What every technician should know about flea control (Proceedings)

Flea life cycle

Point 1: Be familiar with the flea life cycle and where the stages live. Things you may not know:

a) Flea eggs and flea detritus (flea dirt) are picked up by vacuuming. Larvae and pupae less so. Flea larvae feed on flea poop. Vacuuming decreases their food supply.

b) Flea larvae are photophobic (avoid light) and kinesophobic (avoid motion). They can and will crawl UNDER furniture to avoid light and traffic. This is important to know when discussing environmental flea control.

c) Pupae are stimulated to hatch into adults with motion and heat – such as a vacuum beater. Therefore, vacuuming BEFORE treating for fleas will decrease the population of the stage most difficult to kill.

Point 2: The most important thing we can do to interrupt the flea life cycle is stop flea egg production.

Point 3: There is not one magical flea product that will control fleas and egg production 100%. While the residual flea control products introduced since the 1990's have done wonders with improving flea control, we still need integrated pest control, meaning treatment on the pets and in the environment for both adulticide activity and growth regulators to interrupt the life cycle. May be best to rotate products.

a) A study by Dr. Mike Dryden at KSU showed production of viable flea eggs by 20 days after application of imidocloprid or fipronil to cats. The number increase as more time elapsed.

b) Systemic products such as selamectin, spinosad, and nitenpyrem are more effective at stopping egg production.

c) While we have not proven resistance to flea products in "the real world," the fleas in Dryden's KSU lab are showing resistance to some residual flea control products.

Point 4: Topical products may be affected by frequent bathing or bathing with medicated shampoos.

a) Imidocloprid, dinotefuran ± permethrin, and metaflumazone most likely to be affected by shampooing. Fipronil less so. Selamectin much less so.

b) Ask how often a pet is being bathed.

Point 5: Most cases of "flea resistance" to a flea product are not from true resistance but from client oversight (not knowing all they that need to do for flea control) or poor compliance, to which they are unlikely to admit guilt. Be careful not to ask leading questions re: do you use it monthly? Instead, ask them how often do you apply it? And watch their body language!! And for elderly or physically challenged clients, it can be difficult to apply the product. Good to ask "do you have any problems applying the product?"

Point 6: And they believe fleas will be obvious to them if a pet has them.

We need to point out that when a pet is very itchy, grooming excessively, fleas don't stay on that pet for very long. We need to look for other evidence of fleas: fleas on other pets, ask about tape worms, use flea combs to look for flea detritus. Flea traps can be very helpful in documenting a flea population within the home.

Point 7: Some clients perceive that saying their pet has fleas implies they and their pets are "dirty" or they are bad owners. This is of course very far from the truth and fleas are a fact of life for dogs and cats, especially cats that go outside. I call cats "flea school buses." I like to make clients more at ease by saying, "fleas are a fact of life, especially with wildlife and feral cats around us."

Point 8: Owners think they just need to treat the pets that are indoor / outdoor or the ones with skin problems. As long as there is a host in the home environment (and I mean not just the house but the surrounding yard), we increase the risk of production of viable flea eggs significantly. ALL pets in / around the home must be treated.

Point 9: More clients are concerned about "poisoning" their pets with insecticides (safe and effective flea control products).

a) Clients should be reminded that fleas (and especially ticks) carry diseases for pets AND people: Tape worms, Bartonella henselae (cat scratch fever agent) and cat fleas may play a role in helping spread plague (though the rat flea is much more important here).

b) Flea allergy is the most common dermatitis in pets. It is uncomfortable and leads to secondary infections. There is far more chance a pet will experience flea bite hypersensitivity than experience an adverse event from a flea control product.

c) There are some very safe means of insect control such as boric acid, nematodes and pyriproxyfen. (discussed later).

Point 10: We have to sit down and communicate these facts to clients. Yes, we have to talk to people. Even if they are buying flea control product over the counter, we are the experts and need to discuss flea biology so the client understands WHY we recommend what we do.

Point 11: People retain only about 20% of what you say. We retain more by seeing. Use handouts, dry erase boards, scrap paper, show the flea video, do anything to incorporate sight and keep the client's attention. Keep the discussion succinct to the most important points (e.g., need for environmental control, how the pupae are resistant to insecticides; have to treat ALL pets in the home, etc). Make sure the client is listening to you. The video is at: www.comfortis4dogs.com/about-flea.

Choosing the best-fit flea control product: Things to consider

Bathing often? Yes: Spinosad (Comfortis), Revolution, ± Frontline Plus. No: Any veterinary-approved product with good safety and efficacy studies.

Is pet topically-sensitive, untouchable (e.g., feral cat), or is the client averse to topical therapies? Use oral products such as spinosad (dogs only at this time) or lufenuron.

Need other parasite control?

Ticks: Selamectin, fipronil + methoprene, permethrin-containing products (dogs only!), amitraz

HW: selamectin, moxidectin, lufenuron + milbemycin.

Intestinal Parasite control: selamectin, moxidectin, milbemycin

How many pets are being treated?

