October 28, 2014 9:56 AM   Subscribe

I recently adopted a cat. He is infested with fleas. I asked the vet for suggestions and need to confirm if this combination of treatments is safe.

I just adopted this cat a week ago so the problem is NOT that the house is infested and he is getting re-infected. We have been vacuuming, doing laundry, putting down diatomaceous earth on everything, etc. every single day. Fleabag cat received a topical flea treatment (Advantage II) 2 weeks ago. Still there are fleas. On Sunday he got a bath using flea shampoo. Still there are fleas. The vet says we can also give him Frontline now and in 2 weeks give him Advantage again and that this will not overdose him on medications. But, the googling I did says it's not safe to combine these 2 medications. So, who's correct? I do not want to kill this cat, but I also want these fleas to go away ASAP.
posted by Librarypt to Pets & Animals (28 answers total) 2 users marked this as a favorite
I would be bathing the cat fairly regularly with a mild cat shampoo and using flea powder on rugs, leave it for an hour, then vacuum. Make sure kitty's bed gets washed a lot, probably daily.
posted by theora55 at 10:03 AM on October 28, 2014


Look online to order, or ask your vet, for REVOLUTION

Revolution has safer medicine (I once did extensive research on this, but the scientific papers I found are buried under google results of advertising and blog posts - sorry no clicky) and best of all, it is used less frequently, so fleas have not built up an immunity to it. Frontline and Advantage both have problems with efficacy because fleas are getting immune to them.

Also, Revolution kills ear mites, which the other two do not.

Hope that info helps!
posted by jbenben at 10:09 AM on October 28, 2014 [6 favorites]

Seconding. Revolution = magic = dead fleas and no future flea babies.
posted by SuperSquirrel at 10:12 AM on October 28, 2014 [3 favorites]

Response by poster: He already had a Revolution treatment when the rescue found him 3 months ago. Apparently it didn't work.

To clarify, I am not looking for advice for other ways to deal with the fleas. I have already done extensive research. I am just trying to find out if my vet is giving me accurate information or not because the information I found contradicts what they told me.
posted by Librarypt at 10:13 AM on October 28, 2014 [1 favorite]

Where I live (NC in the USA) a lot of fleas are immune to Frontline. I'm not sure I would bother with it.

[on edit: sorry to give more flea info! Maybe someone will find it useful.]

Have you flea-combed him during the bath?

Also, if he trusts you enough (he may not since you just adopted him -- use your own judgment), you might try this interesting approach: here's a video of a guy enclosing most of his cat, except the head, in a plastic bag, and then rubbing/brushing diatomaceous earth through her fur. I think it's a really good idea, especially since it keeps the cat from breathing the dust.

If you try this, start of by gently getting the cat used to standing still; to being around rustling sounds while standing on a counter with you petting him; to standing up on top of an open bag; then to gradually raising the bag around him, first just up to the hocks of his back legs, then to the middle section of his back (use your own judgment for the right degree of change). Really, it's mostly him standing there with you petting him, so it might be easy and completely fine (and even a fun bonding experience). What you don't want is a panicked cat clawing his way out of a bag and spreading dust everywhere.

I haven't tried diatomaceous earth personally, but it was recommended by a small local pet supply store, and apparently the guy in the video has used it several times. There are more videos of it being used on pets, for example someone brushing it into the coat of a large dog without using a plastic bag.

I did learn that you probably want amorphous diatomaceous earth (rather than crystalline) since it's less likely to cause problems if breathed (probably what most people buy is this form). Avoid breathing it anyway, of course.

If you do something like this, or another bath, I'd make sure the newly-flea-free cat was in a comfortable place (like a bathroom with some fresh clean blankets under him) for a few hours and clean the house before letting him back out. You might want to clean one room, let him live in there while you clean the rest of the house, etc. -- in other words, be completely systematic and thorough about making sure no flea can get to the cat once the population is eraticated.

I had a mild problem with this recently, and looked up the lifespan of fleas, since I was basically waiting for all the current fleas to die off before declaring the Advantage Plus [or synonym for Plus - it handles heartworms etc. too] treatment a failure. The lifespan was much longer than I'd thought.

Some treatments don't kill the fleas, they just render them sterile. The fleas on our treated cat were lethargic and easy to catch, so I figured it was doing something.
posted by amtho at 10:17 AM on October 28, 2014 [1 favorite]

Just FYI, a single treatment of any of those topical meds isn't enough to kill an infestation. You need at least two, since eggs hatch in a 6 week cycle.

From my own personal experience, revolution is the way to go. But if you're worried about combining meds, CapStar is safe to combine with topical meds and it kills all adult fleas within 24 hours.
posted by zug at 10:18 AM on October 28, 2014 [6 favorites]

Reiterating that just because the fleas recurred after one application does not mean the medicine didn't work. It takes time and multiple doses.

