PET WELLNESS SERVICES
Pet Wellness Exams, Vaccinations, Flea & Tick Prevention, Puppies & Kittens Wellness, Senior Supportive Care, and At-home pet euthanasia.
Dog & Cat Wellness Exam
Regular wellness exams are the key to keeping your pet healthy. We recommend all pets undergo an annual nose-to-tail wellness exam, though more frequent exams are encouraged. As the old saying goes, an ounce of prevention is worth a pound of cure, and frequent exams can help spot health problems in your pet before they become expensive to treat and potentially life-threatening.
During an exam, we examine your pet’s nose, eyes, and ears, check your pet’s teeth and oral cavity, listen to your pet’s heart and lungs, carefully examine the skin and coat for any unusual lumps or swelling, palpate the abdomen and muscles and perform an orthopedic evaluation of the bones, joints, and back. In addition to physical exams, your pet’s wellness program includes parasite testing, heartworm and flea control, and specialized blood tests for all life stages.
We also take the time to listen to your concerns, answer your questions, and keep you up to date on all the information you need to be the best caregiver to your pet. Good communication between you and your pet’s doctor ensures your beloved companion is receiving the optimal care and attention he deserves, so he can live a long, healthy life.
VACCINATIONS
Which vaccines should I do?
Vaccinations are one of the most important ways you can keep your pet healthy and free from disease. However, not every pet requires the same series or frequency of vaccines. At Tequesta Veterinary Clinic, our veterinarians determine a vaccination protocol based on your pet’s lifestyle, susceptibility to disease, geographic location, and the most current recommendations from the American Animal Hospital Association and the American Veterinary Medicine Association. Our goal is to maintain optimal health and protection while not over-vaccinating your pet.
What is the schedule for vaccines for Dogs?
Dr. Sutton wants you to be involved in your pet’s vaccination choices! Surprisingly, some local clinics still vaccinate for everything every year. We follow vaccine protocols set forth by the American Animal Hospital Association. If your pet’s lifestyle doesn’t warrant a vaccine, we won’t give it. We also try to spread out vaccinations to minimize adverse events from vaccinations. Whenever possible we use non-adjuvanted vaccines. We take the time to discuss vaccines with you to best determine what vaccines are warranted for your pet’s lifestyle. We are asking about your lifestyle to help determine what is best for your pet—We aren’t just being nosy!
In general, we recommend all of our canine patients receive core immunizations against distemper, hepatitis, and parvovirus and parainfluenza (DHPP), and rabies. After the first series of immunizations are administered, we then recommend vaccinations every three years, beginning a year after completing the puppy series. Exceptions to the 3-year protocol are leptospirosis and bordetella (aka kennel cough) vaccines which are given yearly if a pet’s lifestyle warrants. For our snowbird doggies, we might also give the Lyme vaccine. We offer the oral bordetella vaccine for dogs who don’t like the intranasal bordetella/parainfluenza vaccine. (The intranasal vaccine contains parainfluenza whereas the oral option does not. We try to maintain Fear Free protocols as much as possible, but the intranasal bordetella vaccine is a bit better. Many dogs accept the oral version better than the intranasal version.)
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At Tequesta Veterinary Clinic, we know how much you love your pets, because we love them too. You want to do everything you can to keep your pet healthy and happy for as long as possible. Our veterinarians have a wealth of knowledge about the risks of exposure to infectious diseases your pet will face during their lifetime. Dr. Joi, Dr. Javi, and Dr. Bill have developed a schedule of vaccinations to minimize your pet’s risk from both infectious diseases and complications that can occur.
Many people don’t understand that vaccines are not all the same. Some companies use “adjuvents” such as aluminum in their vaccines. We use only the safest NON-adjuvanted vaccinations for your pets. These vaccines cost us more, but they are the vaccines we would choose to give our own pets. Furthermore, We take the time to discuss vaccines with you to best determine what vaccines are warranted for your pet’s lifestyle. We ask that YOU are involved in the vaccination choices. Dr. Joi was using the 3-year vaccination protocol for years before it was the norm (based on science rather than how many vaccines were FDA approved).
