Features September 2017 Issue

Bravecto, Nexgard, or Other: Which Oral Flea Control Should You Use?

Get updated on the side effects, safety, and methods of the most widely prescribed flea-killing medications for dogs on the market.

Note: Since this article came out in the September issue of Whole Dog Journal, we have received a number of reader comments expressing concern over the fact we might condone the regular practice of feeding oral flea medications to our dogs. Perhaps our standard caveats weren’t strong enough: We always promote simple, safe, and natural solutions for our dogs’ health, training, and behavior before promoting chemical (or toxic) answers to their wellness needs. But, as we have from our beginning 20 years ago, we aren’t so hard over on the natural wellness route that we dismiss out of hand all mainstream or veterinarian-prescribed treatments to our dogs' most vexing problems.

There’s no getting around the fact that the most common trigger for allergic reactions in dogs is flea bites. Flea allergy dermatitis is so common, in fact, that if your dog is persistently itchy, your veterinarian might not be willing to evenconsider any other potential cause of his itching until your dog has been maintained on whatever flea-prevention treatment your veterinarian approves of for at least a few months! If your veterinarian takes this position, and if you consent, then you’ll have to make some choices about which oral flea medication to use.

We hope this comparison article will serve as a guide if you and your veterinarian decide oral flea medication vs. topical is the best way to eradicate these parasites. If you do, make sure you read the fine print regarding contraindications: that is, whether or not your dog’s pre-existing conditions or medications might preclude her from taking oral flea meds. More on that below.

itchy dog

Most dogs who get bitten by a flea will itch. But flea-allergic dogs often itch and scratch and chew on themselves until they create hot spots (acute moist pyotraumatic dermatitis). For these dogs in particular, an oral flea-control medication may make the most sense.

Keep in mind that a decision to use one of these drugs needn’t be “forever”. We feel they should be used for only as long as it takes to get the flea population in your home under control. Then, alert surveillance and routine cleaning should be enough to keep fleas at bay.

It begins with a simple itch.

If a dog is particularly itchy – and especially if he’s focusing on itchy places such as his flanks and his back at the top of his tail – the first thing to suspect is that he’s been bitten by fleas, or maybe even just one flea. All dogs itch when bitten by fleas, because flea saliva, which is injected into your dog when the flea bites and feeds on your dog’s blood, is irritating. But dogs with an allergy to flea saliva may go berserk with pruritus (severe itching), chewing and scratching themselves until a hot spot (formally known as acute moist pyotraumatic dermatitis) forms.

Today, there are any number of tools and tactics an owner can employ to eliminate fleas as a source of her dog’s discomfort. These include:

- Oral medications

- Topical “spot-on” pesticides

- Insect growth regulators (IGRs), which prevent the normal development of flea eggs and larvae

- Other topical pesticides: shampoos, dips, powders, sprays

- Treatments for the dog’s environment

- Cleaning methods aimed at ridding/killing non-adult fleas

- An approach that encompasses several or all of these would be called integrated flea control, or more generally, integrated pest management

For several reasons, veterinarians tend to put the most stock in the first two on this list – and more specifically, the prescription-only versions of these. In fact, these are the two most effective solutions for killing fleas – but they aren’t without potential side effects and they should represent only a part of a dog owner’s efforts to control fleas.

This month, we’ll examine the prescription oral flea-control medications that kill adult fleas. In the October 2017 issue, we’ll discuss prescription oral medications that help control fleas through the use of insect-growth regulators, as well as the over-the-counter oral products that kill fleas. In later issues, we’ll survey the spot-on pesticides and other flea-control strategies.

Why Choose Oral Flea Medication Over Topical?

Last year, I fostered a Great Dane who had a very thin coat and who was very itchy. When I took her to a veterinarian for a complete examination and discussion of what we could do for her itching, the vet essentially refused to consider any sort of allergy diagnosis or treatment until the dog had been on an oral flea-prevention medication for a minimum of three months. She said, that in her opinion and experience, “only longer-term oral medications offer enough protection from fleas to rule out an allergy to fleas as the cause of persistent itching.” To that end, she prescribed a medication called Bravecto, a drug that can kill any fleas that bite the dog for as long as 12 weeks after the dog is dosed.

I countered that I could repeat topical insecticides at regular intervals. But the veterinarian was firm in her belief that only a dose of Bravecto would ensure that there would be no gap in flea prevention for long enough to ensure that the Dane’s itching was not caused by fleas.

Merck, the maker of Bravecto, strongly promotes this point, taking slightly different tacks on its product website pages for owners and veterinarians. Owners are told that Bravecto makes flea control easy: “With Bravecto Chew, dogs get 12 weeks of flea and tick protection with a single treatment. That’s nearly three times longer than monthly treatments. This makes it easy for you to provide long-lasting coverage to your dog, without having to worry about remembering frequent treatments.”

On Merck’s pages for veterinarians, the most-promoted benefit is owner compliance: “Convenient long-lasting protection means less chance of noncompliance,” it says on one page. “Bravecto makes all the difference in improving pet-owner compliance,” it says on another.

Advantages of Edible Flea Medication

There are a number of other advantages to using an oral flea-control product:

If you or your children pet the dog, you may prefer not to have contact with a topical product. This could also be true in a multi-pet household where pets groom each other.

Dogs with longer coats often sport a “greasy spot” for several days after topicals have been applied, increasing the concern of petting the dog and coming into contact with the pesticide.

Owners of dogs with skin problems, or who have had a reaction in the past to any sort of topical product, might prefer to use an oral one.

Bathing or even swimming too soon after application may reduce the effectiveness of topicals.

Some ingredients used to kill ticks, such as permethrin (used in K9 Advantix and other products) and amitraz (used in Certifect and the Preventic collar), are toxic to cats, which can be a problem in a household that includes both, especially if they are friendly with each other. In that case, giving the dog an oral product would be safer for the cat.

Because the insecticides in the newer oral products haven’t been used for very long, they can be more effective in areas where fleas and ticks may have built up some resistance to the older topical products.

Last but not least, oral flea-control medications have been proven to be more effective than topical pesticides in both killing fleas and helping to control a household infestation more quickly.

