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Ask Your Vet: Fleas- Prevention & Treatment by Stefanie Wong, DVM
June 28, 2016

A few years ago, I had a 5 week old kitten come in to the hospital, presenting for difficulty breathing, white gums, no interest in eating and being lethargic. A day prior, the kitten had been found covered in fleas – so many that its white coat had appeared black.

They had given the kitten a flea bath but there were still a significant amount of fleas. We measured the kitten’s red blood cell count and it was extremely low. Normal PCV (packed cell volume) in a kitten sits around 26%; this kitten had a PCV of 7%. He was barely hanging on.


Needless to say, flea prevention is extremely important. When you look at your options for flea preventatives, there are numerous options to choose from. I will now go over the flea preventives that we recommend at Bishop Ranch Veterinary Center and the differences between them.


Types of flea preventatives

These simply can be divided into topical (placing a vial of liquid onto the skin) and oral (giving a pill).


The topical products that we often reach for with flea prevention are Frontline or Advantage. (Note: if you want flea AND tick prevention, you should be reaching for Frontline Plus or Advantix – it is important to highlight here that the flea/tick products are for dogs only – do not give these to cats as they are toxic to them!).


We also have oral flea prevention. Oral flea preventatives include Comfortis (flea prevention only), Trifexis (flea and heartworm prevention) and Bravecto (flea and tick prevention). Unfortunately, we do not yet have an oral product that provides all 3 (flea, tick and heartworm).


All of the above products are given monthly, with the exception of Bravecto, which is one dose every 3 months.


Why choose oral flea prevention over topical?

  • To be completely honest, oral flea preventatives are simply more effective. Frontline has been on the market for many years at this point – in some cases where dogs live in “flea heavy” areas, we are seeing flea resistance to the product
  • We have some dogs (and cats!) that have Flea Allergy Dermatitis. These pets are exceptionally sensitive to fleas. Just a single flea bite will cause them to be extremely itchy and uncomfortable, break out into bumps all over their body and get a skin infection (often centered over the hind end/tail where fleas like to bite).
  • Owners with young children often have concerns with topical products
  • We have some pets who don’t like the application of the liquid but will happily take down the pills (which are often beef flavored – some dogs will take them as treats)


How do I tell if my pet has fleas?

  • You may see flea dirt (little black specks) – if you pick up some of this and place it on a towel or other white surface and add some water, you’ll see those specks turn red (flea dirt is dried blood).
  • You or members of your family may start getting flea bites.
  • If you flea comb your pet or part the hair in several different areas you may see a flea crawling across their skin (you will not be able to see them if you don’t get down to the skin level).


What do I do if my pet already has fleas?

If your pet is not on a flea preventative, the first thing to do is to start one of these. If they are on a topical, your options are: switch to oral flea prevention or you can try giving the topical more frequently (every 3 weeks instead of every 4).


Environmental control is the most important. Wash all the bedding that your pet lays on and vacuum frequently (stick a flea collar in the vacuum receptacle so that fleas that enter will die). Fleas love to hide in dark places so make sure you vacuum under and behind the couch, under the table, etc.


So how did it all turn out?

We placed the kitten in oxygen, gave a medication called Capstar to kill the live fleas on him and then got ready to start a blood transfusion.  Halfway through the blood transfusion the kitten (who at the beginning was barely responsive, laying on his side and working to breathe) – started sitting up and meowing. The next day he was doing great – he was eating vigorously, purring and wanting to play!


Thankfully, we do not see life-threatening flea anemia happen often. This case does however highlight the importance of flea prevention!


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