Vaccinations make up a small part of what we do here at Tequesta Veterinary Clinic, and we have chosen the safest vaccinations on the market for your pets. If you go to a “mobile vaccine clinic” there is a good chance that the vaccine chosen was based on economics rather than safety. Our markup is minimal on vaccinations as we don’t wish for clients to go to a mobile vaccine clinic where the pet might get a lesser vaccine.
Just as diseases that threaten humans, such as polio, have been virtually eliminated by vaccinations, there are also safe, effective vaccines that your pets need to protect them from specific diseases. After examining your pet and gathering information to assess their risk, we can implement a vaccination schedule for your beloved companion. With this up to date pet vaccination schedule, you will know you have done your part to help keep your furry friend free from costly or even life-threatening illnesses.
What is the schedule for vaccines for cats?
Dr. Sutton wants you to be involved in your pet’s vaccination choices! Surprisingly, some local clinics still vaccinate for everything every year. We follow vaccine protocols set forth by the American Association of Feline Practitioners. If your pet’s lifestyle doesn’t warrant a vaccine, we won’t give it. We also try to spread out vaccinations to minimize adverse events from vaccinations. We use only the highest quality of NON-adjuvanted vaccines. We take the time to discuss vaccines with you to best determine what vaccines are warranted for your cat’s lifestyle.
For indoor cats, we recommend immunizations against distemper, rhinotracheitis, feline calicivirus, and rabies. Cats who go outdoors should also get feline leukemia vaccinations. Once the kitten series is complete, we begin the 3-year vaccination protocol a year later. We encourage you to discuss immunization options for your pet with our veterinarians and medical staff.
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At Tequesta Veterinary Clinic, we know how much you love your pets, because we love them too. You want to do everything you can to keep your pet healthy and happy for as long as possible. Our veterinarians have a wealth of knowledge about the risks of exposure to infectious diseases your pet will face during their lifetime. Dr. Joi, Dr. Javi, and Dr. Bill have developed a schedule of vaccinations to minimize your pet’s risk from both infectious diseases and complications that can occur.
Many people don’t understand that vaccines are not all the same. Some companies use “adjuvents” such as aluminum in their vaccines. We use only the safest NON-adjuvanted vaccinations for your pets. These vaccines cost us more, but they are the vaccines we would choose to give our own pets. Furthermore, We take the time to discuss vaccines with you to best determine what vaccines are warranted for your pet’s lifestyle. We ask that YOU are involved in the vaccination choices. Dr. Joi was using the 3-year vaccination protocol for years before it was the norm (based on science rather than how many vaccines were FDA approved).
Vaccinations make up a small part of what we do here at Tequesta Veterinary Clinic, and we have chosen the safest vaccinations on the market for your pets. If you go to a “mobile vaccine clinic” there is a good chance that the vaccine chosen was based on economics rather than safety. Our markup is minimal on vaccinations as we don’t wish for clients to go to a mobile vaccine clinic where the pet might get a lesser vaccine.
Just as diseases that threaten humans, such as polio, have been virtually eliminated by vaccinations, there are also safe, effective vaccines that your pets need to protect them from specific diseases. After examining your pet and gathering information to assess their risk, we can implement a vaccination schedule for your beloved companion. With this up to date pet vaccination schedule, you will know you have done your part to help keep your furry friend free from costly or even life-threatening illnesses.
Puppies & Kittens Wellness
The first year of care for your new puppy or kitten is the most important. Like human infants, puppies and kittens require special attention to grow and develop well.
At Tequesta Veterinary Clinic, your veterinarian will partner with you to create a custom health plan so your new companion receives the care required to get the best start in life.
Your puppy’s and kitten’s first year of care at Tequesta Veterinary Clinic includes:
Physical Examinations: Your puppy’s or kitten’s lifetime of wellness starts with the first comprehensive physical exam. Puppies and kittens should have 3-4 exams between the ages of 8-16 weeks. These visits are important because they provide your pet’s veterinarian with an opportunity to assess your pet’s overall health and to administer vaccines.
Vaccinations: Due to their developing immune systems, puppies and kittens must receive a series of properly staged vaccines. Because every puppy and kitten is unique, we tailor our vaccination recommendations based on their lifestyle, breed, and suggested medical guidelines.
