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No, this is no advertisement for Advantage and its familiars. This is the truth and consequences of fleas on pets—even indoor pets, as this case will prove.

Dingleberry (so named for his long fur’s talent for capturing stray fecal balls in the litterbox) was a beautiful black Persian cat we’d occasionally undertake to anesthetically groom (he wouldn’t have it any other way and his fur required more attention than he would deign to permit). But when I saw Dingleberry for the first time this year I was appalled at his condition.

“What happened to him?” I asked (perhaps indelicately), believing his owner might have a better clue as to his state than I would.
“I don’t know,” she explained, “A few days ago he just stopped acting like himself and now he only picks at his food.”
(A few days…?)

Dingleberry had lost almost 30% of his body weight. His fur, once puff-ball black, had faded to a brittle copper in odd patches. What’s more, he had that depressed, hang-dog look about him (if any cat can be said to look so).

On closer inspection, his gums were pale, ashy and sticky, the skin of his scruff stuck straight up when tented (a sign of dehydration to match his dry mouth), and fleas riddled the surface of his skin once his fur was parted.

Now, Dingleberry’s mom is an ordinarily conscientious person with a bit of an anti-chemical streak about her—and I can’t really blame her for that. After all, I tend to pass on chemicals, too—whenever possible. This wasn’t one of these times. I popped little, emaciated Dingle a Capstar just before drawing just enough blood to run basic tests (I didn’t want to take even one drop more than I had to).

Dinglebery had been bled dry by the fleas—right under his mom’s nose. Of course she knew he had fleas—but she had no earthly idea how many (since he doesn’t allow his fur to be manipulated in any way). How she missed his dramatic deterioration before a few days ago is a whole other issue…

Before the day was out, Dingleberry had received a blood transfusion, fluids, antibiotics (he also had a urinary tract infection) and multiple, careful rounds of flea-picking. The Capstar had done its job but not quickly enough for me. I didn’t want even one flea to undo any of our work with its vampiric mouthparts.

Dingle may well need another transfusion. He’ll be with us at least a few more days. After that, he’ll be going home with some Advantage and a lifetime supply of iron-supplemented vitamins.

As I said before, I eschew chemicals whenever possible, but not at the expense of my patients’ lives. In Florida, even indoor pets like Dingleberry are at risk of flea infestation and life-threatening anemia—especially given that we consider our screened-in patios “indoors.”

Fleas are dastardly and wily and our pets’ natural defenses are no match for their collective bloodlust. And while few infestations are ever as severe as Dingle’s, years of untreated, low-level flea exposure can be chronically taxing. So consider this cautionary tale next time you turn up your nose at a preventative. Unless you can examine your pets thoroughly and ensure they’re truly flea-free, prevention is your best bet.

Comments
Is there a reason you prefer Advantage over Heartguard and Frontline? I currently use the latter. Please provide some insight. We trust you!
Thanks.
# Posted By Kelly | 8/1/07 1:46 PM
The good old days before topical flea treaments-NOT!
Even when I combed every single day the elderly and sick cat was flea ridden. No safe herbal powder did anything to the fleas either. So since he loved to sleep beside me in bed-and the fleas loved to crawl on me-he slept in a pillowcase. It did keep the fleas off me-it just didn't help much with the hyperthesia seizures caused by the itchy fleas.

And Advantage keeps the fleas off the other hyperthesiac(is that even a word?) cat so he won't have seizures. All in all-those are chemicals I love!
# Posted By heather | 8/1/07 1:52 PM
Advantage and Frontline are basically interchangeable and may times I'll alternate from one to another when I suspect resistance. My only preference with Advantage is that it always stays on the surface and isn't absorbed by the skin at any point. Not that this is any less of an indication of potential toxicity (I haven't heard of any with either preventative) it's just that for some reason it makes me feel better. Not a good reason, I know but it's mine. Some animals just don't respond well to one or the other and then I switch around (such as salivation with cats that smell Advantage and go nutso). Revolution is my absolute favorite for outdoor or indoor/outdoor cats (because we see so much heartworm disease in these parts) but it's no match for a severe infestation. Capstar works great in pets with flea allergies or to get rid of an infestation quickly. I usually use it along with the other meds--sometimes as often as every other day or for just a few days in a row.