Concerns with Oral Flea Medications

Every product you feed or use on your dog poses some amount of risk, and some percentage of dogs will react badly to any product.

One disadvantage of these medications is that, once a dog digests one, it’s in his system for as long as it’s designed to be. If a dog has an adverse reaction to a topical pesticide, his owner can immediately bathe him to reduce the adverse effects. The effects of an oral medication can’t be mitigated in this way.

That said, the most common adverse side effects of oral flea-control medication are stomach upset and vomiting. The very fact that a dog can vomit up the medication – and the possibility that he might do so without you being aware of this – is a fairly significant disadvantage, too. If you don’t find the vomit, you may think the product was just plain ineffective. And then there is the possibility the vomit is discovered and eaten by another one of your dogs!

It should also be noted that while all of these products are formulated with palatants to entice a dog to chew them up and eat them, some dogs may refuse. In this case, you will be forced to either sneak the medication into the dog’s food or give it to him like any other pill – and you’d have to break the larger doses for large dogs into pieces to “pill” them.

It should be noted that an oral medication can compromise the integrity of a necessarily strict food-allergy trial.

Only a very small percentage of dogs suffer the most serious adverse reactions posed by this class of medication: seizures and other neurological reactions.

Types of Oral Flea Control Products for Dogs

There are several types of oral products that are marketed to dog owners to help with flea infestations:

1. Prescription oral flea-killing medications. These work in the dog’s system for at least a month.

2. Over-the-counter (OTC) oral flea-killing medications (Capstar, Capguard, FastCaps, Advantus). None of these products work for longer than 24 hours – but they do work quickly to kill fleas.

3. Prescription medications that do not kill fleas, but contain insect-growth regulators, which help control flea populations by preventing the fleas from maturing and reproducing (Sentinel, Sentinel Spectrum). Fewer adverse reactions in dogs are reported for these products than for the flea-killing medications.

Again, this month, we’re going to discuss only the prescription oral flea-killing medications. We’ll look at the other two categories next month.

Prescription Oral Flea-Killing Medications

PRODUCT EFFECTIVE AGAINST CHEMICAL CLASS ACTIVE INGREDIENT FREQUENCY EFFICACY DATE OF FDA APPROVAL MIN. AGE AND WEIGHT
BRAVECTO
Merck
(800) 224-5318
Fleas, ticks, demodex* Isoxazoline Fluralaner Up to 12 weeks >98% of fleas and 100% of ticks within 12 hours 2014 6 months, 4.4 lbs.
NEXGARD
Merial
(888) 637-4251 (opt 3)
Fleas, ticks, demodex* Isoxazoline Afoxolaner Monthly 100% of fleas within 24 hours (no claims made for ticks) 2013 8 weeks, 4 lbs.
SIMPARICA
Zoetis
(888) 963-8471
Fleas, ticks, demodex*, scabies* ear mites* Isoxazoline Sarolaner Monthly Starts within 3 hours for fleas, 8 hours for ticks 2016 6 months, 2.8 lbs.
COMFORTIS/ ACUGUARD
Elanco
(888) 545-5973
Fleas Spinosyn Spinosad Monthly 100% of fleas within 4 hours 2007 14 weeks, 3.3 lbs.
TRIFEXIS/ COMBOGUARD
Elanco
(888) 545-5973
Fleas, heartworms, roundworms, hookworms, whipworms Spinosyn Spinosad, milbemycin oxime Monthly 100% of fleas within 4 hours 2011 8 weeks, 5 lbs.
*Not yet approved in the U.S. for control of these parasites, though veterinarians might suggest them as “off-label” treatments.

Isoxazolines

There are not that many medications approved by the FDA for controlling fleas on dogs. Most products contain one significant “active ingredient” that controls fleas, although a few contain more than one.

The newest class of insecticides are isoxazolines, chemicals that are selectively toxic to insects (fleas) and acarines (mites and ticks) in a way that does not pose a risk to mammals. Isoxazolines kill fleas and ticks by inhibiting their ligand-gated chloride channels, in particular, those gated by the GABA neurotransmitter. This blocks pre- and post-synaptic transfer of chloride ions across cell membranes, resulting in uncontrolled activity of the fleas’ and ticks’ central nervous system (CNS) and death.

In plain English? The operation of many physiological processes rely on ion channels, chemical pathways where charged ions from dissolved salts (including sodium, potassium, calcium, and chloride) pass through otherwise impermeable cell membranes. Most of these channels are gated, opening and closing in response to certain stimuli. Isoxazolines close the chemical gates on chloride channels that are essential for the CNS of fleas and ticks, resulting in their death.

NexGard

nexgard chewables

The active ingredient in NexGard, a product introduced by Frontline Vet Labs, a division of Merial, Inc., in 2013, is an isoxazoline chemical called afoxolaner. It is given once a month. Each NexGard treatment kills fleas and the black-legged tick, American dog tick, Lone Star tick, and brown dog tick. It also kills the mite responsible for demodectic mange, though it has not yet received FDA approval for this use.

Studies indicate NexGard was 100 percent effective against fleas within 24 hours, and more than 97 percent effective against American dog ticks and Lone Star ticks, 94 percent effective against black-legged ticks, and 93 percent effective against brown dog ticks.

NexGard can be given with food or on an empty stomach.

The most common adverse reactions recorded in clinical trials were vomiting, itching, diarrhea, lethargy, and lack of appetite.

Nexgard is said to be safe for dogs and puppies who weigh four pounds or more and who are at least eight weeks of age. No adverse reactions were observed in preapproval studies when NexGard was used concomitantly with other medications, such as vaccines, dewormers, antibiotics, steroids, NSAIDS, anesthetics, and antihistamines. The safe use of NexGard in pregnant, breeding, or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures.

Bravecto

bravecto chewables

The active ingredient in Bravecto, a product introduced by Merck Animal Health in early 2014, is an isoxazoline chemical called fluralaner. It is given once every three months. Each Bravecto treatment kills fleas and certain species of ticks (black-legged tick, American dog tick, and brown dog tick) for 12 weeks, three times longer than any other oral flea treatment. It kills the lone star tick for eight weeks. It also kills the mite responsible for demodectic mange, though it has not yet received FDA approval for this use. Studies indicate that Bravecto kills more than 98 percent of fleas, and 100 percent of ticks, in less than 12 hours after administration.