Diagnostic Testing:Puppies over 6 months of age will be tested for heartworm disease. Kittens will be tested for feline leukemia virus and feline immunodeficiency virus. Both puppies and kittens will have complete fecal testing for eggs and cysts and antigens for giardia, hookworms, whipworms, and roundworms.
Additional Recommendations: Your veterinarian will also discuss and recommend other services, such as spaying, neutering, and microchipping.
We also take plenty of time during these visits to offer health care, nutrition, and training advice and discuss any concerns you have. This is your new kitten or puppy and we’re happy to answer all your questions.
Senior Supportive Care
It may seem like only yesterday that your pet was a playful puppy or frisky kitten, but pets are considered senior citizens around seven or eight years of age. Like you, your pet’s medical needs change as he or she grows older, and pets in their senior years begin to go through a gradual reduction of their physical capabilities. However, this process can be slowed and managed through proper veterinary care, thereby offering your beloved pet an extended period of vitality and good health.
At Tequesta Veterinary Clinic, we have developed a comprehensive senior wellness program for pets entering their golden years. The key to keeping your older pet healthy is preventive care. Regular wellness exams, blood, urine, and parasite testing plus other preventive measures can help spot potential health risks before they become chronic and difficult to treat. Our veterinarians and staff work with you to develop a wellness plan that takes into account your pet’s unique needs and lifestyle.
There is also an important role for you to play as your pet’s primary caregiver. While you cannot control age-related decline, you can influence your pet’s activity level, living conditions, access to quality senior veterinary care, and daily nutrition. With help from your veterinarian at Tequesta Veterinary Clinic, you can prolong your pet’s vitality and well-being even as his or her pace slows a bit.
Flea & Tick Prevention
The first year of care for your new puppy or kitten is the most important. Like human infants, puppies and kittens require special attention to grow and develop well.
At Tequesta Veterinary Clinic, your veterinarian will partner with you to create a custom health plan so your new companion receives the care required to get the best start in life.
Your puppy’s and kitten’s first year of care at Tequesta Veterinary Clinic includes:
Physical Examinations: Your puppy’s or kitten’s lifetime of wellness starts with the first comprehensive physical exam. Puppies and kittens should have 3-4 exams between the ages of 8-16 weeks. These visits are important because they provide your pet’s veterinarian with an opportunity to assess your pet’s overall health and to administer vaccines.
Vaccinations: Due to their developing immune systems, puppies and kittens must receive a series of properly staged vaccines. Because every puppy and kitten is unique, we tailor our vaccination recommendations based on their lifestyle, breed, and suggested medical guidelines.
Diagnostic Testing: Puppies should be tested for Heartworm and kittens tested for Feline Leukemia and Feline AIDS.
Additional Recommendations: Your veterinarian will also discuss and recommend other services, such as spaying, neutering, and microchipping.
We also take plenty of time during these visits to offer health care, nutrition, and training advice and discuss any concerns you have. This is your new kitten or puppy and we’re happy to answer all your questions.
FLEA AND TICK & HEART WORM CONTROL FOR DOGS:
Dr. Joi’s opinion of the heart worm and flea and tick options for dogs in Tequesta and Jupiter. I’ve been a veterinarian since 1993 and have been in vet clinics most of my life. In that time I’ve seen lots of heart worm and flea products come onto the market. They each have pros and cons. We in South Florida need to keep our pets on heart worm preventatives! We live in paradise, but it is also the heart worm war
zone. The following list is the products I carry for flea and tick and heart worm prevention. I discuss when I might choose which. Hopefully, this article will help you choose what option is best for your pet. Dr. Joi Sutton December 2021
FOR DOGS:
SENTINEL SPECTRUM (This is my hands-down favorite product for dogs due to its safety profile and affordable price.) Sentinel has been on the market for many years. It contains milbemycin, the same active ingredient as in Interceptor and Trifexis. Milbemycin is very safe for all breeds. I chose to carry Sentinel Spectrum because it is a tasty chew Sentinel Spectrum contains Program (aka lufenuron) which is “birth control” for fleas. Lufenuron prevents the formation of chitin which is a flea’s exoskeleton. Mammals don’t have an exoskeleton.
