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Dr. B.
Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 21744
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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My dog keeps catching fleas and frontline isn't working

Resolved Question:

Hi my dog keeps catching fleas and frontline isn't working I've been recommended advocate be the local council pest control. I have a local vet but my dog has anxiety and I can't get him in the car and it's £60.00 for a prescription please help!emma xx
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 2 years ago.
Advocate contains both moxidectin and imidocloprid but if you don't need a heartworm preventative such as moxidectin, I would purchase the over the counter Advantage which only contains the imidocloprid, the drug that acts as the flea adulticide. It's available over the counter in pet/agricultural merchant store or you can purchase it online here: http://www.vetuk.co.uk/flea-products-flea-treatments-advantage-flea-control-c-3_660. When fleas continue to be a problem in spite of your treating Winston regularly, it's important that your premises be treated by a professional or you can purchase over the counter area treatment sprays (not the less effective foggers) which contain an insect growth regulator (IGR) such as methoprene. The IGRs don't allow flea eggs of larvae to develop into adult fleas, thus breaking up the life cycle of the flea. Please respond with further questions or concerns if you wish.
Customer: replied 2 years ago.
We have many slugs at night do you recommend?
Expert:  Dr. Michael Salkin replied 2 years ago.
I see that you're concerned about lungworms - Angiostrongylus vasorum - which are endemic in the UK. We don't prescribe a preventative where I live but, instead treat with various drugs should we diagnose lungworms in our patient. I'm going to contact my UK colleague for you. She should be up on the latest care and might have a more cost-effective approach for you. Neither of us can prescribe through this venue, however. I'm sure she's asleep at this time but hopefully will get back to you in a few hours.
Expert:  Dr. B. replied 2 years ago.
Good morning Emma,

In regards ***** ***** UK perspective, let me first say that we are see high levels of flea resistance to Frontline. Its just not working at all for our patients. So, we do tend to use other products for these situations. From a flea treatment point of view, Capstar, Advantage II, Advantix, Activyl, Vectra 3-D or Bravecto would all be options. I'd note that most are prescription but Advantage II + Capstar can be obtained at Pets At Home. So, those would be options for at least treating for the fleas.

Otherwise, Dr. Salkin and the council are absolutely right about our treatment of choice for lungworm alongside fleas.Though I would note that we are a wee bit different from our US friends, as we do use Advocate regularly as a preventative for lungworm (akin to what they do for heartworm). So, often we have dogs on regular treatments of Advocate.

Now in regards ***** ***** this, you are correct that Advocate is a prescription product. That said, most vets don't require that the dog be seen by a vet for this, but instead has a recent weight (and has been seen before). In fact, we often have patients pop in for a weight check with the nurse before this is dispensed. Afterwards, their owners can choose to just buy a month's supply or more as needed.

With that all in mind, I'd note that your estimate seems a wee bit off for a prescription only. These do not tend to cost that much (in my practice they are £11 & then you obviously pay the online pharmacy their fee for the medication). I suspect that is a consult fee plus a prescription fee or the cost of the medication may have been included in this too. So, it is worth clarifying what that £60 includes. Otherwise, since most practices only require a weight check before dispensing (to ensure the right dose is given), you may want to ring around to other practices to see if they can offer a less painful estimate.

Now I do appreciate that he is not a keen traveller, but we do at least need a recent weight for his vet this once. So, I would suggest seeing if there is a closer practice or branch (RCVS practice database HERE) that you could walk to with him. Or you could speak to the practice about a home visit (though these tend to cost a wee bit). In either case, it is just that weight they will need to be able to then dispense that to him. Or again if that is not an option at all, then we'd need to consider at least addressing the fleas with Capstar or Advantage II from Pets At Home.

Take care & all the best for Winston,
Dr. B.
Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 21744
Experience: General practice veterinary surgeon with extensive experience in a wide range of species.
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