Flea and Tick Prevention: 2015 Update

Photo: Vetstreet.com

When I started my career as a veterinarian, the options for flea and tick control were limited, smelly and messy. I dispensed cans of spray, bottles of dip, and cartons of powder, but hardly ever prescribed a flea collar. Back then, the collars were not that effective and some thought the only way a flea collar killed a flea was by squashing it when you put the collar on your pet. Thirty years later, the options for pet owners to prevent ectoparasite infestations are infinitely better and way more numerous.

Better flea and tick control has resulted in healthier pets. I used to routinely see dogs and cats crawling with fleas from head to toe. Many developed flea allergic dermatitis, often complicated by a superficial skin infection. While we still see allergies in pets, flea allergic dermatitis is much less common and pets are much more comfortable, thanks to these new products.

Top Spot Products
The big revolution in flea and tick prevention started when top spot products were introduced. These are the little tubes of liquid that come in multipacks for monthly application to the nape of your pet’s neck. The product then distributes throughout the haircoat and kills fleas and ticks when they come in contact with the medicine on your pet’s hair. They also come with stickers for your calendar or an app for your mobile device to remind you when to apply the medication. Many of the manufacturers of these products have videos on their website demonstrating proper application of the product.

Oral Flea and Tick Prevention
Oral products can be active against only fleas or prevent multiple species of ticks as well. Most oral products come as tasty chew treats and are administered monthly; although long lasting products are also available. Not all oral products start working instantly. If your pet has a flea infestation because you missed a dose, check with your veterinarian about a rapidly acting oral product for quick flea takedown.

Long Lasting Collars
Unlike the early flea collars, today’s models last for months at a time. Depending on which collar your veterinarian prescribes, modern flea collars may be active against a single species of tick or fleas and multiple species of ticks. If you choose a collar, check the label carefully as some collars may take a week to reach full strength on your pet.

Choosing What’s Right for Your Pet
When selecting from this array of products, consider the following criteria:

1. Talk with your veterinarian about the types of parasites in your area. Selecting a product with a profile that fits your area’s parasite population is critical.
2. Top spot products often repel as well as kill fleas and ticks. If you live in a geographic locale with high numbers of fleas and ticks, you might want this added protection.
3. Certain collars and oral preventatives last for months at a time. If you are busy and forgetful, one of these products might be a good choice.
4. Not all top spot preparations and collars are waterproof. If your dog is a swimmer, choose a waterproof product or consider an oral flea and tick preventative.
5. If you have a puppy or kitten, make sure the product you select is safe for the newest family member. Some products are not labeled for pets < 6-12 weeks of age.
6. Use dog products for dogs and cat products for cats. Never switch, or you may need a trip to the animal ER.

What’s New for Fleas and Ticks?

Ticks have been around forever. Even the ancient Roman author, Pliny the Elder (23-79 A.D.) was vexed by these creatures. He is reported to have said, “Ticks: the foulest and nastiest creatures that be.” Ancient Rome must not have had fleas, or Pliny would have included them on his nasty creature list as well. Besides being nasty, fleas and ticks spread disease to you and your pets.

A new kind of collar

Collars to prevent flea and tick infestations have been around a long time, but their effectiveness has been limited. A veterinary school professor of mine said, “The only fleas killed by a flea collar are those squashed when the collar is put around the pet’s neck.” Polymer technology has advanced flea collars from a dusty plastic strap to a timed release medical device, and in the newest version even repels ticks before they attach. For additional information on year-round flea and tick control, check with the Companion Animal Parasite Council.

A new way to remove ticks

One of my most frequent calls is from an owner who finds a tick attached to their dog or cat and wants to know how to get rid of the nasty critter. The internet is rife with misinformation on how to remove ticks – nail polish remover, smoking matches and petroleum jelly. All of these are bad ideas. Either grasp the tick firmly with tweezers or a tick removing device and pull the tick, head included, out of the skin. This is easier said than done in a wiggly dog with a teeny tiny embedded deer tick. Now, there is a way that will make pet owners ecstatic with an easier way! A new a non-toxic product has been designed and produced to loosen the tick’s grip on the skin and allow it to be lifted off your pet with a cotton ball or moistened pad.

