CAPC Recommendations:
General Guidelines:
Controlling Internal and External Parasites
in U.S. Dogs and Cats
New 2008 General Guidelines
Parasite Control Should Be Guided by Veterinarians
- Prescribe control programs to local parasite prevalence and individual pet lifestyle factors.
- Adapt prevention recommendations to address emerging parasite threats.
- Conduct physical examinations at least every six to twelve months or as deemed advisable by your veterinarian.
- Conduct annual heartworm testing in dogs; test cats prior to placing on preventative and thereafter as indicated by history and physical findings.
- Conduct fecal examinations two or four times during the first year of life and one to two times per year in adults, depending on patient health and lifestyle factors.
Every Pet, All Year Long
- Administer year-round broad-spectrum parasite control with efficacy against heartworm, intestinal parasites with zoonotic potential, fleas, and ticks.
- Administer anthelmintic treatment to puppies and kittens starting at two weeks of age repeating every two weeks until regular broad spectrum
parasite control begins. - Maintain pregnant and nursing dams on broad-spectrum control products.
Healthy Lifestyle, Healthy pets, Healthy People
- Feed pets cooked or prepared food (not raw diets) and provide fresh, potable water.
- Cover sandboxes when not in use and protect garden areas from fecal contamination.
- Pick up feces immediately whenever walking a dog in a public area; remove feces from the backyard environment at least weekly, preferably daily.
- Keep dogs and cats under control; do not allow roaming.
- Practice good personal hygiene when handling animal waste, particularly important for children and other individuals at increased risk.
If Less Than Optimal Control Is Practiced
- Deworm puppies and kittens starting at two weeks, repeating every two weeks until two months of age, and then monthly until the pet is six months old.
- Conduct fecal examinations two to four times a year in adult pets, depending on patient health and lifestyle factors, and treat with appropriate parasiticides.
Links to Specific Recommendations
Additional information is available with links below and on the menus above, including specific recommendations for individual parasites of clinical importance to dogs, cats and humans:
Internal Parasites
Protozoa
External Parasites
- Fleas
- Ticks
- Mange mites (Demodex)
- Lice
Consideration 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:- 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); and
- 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); and
- 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.1 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 in the following PDF Files:Canine Parasites (PDF of PowerPoint, 2.4MB)
Feline Parasites (PDF of PowerPoint, 1.6MB)
Human Parasites (PDF of PowerPoint, 1.1MB)
Recommended protocol for common helminth and arthropod control:
- The 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.
- Presence of mosquitoes and their ability to transmit heartworm is unpredictable.
- Year-round prevention may improve compliance (currently less than 50 percent) and eliminate the need to predict potential transmission seasons and minimize chance for breaks in protection.
- Pets may travel to regions where transmission is active.
- Dogs and cats may be exposed to and become infected with roundworms, hookworms, tapeworms, and other 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 (see PDF downloads Parasiticides - Internal and Parasiticides - External).
- 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 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 (see Heartworm).
- Periodic retesting for feline heartworm infection should be considered. Although feline heartworm testing achieves different objectives than canine testing (because ofdifferences 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; and
- Assess risk of heartworm infection (for an individual or a practice area).
- Appropriately conducted fecal examinations (see Fecal Examination Procedures) should be performed:
- Using at least 1 gram of feces and 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), and
- One to two times per year in adult pets, depending on patient health and lifestyle factors. This allows monitoring of compliance with monthly preventive medication while facilitating 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 laying eggs. 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 they can be put on a monthly preventive at 8 or 9 weeks of age. Nursing bitches and queens should be treated concurrently with their offspring since they often develop patent infections along with their young.
- Because geographic, seasonal, and lifestyle factors substantially affect parasite prevalence, veterinarians should tailor prevention programs to fit the needs of individual patients.
- Treat puppies and kittens early and often to prevent patent infections. When no monthly preventive is administered, deworming should be performed repeatedly, e.g., 3 to 4 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 1/2 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 previously. Nursing bitches and queens should be treated concurrently with their offspring, since they often develop patent infections along with their young.
- Conduct fecal examinations two to four times a year in adult pets, depending on patient health and lifestyle factors, and treat with appropriate parasiticides.
- Determine 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.
Environmental Control of Parasite Transmission
To minimize resistant environmental stages (eggs, larvae), environmental control is an integral component of parasite prevention and control.- Parasite transmission stages are long-lived in the environment and responsible for infection of pets as well as zoonotic transmission. Therefore, it is most important to prevent initial environmental contamination with parasite stages through the comprehensive parasite control program priviously described.
- Parasitized animals should be aggressively treated to prevent environmental contamination and monitored by fecal exam to confirm treatment efficacy.
- At least weekly (preferably daily), conduct fecal cleanup/removal with proper disposal and sanitation. Feces can be bagged and put in the trash, burned, or flushed down a toilet. Following treatments, any worms passed should be similarly disposed of.
- Leash laws and fecal cleanup (“pooper-scooper”) laws should be enforced.
- Ascarid and whipworm eggs are highly resistant to environmental conditions and may persist in the soil for years. Extreme measures are needed for decontamination, including:
- Application of heat (boiling water, steam, propane gun, burning straw, etc.) to kill the eggs;
- Removal of contaminated substrate (e.g., 5 to 6 inches of soil properly disposed of); and/or
- Entombment of eggs under concrete or asphalt.
- Children’s sandboxes should be covered when not in use.
- To remove hookworm larvae, metal or concrete surfaces should be decontaminated with bleach or ammonia, while soil and gravel should be decontaminated with heat or a desiccant such as sodium borate. Note that sodium borate will kill vegetation.
- Where appropriate, EPA-approved pesticides and/or growth regulators should be applied to the premises to kill environmental stages of fleas and ticks.
- For indoor infestations of brown dog tick, local pest management specialists should be contacted.
- Mosquito abatement should be considered in certain environments.
Staff, Pet Owner, and Community Education
Medical protocols for the control of parasitic infections should be communicated to veterinary and nonveterinary staff and consistently applied. Encourage clients to seek veterinary care in the form of prevention, diagnosis, and treatment of parasitic infections in companion animals.Inform clients about the health risk to pets and people associated with parasitic infections and methods to minimize risk. Consider the use of brochures, posters, and staff to convey educational messages to pet owners.
- When potential zoonotic infections are diagnosed in pets, advise owners of their risks and refer them to a physician when appropriate.
- Take precautions to prevent nosocomial infections and occupationally acquired zoonoses in the veterinary hospital.
- Veterinarians are encouraged to interact with local physicians to increase physician awareness and understanding of pet-associated zoonotic infections and the value of preserving the human/animal bond.
Owner Considerations in Preventing Zoonotic Disease
Some people are uniquely susceptible to certain vector-borne infections and parasites. Veterinarians and staff should take special care in counseling these clients, who may include:- Immunocompromised individuals, such as:
- People with HIV infection;
- People undergoing immunosuppressive therapy (e.g., chemotherapy patients, organ transplant patients, patients undergoing treatment for autoimmune disease);
- People with advanced liver disease;
- Diabetics;
- Pregnant women;
- Infants and young children;
- Elderly individuals;
- Individuals who are mentally disabled; and
- Individuals with occupational risk.
