Flea, tick and heartworm prevention may be part of a DVM’s regimen, but lack of client education is contributing to an increased number of potentially zoonotic disease carriers in the U.S., parasitology experts say. “There’s not enough aware- ness of the significance of the problem,” says Michael Paul, DVM, executive director of the Companion Animal Parasite Council (CAPC), an independent group established five years ago to create guidelines for optimal control of internal and external parasites. “Heartworm, for example, is essentially 100 percent preventable, yet 250,000 cases of the disease are diagnosed a year.” Though heartworm doesn’t endanger humans, the parasite continues to be a major threat to canine and feline wellness. Studies show that lack of parasite prevention efficacy isn’t the issue–rather, it is awareness and compliance. “When only 50 percent of animals whose owners provide veterinary care are on prevention and 25 percent of the population as a whole is making a prevention attempt, the impact is drastically affected,” Dr. Paul says. “It’s along the same vein as people who continue to smoke or don’t wear their seat belt. They are in denial they will be affected.” Where Danger Lies Animals venturing outdoors are hypothetically at a higher risk, but the only way to eliminate that risk is through prevention. “Vets don’t want to spend their clients’ money when they believe their geographic area isn’t desirable to the vectors,” Paul says. “But veterinarians shouldn’t make assumptions about clients’ willingness to pay for any service or medication. If you educate clients to your best ability and they choose not to use parasite prevention, you have still done your job. If you haven’t been persistent or informed them of risks, you have not.” Experts say prevention has to be a priority to veterinarians before it will appear to be important to clients. The CAPC initiated its current parasite awareness campaign June 27 in Denver. The council’s goals are to cater to the veterinary audience, but technicians and owners are the focus this year. The council’s website, CAPCvet.org, offers a wealth of parasite prevention information and in the fall will map reported diagnosed cases by municipality. This information will reveal areas in which veterinarians are not testing for disease and, according to Paul, vets will be shocked with where diseases are popping up. Joining Forces In 2008, the council and the federal Centers for Disease Control and Prevention (CDC) in Atlanta united to bridge gaps in knowledge between human and animal parasite prevention. “We learned that there isn’t a good diagnostic parasite test or data for people,” says Susan Montgomery, DVM, MPH, a veterinary medical officer in the CDC’s Division of Parasitic Diseases. “Many veterinarians do not know that 13.9 percent of the U.S. population has been exposed to toxocara. This information was made available by Kimberly Y. Won in a 2008 paper published in a tropical medicine journal, based on data gathered in the 1990s. “If people knew that roundworm larva could burrow in their skin, they may be a little more apt to comply with prevention.” Elizabeth M. Hodgkins, DVM, Esq., of Summit VetPharm Veterinary Services, says veterinarians need to be more concerned about flea and tick control. “Fleas and ticks are vectors of potentially lethal diseases and (veterinarians) aren’t taking this approach with clients when or if they advise preventive measures,” Dr. Hodgkins says. “Heartworm has been the poster child for vector-borne diseases, but fleas and ticks, which are most concerning, haven’t been dealt with properly.” She says veterinarians in the Northeast U.S. may advise clients more diligently than in the Southwest, but the important thing to know is that the appearance of new tick species is happening globally. “Climate change that favors the flea and tick life cycle, mobility of people and pets, and encroachment into highly populated wildlife areas are all contributing factors to disease prevalence,” Hodgkins says. “Another reason these parasites propagate is because owners think indoor pets are safe, when the fact is fleas love to be in the house. Even indoor dogs go on walks and run in wooded or grassy areas, increasing their exposure risk and bringing parasites home to other pets and the family.” Veterinarians and manufacturers contend that client compliance is higher for canine patients than for feline patients primarily because more dogs make their way to the office. But again, the lack of knowledge about parasites plays a role. “Compliance is less with cat owners,” says Joe Hostetler, DVM, of Bayer Animal Health. “Many believe indoor cats do not need parasite control. Additionally, routine visits to the veterinarian are less frequent for cats and cat owners. “Veterinarians need to convey persistent and consistent messages regarding the importance of year-round parasite control. Also, direct clients to third-party organization sites such as CAPC, which also endorse year-round protection.” Another Tactic Telling clients about the potential for disease transfer, rather than just focusing on the annoyance of parasites, may help bring the message home. “The millions of parasite species may seem overwhelming, but a focus on vector-borne diseases is extremely important,” Hodgkins says. “I have even been remiss in telling clients about vector-borne diseases, but it’s something we’ll all need to be better at.” Some experts say it wouldn’t hurt for veterinarians to make testing for Lyme disease and ehrlichiosis—the second most common infectious disease—part of an annual exam along with heartworm testing. “It’s not as if the technology isn’t available,” says CAPC President Jay Stewart, DVM, who practices at Aumsville Animal Clinic in Aumsville, Ore. “Idexx has a 4DX snap test that can be used right in the practice that will help veterinarians diagnose and treat pets much earlier than waiting for symptoms that may never really surface.” Some interesting statistics become apparent when the incidence rate of parasites in shelter animals is compared to those animals receiving veterinary care. “In regions of the country where there is a high incidence of heartworm, we see a large reduction in the rate of internal parasites due to a high percentage of the animals being on broad spectrum heartworm preventive,” Dr. Stewart says. “In regions of the country where there is a perception among veterinarians and pet owners of a lower incidence of heartworm, we see that pets under veterinary supervision have a relatively high incidence of internal parasites, since fewer animals are on preventives that also control internal parasites.” Experts say prevention has to be a priority to veterinarians before it will appear to be important to clients. “Fleas and ticks are an annoyance, but the diseases they transmit are a whole other story,” the CAPC’s Paul says. “It all boils down to value. There is a lack of perceived value in parasite prevention. This ignorance is a real gamble.” <HOME> This article first appeared in the August 2009 issue of Veterinary Practice News