Mammals don’t have chitin! If your dog takes lufenuron (which is in Sentinel Spectrum), any flea eggs in the environment exposed to your pet cannot hatch. The flea’s “egg tooth” (the little triangular piece that the larva claws its way out of the egg to hatch) is made of chitin! This is both disgusting and cool at the same time. Yes, I said larvae. The vast majority of the flea population are eggs, followed by flea larvae, the pupae and then a very small percentage of the flea population is adult fleas. Nobody wants flea larvae in their carpets. Lufenuron is EXTREMELY SAFE flea control.
Sentinel Spectrum treats hookworms, whipworms and roundworms, and 2 types of tapeworms and is a heart worm preventative Sentinel Spectrum does NOT treat ticks. And as I mentioned above, it acts as birth control for fleas, but it does NOT kill adult fleas. Nonetheless, it will likely prevent a random hitch-hiker flea who jumps onto your pet outside from turning your house into a flea-infested home. For the typical city slicker dog in Jupiter and Tequesta, using Sentinel Spectrum year-round and adding in Bravecto or Nexgard in the summer months is a great option. If the pet is a rootin’ tootin’ outdoorsman, we will recommend a flea adulticide product year-round in addition to the Sentinel Spectrum. We are eagerly awaiting a new combination product in 2022 that has both Sentinel Spectrum AND Bravecto in one chew.
I know my clients. Most of us do not want to put our pets on flea and heart worm and tick products. I get it. I’m from Oregon, home of tree-hugging hippies. I rarely take medication myself. I understand when my clients don’t want to use a flea adulticide product year-round. If my dog patients are on Sentinel Spectrum it is highly unlikely that they will get internal parasites, heartworm disease, or have a flea infestation. The only thing Sentinel Spectrum doesn’t address is ticks. Finally, Sentinel Spectrum is a hydrolyzed protein. We treat a lot of allergy dogs here in South Florida. If a pet is on a special hypoallergenic diet we don’t have to worry about setting off an allergy flare each month when the pet receives a heart worm prevention dose.
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IVERHART MAX AND HEARTGARD PLUS
(These are 2 very similar products. I have a preference for Iverhart Max over Heartgard Plus simply because Iverhart Max has a hydrolyzed protein and is a little more broad spectrum and just a tiny bit less expensive than Heartgard Plus.) I am a huge fan of Iverhart Max and Heartgard Plus. These 2 products are essentially the same thing except Iverhart Max also has a tapeworm medication called Praziquantel. Both of these products contain ivermectin and Pyrantel. Both have been out for years and are very tasty and effective. They not cause nausea. Word on the dog street is that they are truly delicious. It so much easier giving a pet medication when the pet gobbles it up as if it were a treat. Not all heart worm preventatives are so tasty. For herding breeds, we usually choose Sentinel Spectrum as ivermectin (the active ingredient in Heartgard Plus) can adversely affect herding breeds. This herding
breed receptor defect is rare and at the dose, in Iverhart Max or Heartgard Plus it would be unlikely to cause issues. Nonetheless, we do still guide the herding breeds toward milbemycin (the active ingredient of Sentinel Spectrum). Iverhart Max and Heartgard Plus treat roundworms and all 3 types of hookworms. They are also heart worm preventatives. Iverhart Max and Heartgard Plus are given monthly.
They do nothing for fleas nor ticks. I usually pair Iverhart Max and Heartgard Plus with Nexgard or Bravecto. TRIFEXIS (I no longer carry Trifexis even though it was once my favorite HW/flea product about a dozen years ago. We now have better options.) I like Trifexis. It is the combination of milbemycin (what is in Sentinel and Interceptor) plus Comfortis (which is a flea adulticide). I carried Trifexis in my pharmacy when I opened Tequesta Vet Clinic. It’s a great product—very effective for heartworm prevention and fleas and internal parasites, all in one pill. Unfortunately, Trifexis has a few issues. The biggest complaint I heard is that it doesn’t taste good! Clients told me repeatedly how they have to cut it into bits and hide it in food or just send it down the hatch manually. It’s a hard little pill. Additionally,
some pets will vomit when they take Trifexis, especially if they take it on an empty stomach. If a pet has a history of seizures, we do not recommend Trifexis. The evidence is fuzzy, but we err on the side of caution. Any neurologic patient should steer clear of Trifexis due to the Comfortis component. Nonetheless, most pets do very well on Trifexis! If a client wishes to use Trifexis, we can set up a prescription through our online pharmacy. Trifexis does NOT treat for ticks.
