Puppy

• Simparica Trio Chewable Tablets is the only broad spectrum single preventative and thus our Tier 1 recommendation. Simparica Trio provides protection from fleas (kills adult fleas and the eggs after they hatch), ticks, heartworm, hookworms and roundworms.

• In case of known sensitivity to Simparica Trio, the recommended alternative is a combination of Interceptor Plus (puppies 6 weeks of age and older) and Credelio (puppies 8 weeks of age and older). This combination provides protection from fleas, ticks, heartworm, hookworms, roundworms, whipworms and tapeworms.

• For pets previously positive for whipworm, the combination of Interceptor Plus and Credelio should be recommended. This is due to its high pathogenicity and ability to stay in the ground for a long period of time.

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Parasiticides Comparison

Companion Animal Parasite Council (CAPC) Data

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Raw food diets

The AVMA and AAHA discourage the feeding of raw animal-source protein due to the high risk of illness to both pets and humans. Pathogens found in raw protein diets can be transmitted to the human population by contact with the food, pet, or environmental surfaces.

• https://www.aaha.org/about-aaha/aaha-position-statements/raw-protein-diet/
• https://www.avma.org/raw-pet-foods-and-avmas-policy-faq

Neutering/Spaying

Neutering is associated with a prolonged life expectancy for both sexes compared to their entire
counterparts. This has been reported in multiple studies. In female dogs, neutering reduces or
eliminates the risk of pyometra, a potentially life-threatening condition. Neutering is linked to a
reduced risk of cancer of reproductive organs and heart disease, but an increased risk of joint
disorders and some cancers (lymphoma and hemangiosarcoma) especially in females. [1,2]

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Breed Associated Health Risks [1-4]

Health risks by breed can be found at https://www.akc.org/ under the Health link on each breed information page. A handful of larges cale publications on breed related mortality are available.

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Brachycephalic (short nosed) breeds

Brachycephalic breeds (French Bulldog, English Bulldog, Pug, and American Bulldog) are predispositions to life-limiting disorders that occur early in life, such as brachycephalic obstructive airway syndrome (BUAS), spinal disease, and dystocia.
Brachycephalic breeds should avoid high temperatures, overexertion, and over-conditioning (obesity). Harnesses rather than collars should be used for leash walks. Pre-emptive surgical intervention to improve upper airway conformation should be recommended before a respiratory crisis occurs.

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Deep chested, large and giant breed dogs

Deep chested, large breed dogs (Great Danes, Weimaraners, St. Bernards, Irish setters, Gordon
setters...) are predisposed gastric dilation volvulus (GDV). Pre-emptive gastropexy should be
recommended to reduce the GDV. Feed more than one meal a day and select a dog food with a
low fat and oil content.

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Chondrodystrophic breeds

Chondrodystrophic breeds (Dachshund, Pekinese, Beagle, Lhasa Apso) are pre-disposed to
intervertebral disk disease (IVDD). Avoid over-feeding and obesity. Use a harness rather than a
collar for leash walks. Avoid high impact activities like jumping on and off furniture, consider the
use of portable pet stairs.

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Congenital cardiovascular disease [5,6]

Many breeds are predisposed to congenital heart disease. If a murmur or arrhythmia is
detected on annual physical exam, a thoracic radiograph or EKG should be pursued. If these are
abnormal, a cardiology referral is recommended. [6, open access journal with helpful diagnostic
flow chart]

• Aortic Stenosis: Boxers, Golden Retrievers, Rottweilers, German Shepherds, Newfoundlands
• Pulmonic Stenosis: Boston terriers, Boxers, English Bulldogs, French Bulldogs, Boykin
  Spaniels, Jack Russell Terriers, Keeshonds, terriers
• Patent Ductus Arteriosus (PDA): Small breed dogs, German Shepherds, Newfoundland
• Ventricular Septal Defect (VSD): English Springer Spaniels

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Congenital kidney disease

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• Renal dysplasia: Alaskan Malamutes, Bedlington Terriers, Chow Chows, Cocker Spaniels, Doberman Pinschers, Keeshonden, Lhasa Apsos, Miniature Schnauzers, Norwegian Elkhounds, Samoyeds, Shih Tzus, Soft-coated Wheaten Terriers, and Standard Poodles o Usually diagnosed via renal ultrasound imaging in juveniles in conjunction with azotemia, isosthenuria.
• Polycystic kidney disease: Beagles, Bull Terriers, Cairn Terriers, and West Highland White Terrier
  Diagnosis is usually made via renal ultrasound in juveniles

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Congenital hepatobiliary disease including vascular anomalies

• Ductal plate malformations: Boxers
• Portosystemic vascular malformations (Extravascular portosystemic shunts): Small and Toy breeds (Bichon Frise, Border terriers, Maltese, Yorkshire terriers, Cairn terriers, Havanese, Miniature schnauzer, Silky terriers) should be screened for congenital portosystemic vascular malformations. Large breed dogs (Labrador retrievers, Siberian Husky) occasionally have intrahepatic portosystemic shunts.
  
  If a paired serum bile acids test is abnormal, submit a protein C level to Cornell Coagulation Laboratory. A protein C less than 70% is consistent with a portosystemic shunt, between 70-99% is in the grey zone, and a value greater than 100% is normal, consistent with microvascular dysplasia. Dogs with a portosystemic shunt should be started on medical management (modified protein diet (Hill’s l/d orRoyal Canin Hepatic, lactulose, and gut flora modulation). A CT angiogram will be needed if surgical shunt attenuation will be pursued or to definitively diagnose dogs in the grey zone. No therapy is needed for dogs with microvascular dysplasia.