CAPC primary guidelines

Editors' note: This is an abbreviated version of the CAPC primary guidelines. A complete set of guidelines can be accessed atwww.capcvet.org.

Considerations of pet health and lifestyle factors

Animals require care tailored to their individual needs. Certain factors may dictate more intensive monitoring and treatment, while others may suggest a less aggressive approach. When recommending a parasite management program, veterinarians should consider:

Primary recommendations for controlling internal and external parasites in U.S. dogs and cats

• Environment of the animal, including:

• Source/origin of the pet;

• Environmental exposure (e.g., climate, hunting and predation, dog parks, wild animal contact, previous infection in the household, exposure to other pets in the household or neighborhood);

• Travel (e.g., vacation trips, boarding and day care facilities, dog and cat shows, and field trials);

• The animal's nutrition status, including the potential for parasite exposure through food or water;

• Clinical presentation of the animal (health and vaccination history);

• Age (puppies, kittens, and geriatric animals are at greater risk than healthy adults).

Lifelong prevention of common internal and external parasites

Pet-owner awareness of heartworms and fleas can serve as the foundation for effective prevention and control of other parasites. Ascarids, hookworms, and whipworms are the most common intestinal nematodes in companion animals, and ascarids and hookworms are a significant cause of zoonotic disease. Several tapeworms of dogs and cats can also cause zoonotic infections. Fleas and ticks produce disease through blood loss, injection of salivary proteins, and transmission of infectious agents. Environmental transmission stages are a source of infection for pets and humans. While the CAPC guidelines currently focus on these common internal and external parasites, a more comprehensive list is detailed on the CAPC Web site, www.capcvet.org.

Recommended protocol for common helminth and arthropod control:

• CAPC recommends year-round treatment with broad-spectrum heartworm anthelmintics that have activity against parasites with zoonotic potential for several reasons:

• Although experts agree heartworm transmission does not occur year-round in all areas, a significant portion of the United States experiences transmission during most of the year.

• The presence of mosquitoes and their ability to transmit heartworm are unpredictable.

• Year-round prevention may improve compliance (currently less than 50%) and eliminate the need to predict potential transmission seasons and minimize the chance of breaks in protection.

• Pets may travel to regions where transmission is active.

• Dogs and cats may be exposed to and become infected with intestinal parasites throughout the year. Consequently, stages capable of transmitting parasites can be shed into the environment, regardless of season or climate.

• Adult dogs and cats may develop patent infections leading to environmental contamination.

• Many broad-spectrum products eliminate these potentially zoonotic parasites.

• Dogs and cats should be placed on year-round preventive flea and/or tick products as soon after birth as possible (consistent with label claims) for the life of the pet.

• A thorough physical examination and complete history are important for the diagnosis, treatment, and control of most parasites and should be performed at least annually by a qualified veterinarian.

• Pets should be fed cooked or prepared food (they should not be fed raw meat) and provided fresh, potable water.

• Periodic (annual is ideal) retesting for canine heartworm infection will help ensure that preventive practices, including owner compliance, are adequate.

• Periodic retesting for feline heartworm infection should be considered. Although feline heartworm testing achieves different objectives than canine testing (because of differences in testing methods, test performance, and parasite biology), it plays an important role in heartworm management and monitoring. Cats should be tested for heartworm infection to:

• Help establish a diagnosis in those cats with clinical signs suggesting infection;

• Monitor infection (or exposure) status in cats previously diagnosed with heartworm disease or after surgical removal;

• Establish a baseline reference prior to starting heartworm prevention;

• Assess the risk of heartworm infection (for an individual or a practice area).

• Appropriately conducted fecal examinations should be performed:

• Using at least 1 g of feces and the centrifugal flotation technique, augmented by other methods (direct exams, sedimentation, stained smears, etc.) as needed;

• Two to four times during the first year of life (may be associated with vaccine schedule);

• One to two times a year in adult pets, depending on patient health and lifestyle factors. This allows monitoring of compliance with monthly preventive medication while facilitating the diagnosis and treatment of parasites not covered by broad-spectrum preventives.

• Puppies and kittens require more frequent anthelmintic administration than adult dogs and cats, because 1) they often are serially reinfected via nursing and from the environment, and 2) they often harbor parasite larvae in migration that later mature and commence egg laying. Intestinal parasite infections in puppies and kittens may cause serious illness or even death before a diagnosis is possible by fecal examination. Puppies and their mothers should be treated with appropriate anthelmintics when puppies are 2, 4, 6, and 8 weeks of age, then put on a monthly preventive. Because prenatal infection does not occur in kittens, biweekly treatment can begin at 3 weeks of age, and at 8 or 9 weeks of age they can be put on a monthly preventive. Nursing bitches and queens should be treated concurrently with their offspring since they often develop patent infections along with their young.

• Since geographic, seasonal, and lifestyle factors substantially affect parasite prevalence, veterinarians should tailor prevention programs to fit the needs of individual patients.

Not using year-round heartworm preventive/intestinal parasite combination products increases the risks of parasitism in pets and zoonotic parasite transmission. Additional diagnostic tests and anthelmintic treatment programs are recommended in this situation. Recommendations include:

• Treating puppies and kittens early and often to prevent patent infections. When no monthly preventive is administered, deworming should be performed repeatedly (e.g., three to four times at biweekly intervals). Ideally, deworming should take place at 2, 4, 6, and 8 weeks of age, and be continued monthly until the pet is 6 months old. To treat for ascarids alone, begin anthelmintic administration by 2 ½ to 3 weeks of age or at initial examination and treat every two weeks for at least three additional treatments. Because prenatal infection does not occur in kittens, biweekly treatment can begin at 3 weeks of age and be extended to 9 weeks of age, as outlined above. Nursing bitches and queens should be treated concurrently with their offspring, since they often develop patent infections along with their young.

• Conducting fecal examinations two to four times a year in adult pets, depending on patient health and lifestyle factors, and treating with appropriate parasiticides.

• Determining heartworm status using an antigen test yearly in dogs and/or before starting preventive medications, with additional testing six months after initiating or changing heartworm medication.

The Companion Animal Parasite Council (CAPC) is an independent council of veterinary practitioners, parasitologists, physicians, legal experts, and others working together to create guidelines for the optimal control of internal and external parasites that threaten the health of pets and people.