Apr 23 2015

Heartworm, flea, and tick prevention options.

With the return of the nice weather and the end (finally) of winter, our thoughts turn to protecting our furry friends from parasites. The big three for Niagara would be heartworms, fleas, and ticks. There are many products on the market and it can be confusing trying to figure out what is right for you. Since everyone’s case is unique it is best to discuss this with staff or Dr. Toles. However I’ve put together below a brief breakdown of the products we are carrying, what they prevent, how they are applied/administered, and some other basic information. Hopefully this guide can answer some questions and at the very least guide everyone to have a little better understanding of what is available. If you have any questions about the products we carrying our about prevention for your pet, we are available to help.


Bravecto:  Active Ingredient: Fluralaner   Prevents: Ticks (American dog tick/rocky mountain tick, deer tick, brown dog tick), fleas (cat/dog flea)

Bravecto is a chewable (jerky treat) form of prevention for fleas and ticks, it contains a pork based flavouring. It is given orally (by mouth) and is absorbed into the bloodstream and body tissues (specifically the fluid between cells). Since the medication works in the blood stream it is necessary for the flea or tick to bite before they ingest the product and die. This product is safe for pregnant and lactating female dogs. You should give it with food to be easier on the stomach and this will also improve how well it gets absorbed. Bravecto is effective for 12 WEEKS (roughly 3 months) of protection from fleas and ticks with each dose.  Only for Dogs


Nexgard: Active ingredient: Afoxolaner  Prevents: Ticks (American dog tick/rocky mountain tick, deer tick, and lone star tick), fleas (cat/dog flea)

Nexgard is also chewable (jerky treat) form of prevention for fleas and ticks. The flavouring here is soy base and designed to taste like beef, the chew is given orally (by mouth) and should be given with food, BUT does not have to be. This product gets absorbed into the bloodstream and fluid between cells in the body (interstitial fluid). Just as with Bravecto (or any oral prevention) the flea or tick will need to bite to receive the product, but will die quickly after before producing any eggs or transmitting any diseases. Nexgard is effective for 30-31 days, or 1 month at a time. This product has not been tested on pregnant or lactating female dogs.  As a bonus Merial (the manufacturer) has provided a discount if you are using Nexgard with Heartgard (see below) for your flea/tick and heartworm prevention this year.  Only for dogs


Advantix: Active ingredients: Imidacloprid, permethrin, pyriproxyfen Prevents: Ticks (American dog/rocky mountain tick, deer tick, lone star tick, and brown dog tick), fleas (cat/dog flea)

Advantix has been on the market for several years and it has been very effective in treating and preventing ticks and fleas in our experience. Advantix is a topical (applied directly to the skin) medication and is an excellent choice for pets with food sensitivities or allergies. Advantix is absorbed through the skin and works in the oil on the dogs skin and fur. It is important that any dog that receives a dose of Advantix be separated from any CATS for 8-12 hours while the product initially absorbs/dries. The active ingredient to kill ticks is toxic to cats if they are exposed to it, but once absorbed the dog is perfectly safe to be around the cat. Advantix when applied properly, provides 30 days of protection against fleas and ticks. The product is effective even if you dog gets wet throughout the course of the month, but bathing with shampoo’s or daily swimming may reduce the efficacy, the recommendation in these cases is to apply every 3 weeks instead of every 4 weeks. ONLY FOR DOGS.


Advantage: Active Ingredient: Imidacloprid, Pyriproxyfen  Prevents: Fleas (Cat/dog flea)

Advantage was the first topical flea treatment to come on the market back in the 90’s, it is a tried and tested product that is very effective as a form of flea control. Just like Advantix the product is applied directly to the skin and absorbed. Like all topical products it is a great choice for pets with food sensitivities, allergies, or if they are picky/difficult to give chews. Advantage is safe for both dogs and cats as a form of flea control. Advantage should be applied every 3 weeks instead of every 4 weeks if the animal is bathed with shampoo or spends large amounts of time in the water (i.e. swimming every day in a pool or lake), but otherwise Advantage is effective for 4 weeks (30 days to be exact). For dogs and cats.