Bravecto should be administered with food to maximize the bioavailability of the active ingredient.

The most common adverse reactions recorded in clinical trials were vomiting, decreased appetite, diarrhea, lethargy, polydipsia (excessive drinking), and flatulence.

Although its maker offers no specific warning about this in its product literature, Bravecto should be used with caution in dogs with a history of seizures, similar to other drugs in this class.

Bravecto is said to be safe for pregnant, breeding, and lactating dogs, dogs weighing at least 4.4 pounds, and for puppies who are at least six months old (and 4.4 pounds). No adverse reactions were observed in pre-approval studies when Bravecto was used concurrently with other medications such as vaccines, de-wormers, antibiotics, and steroids.

Simparica

The active ingredient in Simparica, a product introduced by Zoetis in 2016, is an isoxazoline chemical called sarolaner. It is given once every month. Each Simparica treatment kills fleas (100 percent within 24 hours) and certain species of ticks (almost 97 percent of Lone Star tick, Gulf Coast tick, American dog tick, black-legged tick, and brown dog tick) for one month.

Simparica also kills the mites responsible for demodectic mange (demodex), sarcoptic mange (scabies), and otodectic mange (ear mites), though it has not yet received FDA approval for these uses. (We’ve seen reports from veterinarians who are using it for this off-label use with great success.) Its claim to fame is its speed; Zoetis claims that Simparica starts killing fleas within three hours and ticks within eight hours of administration.

Simparica may be administered with or without food.

Simparica may cause abnormal neurologic signs such as tremors, unsteadiness, and/or seizures. Simparica has not been evaluated in dogs who are pregnant, breeding, or lactating. Simparica has been safely used in dogs treated with commonly prescribed vaccines, parasiticides and other medications. The most frequently reported adverse reactions were vomiting and diarrhea.

Simparica is said to be safe for dogs weighing at least 2.8 pounds, and for puppies who are at least six months old (and 2.8 pounds).

Spinosyns

This class of chemicals does not kill ticks, only fleas. Spinosyns work in a similar fashion as the isoxazolines, in that they activate reactions in the flea’s cellular ion channels (in this case, the nicotinic acetylcholine receptors or nAChRs), causing a fatal CNS reaction in the fleas. Insects treated with spinsyns show involuntary muscle contractions and tremors resulting from activation of motor neurons. Prolonged spinosad-induced hyperexcitation results in prostration, paralysis, and flea death. The selective toxicity of spinosad between insects and vertebrates may be conferred by the differential sensitivity of the insect versus vertebrate nAChRs.

The prescription oral flea-killing products in this class of medications all utilize a spinosyn called spinosad.

Comfortis
AcuGuard

These products are the same thing; Elanco makes AcuGuard for the VCA chain of veterinary hospitals under the Vethical brand.

comfortis flea medication

As previously mentioned, the active ingredient in Comfortis and AcuGuard is spinosad. These products were FDA-approved in 2007. They are given once every month. Each treatment kills fleas for one month. Flea count reductions of 97.9 percent were observed one month after the first treatment and 99.9 percent after three monthly treatments with Comfortis or AcuGuard.

Administer these products with food for maximum effectiveness.

The most common adverse reaction reported from Comfortis/AcuGuard is vomiting. Other adverse reactions reported in decreasing order of frequency are: depression/lethargy, decreased appetite (anorexia), incoordination (ataxia), diarrhea, itching (pruritis), trembling, excessive salivation, and seizures.

Following concomitant extra-label use of ivermectin (very high doses used to treat mange) with Comfortis/AcuGuard, some dogs have experienced the following clinical signs: trembling/twitching, salivation/drooling, seizures, incoordination (ataxia), excessive dilation of pupils (mydriasis), blindness, and disorientation. Products containing spinosad should be safe when used along with the normal heartworm preventive dosage of ivermectin or milbemycin oxime, but use with caution in dogs who have or may have the MDR1 mutation that causes sensitivity to certain drugs. See “Dogs with the MDR1 Mutation: Drug Sensitivites,” (December 2012) for more information.

acugard for dogs

Neither should these products be combined with high doses of milbemycim oxime (Interceptor, Sentinel), used to treat demodectic and sarcoptic mange, as this combination can cause serious adverse neurological effects.

While Elanco says these products can be combined with other flea and tick products, we wouldn’t recommend it. Nor should Comfortis/NexGuard be used for dogs with epilepsy or other seizure disorders.

Use with caution in breeding females. The safe use of Comfortis/AcuGuard in breeding males has not been evaluated.

Comfortis/AcuGuard is approved for use in dogs 14 weeks of age or older and 3.3 pounds of body weight or greater.

Trifexis
ComboGuard

These products are the same thing; Elanco makes ComboGuard for the VCA chain of veterinary hospitals under the Vethical brand.

Trifexis and ComboGuard combine spinosad with milbemycin oxime, a chemical that is used as a heartworm-preventive and is effective against intestinal parasites (hookworms, roundworms, and whipworms).

Trifexis/ComboGuard is approved for use in dogs and puppies eight weeks of age or older and five pounds of body weight or greater.

Administer these medications with food for maximum effectiveness.

Treatment with fewer than three monthly doses after the last exposure to mosquitoes may not provide complete heartworm prevention. Prior to administration of Trifexis/ComboGuard, dogs should be tested for existing heartworm infection. Use with caution in breeding females. The safe use of these medications in breeding males has not been evaluated.

Use with caution in dogs with pre-existing epilepsy.

What Elanco calls “mild, transient hypersensitivity reactions manifested as labored respiration, vomiting, salivation, and lethargy” have been noted in some dogs treated with milbemycin oxime carrying a high number of circulating heartworm microfilariae. These reactions are presumably caused by release of protein from dead or dying microfilariae. Milbemycin oxime is more effective against microfilariae than most other heartworm prevention medications (including ivermection) and may therefore cause anaphylaxsis if given to a heartworm-positive dog.

Just as with Comfortis and AcuGuard, following concomitant extra-label use of ivermectin with spinosad, some dogs have experienced the following clinical signs: trembling/twitching, salivation/drooling, seizures, incoordination (ataxia), excessive dilation of pupils (mydriasis), blindness and disorientation. Spinosad alone has been shown to be safe when administered concurrently with heartworm preventatives at label directions.