A new method to decrease ticks in the environment

Currently under investigation for the control of Lyme disease are bait boxes for mice. This clever study aims to attack Lyme disease where it starts, with the deer ticks that feed on the reservoir host of the Lyme disease bacteria: the white footed mouse. Bait boxes are placed outdoors. Mice enter the box and a mouse sized dose of fipronyl gets rubbed on their back. Fipronyl is an Environmental Protection Agency registered product found in several top spot tick and flea preventative medications for dogs and cats. When applied to mice, it kills ticks, decreasing the number of ticks which can bite you and your family.

Do you still want more information about ticks? The Connecticut Agricultural Experiment Station has an exhaustive tick handbook available online.

Confused about flea and tick preventatives for your dog and cat? Make an appointment with your veterinarian to find the right prescription for your pets. Follow their directions exactly, because reactions to flea and tick products are most commonly due to improper use of these products.

Allergies in Dogs: 4 Treatments to Help Scratch Your Dog’s Itch

The summer of 2012 will go down in my personal history book as the summer of allergies. Not for me, but for my canine patients. I have received many frantic calls from my cancer patients’ families concerned that their beloved pet’s cancer has returned. After a check-up with me at The Animal Medical Center, I have reassured them the cancer continues to be in remission, but their allergies are way out of control.

Scratching bad

Today, the preferred term for allergies to things in the environment, like house dust mites pollen, mold, trees and grasses, fleas, and even your unsuspecting household cat, is allergic dermatitis. Allergic dermatitis is also known as atopy, allergic inhalant dermatitis, seasonal allergy, or environmental allergy. Whatever it’s called, the manifestation is red skin, “hot spots,” ear infections, recurrent skin infections and scratching like mad. The development of allergic dermatitis requires two things: a dog with a genetic predisposition to developing allergies and an allergen in the environment to incite the allergic response. Allergic dermatitis is a complicated disease and often requires complicated therapy.

Complicated cause

At least three mechanisms play a role in allergic dermatitis in dogs. First, the environmental allergen causes the release of histamine from a cell known as a mast cell, which sets off an allergic reaction. T-cells have a yin-yang effect on the immune system, both ramping up the immune system and blocking a protective effect against allergies. Finally, normal skin protects the body from invasion by allergens. Dogs suffering from allergic dermatitis likely have impaired function of the skin cells, allowing allergens access and predisposing your dog to yeast and bacterial infections.

The net effect of all this cellular hysteria: an itchy dog.

Complex treatment regimen

Given the complexities described in the pathways leading to allergic dermatitis, you should not be surprised to receive a small pharmacy’s worth of prescriptions when your dog is diagnosed with allergic dermatitis. What follows is a brief description of some of the more common medications used to treat allergic dermatitis.

1. Although the role of histamine is limited in canine allergic dermatitis, antihistamines, if they decrease itchiness, are very safe and cost effective.
2. Shampoos play multiple roles in the management of allergic dermatitis. Bathing your dog is soothing to the skin and decreases surface allergens, and medicated shampoos decrease surface bacteria and yeast. Hopefully, new shampoos will be developed to help augment the lost barrier function of the skin.
3. Antibiotics and anti-yeast medications are critical in controlling secondary infections in the skin of itchy dogs. The function of deregulated T-cells can be modified by the use of immunosuppressive agents, most commonly steroids, and more recently cyclosporine.
4. Finally, dogs can get allergy shots, a form of immunotherapy where the immune system is gradually desensitized to the offending allergen. For several of my patients, this form of treatment has dramatically improved their quality of life by decreasing their itchiness and skin and ear infections.