What sources conflict with your vet's advice? I'd bring the sources to your vet and ask them what their response is.
posted by soelo at 10:23 AM on October 28, 2014

Seconding CapStar. It's not the only thing you'll to do, because it only kills the fleas *on* the cat, but it's great for reducing the fleas actually on the cat ASAP.
posted by foxfirefey at 10:23 AM on October 28, 2014 [2 favorites]

Not a vet, but a cat owner for decades:

Revolution, Frontline and Advantage are all intended as monthly treatments. A single treatment of any is unlikely to put a permanent stop to the fleas. I've found that it usually takes a three month cycle to be 100%. I typically see 50% the first month, 90% the second, and none the third. (Another Revolution believer here, BTW)

None of them are OK to combine at the same time. You can't use one and then use another the next day. Your vet is just suggesting that in this case two weeks vs. the usual month is long enough to wait as a one-time fix based on the type of medicine s/he is suggesting, the cat's age, condition, and health etc.

You should take your concerns back to the vet for a real answer from an expert.
posted by tyllwin at 10:28 AM on October 28, 2014 [4 favorites]

We have three dogs. I can't speak for cats, but I can tell you with 150% certainty that Frontline is absolutely useless against fleas and ticks on our dogs. We've had slightly better luck with Advantix/Advantage II (these are the same medication both made by Bayer), but not much.

You have to wait a certain amount of time between treatments to avoid overdosing. Two weeks seems to ring a bell. I'd skip the Frontline and give two doses of Advantix spaced two weeks apart.
posted by tckma at 10:31 AM on October 28, 2014 [1 favorite]

Revolution is intended to be given monthly. So, I wouldn't write it off based on the idea that the rescue dosed the cat with it 3 months ago. When my cats got a flea infestation this past summer, one application of Revolution took care of it within a couple of days (we had gotten lax with the monthly doses--so sorry kitties!)

I'd ask your vet if you can give him Revolution now given the Advantage II dose was 2 weeks ago.
posted by msbubbaclees at 10:31 AM on October 28, 2014 [1 favorite]

tyllwin is right - these are all preventative measures, meant to be given monthly. I do know that fleas are immune to some of the older medications, although I am not familiar with cat meds specifically.

I have heard great things about Capstar, which kills all the fleas that are currently on your animal.

I would also be giving baths (ugh I know, cats hate them) because it will kill the fleas on him. I don't think it's the medicated shampoo as much as it is drowning the little jerks.
posted by radioamy at 10:34 AM on October 28, 2014

Best answer: We did this when I first got my current cats. They had Frontline in their previous home just before coming to us, then we gave them Advantage soon after we got them. There would have been 1.5-2 weeks in between treatments. We got them at eight weeks old and they had a lot of fleas, so this wasn't planned so much as done out of necessity. The vet was fine with it though and the cats are very happy and healthy five or so years later.

Then we continued with Advantage monthly for six months or so, then treated them every three months until we moved to Ireland where there just don't seem to be any fleas. We also switched to Revolution at some point but Advantage is still miles better than Frontline (which, yeah, lots of fleas seem to be immune to). You do need to keep up the repeat treatments to really get on top of the problem. Killing all the current fleas isn't enough, you need to get the ones waiting in egg form too.
posted by shelleycat at 10:38 AM on October 28, 2014

As others have said flea drops like those mentioned need to be given monthly, one does 3 months ago won't keep working. Also bathing the cat may decrease the effectiveness of the products given. It would be better for the cat to do the drops than to keep doing flea baths. If looking for a low toxicity solution a flea comb & patience can work wonders, especially on something as small as a kitten. Any fleas you brush out are easily crushed to death with a disturbingly satisfying pop between your fingernails.
posted by wwax at 10:39 AM on October 28, 2014 [1 favorite]

Response by poster: Sigh. It sounds like I am just screwed and there is no way quick way to get rid of these bastards. I am super frustrated because the rescue didn't tell us he had fleas -- we just got delivered a flea infested cat with no warning. We have him locked in one room so he doesn't infect our whole house, I guess he is just going to have to live in that room for 2 months. Ugh.
posted by Librarypt at 10:42 AM on October 28, 2014

Response by poster: Someone reminded me that I forgot to post photos of the fat old fleabag.
posted by Librarypt at 10:54 AM on October 28, 2014 [1 favorite]

Are you sure this is fleas?

Vets and rescues pretty much universally use Capstar at the sign of fleas. After that, monthly treatments absolutely do work.

Shampooing and flea combing work, too.

If you are doing even half of these things, it should take care of the issue.