Again, products containing spinosad should be safe when used along with the normal heartworm preventive dosage of ivermectin or milbemycin oxime, but use with caution in dogs who have or may have the MDR1 mutation that causes sensitivity to certain drugs.

The most common adverse reactions reported are vomiting, depression/lethargy, itching (pruritic), decreased appetite (anorexia), diarrhea, trembling/shaking, ataxia, seizures, hypersalivation, and skin reddening. Puppies less than 14 weeks of age may experience a higher rate of vomiting.

Tips for Safe Flea Medication Use

1. Read the medication directions before giving to your dog.

Always read the instructions for use carefully before administering to your dog, especially the cautions and contraindications. It’s always shocking when we hear that someone gave their dog a medication without reading the instructions – and often refusing to take responsibility. “My veterinarian prescribed it! How was I supposed to know it could make my dog sick?” While it’s true that a veterinarian should inform her clients about the contraindications of any product she recommends, in reality, few vets have or take the time. If you read something in the product insert’s cautions and contraindications that seems like it would apply to your dog and concerns you, call your veterinary hospital and ask for the vet to call you back to discuss it – again, before you give the product to your dog.

2. Pay attention to the instructions.

Always follow the directions carefully. Products for cats and dogs are not interchangeable; a number of products for dogs are potentially fatal for cats. Topical products should not be ingested. Pay special attention to weight and age minimums for safe use, as well as the cautions regarding administration to sick, weak, old, medicated, pregnant, or nursing dogs.

3. Observe your dog carefully after administering a flea-control medication.

Most adverse reactions happen within a few hours. Contact your veterinarian with a speed that is congruent with the seriousness of your dog’s symptoms. (Serious? Go the to veterinary ER! Mild? Call your vet the next day to report and ask the staff to note this in your dog’s chart.)

4. Treat every pet.

It’s important to treat all dogs and cats in a household. Fleas can reproduce on untreated dogs and cats and allow infestations to persist.

5. Start a flea control calendar.

Keep track of when you administer a flea-control product to your dog. It’s advisable to write the date, time, product, and dosage on a calendar that you can easily refer to if your dog has an adverse reaction and you need to recount details to your veterinarian. Also note any abnormalities you may notice in your dog’s health, appetite, digestion, and demeanor after administration.

Nancy Kerns is the editor of WDJ.

Comments (40)

We have been chemical free for our animals for a long time. Why would I want to add any pollutants directly on my beloved pets? To me that is like adding it to my home and myself. And if you stop and read the information folder I wonder why these companies are still in business selling products. And no we have no fleas, ear mites, or anything else.
Shame on you WDJ for not advocating better for animals.

Posted by: Bunny | September 17, 2017 7:10 PM    Report this comment

One thing that the article - which is very lazy journalism, by the way, a mere rehash of the pharmaceutical company inserts - does not mention is cost. These products are formidably expensive to buy, and extremely profitable for the the companies which make them. In addition, they have been manufactured and sold under pretty lax regulation, either non-existent or not enforced. At best, they may be seen as a "lesser evil" in certain situations of extreme infestation. Since this is a multi-part series, I will read all before making final judgement, but I suggest right now that an article with more critical analysis, offering alternatives to these products, be added to the series.

Posted by: errigal | September 3, 2017 11:19 AM    Report this comment

WDJ now says Note: Since this article came out in the September issue of Whole Dog Journal, we have received a number of reader comments expressing concern

Concern? This essay consumes a number of pages of the ($6 a copy) current issue, in which the author merely parrots manufacturer promotional dialog, including a list of advantages of the oral products, even admonishment to (additionally!) treat all dogs and cats in a household, and conditioned by [product] is said to be safe and spare mention of adverse reactions culled from the companys own pre-approval studies. There is no discussion about the methodologies of these tests, how little is required for pre-market study, and how inadequate government oversight actually is. Neither did your author mention that if a readers dog DOES have a reaction to these drugs, there is no antidote, no means to flush the drug from the dogs system, as it may continue to pressure his immune system unchecked for perhaps months. It is more than a missed opportunity to offer meaningful information: it is a gross misuse of the WDJ platform, to which the pharmaceutical conglomerates must be cheering as very nearly free publicity.

This is more than just unworthy of WDJ: it is truly offensive to the ordinary, common-sense reasoning needed to evaluate use of these products. I was stunned when this copy and its simply bad journalism arrived on the doorstep.

There is no discussion of the process for after-market reporting by consumers.

It is, in fact, the consumer who conducts real-life, long-term testing of these products on their own dogs in their own homes. According to the FDAs Center for Veterinary Medicine, Not everything is known about a drug when it is first marketed. Due to the limited size and controlled nature of pre-marketing clinical trials, only the most common adverse events will be observed and included in product labeling at the time of FDA approval. An accurate safety profile emerges only after a product is marketed and the number and spectrum of animals receiving the drug increases.

Rather than a note preceding this article, WDJ owes its subscribers an apology. Your editors who posted this note seem to fail to understand how damaging this essay has been.

Posted by: Peter999 | September 3, 2017 6:59 AM    Report this comment

Nothing is risk-free. Google side effects for Neem

From webmd.com (yes, this is for humans, but is cause for thought).

Pregnancy and breast-feeding: Neem oil and neem bark are LIKELY UNSAFE when taken by mouth during pregnancy. They can cause a miscarriage.

Not enough is known about the safety of neen during breast-feeding. Stay on the safe side and avoid use.

Auto-immune diseases such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Neem might cause the immune system to become more active. This could increase the symptoms of auto-immune diseases. If you have one of these conditions, its best to avoid using neem.

Diabetes: There is some evidence that neem can lower blood sugar levels and might cause blood sugar to go too low. If you have diabetes and use neem, monitor your blood sugar carefully. It might be necessary to change the dose of your diabetes medication.

Posted by: punk11n | September 1, 2017 11:15 PM    Report this comment

Thank you, WDJ for explaining how each of these meds work. I always try to use the least toxic option with everything, but sometimes the "big guns" need to be brought out. Incidentally, for the last two years, I've used NexGard on two of my dogs with great results, even though I left my third dog with epilepsy untreated. I only treat them one or twice at the beginning of flea season.