What a pet owner can do

If your dog is scratching, as are many of my patients, see your veterinarian. When my itchy dog patients need more specialized skill than I have to manage their allergic dermatitis, I refer them to a dermatology specialist. You can find a board certified dermatologist on the American College of Veterinary Dermatology website.

I hope one or more of the treatments I have described can help make your dog more comfortable in these waning summer months.

Heartworm Prevention

Are heartworms becoming resistant to preventive medications?

This week marks the first day of spring and for many dogs and cats, spring means a trip to the veterinarian’s office for a heartworm test and renewal of a prescription for heartworm prevention.

To help me address the timely topic of “heartworm disease,” I invited a recognized expert, Dr. Clarke Atkins, to provide some insight.

Q: Do dogs really need an annual test — and should dog owners stop giving the preventative medication when winter comes?

A: Year-around preventive and yearly testing are solidly recommended by the Companion Animal Parasite Council (CAPC) and the American Heartworm Society for these important reasons:

1. Heartworm infections are actually greater than 10 years ago, making annual testing critical for your dog.
2. Year-around preventive provides a safety net of prevention for your dog.
3. Current heartworm preventives provide protection against other year round pests.
4. Starting and stopping preventive administration has the potential to lead to lapses in preventive therapy.
5. People in the metro New York area — those who either vacation at or have homes in “heartworm-endemic areas” — may be at risk year round.
6. Financial savings are modest and very small compared to the cost of treating a heartworm infection.

Q: Some dog owners are worried about overmedicating their dogs and give the heartworm medication every other month. Do you advise this protocol?

A: The practice of every other month administration of preventive is frankly a terrible idea. Lapses of greater than 45 days between treatments can result in heartworm infection.

Q: Are cats susceptible to heartworms and should they be on preventative medications like dogs?

A: Cats are susceptible to heartworm infection, although less so than dogs, and there is no practical and safe treatment for this life-threatening disease in cats. In any region in which heartworm preventive is used in dogs, cats absolutely should be on heartworm preventive, even if they are housed indoors. Interestingly, in a study we carried out several years ago, the exposure rate to heartworms in cats in NYC was 5% and on Long Island was 9%.

Q: I’ve heard heartworms are becoming resistant to medication. What should a dog owner do?

A: In certain areas of the southern U.S. — specifically Arkansas, Louisiana, Tennessee and Mississippi — there are concerns with increasing reports of “lack of effectiveness” from medications, and there is some evidence to suggest that some heartworm preventives are not perfect against all strains of heartworm.

Pet owners should talk with their veterinarian if they have any concerns in this regard. However, the most important thing is that all pets receive heartworm preventive medications.

My thanks to Dr. Clarke Atkins, Diplomate, ACVIM (Internal Medicine and Cardiology) and the Jane Lewis Seaks Distinguished Professor at North Carolina State University, for his time and response to important questions about heartworm disease.

The Companion Animal Parasite Council tracks parasitic diseases in dogs and cats–including heartworms. The map below is courtesy of CAPC:

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This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit http://www.amcny.org. To make an appointment, please call 212.838.7053.

Bedbugs and Pets

A few weekends ago, I was volunteering at The AMC’s “Ask the Vet” booth during AKC’s Meet the Breeds show at the Jacob Javits Center in New York City. A pet owner came to the booth with questions about bedbugs and pets. I know there is a nationwide epidemic of bedbugs, but in veterinary school parasitology, I remember learning bedbugs are a nuisance to humans not animals. I decided to do some reading and here is what I found.

First, a bit about bedbug biology. They belong to the family Cimicidae and are flightless, so they crawl to their host. Like most parasites, bedbugs are very specific in their choice of host. And fortunately for your pet, bedbugs prefer people over pets. The blood of humans, dogs and cats is different and bedbugs have evolved to feast on human blood. Bedbugs climb on their host only to feed and spend the rest of the time in mattresses, furniture and crevices. As nocturnal creatures, they feed at night, attacking their sleeping host, hence their colloquial name bedbug. For more information on bedbug biology from entomologists (bug experts), go to http://www.oasas.state.ny.us/AdMed/FYI/bedbugs.cfm.