Advantage Multi:  Active Ingredients: Imidacloprid, Moxidectin  Prevents: fleas, heartworm, whipworms, hookworms, roundworms, ear mites, and 2 types of mange mites (demodex and sarcoptes)

Advantage Multi has also been on the market for several years, it is effective in treating fleas (and preventing them), and effective in preventing heartworm, whipworm, hookworm, and roundworm. Advantage Multi is not absorbed in the bloodstream, it is absorbed into the skin and works in the skin oils of the pet. The safety of Advantage Multi has not been tested in pregnant or lactating dogs. It is safe for any dog that is over the age of 7 weeks. Advantage Multi is a great option for flea and heartworm prevention for any dog who has issues with food allergies/sensitivities or is difficult to give oral medication. The topical application means that the product will need to dry for 8-12 hours before it is fully absorbed into the skin. After the initial 8-12 hours period if the dog gets wet with water it should not impact the efficacy of the product, if however the dog is being bathed with shampoo or spends significant time submerged in the water on a regular basis this may not be the product for your pet. Also Advantage Multi does not provide any protection against ticks, however it can be safely combined with other products (i.e. Advantix, Bravecto, Nexgard) safely. Also Advantage Multi (like Advantage) is safe for use in cats as a flea and heartworm prevention. For dogs and cats.


Revolution: Active Ingredient: Selamectin  Prevents: Fleas, heartworm, roundworm, hookworms, ear mites, and American dog ticks*

(*=may require more frequent dosing than once monthly to be fully effective against American dog tick).

Revolution has been on the market for over a decade and was the first topical product available for both fleas and heartworm prevention. Like other topical products it takes approximately 8-12 hours to be absorbed and dry. Revolution works in the skin oils of the pet and also gets absorbed into the blood stream and interstitial fluids.  Also like other topical products, it is advisable to apply doses more frequently (every 3 instead of ever 4 weeks) if your pet is being bathed with shampoo or spends large amounts of time submerged in water on a regular basis. It is important to note that although Revolution is labeled for prevention of the American dog tick (Dermacentor variabilis), it may be necessary to apply the product every 2 weeks instead of every 4 weeks to be fully efficacious. A second caveat with Revolution is that it does not have a label claim for preventing the Deer tick (Ixodes scapularis) which is found in Niagara and is also the carrier and transmitter of Lyme disease. It is still a good choice for any dog or cat that has issues taking oral medications for flea or heartworm prevention, and will aid in the treatment of ear mites, roundworms, hookworms, or sacoptic mange. Revolution is SAFE for pregnant or lactating female dogs or cats, so this is an ideal product if your pet is gravid and in need of protection. Revolution in general is safe for any pet over the age of 6 weeks. For dogs and cats.


Trifexis: Active Ingredients: Milbemycin Oxime and Spinosad Prevents: Fleas, heartworm, roundworm, hookworm, and whipworm.

Trifexis is a newer product that has been on the market for a little over 3 years now, it combines a tried and tested heartworm prevention, namely milbemycin oxime (previously found in Sentinel and Interceptor). Milbemycin oxime is also effective at preventing (and in some cases treating) roundworm, hookworm, and whipworms. To combat fleas Trifexis contains spinosad, a newer flea prevention compound that has been on the market for approximately 4 years (found in Comfortis, same manufacturer) and is quite effective at managing flea infestations. Trifexis is an oral medication (given with a full meal) that comes in the form of a chewable tablet that has a soy based beef flavouring. Trifexis is a great choice for any dog owner who’s pet receives regular grooming/bathing with shampoo, who like to spend a lot of time in the water, or who hate having topicals applied. Since Trifexis is absorbed via the gastrointestinal system it is found in the blood stream and interstitial fluid of the body. Since Trifexis is found in the bloodstream and interstitial fluid it does require that a flea bite the pet before receiving the spinosad that will kill it. However because the spinosad is fast acting the flea will still die before it can lay any eggs, preventing any infestation from occurring.  Trifexis is safe and effective for any patient over the age of 8 weeks, the safety of Trifexis in pregnant and lactating females has not yet been confirmed, nor has it been confirmed in breeding males. For dogs only.


Comfortis:  Active Ingredient: Spinosad  Prevents: Fleas

Comfortis is an oral chewable tablet that is beef flavoured and produced by the same company that makes Trifexis. Both dogs and cats can take Comfortis for flea prevention and treatment. Comfortis last for 4 weeks at a time and is absorbed into the bloodstream and interstitial fluid of the pet. Just like any orally given preventative (with a full meal) the flea will need to bite to receive the product and die. Also like Trifexis and other oral prevention the flea will still die before it has a chance to produce an egg and will therefore control the flea infestation effectively. Comfortis is safe for pets aged 14 weeks and older (most likely safe in pets 8 weeks and older because Trifexis is, but no testing was done to confirm this), but has not been tested to see its efficacy and safety in pregnant or lactating female dogs or cats.


Heargard Active Ingredients: Ivermectin and Pyrantel  Prevents: Heartworm, roundworm, and hookworms

Heartgard is the tried, tested, and true heartworm prevention that has been on the market longer than any other heartworm prevention we offer in the office. Heartgard is an orally given (does not have to be given with a full meal) chewable beef flavoured tab (similar to a beef jerky treat). Ivermectin and pyrantel are absorbed into the bloodstream and interstitial fluids where they work to kill microfilaria (baby heartworms) and also roundworms and hookworms in the intestinal tract. Heartgard is not a good choice if your pet has a food allergy/sensitivity, but is otherwise generally well tolerated. There are some breeds in which ivermectin can lower their seizure threshold, but this is not usually an issue at the concentration found in heartgard. Any dog over the age of 6 weeks can take heartgard and it is safe in pregnant and lactating female dogs. For dogs only.