REVOLUTION
Revolution has been on the market for many years. It is a topical flea and heart worm preventative. It is a great product for treating fleas and for heart worm prevention. Unfortunately, it doesn’t do a very good job for internal
parasites for dogs. (It is better for gi parasites in cats.) The company recommends that pets who take this also take pyrantel (one of the ingredients in Iverhart Max and Heartgard Plus). Back when I was a relief vet I worked out at the clinic in the farms for a few months. The owner of that practice really loved
Revolution. I saw numerous pets who were on Revolution present with hookworm infestations. We are (unfortunately) in hookworm country. For this reason, I’m not the biggest fan of Revolution. I also saw 2 dogs at that practice who came up positive for heart worm despite the owners’ claims that they had not missed a dose. Both of these dogs were very furry dogs and I suspect they were treating the fur rather than getting the liquid onto the skin. For this reason, I’m more trusting of oral heart worm preventatives than topical heart worm preventatives. Nonetheless, Revolution has a couple of instances where it is FANTASTIC… One of my favorite times to use Revolution is for the very small breed of dogs. Many of these dogs don’t like to take the oral options for heart worm prevention.
Revolution can be used in dogs less than 5 pounds. If we have a pet with a food allergy, Revolution can be used as it is topical. Another time when I reach for Revolution is for very itchy dogs. We see TONS of allergy dogs here in south Florida. Sometimes we wonder if there is underlying SARCOPTIC MANGE (aka scabies). Scabies is really hard to identify. These mites are stinkers to find on skin scrapings and sometimes we will treat with Revolution, every 2 weeks instead of every month, for a total of 3 treatments. When we have a very itchy pet (particularly if they don’t respond well to our allergy treatments), we may try this 3 dose trial of Revolution. Flea control: NEXGARD and BRAVECTO I love Nexgard and Bravecto. Nexgard was the first of the oral flea and tick preventatives that came on the market. I carried Nexgard when it first became available.
Then later that year a sister drug came onto the market called Bravecto. Later 2 more sister drugs came out in the same drug class (Simparica and Credelio). Nexgard is still my favorite and in 2017 it got FDA labeling as a Lyme Disease preventative. Nexgard and Bravecto both kill ticks and fleas. Nexgard lasts for one month for fleas and ticks. Bravecto lasts for nearly 4 months for fleas and 2 or 3 months for ticks. Bravecto is coming out with a one month version as well and word on the street is that Merck may soon pair it with milbemycin. That will be a great combination for South Florida doggies! It’s easier to give a Nexgard along with your heart worm preventative than try to remember to give Bravecto every 3 or 4 months. If you have memory issues, buy the Nexgard. Nexgard is a smidge more expensive than Bravecto. Both Nexgard and Bravecto are very effective against Demodex mites. Demodex (aka mange) is very common in the environment. Puppies are particularly prone to demodex until their immune system fully develops.
Bravecto is approved for pets 6 months and older (per the company) simply because if it is given to a younger pet the pet may grow out of the weight range before the 3 month period is up. Topical flea meds for dogs I do have a negative bias for topical medication simply because I don’t like petting a dog and having the topical goo on my hand. I typically rely on oral flea medications for dogs because of this. (Note below that I tend to use topical medications for cats because many people have trouble getting oral medications into their cats.) I no longer carry any of the following flea products at TVC but will discuss them below.
