How We Control and Prevent
Fleas, Ticks, Mange, and other Skin Parasites

February 2019 Update:
Now that the new generation of isoxazoline class pesticides are available, most of the information writen below the red line is now obsolete.  The brand names of the new generation pesticides are: Bravecto, Credelio, Nexgard and Simparica and as of February 2019; Revolution Plus.  This new class of pesticide is so superior at killing fleas and ticks ... and so safe... there's not much more you need to know.

For dogs, my number one recommendation is NexGard.  Near perfect control of fleas and ticks... including those that carry Lyme disease... for at least a month at a time.  

For heartworm prevention;  I recommend ProHeart injection which gives excellent prevention for 6 months at a time. (the version that lasts a year is due to become available fairly soon).  All the products labeled for heartworm prevention work well (HeartGard Plus, TriHeart, Sentinel) but the injection solves the problem of people forgetting to give the preventive on a timely basis.

For cats, now that Revolution Plus is available... safely and easily protecting your cat from everything (fleas, ticks, ear mites, mange, heartworms, and intestinal worms), it's the way to go.  The added "Plus" is sarolander (brand name Simparica) and sarolander is an extremely effective killer of fleas and ticks... including those that carry Lyme disease.


More and more people are welcoming their pets into their homes as nearly full family members.  For most of us, their companionship brings us great joy and satisfaction, and besides pets are a whole lot less trouble than teenagers. 

According to my wonderful wife, I've taken the concept of making our pets full fledged family members a little too far when I replaced her picture over the mantle with a picture of my dog Sally.

At any rate, family members or not, we need to take good care of our pets, and one of their needs is for high quality parasite control on a regular basis.

Without our intervention, most pets suffer various degrees of discomfort and even death from heartworms, whipworms, hookworms, roundworms, tapeworms, fleas, ticks, lice, mites, and mange. 

Luckily, keeping your pet relatively parasite free and comfortable is fairly simple and easy, and the newest products, though somewhat expensive, are working well.

This page is an outline of the major parasites problems we deal with daily in our practice and a quick summary of the better products to prevent and treat these problems.

Fleas, of course, are aggravating little insects that carry disease, frequently cause intense skin reactions and allergies in our pets, and can be extremely difficult to control.  

Things to know:  

Fleas lay hundreds of eggs daily, so killing a few adults doesn't usually solve your problem.

Fleas have become resistant over the years to most over the counter pesticides

A few of the newer flea products are working great, in general, but sometimes it's necessary to really get aggressive and use several products together at first.  For example Capstar, Frontline, Sentinel, and KnockOut.  All these products will be discussed below.

"Natural Flea Control"
 A lot of people are enamored about all the "natural" parasite control products available.  Or they have the opinion that somehow pharmaceutical companies are evil and maybe even vote Republican.
These are the same people that believe eating garlic will protect them from mosquitos ... until they actually go to the swamp.
Orange peels, Amethyst rock, brewers yeast, garlic, lemon zest, marigolds, pyrethrins or rose oils don't work well enough to make your pet comfortable.  I'll happily retract this statement if I ever see some real evidence to the contrary.  
There is one exception...boric acid powders put on your floors and worked into your carpets can work well at reducing the flea load in a home, but that leads to potential practical and safety problems.  And, of course, Boric Acid is a chemical...not a "natural" or "herbal" product.

Pesticides available at Yard Care Stores
Pesticides that used to work really well...sevin, dursban, diazonon, pyrethrin, and permethrin, flea collars... are now killing a much smaller percentage of fleas and for shorter periods and as a rule, they are now not working well at all anymore. 
And some of the pesticides are fairly toxic.

Bathing and combing with a flea comb is helpful...but not for serious flea problems...most of the flea population lives off the pet and each surviving flea can lay 100 eggs a day...killing 10 fleas with a comb doesn't make much of a dent.

Not to worry, the big pharmaceutical-chemical companies have come up with new and much better pesticides and the government has recently approved them as prescription treatments.  They have cleared the very tough standards of the FDA, they are very safe as far as we can reasonably tell, and they are working well.

Because of their patented and prescription status, they are fairly expensive and most only available legally at vets, but they are really great compared to anything else.

I've written a short summary of the products available for flea and tick control below.
For more information, please go to our page about flea and tick control products.

This once a month, chewable tablet is a very good product... not very expensive....rarely any side effects.... and works great at controlling intestinal worms, preventing heartworms... and does a pretty good job at controlling fleas.  It controls fleas by making the females sterile.

Also made by Novartis, this new tablet is extremely inexpensive, very effective (95-100% kill of all adult fleas within a few hours) and safe even for young kittens and puppies.  It was designed to be given along with Sentinel or Program until those products had time to kick in.

What's the catch?  Capstar is metabolized and excreted from the body in about a day.  So quick, great, safe, inexpensive, flea control; but only for a day.  

This is a great product for short term use along with Sentinel as it was intended...but also great for when you've just found or bought a pet or are taking a pet to a new home or for boarding to prevent transfer of fleas.

