The Vector-Borne Disease Prevention Compliance Gap: Are Your Clients Really Using Preventives?

Recent research suggests that many veterinarians may be overestimating their clients' use of flea, tick, and heartworm preventives. With so many options for vector-borne disease (VBD) prevention available, pet owners rely on their veterinarians for the most up-to-date and reliable recommendations. As a result, it is imperative to screen annually for VBDs because even though the importance of flea and tick preventives are communicated to pet owners, the data show they are not compliant with those recommendations.

By screening annually and adding targeted communication on VBD prevention to your annual wellness exams, you can help prevent the spread of these diseases in pets and in people.

  SNAP 4Dx Plus Test. The accuracy and support you want. The efficiency you need.

Waning Preventive Compliance

According to a study in Parasites & Vectors, while veterinarians almost always recommend year-round flea and tick prevention, only 62% of clients remembered that recommendation when asked within a week of the visit. This seems to influence how often clients are actually purchasing year-round protection.

A 2022 data study by IDEXX of over 7,000 veterinary practices across the U.S. investigated trends in flea, tick, and heartworm preventive use. This study showed some compelling results: less than 29% of dogs that visited the veterinarian over the course of the year left with any flea or tick preventive at all, and of those, only 20% purchased enough doses of flea and tick preventives to provide uninterrupted coverage for the full year.

It's important to note that this data only represents purchases from the veterinary practice and may not represent the doses actually given to pets, meaning the administered doses could be even less than purchased.

This study also showed that the average purchase was for just over six months of flea and tick coverage and up to eight months of coverage for heartworm preventives. This data aligns with published results in Parasites & Vectors showing that owners who do purchase flea and tick preventives from their veterinarian only take home three to six months' worth over the course of a year, leaving pets unprotected for much of the year.

Strategies to Improve Pet Owner Compliance

Veterinarians can use several strategies to improve pet owners' compliance with flea, tick, and heartworm preventives. How you ask the question matters. If you ask something like, "Do you have enough flea and tick preventive today?" pet owners tend not to truly think about the answer and might simply answer, "Yes." Rather, consider asking something like, "What flea and tick preventive do you use, and when did you last give it?" With that open-ended question, you have an opportunity to educate the pet owner and focus your conversation to meet their need.

If clients initially decline preventives, be persistent—if clients don't get these preventives from you, they may not be getting them at all or may be getting an inferior or less reliable product elsewhere. It may take repeating the same questions multiple times before someone might change their mind, so don't feel bad if multiple people across the care team ask a client about preventives throughout the visit. In fact, that can be an effective strategy to demonstrate the importance of preventives and increase the likelihood someone might actually start purchasing them year-round.

Once people do purchase preventives, you can use reminder systems to help pet owners stay on schedule. According to the American Heartworm Society, this is particularly important for heartworm preventives, since lapses can necessitate extra testing prior to reinitiating preventives.

The Importance of VBD Screening

With only 20% of the dogs that purchased flea or tick preventives at the practice going home with enough flea and tick coverage for a 12-month period, there's a large group of dogs at these veterinary practices that are potentially susceptible to infection with flea- and tick-borne diseases—which circulate year-round across the country. And one tick can transmit multiple pathogens with different transmission times. For example, while it may take up to 72 hours for Borrelia burgdorferi to be transmitted, Anaplasma phagocytophilum can be transmitted much earlier in tick feeding—within 24 hours. This further highlights the importance of VBD screening, since owners might not recognize ticks attached for such short times. Annual screening can illuminate these gaps and motivate owners to close them.

Vector-borne diseases aren't only a threat to pets' health but can also be a threat to human health since many of these diseases are zoonotic. Comprehensive screening during wellness exams and testing for specific pathogens that indicate vector exposure, like Borrelia burgdorferi and Anaplasma species, can help owners understand their shared exposure risks. In addition, delving deeper into vector history—including asking clients whether they've seen fleas and ticks on themselves or their pets and doing a thorough physical exam including flea combing—can all make recommendations for year-round preventives seem worthwhile.

Keeping Pets Healthy

While compliance with year-round flea, tick, and heartworm preventives may not be as pervasive as you hope, you can take steps to improve these numbers. Providing clear and easy-to-understand information and recommendations, being persistent, using reminder systems, and offering comprehensive VBD screening at wellness exams can improve pet owners' compliance with flea, tick, and heartworm preventives and can ultimately help keep pets healthy at home.

IDEXX Practice Intelligence data cited in this article includes a sample of ~7,000 practices representing six different practice information management systems, weighted based on practice size and region to reflect market composition.

Erin Lashnits

Dr. Lashnits is a clinical assistant professor in small-animal internal medicine at the University of Wisconsin School of Veterinary Medicine. She received her MS in biology from Stanford University, DVM from Cornell University, and PhD in comparative biomedical sciences from North Carolina State University. She spent a few years in general practice and emergency medicine before completing her internal medicine residency at NC State University. Dr. Lashnits’s current research focuses on the epidemiology of zoonotic vector-borne diseases and other infectious diseases affecting underserved veterinary populations in a One Health context. The views and opinions in this piece are the authors own, and do not necessarily reflect the views of either The Vetiverse or IDEXX.

Welcome to The Vetiverse