This is just a brief overview of the products we have available, if you have any concerns or questions about them please call the office or ask when you bring your dog in for heartworm testing (and picking up prevention) for the summer.




ahsadmin | Uncategorized

39 thoughts on “Heartworm, flea, and tick prevention options.”

  1. Carol says:

    Can Bravecto for ticks and Revolution for heartworm be safely used together?

    1. ahsadmin says:

      Yes, Revolution can be used together with Bravecto safely. However other options, such as Heartgard, would be more appropriate a combination because it would avoid any overlap of prevention products. Unless you have a specific reason for wanting to use Revolution with the Bravecto (we generally recommend Advantage Multi over Revolution at our clinic).

  2. Nicole says:

    Can these medications be purchased without bringing my cat in for an appointment?

    1. ahsadmin says:

      Any medications require a veterinary client-patient relationship so if your kitty has been a patient in to see Dr Toles recently we can prescribe these meds. We advise calling the office to discuss this further.

  3. freida damon says:

    my dog is allergic to beef
    what are my choices for heartworm prevention

    1. ahsadmin says:

      The best option for a dog with food allergies would be a topical product. Such as Advantage Multi, or Revolution.

  4. Maria says:

    Can revolution be used to treat deer tick?

    1. ahsadmin says:

      Revolution does not have a label claim for Ixodes scapularis (the Deer Tick) either in prevention or aid in prevention. For control of deer ticks (Ixodes scapularis) we would recommend Bravecto, Nexgard, or Advantix for dogs, and Bravecto topical for cats (the only product that is effective against ticks for cats).

  5. Michele Richards says:

    Is it safe to combine Advantage Multi with Advantix ii? It seems like the dog will be overmedicated with flea meds. Is there an all in one medication?

    1. ahsadmin says:

      There is no all in one medication that covers flea, tick, and heart worm. Revolution does have a label claim for aiding treatment with ticks, but is not effective at once a month dosing. You can use both Advantix and AdvantageMulti, but should alternate dosing by 2 weeks. If you want more information please contact the office.

  6. Viki says:

    I need advice
    My dog is 2.4kg chihuahua and he had pain and diarrhea after second dose Bravecto orally and this same reaction after Interseptor pills.
    It is save give Him Bravecto topical every 3month and Revolution monthly? It will be double coverage fleas
    He is very sensitive

    Maybe any better advice ?

    1. ahsadmin says:

      Is your dog a patient at our hospital? It would be difficult to provide a good answer to your question without knowing more about your dog and his medical history. I can say there is no reason you could not use Revolution and Bravecto on the schedule you mentioned. However there may be better options if this upset your dogs stomach. You can always call the office to discuss his case if he is a patient of ours.

  7. Viki says:

    Thank you for professional answer. Appreciate!
    Im from Toronto .
    I wanna discover why he is so sensitive and help if possible. He had also severe reaction after combain vaccin Lapto and Rabbies

  8. Chris says:

    I have gotten mixed opinions.
    If not taken together Can Heartgard and Comfortis be given to the same dog?
    I try to give her the meds about a week apart but only give the comfortis during flea season.

    1. ahsadmin says:

      Heartgard and Comfortis can be given to the same dog. It is a good idea to separate them by a day or two just so you know which one may be an issue if the dog ever has a reaction to one or the other. Although I would personally suggest something like Nexgard, Simparica, or Bravecto for an oral flea treatment as Comfortis does not protect against ticks. The other 3 products all protect against ticks and fleas, they are also generally more palatable oral medications.

  9. David says:

    Hi, would using Bravecto and Sentinal Spectrum be a problem? The only double up would be for fleas but by using different active ingredients to kill them. Thank yiu

    1. ahsadmin says:

      I would recommend using the 1-800 number on the packaging to contact the companies directly to see if there would be any conflict or contraindication for using both of those medications at the same time.

    2. Dean says:

      David, our vet recommended using Bravecto and Sentinel together. We’ve been doing so for years. No issues for our dog and never one tick found on her.

  10. Jessica Tabarovasky says:

    Is it safe to combine Nextgard Spectra with revolution topical treatment? I gave Nextgard Spectra to my dog and a rash came out on her belly and she scratches her whole body a lot, her whole body itches. With Revolution alone it was just fine, but a veterinarian recommended me Nextgard spectra and I gave her. I’m so sorry. I don’t see fleas on her and she has no ticks.