Bedbugs live in environments, not on pets or people, and can easily be confused with other household bugs. If your pet has critters crawling in its fur, black specks deposited on its blanket and is scratching up a storm, most likely your pet has fleas, not bedbugs. This time of year when the weather gets cold, fleas are looking to move indoors and you might be more likely to see them in your house. 

If you do discover bedbugs, there are a few things you can do to decrease the number of bedbugs in your home. Wash bedding in hot, soapy water and dry them in a hot dryer (>120 degrees F). Vacuuming thoroughly and discarding the bag after each vacuuming session will help decrease bedbugs in the environment. Ultimately, most people need a professional exterminator to clear the bedbugs from their home. For more information on eradicating bedbugs from your home, go to http://www.nyc.gov/html/doh/downloads/pdf/vector/bed-bug-guide.pdf.

If you use the services of a professional exterminator, follow his directions explicitly. Keep in mind, insecticides are common causes of toxicity in pets. Insecticides used in the treatment of environmental bedbugs are generally safe for pets if used properly. 

If your pet has previously experienced reactions to flea and tick preventatives, check with your veterinarian to determine if the product your exterminator recommended is safe for your pet.

This blog and many others may be found in the “Tales from the Pet Clinic” blog from WebMD.
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For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Flea & Tick Treatments: Are They Safe or Not?

You may have heard or read recent media reports about pet owners who believe their animals have experienced harmful side effects from the use of “spot on” or “top spot” flea and tick preventatives. In fact, a recent article in the Wall Street Journal states that “the number of incidents reported to the Environmental Protection Agency (EPA), the agency which regulates these pet treatments has increased 53% over the past year.”

This statistic came from a statement issued on April 16, 2009 by the Environmental Protection Agency announcing an increase in adverse event reports associated with application of EPA approved spot on flea and tick preventatives. The statement suggests that  The EPA will be intensifying its evaluation of all approved spot on products and issued an consumer advisory.

Does this mean you should stop administering the preventative to your dog or cat? Not at all, but it does mean you need to do some legwork to be your pet’s best healthcare advocate.

First, scrutinize the data. If product A has 100 adverse events reported and product B has ten adverse events reported, does that mean product A is ten times more likely to cause an adverse event than product B? Not necessarily.  The answer depends on how many doses of both products have been administered. If 100,000 doses of product A have been administered, it has an adverse reaction rate of 0.1%. If 10,000 doses of product B have been administered, it has an equal adverse reaction rate of 0.1%. 

Second, talk to your veterinarian. Have a conversation about the risks in your community of fleas and ticks carrying an infection. An urban, apartment-dwelling pet is not very likely to get ticks, but fleas can easily be transmitted in a carpeted apartment building hallway.  During this discussion, you and your veterinarian can choose the preventative for the pests most likely to affect your pet.  Your veterinarian will also know which flea and tick preventatives work best in your neighborhood. 

Finally, successful use of any medication requires you to follow the manufacturers guidelines and flea and tick preventatives are no different. In fact, the EPA reports the majority of adverse event occur because the pet owner does not follow the manufacturer’s guideline for use of the products. These guidelines are developed with your pet’s health and safety in mind.

This announcement involves only the spot on flea and tick preventatives under the jurisdiction of the EPA. Some flea and tick products are regulated by the Food and Drug Administration’s Center for Veterinary Medicine. For additional information and a list of EPA regulated products, visit these sites:
http://www.epa.gov/pesticides/health/prodname-reg.pdf
http://www.epa.gov/pesticides/health/flea-tick-control.html

The EPA suggests the following resources:
• The National Pesticide Information Center has collated information for consumers in the Least Toxic Pest Control Guide
• Less-Toxic Product List, a resource guide by Our Water, Our World

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For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts.  Send your contribution to: The Animal Medical Center 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.