Posted by: Christine4444 | August 31, 2017 2:54 PM    Report this comment

go to vitalanimal.com and really read about these poisons, whole dog journal has been compromised or hijacked, unbelievable, maybe the name needs to change because it has nothing to do with being a whole dog anymore

Posted by: Kona12 | August 30, 2017 6:58 PM    Report this comment

Addendum: We also tried vacuuming like crazy, eucalyptus oils and leaves, salting the carpets and where the wall meets the floor. We sprayed our dogs with "natural" anti-flea concoctions and washed dog beds constantly, used flea combs, etc etc. Comfortis has made our dogs and domicile flea-free.

Posted by: chiwoowa9 | August 29, 2017 2:16 PM    Report this comment

Comfortis changed our lives. I don't like pesticides. Spinosad is "a natural substance made by a soil bacterium."

We live in Santa Barbara, which, up until about a decade ago, seemed to be the Flea Capital of The World. I am not kidding.

We had cats and lots of kittens when I was a child. No one had their cats spayed/neutered back in the '60s. Our house was hopping with fleas. As a child, I had flea bites from my ankles to my knees---every single flea "season." It was horrible. Torment. Every Spring, fleas fleas fleas.

When I grew older, I even tried giving my dogs "flea dip" treatments. When my one dog slid down the green grass, after his dip, and the grass died wherever he had touched it, I knew something was very, very wrong with flea dips.

We tried flea collars and dusting for fleas. We even (Heaven forbid) tried setting off flea bombs. Flea traps used in the basement (where the cats liked to stay, years ago) killed everything that had the misfortune to hop or crawl onto the sticky pads. It was appalling.

Then came topical meds. I hated the topical treatments for my dog. Once, I put the stuff on my dog and forgot and stuck my face right on her neck, to give her a kiss. Oh, no! I ran to the kitchen and scrubbed and scrubbed my face with soap, like crazy. Why oh WHY would I put this stuff on her, when I was terrified of getting it on myself?

My vet recommended Comfortis (circa 2007) and all of our flea problems ended. Like magic. Incredible. And we soon figured out that we only had to give our two dogs (no cats now) one tablet each, as soon as we saw a flea or evidence thereof----and things were good until the next Spring. A miracle. No fleas on the dogs, no fleas in the house and no fleas biting me. Hooray.

Posted by: chiwoowa9 | August 29, 2017 2:12 PM    Report this comment

Have to agree with the overwhelming majority here: you are peddling poison and potential death. I actually worked, pre-launch, on one of the orals you promote here, and I can tell you without reservation that the oft-quoted clinical studies here and summarized in the Prescribing Information were selectively culled from a mass of studies, in order to show the drug in the best possible light.
You should know better.

Posted by: longfellow | August 29, 2017 12:25 PM    Report this comment

I've used Trifexis for 14 years for my Border Collie and Goldens without any discernable side effects and great results. My B-Collie is 14 years old and in outstanding health. My wonderful Golden was diagnosed with cancer at 12 and did not survive, but it would be hard to attribute his condition specifically to Trifexis. My 2-1/2 year old Goldens are both on Trifexis with no noticeable side effects. Mild and even severe reactions to meds is always possible, and it is appropriate to be cautious and questioning regarding any meds and treatments -- I appreciate both this article and all the comments -- but if these treatments are as harmful as implied by many herein, we would have an national epidemic of pet deaths and these companies would be out of business. Most of the people working in these companies as well as vets recommending their products are hugely caring and compassionate, as well as passionate pet owners. To suggest the entire industry is in it for a buck is just ignorant.

Posted by: RickB | August 28, 2017 1:26 PM    Report this comment

Very enlightening article. I've never used oral flea treatments as it just didn't seem like it was a good idea and then I found out my vet strongly discourages them. I use a new topical, Actyvle (spelling?) only a couple of months a year. My American Eskimo who was allergic to the carrier is most topicals had no problem with this one. I found that Frontline topical did nothing, but the Frontline spray works wonders against ticks. Luckily, I've only had to use it once every few years. By the way, I live in South Florida, bug heaven. I also use Borax in carpets and that works great. Do your research and you'll stumble across something not so toxic that will work.

Posted by: Jayne | August 28, 2017 9:16 AM    Report this comment

This essay is little more than re-typed information from product labels and manufacturer data sheets. Most notably is the failure to discuss the limitations of manufacturer-provided "data" on potential side effects, drawn from carefully controlled pre-marketing clinical trials that they conduct themselves for FDA approval.

This essay is not worthy of WDJ.

Posted by: Peter999 | August 28, 2017 5:33 AM    Report this comment

Thanks for the clear explanation of the science behind the oral flea control drugs. I've used them successfully on six dogs of various breeds over the past twenty-odd years and would never go back to the old flea powder-plus-flea baths-plus-flea comb-and-periodic flea bomb-method. As for the folks who're convinced these drugs are universally toxic, I'm curious about how they protect their dogs from heart worm?

Posted by: califgrl | August 28, 2017 3:36 AM    Report this comment

I have a 7 years old Aussie, we leave nearby a large wood where thicks are anything else but a rarity.
In the Aussies first 4 years, I tried every kind of topical treatment to keep ticks away, and I never found one (topical) that was efficient enough.
I have always used the same vet and 3 years ago while I was expressing my frustration over the limited efficacy of topicals treatments, the vet introduced me to Bravecto. The vet said that since my Aussie was very much in shape and never had any important health issue, we could give it a try. I was requested immediately give him a call if any changes in the Aussies behavior was noticed.
Now we are on our 3rd year on BRAVECTO, my Aussie is 100% free from ticks and fleas. Will I continue with this treatment? Well until an effective poison-less treatment is available, I am quite sure I will continue with Bravecto. One thing is for sure, I will not change from one poison to another.

Posted by: Riddle | August 27, 2017 11:16 PM    Report this comment

And something further to note - These oral flea/tick meds DO NOT prevent Lyme Disease. The tick has to bite your pet to be killed by the systemic poison. That bite can still transmit Lyme. It's so much better to use natural preventatives that will make your dog unpalatable to the bugs, such as herbal sprays and garlic and brewer's yeast pills.

