How do we take a risk based approach to Parasiticides on pets?

Like many of you I have read the alarming reports of fipronil and imidacloprid being found in our rivers and worried about the harm we may be inflicting on invertebrates and the biodiversity of our natural world. We have all spent many years dutifully persuading our clients to regularly treat their pets for fleas and worms and incorporated that into our health plans. Indeed, such preventative medicine underpins the finances of many practices. Yet it now seems clear that we cannot continue to use these products so widely but must formulate alternatives, continue to keep our patients and their human families healthy and somehow take our clients with us.

So how to do this? I certainly don't have all the answers, far from it, but will share with you the start of our journey at Old Hall Vets and how we plan to develop and hopefully it might stimulate others to rethink their strategy.

Assess local parasite risk

We started out by assessing the lungworm risk in our area. We had diagnosed 2 cases in the previous 10 years so were recommending monthly worming. However, with no further cases we started to suspect these originated elsewhere and it wasn't endemic.

Over 18 months we blood tested twenty young, at risk and coughing dogs. All tested negative. It wasn't a particularly scientific study but gave us the confidence to say it was very unlikely we had endemic lungworm in our locality. This enabled us to reduce our recommended worming frequency to once every 3 months for some animals, depending on lifestyle.

Assess patient risk

We assess the relative parasite risk of each animal at vaccination/health check or when they sign up to our health plan, asking questions about behaviour (are they poo or carcass eaters?), feeding (are they on a raw diet?), people in household (is anyone under 5's or immuno-compromised?). To save time, this can be done via a questionnaire which clients can fill in whilst waiting.

This information helps us to decide on a worming frequency recommendation. We also give clients the option of faecal worm egg testing instead of routine treatment and have an account with a lab who will do this. The owner sends a faecal sample to the lab in a pre-paid pack then the results are sent to us, so we still get to advise.

Clients are also asked if their dog swims, goes to the groomers or gets bathed at home to assess the likelihood of parasiticides entering the water courses. If yes to any of the above they are advised not to use spot on flea/tick products. Our nurses are great at talking clients through these risk questions either in the surgery or on the phone.

Decide on products

As yet we haven't had the confidence to reduce treatments for fleas and ticks. There are a lot of ticks in Cumbria and we have seen a few Lyme disease cases, plus we know that fleas are a constant issue.

Instead we have thought about our choice of product and decided to use the isoxolaners, as all these are excreted in the faeces. For dogs, this can be picked up and disposed of, so the chemicals are less likely to have a negative environmental effect - although I would like to know more about effluent from landfill. Faeces spreading the chemicals is still an issue for isoxolaner treated cats, unless they are litter tray users, so other spot on products may have a place here.

Client education is key, so we give out leaflets with the products explaining the environmental reasons for disposing of faeces properly, helping to raises awareness. All the client leaflets we give out are on our website. Please feel free to copy/use them if you wish.

Health plans

We now offer two plans, so clients can choose a reduced worming (and reduced cost) protocol for dogs and can read all about the options and reasoning on the website. They can also choose to have a faecal worm egg count instead of routine prophylactic treatment.

The future

It would be good to move away from blanket preventative treatments and our plan is to encourage more faecal testing as is done in Germany. We also think that trials using natural products would be extremely helpful as these may prove useful in prevention, so I would love to hear from anyone with experience of alternatives for endo or ectoparasites. What about providing our clients with flea combs to regularly monitor and only treat where necessary? This could work for some.

We should also be demanding more information from the pharmaceutical companies regarding the environmental effect of parasiticides, so please ask your reps. If we are all asking the same question it will eventually feed through and we may get the answers we need.

The above are only baby steps and we have much further to go. An important part of it all is making clients aware and having those conversations. Hopefully it will stimulate people to think of the wider environment and biodiversity in other parts of their lives as well.

Good luck in your own journey.