Vet hospital bugged by missing info in recent flea medication article

Scanning Electron Microscope (SEM) image
of a flea from the Australian Museum

Many clients have had questions about flea medications lately. A recent memorandum from the Nova Scotia Veterinary Medical Association (NSVMA) has caused a lot of discussion. The article is rather erroneously titled "Vets bugged about rule for prescribing flea medication". I can't speak for the entire veterinary industry, but many of us are not “bugged” by these rules at all. Rather, we are bugged by the important facts that seem to be missing from this article.

1. Health Canada determines what drugs may be sold for use in Canada, both for humans and for animals. Health Canada also determines which drugs may be sold over-the-counter (OTC) and which must be sold by prescription from a doctor or veterinarian. Medications are classified as prescription medications for the patient's safety: serious, and even fatal, complications can arise from using prescription medications for a case where the patient's medical history would indicate that the medication would not be safe to use.
2. The NSVMA provides the bylaws that govern the practice of veterinary medicine in Nova Scotia and licenses all veterinarians and veterinary hospitals for practice in the province. The bylaws concerning prescriptions apply to all prescription medications, whether for fleas or for heart disease. As Health Canada determines which medications are prescription, the NSVMA can not pick and choose which medications will fall under the scope of the bylaws: all prescription medications must be treated equally.
3. Most (if not all) flea medications that treat fleas only (and do not treat worms) are OTC. These products include Advantage, Program, and Capstar. They can be sold without a prescription from a veterinarian, and can be sold for use in animals who are not patients of the veterinary hospital.
4. Medications that prevent heartworm, in addition to treating fleas and intestinal parasites, are prescription medications. These medications include Sentinel, Revolution, and Advantage Multi. Heartworm are parasites that live in the heart and lungs of animals. They are transmitted by mosquitoes. Heartworm preventative medication kills the microfilaria, which are the tiny pre-adult form of the parasite that are transmitted by mosquitoes. After entering the host animal, the microfilaria travel to the heart and lungs where they grow into adult heartworm. Preventative medications kill the microfilaria before they can become adult heartworms. Patients who already have heartworm should not be given preventative medication as this does not treat the adult worm. Use of preventative medication in animals who already have heartworm can cause the patient to die.
5. What does this mean for our clients? As the regulations are not new, there will be no change to the way we dispense flea and worm medication at Acres. Patients who have been examined in the past 12 months, including for vaccinations, will be assessed by the veterinarian at the time of the examination. If the patient is in good health, the patient's prescription for flea and heartworm medication will be renewed. The medication can then be dispensed at any time in the next 12 months. For patients who have never been on a heartworm preventative medication, a heartworm test may be recommended to ensure that the patient does not have heartworm.

If you have any questions or concerns about your pet's flea and heartworm medication, give us a call and we will be glad to answer your questions.