Economics come into play when treating several pets.

I also learned that a mismatch between the number of pets to be treated and number of doses of product per package influences client compliance.

A client with 2 cats was buying 3-packs of Frontline. They found they used the first 2 tubes and then when the cats were due in 1 month, they had only one tube and said to themselves, "we'll treat them when we get another package." A week would go by and they'd failed to get more Frontline and one tube still sitting at home unused. Their compliance turned around when we switched to dispensing an even-numbered package of flea control.

The "orphan" tube of flea control product also leads to an owner trying to divide a dose between pets. Under dosing the products is ineffective, but the client thinks, "we'll I've done my job; I put the stuff on, Not my fault if it doesn't work."

What about combining products? This can give us better "coverage" to assure no viable eggs are produced. We should avoid 2 products with similar mechanisms of action (such as dinotefuran (Vectra) and imidoclopride (Advantage). Better to combine a systemic product such as spinosad (Comfortis) or leufenuran (Program) with a topical such as fipronil or imidocloprid. And do them 2 weeks apart.

Recommendations for environmental control: Things to consider

Where does the pet spend most of its time, especially where does it sleep? This is the area that needs the most attention. For example, if a pet sleeps at the end of the bed, most of the flea eggs, larvae and pupae are going to be in an area around the end of the bed (including UNDER the bed).

What type of floor surface(s) does the pet contact regularly? If the home is heavily carpeted, I recommend vacuuming, spraying with an adulticide + insect growth regular (e.g, pyrethrin + pyriproxyfin), and follow up with a boric acid powder product such as Flea Busters or FleaGo. I recommend repeating the spray 3-4 weeks after the first application. I like hand-held aerosol canisters and not foggers.

Boric acid products act as a dessicant, dehydrating flea eggs and larvae. Larvae that ingest flea feces with boric acid also experience a poisoning effect. Do not fall for the "cheap" option of sprinkling 20 Mule Borax on to carpeting. This will be vacuumed up quickly. Products such as FleaBusters have a very fine granule and are statically charged to cling to carpet fibers. They are not readily removed by vacuuming and are effective for a long time. These products are not recommended for wood or other solid floors.

For homes with "solid" floors, I recommend vacuuming and mopping. Make sure to vacuum any cracks / crevices in wood floors.

What about furniture? If pets get on the furniture, it must be treated. Make sure to turn over cushions. Boric acid powder can be applied to upholstered furniture as well.

Any pet beds should be washed in hot water. If the whole bed cannot be washed, such as foam beds, I recommend either replacing the foam, or spraying the foam with area treatment in addition to washing the cover. If owner chooses the later, must repeat spraying in 3 weeks (for the emerging pupae). If the bed is made of shavings, throw out the shavings. If the pet sleeps in the owner's bed, sheets should be removed and washed. It is most thorough to recommend spraying the mattress or applying boric acid powder product.

What about flea control for the yard?

Fleas do not like direct sunlight. They love shade and mulch. Ask the owner to think about where the pet spends their time outside. Any access to under a deck? Block it off. Leaves and other debris? Rake it up. Tall grass? Pay the neighbor's kid $20 to mow for you, for Pete's sake.

A nice alternative to broad spectrum insecticide is use of a nematode that feeds on flea larvae (Steinernema carpocapsae). These worms have their own enemies and need to be re-applied monthly. They treated area should be kept moist as well. They are available through the FleaBusters website as well as other websites and stores that cater to non-chemical insect control.

It is also important to ask who else has access to the yard. Are there neighborhood cats that "hang out?" They may be bringing in fleas. Any wildlife taking up residence in the yard? These guys can be aiding and abetting our foe.

What I want you to take away from this little chat

1) There is no perfect flea control product and we can help our clients by taking time to ask questions (and listen to answers) to determine what product would be best for them and their pets. Even if they buy their flea control product somewhere else, they need to look to us for advice on best product use.

2) In cases of flea infestation, you and the vet need to ask many questions, trying to determine the "weak link in the clients flea control." 3) As you are SQUIRREL! discussing flea control, remember SQUIRREL! the client is only going to retain SQUIRREL! 20% of what SQUIRREL! you say. Give 'em handouts and a link to the Dryden video.

4) Tell the client the most important thing YOU want THEM to remember is to BE CONSISTENT with flea control, especially for pets with flea bite hypersensitivity. It is much better to be proactive than reactive and have the pet be miserable from allergic reactions.

Selected references

1. Guerreri J. Canine Flea and Tick Control, A reference guide to EPA-approved SPOT-ON products. Technical Monograph. 2009

2. Dryden Mw. Flea and tick control in the 21st century: challenges and opportunities. Vet Dermatology,July 2009, 435–440.

3. Foil C, Grossman, M. EPA and FDA Flea Products. http://www.veterinarypartner.com/Docs/FleaProductsChart_CLIENTS_072308.pdf

4. Robinson H. Distribution of Cat Flea Larvae in the Carpeted Household Environment. Vet Dermatology, Vol 6, No.3; pp 145-150, 1995.