    1. ahsadmin says:

      We have not begun to use Nexgard Spectra yet so we do not have any personal experience with it. We would recommend contacting the manufacturer with the issue you’re having. Having said that combining Nexgard Spectra with Revolution would be somewhat redundant as there is a lot of overlap between what Revolution covers and what Nexgard Spectra covers. See what the manufacturer says about the rash and itchiness, however this may be coincidental. You may also want to contact your regular Veterinarian that prescribed the Nexgard Spectra to you about this issues as well and get their advice.

    1. ahsadmin says:

      The topical medications they are referring to in the article are the ones available Over The Counter or OTC for short. These are products available at Pet stores. Not those sold by veterinarians. The active ingredients in these OTC products are not related to the active ingredients found in the topical products we use. It is true that products containing permethrin can be very dangerous to cats as cats cannot metabolizes this compound and it damages their kidneys. We only carry one product that contains this compound and it is very clearly and repeatedly indicated that it is NEVER to be used in cats or ideally in a home that has cats.

  11. Cy says:

    Is it safe to give Bravecto for fleas while giving heart worm treatment to a heartworm positive dog? If not, what is a good alternative flea treatment during therapy?

    1. ahsadmin says:

      We are not aware of any issues with using Bravecto while treating a heartworm positive dog. However we would advise you contact the company directly for advise on this subject
      If you follow this link you’ll find a 1-800 number for Bravecto to answer any questions you may have https://us.bravecto.com/contact-us

  12. Sarah H says:

    Is it safe to combine advantix with bravecto chews? My dog ate only about half of the chew and refuses to eat more no matter how I try to hide it. I’ve been trying to get her to finish it for over a week.

    1. ahsadmin says:

      Yes you could use Advantix and Bravecto chews together. However you could also switch from Bravecto chew to Bravecto Topical. We would also suggest you contact the companies directly if you want to be certain there are no issues.

  13. Olivia says:

    Hello, I’m wondering can you combine advantage spot on flea treatment with nexgard ? I’ve noticed that you wrote that advantage multi can be combined with nexgard, but I’m wondering if advantage can be safely combine with nexgard flea and tick after 5 days?


    1. ahsadmin says:

      yes you can use both but there would be little reason to do so as Advantage only prevents fleas and the Nexgard already does this and ticks.

  14. Dan says:

    Great informatiom. Very informative breakdown. We have been using Trifexis and have been quite happy with the results, but are concerned that we aren’t providing our dog with any tick protection. We were contemplating switching to Nexgard with Heartgard Plus or Bravecto with Heartgard Plus, but having a herding dog breed has us concerned with past reports and possible reactions to Ivermectin. If we were to stay with Trifexis, do you have any suggestions on how to address protection from ticks? Your input is greatly appreciated.

    1. ahsadmin says:

      you could use Nexgard Spectra or Interceptor Plus with Bravecto or Nexgard

  15. Casey says:

    I am wondering if I can use NexGard with my dog if it has been less than 30 days since he had K9 Advantix II topical. I cannot remember the exact date I put the K9 Advantix II on him, and I wanted to give him his new NexGard with his Interceptor Plus, which is due. Is it safe to give NexGard, say, two weeks after our last dose of K9 Advantix II?

  16. Brenda Miller says:

    Our dog has been taking Nextguard and Heartguard but is still being bit by something which is giving serious itching and red bumps. Someone mentioned that the wild rabbits that eat and poop in our grass might have mites called Cheyletiella parasitovorax. She said only Revolution can help prevent these mites. Is this statement accurate? If so can I administer even though our dog took her Nextguard?

    1. ahsadmin says:

      We would recommend taking your pet to a veterinarian for an assessment, there could be many reasons why you are seeing red spots. Some diagnostics and a physical exam would help greatly in determining what the condition is and how best to treat it.

  17. Tina says:

    Can I apply advantix or advantage to my dog after he has had credelio oral flea treatment. I am battling a flea infestation and I’d like to speed the process by attacking eggs and larvae

    1. ahsadmin says:

      We would recommend you contact the company as we do not have any first hand experience with Credelio.

  18. Jim says:

    My dog threw up about 2 hours after taking Heartgard and Nexgard on an empty stomach. Should we give another dose?

    1. ahsadmin says:

      That is close to the limit of when the medication would be fully absorbed, I would recommend contacting the companies to see what they advise.

  19. Katrina says:

    Hi. Is it safe to give Interceptor Plus and use Advantage II on the same dog at the same time? Frontline is no longer working for fleas and I’d like to go to imicloprid based treatment. Thank you.

    1. ahsadmin says:

      Check with the companies to be certain but there is no issue with combining these two products that we are aware of.

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