Advantage:  This is a fine product, but I stopped selling it because I think Frontline works even better.  Other Vets disagree.  Perhaps it's like fighting over whether or not Ford or Chevy makes the best trucks.  I will say that on the occasions when Frontline hasn't worked well (probably because it failed to bond to the pet's skin well), Advantage has worked fine...and vice versa.  2014 update; I am getting more and more feedback/complaints that both Advantage and Frontline are no longer controlling fleas as well as in past years.

Frontline "TopSpot" Plus:
Probably the most effective repellent and killer of adult fleas and ticks for 3-5 weeks available.  Safety to mammals is excellent.

No baths for 2 days before or after applying Frontline Plus or it won't bond to the skin as well.  This is a nuisance if you're treating a pet with infected or inflamed skin with medicated baths.
2014 update:  Frontline Plus continues to be one of the best products available for tick control but the fleas in our Southeast region of the country seem to be getting resistant..... more and more of my exam notes say "fleas found despite owner recently applying  Frontline (or Advantage)".

Another update, 2014: "Generic" Frontline is now available at Walmart's, on the Internet and so forth.  Much less expensive than the name brand Frontline Plus, and it contains the same active ingredient that kills fleas, which is fipronil.  The packaging, of course, says compare to Frontline and "Why pay more?".     LIAR
What the knock off brands DON'T contain is the patented microencapsulation binding technology that makes the fipronil stick to the skin for weeks at a time without causing skin irritation.

The original Revolution does a fair job of controlling fleas and ticks.  The new Revolution Plus now available for cats does a great job of controlling fleas and ticks.

It kills and prevents heartworm disease...eliminating the need for other heartworm prevention.  

It does a fair job of killing Ticks.

It kills ear mites and sarcoptic mange mites fairly well.  

It controls intestinal worms in cats and helps a little with control in dogs. 

It is extremely safe, even for young kittens.  Revolution is applied to the back of the neck, just like Frontline, except it's a systemic medication and doesn't rely on sticking to the skin.  Bathing, swimming, or scrubbing doesn't affect Revolution.
Pfizer makes Revolution
​I used to use Revolution on my own dogs with great results but as the fleas have become more and more resistant, I now use NexGard.

Combining Frontline, Revolution, Sentinel, or Capstar
Speaking of overwhelming flea problems, it sometimes help to combine 2 or 3 of the products discussed above for a short period until the problem is under control.  It's safe to do this.

Shampoos, Mousse, and Sprays:
I'm a big believer in the benefits of frequent shampooing with the new moisturizing shampoos for dog skin conditioning and for treating various skin conditions.

But shampooing alone is usually ineffective at controlling all but mild flea problems.  

Fleas have become highly resistant to most sprays and mousses, although most permethrin or allethrin sprays are working well for very short periods.  And two brands work exceptionally well, but they're expensive:
KnockOut Dog spray works well for about a week at a time.
And Frontline spray works great for a month ... the same as Frontline Plus topical drops.

Flea & Tick Collars:
A few brands of collars (especially Preventic Collars) are working fairly well for ticks, but I have yet to find one that consistently controls fleas well.  I rate them as fairly ineffective.  

What about The stuff you can get at Walmart:

As soon as Frontline TopSpot and Advantage hit the market a couple of years ago, and it was obvious that they were working really well, pet product companies changed their packaging to look and sound like Frontline or Advantage.    All these look or sound alike products are applied to the back of the neck like Frontline and Advantage and all come with sales pitches along the lines of why spend twice as much at the vet when this is just like the stuff they sell.  Well, it is just like it except for the active ingredient that does the work!

Almost everyone knows how difficult and expensive it is to get a new chemical product through FDA and on the market in the U.S.  It has to be proven both safe and effective.

But what people don't know is that once a product is on the market, the FDA is pretty quick to remove stuff that turns out to be unsafe (actually, it's usually pulled first by the manufacture fearful of possible lawsuits), but not much is removed just because it's become ineffective.  

And that's what has happened with many flea control products.  The labels that say effective against fleas etc don't say that was back in 1959.  Or effective against laboratory fleas raised in Alaska..not our native Southeastern Flea.   HooBoy.

This is the same problem with believing labels for dewormers, other parasite medicines and pesticides, and in fact, many medicines.

And the Safety Question:  We've had several very sick cats in our clinic due to the application of over the counter topical pesticides meant for dogs...cats are much more sensitive as a rule to pesticides.

Combing & Grooming: 
-Helps a lot with the general health of the skin; no small benefit.

-Helps you to have an intimate familiarity with your pet's skin condition; if you're grooming and combing your pet regularly, you'll spot a parasite problem early.

-It allows the early spotting and removal of ticks

-Grooming and combing usually makes your pet feel much better.

-And regular combing helps maintain your pecking order status as master which helps maintain your pet's sanity.  Have you ever noticed that...dogs who think they're humans tend to become neurotic head cases.  As for cats...

So; grooming and combing is great.  