Posted by: CathN | August 27, 2017 7:38 PM    Report this comment

Boy, I did NOT expect this article from WDJ! Please, please, please, people - go to the Facebook group "Does Nexgard Kill Dogs?" and read story after story about dogs who have been sickened and even died from these oral flea meds! Our story is there as well - two dogs sickened, one with seizures, and the other with a ruined digestive system and an ulcer, which has taken over a year and a half to heal, including nearly daily vomit clean-up and many expensive vet bills. We're actually the lucky ones - so many have lost their dogs to these types of meds. Please do your research!

Posted by: CathN | August 27, 2017 7:33 PM    Report this comment

Wow. This article really bothers me. I looked up to WDJ before this article as being a good resource for myself and my readers, but after this article, I'm going to reconsider suggesting anyone follow anything you post.

After killing one of my beloved dogs a few years ago with the oh so safe (according to my vet and every vet since then) NSAID Previcox, my outlook on just willy nilly giving my pets any pharmaceuticals has changed. Now, before giving my pets ANY drug, I google the side effects. I recommend EVERY pet owner do that. Just type in the following: "_____ killed my dog" if there are any groups, forums, articles, news stories, etc., they will show up. Do the same if you are a cat owner, also.

On the subject of fleas, I take in dumped and abandoned cats and dogs near me and currently have TEN of them. My pets do not have fleas. They may come with them, but I quickly get rid of them through bathing and flea combing. I also clean vacuum my carpets, house and their beds often. Bedding is washed weekly or every couple of weeks. Outside, I keep my yard mowed short (3"). I wrote an article recently on my blog about all kinds of natural ways to get rid of fleas, according to holistic vets who don't have an incentive to promote pharmaceutical drugs.

If you do some research, you'll find fleas look for weak hosts, so getting your pet healthy is the first step to keeping parasites like fleas and ticks off of them. Poisoning them with more chemicals than what they are already exposed to is not the answer and probably why the cancer rate in pets is so high and especially in senior dogs where ones over 10 years old have a 50% risk of getting cancer. I have four natural healing books written by holistic vets and they all say the same thing about all the vaccinating and poisoning of our pets causing health problems. Don't do it.

When people stop looking for the easy/pharmaceutical way out of problems, and look back to nature and natural treatments, everyone will benefit. Except the pharmaceutical companies and the vets that only see them as their profit machine.

Posted by: CC @ Saving Cats, Dogs and Cash | August 27, 2017 6:20 PM    Report this comment

I don't care how you try to justify these products, they are TOXIC POISON that you are pushing for profit. Poison that you are feeding to your loved pets or putting on their skin. Far too many have died from these products due to owner trust, ignorance and lack of research. When the topical treatment first came out for horses, I tried it. My horse allowed me to put it on her twice. The third time, she almost went down on her knees rather than to let me put it on her. That was enough to let me know that it was causing her some kind of discomfort, so I never tried it again. For dogs and cats, there is a natural alternative. Pet Protector @ petprotector (dot)org is good for 4 YEARS and works on scalar energy technology. I'm really surprised at WDJ for promoting this crap!

Posted by: jewellsmom | August 27, 2017 6:18 PM    Report this comment

I don't care how you try to justify these products, they are TOXIC POISON that you are pushing for profit. Poison that you are feeding to your loved pets or putting on their skin. Far too many have died from these products due to owner trust, ignorance and lack of research. When the topical treatment first came out for horses, I tried it. My horse allowed me to put it on her twice. The third time, she almost went down on her knees rather than to let me put it on her. That was enough to let me know that it was causing her some kind of discomfort, so I never tried it again. For dogs and cats, there is a natural alternative. Pet Protector @ petprotector (dot)org is good for 4 YEARS and works on scalar energy technology. I'm really surprised at WDJ for promoting this crap!

Posted by: jewellsmom | August 27, 2017 6:18 PM    Report this comment

After many years of subscribing to WDJ, you can add me to the list of those who are disgusted by this poison pushing. It only takes a bit more EFFORT to keep your pets comfortable without poisoning them. Dr. Will Falconer, anyone. Check him out if you don't want to poison your pets. And I don't think you'll be getting another renewal from me, WDJ. So sad.

Posted by: Donnasandy | August 27, 2017 5:17 PM    Report this comment

Wow! I was looking forward to reading this article to see what alternative treatments were recommended. Wasn't I surprised?
I haven't been following WDJ for long, but you have now just lost me.
What I'm reading here is that is all about the big bucks.
This saddens and disappoints me!

Posted by: htren | August 27, 2017 4:13 PM    Report this comment

My dogs have been on Comfortis for years. They get a monthly dose March-October and go off it during the winter months when the fleas are dormant. Never had an issue with their health and the dogs run in fields every day. I have a strong flea allergy - not my dogs - and I'm glad to find something that works for us. Just offering a point of view that is different from the "Pharma kills dogs" mantra on here.

Posted by: Bluetree | August 27, 2017 4:07 PM    Report this comment

OK, fleas are horrible in the South, a given. However, the FDA had thousands of complaints back in 2007. The EPA tested all the topical flea drops in 2008. The companies refused to release the results. All 5 top Veterinary associations had to file Freedom of Information Act papers, every year, until they finally released the data in Fall of 2016. ** All were listed as organophosphates - nerve gas!! They work on nerve gas carried in the bloodstream of your dog, so a flea bites and gets dead. Why is it causing organ failure across all breeds? Its NERVE GAS,
which kills everything. The worst offender was Frontline Plus with more than 2500 complaints/ailments/reactions/deaths. The least was Sargeants at 40. However if Frontline Plus has great quality control and Sargeants has the least quality control, then it makes no sense. **Next is Comfortis causes severe deformities in newborns, young pups, older dogs. Gets rid of fleas but if it causes deformed DNA what is it doing to your dog? **Last is the worst: Trifexis,
largest danger as it is a derivative of glysophate, which is RoundUp...yes, poison chemicals that kill. I am disappointed in WDJ, very disappointed. Have they fallen victim to Big Pharma in promoting poisons for our pets? AS Pet owners
we want answers that will not kill, maim or make our babies sick. Shame on WDJ.

