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InFocus

Flea, tick and worm control in practice: are we taking efficacy and compliance for granted?

CHARLES CULLEN believes that advice, along with the supply of internal and external parasite control products, remain a critical success factor for practices, especially in the current challenging environment

IN recent years there has been a massive proliferation in the number and variety of flea, tick and worm control products. Now, more than ever, there is an opportunity to offer simple, practical advice that places compliance and prevention at the heart of any treatment schedule, with less focus on discussions about efficacy.

A simple case in point: Frontline Combo is licensed for up to eight weeks for flea control in dogs, but application every four weeks is needed for tick control. We found that by advising four-weekly treatment as our baseline, rather than eightweekly, clients found setting recalls or calendar reminders much simpler, therefore ensuring continuous effective cover, rather than the intermittent “fire-fighting” that occurred when the longer treatment interval was not adhered to.

Murmur of blame

For many years I have heard the murmur of “fipronil resistance”, usually from younger colleagues, being blamed for flea outbreaks. Being the old cynic that I am, I find it hard to believe our delightful climate has produced resistant fleas faster than, say, somewhere like Florida, where the climate is far more suitable.

A quick review of recent client records with “flea problems” invariably shows under-purchasing of flea control products (from our practice at least).

Often by the time of presentation, these lapsed users have already applied Frontline (having seen fleas on their pet). But, of course, by the time this lapsed treatment is applied their home has already been infested, and new fleas are constantly emerging from the environment (indoor and also outdoor).

Owners perceive this to be inefficacy. Indeed, because fipronil kills by hyperexcitation, the client may see increased flea activity on the animal.

Most owners assume the term “flea prevention” implies they will not see fleas on treated pets but of course it is impossible to prevent fleas from jumping on.

This is why compliance and owner education are so important. Regular application of product will ensure these fleas are killed.

Whilst there might be a temptation to blame Frontline, or whichever product had been applied, and then offer an alternative, this in fact actually deflects the problem, as without compliance the same situation will occur again in the future.

Wormers, thankfully, are a more straightforward matter, but typically are given even less frequently than flea treatments.

The BSAVA guidelines 1 have been in place for many years and continue to promote worming four times a year for most dogs under most circumstances. This frequency can be increased or decreased according to individual risk factors.

For the majority of the UK and the majority of dogs, there seems limited evidence that Angiostrongylus infection is a significant cause of disease in dogs, despite increased awareness amongst clinicians 2 and therefore routine monthly worming of all dogs seems ill-advised.

However, to prevent patent infestations of Toxocara canis in dogs, which is an important consideration for families with children and for puppies, monthly treatment is recommended.1

One key factor on which I base my choice is palatability/ease of dosing, as a tablet only works if it is inside the dog and not on the floor or mashed in some food left uneaten!

There is a new broad-spectrum dewormer for dogs called Veloxa which is a highly-palatable chewable tablet that uses PEC technology which coats the bitter actives, making the whole worming experience a good one.

When it comes to giving a cat a tablet, however, it’s a different story. So for many of our cat clients the advent of topical endectocide products, such as Broadline (which covers fleas, ticks, roundworms and tapeworms) has been a blessing.

Health plan promotion

Key to my practice’s success with flea and worm control in 2014 was the promotion of health plans, in which all flea and worm control is included. In addition to the boost in practice revenue by securing all of the client’s flea, tick and worm purchases for the year, it also greatly improves compliance by ensuring a ready supply of product at hand and a simple usage plan, e.g, monthly flea and tick treatment, quarterly worming treatment for dogs (depending on level of risk) and monthly for cats.

Advice and supply of internal and external parasite control remains a critical success factor for practices. In a challenging competitive environment it has never been more important to encourage the bonded clients, and to supply them with straightforward, costeffective products they can trust.

This trust will come not just from the efficacy of the product, but from compliance and prevention.

References

  1. BSAVA Worming Guidelines, BSAVA, 2006. Worm control in dogs and cats, Guidelines 1, European Scientific Counsel for Companion Animal Parasites (ESCCAP), 2010.
  2. Morgan, E. and Shaw, S. (2010) Angiostrongylus vasorum infection in dogs: continuing spread and developments in diagnosis and treatment. JSAP 51 (12): 616-621.

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