Hope this helps!
# Posted By Dr. Patty Khuly | 8/1/07 4:44 PM
Dr Patty, Would you care to comment on the use of Sevin Dust to combat fleas and ticks? I lived a number of years in Dallas, Tx where they are a year round problem and the use of Sevin Dust was recommended by my vet. I used it (sparingly) on both dogs and cats, and never had a problem with either of the pesky little devils, nor did it seem to any of my pets any damage...all lived long, healthy lives. In fact, the canister even gives directions for use on domestic pets, although most people don't seem to know about it when I tell them. I have used it on my dogs here in Minnesota, but only in the summer when there could be a problem. My neighbor's dog gets ticks...but if they come through the fence to my yard they sure don't bother my dogs. Have you had any experience with this? Mari Lynn
# Posted By Mari Lynn | 8/1/07 9:08 PM
"Advantage and Frontline are basically interchangeable...."

I'll preface this by saying I know zip about cats. With that out of the way, and in the interest of accuracy, since you know this but others may not, Advantage and Frontline are not interchangeable. Advantage is for fleas only, Frontline is a preventive for fleas and the much more dangerous tick.

I have to ask, why is your absolute favorite Revolution if you prefer Advantage over Frontline because "it stays on the surface and isn't absorbed by the skin at any point"? Traces of fipronil (Frontline) have only been found in the urine of lab animals used for LD50 tests and fed large amounts of the stuff or soaked in it. And unless I am mistaken, Revolution must be absorbed by the skin and go into the blood to control worms, including heartworm.

At any rate, both Advantage (for fleas) and Frontline (for fleas and ticks) carry far fewer cautions on side effects than Revolution and both work in exactly the same way, pooling in the sebaceous glands to spread over the animal much as oil spreads over a warm engine, continuing to spread as fur grows from those glands and carries the preventive up with it. No difference there that I can see in the way these two work.

So, what is the attraction of Revolution? Is it just that it's a jack of all trades and more convenient for clients who can't be bothered to use both a flea/tick preventive and Heartgard or something similar?

Frankly, nobody is going to get rid of fleas simply by using a preventive. Considering that fleas live most of their lives 'off' the dog (or cat) and reproduce like mad in any crack or crevice, you have to get the fleas out of the environment, too. Rx for Fleas (Fleabusters) does a bang-up job of that.
# Posted By Gil. | 8/2/07 5:08 AM
I live in FL also. I agree it is good to rotate chemicals to prevent resistance, I haven't found that Frontline does a very good job at controlling fleas. Advantage always works, Frontline rarely. Other people seem to complain about the same thing in FL.
# Posted By CathyA | 8/2/07 7:24 AM
Dr, Khuly,
You say you haven't heard of a reaction to either Advantage or Frontline? My holistic vet cautioned me never to use Frontline on my boston terrier, because she has seen MANY reactions to it, some of which were death. Now maybe those dogs were compromised in another way, but still, none-the-less, it's a reaction. She especially warned me never to use it in my 3 year old dog because he has slightly compromised kidneys. Any thoughts on this?
# Posted By Tara | 8/2/07 10:10 AM
Ewww! I remember having to help with the whole transfusion thing with pets that were anemic from fleas and ticks.

One client that sticks out in my mind had two Golden Retrievers. Between the two of them, I picked off well over 100 ticks and I was nowhere near being done before the animals were admitted for a series of baths, being shaved down, ect.

What was bizarre about this client is that she insisted that because she lived in a wooded area, her pets were safe from fleas and ticks. When she got a well deserved speech about deer ticks, Lyme Disease and all of that, she had the nerve to look as though somebody stuck a cat turd under her nose.