ACTIVYL Activyl is a great drug. It is a topical that is approved for puppies 8 weeks of age and older. Activyl is a flea adulticide that has flea repellent qualities that are fantastic. It also kills the immature stages of fleas. If a pet is exquisitely sensitive to flea saliva, I may add Activyl to the treatment protocol. Activyl came out about 5 or 6 years ago and there is no known flea resistance to it. It is a topical medication. ADVANTAGE Advantage came out the year I graduated vet school in ’93. It has been a wonderful thing. There is minimal drug resistance and it remains a fantastic option for flea control. Again, I’m not a fan of topicals on dogs. It can be purchased over the counter at pet stores. There is a fancier option for Advantage called Advantage Multi that has moxidectin for added heartworm protection. We do not carry either of these products for dogs because I prefer oral heartworm and flea preventatives for dogs. And, if I do have a dog with a
food allergy (as many of the orals have beef or pork), I tend to reach for Revolution as my topical medication of choice.
FRONTLINE
Frontline came on the market in the early 90s and I loved it for years. It has a high safety profile, particularly for pets with neurological conditions. Unfortunately, there is significant drug resistance to Frontline. The sturdy fleas we have in SoutFlorida laugh at Frontline these days. If you have Frontline, please give it to your friends up north. The fleas in the northern USA are pansies compared to our badass South Florida flea population. One UF dermatologist calls the fleas we have down here in South Florida “terrorist fleas”. We don’t carry Frontline and don’t recommend it. There are numerous generics of Frontline available over the counter. Frontline better than nothing at all, but we
don’t recommend Frontline nor the generics in South Florida.
SERRESTO COLLARS FOR DOGS
I’ve never been a fan of flea collars, but the Serresto collar (for both dogs and cats) is the best I’ve seen. It lasts for 8 months and has flea and tick repellent qualities. It needs to be snug to the skin (can slide 2 fingers between the collar and the pet) and once applied should not be removed. In general, I prefer Bravecto or Nexgard over the Serresto Collar, but for folks who snowbird up north where there is a much worse tick issue, this is a good choice. I hear they sell like hotcakes up north. I usually have a few on the shelf (for our snowbird clients), but rarely sell them.
FLEA AND TICK & HEART WORM CONTROL FOR CATS:
We’ve come a long way with heartworm and flea prevention for kitties in the last year! For cats in Florida, we strongly prefer to have a heart worm prevention included with the flea treatment. There is no treatment for heartworm disease in cats. Yes, you can get Advantage and Frontline over the counter, but they do not have tick nor heart worm prevention in them. Furthermore, Frontline has significant flea resistance. Please never use a permethrin or pyrethrin on your cat. Back in the 1990s, I treated many cats who were poisoned (presenting with tremors and seizures) by the use of permethrins and pyrethrins.We currently carry Revolution Plus and Bravecto Plus for our feline patients. In the past we carried regular Revolution and Advantage Multi and regular Bravecto.
BRAVECTO PLUS FELINE
Bravecto Plus for Cats is a new product. It is a topical and lasts for 2 months for cats. For cats who are difficult to catch (especially feral cats), this flea product is fantastic! Or, if other products have failed you in the past, there is no known flea resistance to this product. Bravecto Plus has Bravecto (fluralaner) and moxidectin for heart worm prevention and roundworm and hookworm treatment. It is fantastic. You just need to remember to give it every other month. This is Joi’s favorite product for cats. It can be used in cats 6 months of age and greater than 2.6 lbs.
REVOLUTION PLUS
Revolution has long been a great flea product. For cats, it is also great for roundworm, hookworm, and ear mites. Recently Zoetis added Sarolaner for even better flea control AND tick control. It is used once monthly for cats. It is topical. Revolution Plus can be
used in cats 8 weeks of age and older and cats 2.8 lbs or more.
SERRESTO COLLAR FELINE
I’ve never been a fan of flea collars, but the Serresto collar (for both dogs and cats) is the best I’ve seen. It lasts for 8 months and has flea and tick repellent qualities. It needs to be snug to the skin (can slide 2 fingers between the collar and the pet) and once applied should not be removed. It doesn’t have a “break away” piece should a cat get caught by the collar. I’ve seen cats come in with a Serresto collar and yet still have fleas. This is likely because most folks don’t wish to keep the collar on snugly. I prefer Bravecto Plus and Revolution Plus over the Serresto Collar.
I hope this helps you choose the best product for your pet. Please don’t hesitate to ask me or my staff if you need guidance!