Posted by: docdmsfitz | August 27, 2017 3:31 PM    Report this comment

I think it is very important to mention that once Bravecto or any other flea is given that there is no antidote. If there is a problem there is no way to get the toxin out of the system. My father's dog had such violent seizures, that started two hours after the pill was given. We tried waiting it out but within a week she had to be put to down and I cannot emphasize how much she suffered. It was truly criminal and and my father was completely heartbroken.

I'm having trouble that this article has come from Whole Dog Journal. At first I thought it would be an article about alternatives to oral flea pills and a warning against them.

Posted by: afawkes | August 27, 2017 3:22 PM    Report this comment

This is a disappointing article. I gives a good overview of the various products but it stops short.

You should have mentioned a potential side effect of these oral products is death.
Of course the pharm companies won't admit that but if you want to write and be a responsible informer to your readers you should have mentioned that there is a possibility of death from taking these products.

If people want to use these products they should be made aware of all the potential side effects.

Even if the product kills only one dog out of one hundred, it should be stated.
And hope you arent the owner of the one dog.

Posted by: tv | August 27, 2017 2:41 PM    Report this comment

I'm on my fifth Mon.Schnauzer baby right now. My last one encountered Retina issues, lost 70% at 6 years of age, then got kidney issues, and died at nine. I'm on a quest to find out why. I've talked to four breeders here in Florida and PA. They all say highly unusual. Normal age to lose our friend should be 15. I used Advantage. One breeder, highly thought of, swears by Flea Treats, 2/Day. Liver compound keeps fleas at bay. One more to think of-Excessive Shots-we will NOT permit that crap to exist in this household. Love to all dog lovers, Joe in Fla.

Posted by: JoeB | August 27, 2017 2:37 PM    Report this comment

If these kind of insecticides are so safe, then why haven't they developed one for humans? Fleas and mosquitoes just love me! I've used Comfortis in the past because of the area I live in - fleas are year round especially with wild rabbits living in my yard. Every time I've used it I feel guilty. I wish instead you would write an article testing the natural flea preventives and treatments.

Posted by: Kim Kiernan | August 27, 2017 2:22 PM    Report this comment

I've been using Seresto collars for the last three years (seasonally), without any problems

Posted by: AviaMR | August 27, 2017 1:42 PM    Report this comment

I will no longer subscribe to a magazine who promotes poisons for fea control. It sounds as if you have been influenced by big business. I would like to cancel my subscription to your magazine. When you feed bravecto to your dog, why don't you take a dose?

Posted by: Harbor21 | August 27, 2017 1:36 PM    Report this comment

I have six dogs and four cats and NEVER use flea products! I comb my pets a couple of times a week. Flea combs are very reasonably priced and work wonders! I put a bowl of water, with a little dawn soap in it, and drop the fleas into that water. They're dead!! Sometimes I get four or five fleas, but most of the time, I get NONE! I will never use any flea products on my pets since I accidentally touched some Advantage-x (not sure of spelling!) on two of my fingers, ended up waking up in the middle of the night with my whole hand aching so bad I called emergency! I went to the clinic the next day and picked up some medicine. That was about three years ago and those two nails are still deformed from that contact! I feel guilty now for ever using any of it on my poor pets! The comb gets the eggs and the poop too! And my animals love the combing sessions!

Posted by: Jamie | August 27, 2017 1:05 PM    Report this comment

I do not use any poisons on my pets. Only Natural Pet has a squeeze on that you apply once a month. It does not kill fleas, but it does prevent them. So you must start using it before the pet gets fleas. I have used this for 4 years now and have had no fleas. Fleas in my house would be a huge nightmare as I have 8 rescued cats besides my dog. This squeeze on has no poison. It is a mixture of oils. It does leave a little greasy spot that disappears in a day or two. Better to have the spot than to use poisons that are harmful to the animal's health.

Posted by: DP | August 27, 2017 12:53 PM    Report this comment

Of course the veterinary world only considers poisons such as these because they make money for them. Has anyone considered the safest and cheapest way to kill fleas, worms, parasites, ticks, heartworm? It is Diatamaceous Earth. It is a powder that many concerned farmers use and so do knowledgeable pet owners. It can be purchased in most pet stores or feed stores. It is ground up shells and scrapes the underbelly raw of the creatures and kills them. Dosage goes by the size of the animal and should be on the container. For farmers or large users, it comes in 5 pound containers. In pet stores it is a smaller size.. It is given in food and rubbed on the fur and brushed in. If the dog won't eat it plain, in food, just put it in any treat the animal will eat.
The only serious impediment to its being completely effective is the compliance of the pet owner. It must be given every day or two days in the summer or bug and worm seasons and every three of four days in winter when there are no bugs. It still has to be given in winter because a dog may eat or roll in feces and pick up worms from wild animals or other animals that have no protection.

Posted by: Hlevin | August 27, 2017 12:25 PM    Report this comment

I am surprised WDJ is encouraging using oral flea medication on our dogs. Wow. I didn't understand the science,can someone explain in simple terms why this would be safe yet Frontline isn't. My vet rides me hard for not using anything on my dogs and removing ticks by hand (pretty hard with Bernese Mountain Dogs)

I would be willing to use if it was infact safe, but just being FDA approved in 2014 causes me grave concern. Why is WDJ promoting this? I generally trust what they tell me now I am confused.

Posted by: quinnsammi | August 27, 2017 12:17 PM    Report this comment

I would strongly suggest you take a look at websites and FB groups that go by names like: Does Bravecto Kill Dogs?
The adverse effects that are reported (and still get reported) for Bravecto as well as the other mentioned subscription remedies, are far more severe than some stomach upsets and vomiting. They range from epilepsy to even death.
I am very surprised Whole Dog Journal is advocating these kind of poisons.

Posted by: Hapschaartje | August 27, 2017 11:42 AM    Report this comment

I've NEVER used any poisons on any of my animals, cats or dogs. For my cats, I've used a liquid supplement with a B-vitamin, brewer's yeast, and garlic. They tramped around the woods in the summer--never got fleas. For my dogs, I make my own spray from neem, etc. If you research it, you can, too. If you love your pets, please don't poison them just because it's convenient and easy for you.