I also have a anti-chemical streak about me and I won't use them unless I have to. I won't even use bug killer out in the yard unless the said bugs are a threat, like the wasps nest we had to do something with last night as it was right next to the back door. My son has never been stung and we do have Epi-pens in the house, but it wasn't worth the risk. For all other insects that like to attack certain plants in the gardens, I use Neem Oil, so putting stuff on the animals that is considered toxic really isn't my thing.

We haven't had any flea or tick problems for 9 or so years, so I won't put stuff on them just in the name of doing so. Taz hates being outside and my cats are strictly indoors. All of them are groomed regularly so if there ever should be a problem, it will be caught before turns into a issue.

Now I'm itchy from reading and posting about bugs...
# Posted By Stacy | 8/2/07 10:30 AM
And by the way, whoever puts out Advantix really needs to get more information out!

I've run into more people online that either have used it on their cats or are thinking about it. It isn't until somebody stumbles across these posts reminding them that pyrethrin is toxic to cats that these people snap out of their so-called brillant idea of how to handle flea and tick problems.
# Posted By Stacy | 8/2/07 10:34 AM
"...whoever puts out Advantix really needs to get more information out!"

There are warnings on the label about using Advantix on cats or even 'around' cats, there are warnings on the websites where you buy it online. What more should Bayer do? Send a rep to slap a potential buyer's hand before she picks it up and uses it without reading a word?

"My holistic vet cautioned me never to use Frontline on my boston terrier, because she has seen MANY reactions to it, some of which were death. Now maybe those dogs were compromised in another way, but still, none-the-less, it's a reaction."

The only reaction to Frontline I've ever heard of that can be linked without question to the product is something akin to a burn on the skin which shows up within a day after application. Can't miss it but while it's painful, it's not lethal. In a decade of reading about and discussing this topic, I've only known of it happening 3 times. I'd suggest that this vet is reaching just a tad if she blames the death of a dog which was "compromised in another way" on a topical tick preventive.

If dogs actually are dropping like flies from its use, all the more reason for a national veterinary database and a setup like the FDA has for adverse drug experiences where reports can be considered and confirmed, marked questionable or labelled as without foundation. The EPA sure isn't providing it.
# Posted By Gil. | 8/2/07 11:04 AM
There are warnings on the label about using Advantix on cats or even 'around' cats, there are warnings on the websites where you buy it online. What more should Bayer do? Send a rep to slap a potential buyer's hand before she picks it up and uses it without reading a word?

So are you with thge drug companies, against the drug companies, or sitting on the fence?

All sarcasm aside, perhaps owners with multi-pet households should be more informed by the vets about this stuff and sent home with info regarding pyrethrin and the problems it can cause when used on or near their pets.
# Posted By Stacy | 8/2/07 11:42 AM
"So are you with the drug companies, against the drug companies, or sitting on the fence?"

Oh, I'm with them, absolutely, having lost a dog to tick-borne disease. If you want to go through hell, try that.

"All sarcasm aside, perhaps owners with multi-pet households should be more informed by the vets about this stuff and sent home with info regarding pyrethrin and the problems it can cause when used on or near their pets."

That would be nice if most people bought their flea and tick preventives from pets. Do you think they do? Or do they grab them off the shelf in a grocery store?
# Posted By Gil. | 8/2/07 12:03 PM
That should have read "buy them from vets". In case you didn't know.
# Posted By Gil. | 8/2/07 12:09 PM
Most people I know buy all their stuff from PetMeds.com, although I've seen my share of ferrets and cats that have been posisoned by so-called "safe products" purchased from a vets office. Just as I've seen animals poisoned by the stuff from the grocery store.

I'm happy to hear that you support the drug companies. They must make money too after all even though they don't always reveal the facts....
# Posted By Stacy | 8/2/07 1:20 PM
Okay, Stacy, Gil tried, now I'll try: What do you want Bayer to do? Please, be specific. There are warnings on the package, there are warnings on the websites that sell it. You seem to agree that most people aren't buying it from their vets, so that route is out for at least a substantial proportion of their customers.

