes yes no no no yes5 no no no no no no

Broadline (cats)yes4 yes

yes

(Notoedres)n/a no no yes yes yes n/a yes n/a

Panacur (cats &

dogs) no no no no no no yes yes

yes

(not D.

caninum)

yes no no

Drontal (cats &

dogs; tablet or

suspension)

no no no no no no yes yes yes yes no no

Comfortis (cats

& dogs)yes no no no no no no no no no no no

Advantix6 (dogs) yes yes no no no no no no no no no no

Advantage (cats

& dogs)yes no no no no no no no no no no no

Fleas Ticks Sarcoptes/

Scabies

Demodex Ear

Mites

Harvest

Mites

Round

worm

Hookworm Tapeworm Whipworm Heartworm Lungworm

(canine)

Name

1) Milbemax and Milpro contain exactly the same active ingredients. 2) Bravecto has been found to be very effective against Demodex mites in clinical practice, but is not licensed for this use. 3) Stronghold is not licensed for use against Notoedres in cats. 4) We are now seeing widespread resistance to fipronil, the active ingredient that targets fleas in Frontline and Broadline. They are often INEFFECTIVE against

fleas. 5) Frontline spray is not licensed to treat harvest mites, but it works. 6) These contain permethrins, and so are also effective against mosquitoes and sandflies (not found in the UK). They

must NOT be used in cats.

Formulation (tablet vs. spot-on)

Most of the treatments given in the table above are either a tablet or a ‘spot-on’ (a liquid which you

apply to the skin on the back of the animal’s neck.) The ‘spot-on’ treatments are written in purple, and

the tablets are written in black. Some treatments are ‘oral suspensions’ or powders, which can be

syringed into the mouth or sprinkled on food. These are written in blue. How a treatment is

administered is far less important that what the treatment covers for. However, there are obvious

benefits to using ‘spot-on’ treatments in animals that are difficult to give tablets to (especially cats), or

those who have sensitive tummies and/or have reacted badly to a certain oral treatment in the past. For

example, it may be easier to use Profender (a spot-on) to de-worm a fractious cat than Milpro (a tablet).

However, some animals also resent ‘spot-ons’ being applied, so it is important to find out what works

best for you and your pet.

Bravecto is a tablet for dogs but ‘spot-on’ for cats.

Program (cats &

dogs; tablet or

suspension)

yes no no no no no no no no no no no

Scalibor collar6

(dogs)no yes no no no no no no no no no no

Fleas Ticks Sarcoptes/

Scabies

Demodex Ear

Mites

Harvest

Mites

Round

worm

Hookworm Tapeworm Whipworm Heartworm Lungworm

(canine)

Name

Frequency of Administration

The frequency of administration of these treatments depends on the product itself, what you are trying to control, and what other control

products it is being used with. Hence, I cannot go through and specify how often each must be given. It will say on the medication label

that we print how often they should be given.

There are, however, a few ‘general rules’.

1) In both cats and dogs, flea control products require monthly administration. Bravecto is a notable exception to this, as Bravecto can

provide protection from fleas and ticks for 12 weeks.

2) In dogs, Milbemax/Milpro given once every 3 months will cover for all the intestinal worms and heartworm (this is the ‘regular’ or

‘routine’ worming protocol). However, 3-monthly administration will not prevent against lungworm. If lungworm prevention is

required, there are three options:

1) Use monthly Nexgard Spectra and give Milbemax/Milpro or Veloxa once every 6

months to treat for tapeworm. Remember Nexgard Spectra covers for ‘everything’

except tapeworm;

2) Use monthly Advocate and give Milbemax/Milpro or Veloxa once every 6 months

to treat for tapeworm. Remember Advocate does not cover for ticks or tapeworm,

so this protocol does not provide tick control.

3) Use a flea/tick control product such as Nexgard or Bravecto, together with

monthly Milbemax/Milpro.

Nexgard Spectra (left) and Nexgard (right).

3) In cats, Milbemax/Milpro or Profender are given every 2-3 months for de-worming. The frequency with which you need to worm your

cat depends on how avidly they hunt and eat wildlife.

Treatment when your pet is a Member of our Pet Health Care Plan (PHCP)

Dogs

Under the PHCP, you will receive monthly Nexgard Spectra and every 6-

monthly Milpro. This covers for fleas, ticks, and all worms. We understand

there is some overlap between Nexgard Spectra and Milpro but that is

necessary for complete protection from everything. If you prefer to use an

alternative product(s), you can still do this under the PHCP but you need to

let us know what it is you want.

Cats

In cats, we provide Stronghold Plus every month for fleas and ticks, and Milpro or Profender every three months for worms.

Treatment when NOT on the Pet Health Care Plan (PHCP)

If you are not on the Pet Health Care Plan, and you ring up to request more ‘flea and worm treatment’, it is

difficult for us to know what it is you want. Hopefully the table above explains why this is the case.

Without speaking to you, we have no idea what level of protection you require.

When you request more ‘flea and worm treatment’, your pet will now receive the same treatment as

animals on the PHCP (ie. covering for everything). This may cover for more parasites than you had been

doing previously, and so prove more costly than you were expecting!

It is important that you let us know what level of protection you require.

We have now come to the end of this 4 part series on ‘understanding flea, tick, mite and worm control’. If you have any questions about

any of the parasites discussed or the control products, please do get in touch with us. We shall now take a break from routine health care,

and move on to talk about some of the common conditions or illnesses we see in our pets. In the next article, I shall be discussing two of

the more common ‘hormone’ diseases we see - hyperthyroidism in cats and hypothyroidism in dogs, both go which are diseases of the

thyroid gland.