Posted by: Czerny | August 27, 2017 11:33 AM    Report this comment

Until I read this article, I was also under the mistaken impression that using internal flea & tick meds were like "poisoning" my dog too. But if you read the section on the science behind the active ingredient, it's clear that poison has nothing to do with it.

"The newest class of insecticides are isoxazolines, chemicals that are selectively toxic to insects (fleas) and acarines (mites and ticks) in a way that does not pose a risk to mammals. Isoxazolines kill fleas and ticks by inhibiting their ligand-gated chloride channels, in particular, those gated by the GABA neurotransmitter. This blocks pre- and post-synaptic transfer of chloride ions across cell membranes, resulting in uncontrolled activity of the fleas and ticks central nervous system (CNS) and death.

In plain English? The operation of many physiological processes rely on ion channels, chemical pathways where charged ions from dissolved salts (including sodium, potassium, calcium, and chloride) pass through otherwise impermeable cell membranes. Most of these channels are gated, opening and closing in response to certain stimuli. Isoxazolines close the chemical gates on chloride channels that are essential for the CNS of fleas and ticks, resulting in their death."

Thanks for this article! I now feel liberated from using topicals, which have several downsides in regular use.

Posted by: Dogs r us | August 27, 2017 11:28 AM    Report this comment

Any chemical that uses your dog's circulatory or digestive system as a means of delivery to kill fleas/ticks will eventually harm your dog. If you incorporated insecticides into your system so that when a mosquito bites you it will die, don't you think that over many years that it will cause illness?

Posted by: Czerny | August 27, 2017 11:27 AM    Report this comment

Published research challenges claim that Oral is significantly superior to Topical.. samples: (.com extensions deleted, active links not allowed here)

2015 new Frontline efficacy.. Parasit Vectors. 2015 Jan 27;8:50. doi: 10.1186/s13071-015-0682-z. Repellency, prevention of attachment and acaricidal efficacy of a new combination of fipronil and permethrin against the main vector of canine babesiosis in Europe, Dermacentor reticulatus ticks. Dumont P1, Fourie JJ2, Soll M3, Beugnet F4.
⦁ Source pubmed/25622802
2011 Frontline efficacy thru day 36.. Parasite. 2011 Nov;18(4):319-23.
Study of the sustained speed of kill of the combination of fipronil/amitraz/(S)-methoprene and the combination of imidacloprid/permethrin against Dermacentor reticulatus, the European dog tick.
Fourie JJ1, Beugnet F, Ollagnier C, Pollmeier MG.

-------------------------------------
BRAVECTO
Source: bravecto au/vetresources

2014 Source bravecto au/vet-resources/clinical/resource1.pdf efficacy and safety of Bravecto (fluralaner) against Frontline
A total of 108 tick-infested dogs were treated with Bravecto (fluralaner) and 54 tick-infested dogs were treated with Frontline
Results: At weeks 2, 4, 8, and 12, Bravecto (fluralaner) flea-control efficacy in treated households was 99.2%, 99.8%, 99.8%, and 99.9% respectively, while Frontline (fipronil) efficacy was 94.1%, 93.0%, 96.0%, and 97.3%, respectively. Bravecto (fluralaner) tick-control efficacy on treated dogs at weeks 2, 4, 8, and 12 was 99.9%, 99.9%, 99.7%, and 100%, respectively, and Frontline (fipronil) tick efficacy was 97.6%, 93.8%, 100%, and 100%, respectively.
Of dogs showing clinical flea allergy dermatitis (FAD) signs at the study start, 85.7% in the Bravecto (fluralaner)-treated group and 55.6% in the Frontline (fipronil)-treated group were evaluated at each time point as showing no clinical signs of FAD until study completion. Conclusions: Bravecto (fluralaner) administered once orally to dogs in a chewable tablet was highly effective for 12 weeks against fleas and ticks on privately-owned dogs and was significantly non-inferior (ticks) and superior (fleas) in comparison with topical Frontline (fipronil) administered 3 times sequentially.
* p2 An initial parasite count was performed using the World Association for the Advancement of Veterinary Parasitology (WAAVP) comb-counting method [6]
* p3 Tick-control efficacy on individual dogs was higher in Bravecto (fluralaner) treated dogs in weeks 2 and 4. In week 8, Frontline (fipronil) efficacy was slightly higher at 100% compared with 99.7% for Bravecto (fluralaner). Both treatment groups had a tick efficacy of 100% at week 12 (Table 5).
* p4 Overall, 8 adverse events reported during the entire study period of 12 weeks were considered to be possibly related to the administered treatment, with 4 reported in each treatment group despite the 1:2 allocation ratio. There were 2 dogs (0.5%) with vomiting/diarrhea and 2 dogs (0.5%) with appetite loss among the 383 dogs in the Bravecto (fluralaner)-treated group; all of these dogs recovered from their clinical signs and remained in the study. In the 178 Frontline (fipronil)-treated dogs, 3 dogs (1.7%) developed alopecia and crusts in the dorsal lumbo-sacral area and 1 dog (0.6%) developed intense pruritus. All of these dogs remained in the study; 3 recovered and 1 had ongoing clinical signs at the conclusion of the study.

2014 Safety of fluralaner Source: bravecto au/vet-resources/clinical/resource8.pdf


2015 A quantitative evaluation of the extent of fluralaner uptake by ticks..
Source: bravecto au/vet-resources/clinical/resource13.pdf
p6 Efficacy - Based on geometric (and arithmetic) means, the immediate efficacy against an existing tick infestation after Bravecto TM treatment was 100 % (100 %), and persistent efficacy against tick challenges at 4, 8 and 12 weeks following Bravecto TM treatment was 100 % (100 %), and persistent efficacy against tick challenges at 4, 8 and 12 weeks following Bravecto TM treatment was 100 % (100 %),

Posted by: jerbon | August 27, 2017 11:04 AM    Report this comment

Does the Seresto collar warrant consideration in this discussion?

Posted by: Gaines'Partner | August 27, 2017 10:29 AM    Report this comment

I find it outrageous that WDJ condones poisoning your dog with these "medications". Shame on you.

Posted by: GeorgieGirl | August 27, 2017 10:16 AM    Report this comment

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