What, exactly, do you want Bayer to do, that they are not currently doing, to warn cat owners, and especially people who own both dogs and cats, about the dangers of using Advantix on cats?
# Posted By Lis | 8/2/07 1:33 PM
Stacey,
I think its only fair that people take some responsibility for reading the packages before dosing their pets. Bayer manufacturers Advantix for dogs not cats. It says that clearly on the package. What else can they be expected to do?

Comparitively speaking, would you use a new medication without reading to check the proper dosage for yourself?
# Posted By Stacey | 8/2/07 1:56 PM
I really have to agree that Bayer should not be held responsible for people using Advantix on their cats. It says in big capital letters on the front NOT FOR USE IN CATS. And for the illiterate, there's even a big picture of a dog on the package. All of these new-ish flea meds make life much more comfortable for many thousands of pets out there (not to mention their owners) and they really do have excellent safety profiles when used properly. Their makers shouldn't be held responsible for the actions of people too lazy to read the directions.
# Posted By abc | 8/2/07 4:23 PM
Gil: Peraps I overstated. Advantage and Frontline are not exactly interchangeable...I was referring to their efficacy against fleas. I retract. As to their absorption, I checked again today with my Bayer rep and was reassured that it is not absorbed by the skin. I agree that this may not give you any reason to believe it's any safer but... As to my issue with Revolution: I believe the additional risks are acceptable for cats who spend a significant percentage of their time out of doors. That's because of its added benefits in preventing mange, earmites, intestinal parasites and heartworms. Most indoor cats needn't run the risk of those side effects, I'd agree.
# Posted By Dr. Patty Khuly | 8/2/07 9:12 PM
By the way, I'd heartily agree that FleaBusters is an excellent serive and that anyone using Borax powder (FleaBuster's primary ingredient) to control fleas in their environment is right on target. This stuff works and if it keeps fleas off your pets without the use of chemicals, all the better. You go, 20-mule team!
# Posted By Dr. Patty Khuly | 8/2/07 9:15 PM
Every time we sell a box of Advantix, our staff is trained to ask whether cats are in the household and if so, whether they make close contact with the dogs. They are indeed warned of the dangers. I'd like to think a lot of vets do this. The last thing we want to see is a bad reaction to any medication when it could have been easily prevented. The box's label does *prominently* state that it is not to be used on cats but because so many of these products have been viewed as multi-species safe in the past, it's worthwhile to check with owners. That's one defensible reason for having vets--not supermarkets--sell these products.
# Posted By Dr. Patty Khuly | 8/3/07 11:01 AM
"As to their absorption, I checked again today with my Bayer rep and was reassured that it is not absorbed by the skin. I agree that this may not give you any reason to believe it's any safer but..."

Wrong rep. <g> My point was that Frontline is just as safe as Advantage unless you pour a gallon of it down your dog. Believe me, I've waded through the MSDS and all the info on the LD50 tests, not altogether trusting Merial's customer reps to have a clue, which may not be fair to them since they've generally been honest with me, but as you say, "but...".
# Posted By Gil. | 8/3/07 1:26 PM
.Not sure how active this website is, but I just have a question if anyone can answer ASAP.
I just got a 4 year old Siamese Cat from a gal on craigslist. He has fleas and earmites, smells weird, and was drooling excessively when I first brought him in my home. I immediately gave him a dose of Revolution. Then about 6 hours later, I gave him one Capstar. He is also hunching down like he is trying to cough up a hair ball, but it is a very quiet coughing sound, and he does not meow......non-vocal!! I can hardly believe this in a Siamese, as that is the only breed I have had all my life. He is VERY affectionate and sweet, and he has jumped up on my lap and extends his paw out to me like he is wanting to be closer to me. He also loves to be held and likes riding on my shoulder.
My main concern is giving him the Revolution AND Capstar in the same day.
Thanks~L.P.
# Posted By Lynda Johnson | 12/8/07 3:08 AM
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