But not very effective at controlling an established flea problem.  I know there's a certain satisfaction in squishing fleas as you comb them out.  But remember that the adult fleas that you kill represent only the tip of the iceberg...for every adult you kill, there are thousands of larvae and hundreds of thousands of eggs.

This same principle is why flea traps don't work.   Yes, you can attract fleas to jump into a vibrating or hot pan of water, but so what?, you still have a major flea problem.

So, if your pet has anything but a brand new or very minor flea problem; quit dinking around.  Go to your vet and take advantage of the new products listed on your left that work so well.

On This Page:

The products we recommend for the control of fleas, ticks, and other skin parasites

More About Other Parasites on Other Pages:

Intestinal Worms and other intestinal parasites 

Heartworms and other parasites of the blood 

We treat several pets a day for parasite problems.

And at least one case a week of nearly dead pets due to hook worms or whip worms.

And at least 8 cases a month of heartworm disease.

And at least 2 cases a day of ear mites.

And at least 2 cases a day of skin or ear infections associated with allergies to fleas

Then there's the potential problem of pets transmitting intestinal worms to people... especially children ...

Then there's the uncomfortable problem of home infestation and yard.

Parasite control is
Important !

Choose a product that best fits your needs.

Newer Products:

NexGard: 100% control of fleas and nearly 100% control of ticks. 
This is brand new in 2013 with a brand new active ingredient that fleas and ticks are not resistant too.  So super effective.
Highly flavored chewable, once a month treat without nausea (rarely) unlike Comfortis and Trifexis, the 2 other new and super effective products that became available lately.
Negative comments: Expensive (about $20 per month), only kills fleas and ticks.... you will need a separate product for heartworm and intestinal worm control

NexGard is my number one recommendation for flea and tick control in dogs.

Revolution Plus.  New Feb 2019 and my munber one recommendation for parasite control in cats.  Revolution Plus now has sarolaner which is a new generation of extremely safe and effective pesticides (NexGard also contains one of these new generation pesticides).  Revultion Plus... only available for cats at present... is simple to apply...just a few drops on the neck once a month... and now gives cats protection from heartworms, intestinal worms, ear mites, ticks  (including those that carry Lymes disease) and fleas.  Near perfect control of fleas.

Comfortis: 100% control of Fleas for at least a month. Comfortis is a chewable once a month tablet.  Super safe and super effective.  Approved for both Cats and Dogs.  Spinosad is the active ingredient in Comfortis.  Spinosad is derived from a naturally-occurring soil microbe and is considered a "GREEN" pesticide.
Negative comments: Expensive (about $18 per month), only kills fleas.... you will need a separate product for heartworm and intestinal worm control... and a fair number of pets experience a little nausea after administration, especially if given on an empty stomach.
Does not kill ticks.

Trifexis:  Made by Eli Lilly; the same company that makes Comfortis.  Trifexis has the same Spinosad ingredient as Comfortis PLUS milbemycin, the active ingredient in Intecepter, so it also safely and effectively treats and controls intestinal worms and heartworms.  Not yet approved for cats.
Negative comments: Expensive (about $22 per month), and like Comfortis, a fair number of pets experience a little nausea after administration, especially if given on an empty stomach.
Does not kill ticks.
Not officially approved for cats

AdvantageMulti:  I've stopped selling this product because I'm getting too many complaints that it's not working well on flea control any more.  (I'm getting similar complaints about Frontline)


The type of ticks we deal with most often in pet medicine are various types of so-called "hard" ticks and each of the different species and subspecies have similar life cycles.  Adults, which can live for over a year, lay up to 8000 eggs on moist ground.  The eggs hatch in 2-7 weeks.  

The larvae (seed ticks) , which cling to tall grass or low bushes attach themselves to passing pets or other small mammals and feed for several days.  Then they fall off and rest for 6-90 days depending on weather conditions etc.  

After molting into nymphs they again attach themselves to the nearest mammal that walks by and feed again for several days.  Then they fall off and rest for another 3-15 weeks. 

Finally, they molt again into adults that attach themselves again to the most convenient mammal, have sex, feast on blood, and start laying eggs again.

None of this information is likely to help you much other than to know that any place with damp soil, long grass, or low bushes could harbor thousands of seed ticks, nymphs, and adult ticks waiting to attach themselves to you or your pets.  

Spraying such areas with yard pesticides help, but resistance is a problem.  

Resistance is also a problem with the majority of topical sprays , dips, and collars claiming to solve your tick problem.  

Preventic Brand collars seem to work better than any others I've tried, but only for 3-5 weeks in our area of the country...not the up to 3 months on the label.

Our best products for 
tick control:

NexGard for dogs

Revoution Plus for cats

Notice the pyramid graph below:

Flea products that work well either kill adult fleas so fast and so well that eggs aren't laid (products that do this include NexGard, Comfortis, and Trifexis)

Or.... they stop the eggs from developing.  Products that do this well are Sentinel and Revolution.

Most products fall short

Another lesson to learn from this graph; you can't wait until you see adult fleas to start flea control.