You sound like there has been no improvement and there is a raging infestation. I'm confused.

I once managed an apartment building with a serious infestation of fleas under the building. Is it possible the fleas are coming from your property, and not from your cat? Do you live on the ground floor by any chance??

2 weeks in between frontline or advantage type treatments. I've seen Capstar and Revolution applied in the same day. I've never ever seen these treatments fail on the level you are describing. It seems something additional may be going on.
posted by jbenben at 10:57 AM on October 28, 2014

Half a day or so after we treated ours with Advantage for that second treatment I mentioned above, my husband I sat down and picked out all the fleas - more than 50 fleas per tiny cat. The fleas were really sluggish and easy to grab due to the poison so it was just a matter of waiting til the kittens were napping then taking the time. We popped each flea between our nails as wwax said (back of one nail to the back of another, not using the tips) which is so so satisfying, Be careful though, flea blood shooting into your face is not so amusing. I don't think all the fleas would have died otherwise but this method got rid of the lot, then the repeat treatments cleaned up the re-infestations before they took hold again.

A fine tooth comb will also really help given the soft short fur your fleabag is sporting. So poison the blood suckers and get as many out as you can over the next day or so. You should be able to at least get it all to manageable levels pretty quickly.
posted by shelleycat at 11:01 AM on October 28, 2014 [1 favorite]

Oh !

Upon your update - the cat is beautiful!! I would not describe that creature as either fat or old.

You might want to return the cat to the rescue shelter, then have your house treated by an exterminator. I can't think of anything else.
posted by jbenben at 11:01 AM on October 28, 2014

And yeah, this level of infestation at the beginning is perfectly normal even with modern treatments. You'll get on top of it quicker than you think.
posted by shelleycat at 11:03 AM on October 28, 2014

What a cutie!

If you want the fleas gone NOW CapStar really is the way to go as an initial treatment, followed by regular treatments of revolution (You might get lucky with advantage, but a lot of fleas have developed advantage/frontline immunity). You can even give repeated doses of Capstar as needed, I was told you could literally give it every day safely (although you wouldn't need to). It won't kill the eggs, but every flea that bites your cat in that 24hour window is D-E-D dead.

Costco has it at their pharmacy, although they might have to order it for you next-day.
posted by zug at 11:05 AM on October 28, 2014 [1 favorite]

Response by poster: One last update and then no more threadsitting:

The fleas have been decreasing in number as far as I can tell, although they have definitely not slowed down AT ALL. The day after the flea bath we pulled 10-15 more off him, some of which were very much alive. This concerns me because I thought the topical medication was supposed to at least slow them down as shelleycat describes. He is also still leaving noticeable amounts of flea dirt anywhere he sits.

Also, it's hard to tell from the photos, but he IS actually overweight and he's 7 so he's a little old. :)
posted by Librarypt at 12:24 PM on October 28, 2014

Ask your vet about alternating one of the topical treatments with Camfortis. It's oral and kills anything living in about half an hour... Disgusting, yes, but oh so satisfying! It really helped us get on top of things and stopped him dropping live fleas around the house.

He's beautiful! Good luck :)
(At least you can see the fleas... We have a tortie and it's impossible!)
posted by jrobin276 at 2:33 PM on October 28, 2014 [1 favorite]

If he was really badly infested you are going to see fleas keep popping up for another few weeks because the flea life cycle is six weeks long. Worst case scenario is there are eggs around the house that were laid prior to applying the Advantage, and you're going to keep seeing fleas from those eggs until they've all hatched.

I am kind of surprised they have not given him Capstar. The no-fail method I've seen rescues give cats is:

1) Capstar to kill all the adult fleas
2) Revolution at the same time, then monthly for 4-6 months
3) Day after Capstar give a warm bath in dilute Dawn dish soap to kill any sluggish remainders.
4) Re-administer Capstar doses every couple of days to kill off subsequent waves of hatching fleas while you wait for the Revolution to take full effect (supposedly you can give it every day but I wouldn't).

My vets and rescue strongly, strongly recommend against more than once-monthly treatment of the monthly topicals. Definitely not combining.

Frontline is crap-on-a-stick and in my experience Advantage II is only slightly better.

Seriously though, if you want the adult fleas dead then get a bunch of Capstar and give him those while the other shit is taking effect. Be warned, every cat I've given Capstar to has been uncomfortable for the first 12 hours--lots of scratching and crying. I was told this is because the fleas freak out as they're dying and start biting like crazy.
posted by Anonymous at 4:47 PM on October 28, 2014

ALSO if you haven't already get him dewormed, preferably with Profender, then follow up treatment in six weeks in case the hatching fleas re-infect him. Fleas bring tapeworms, and while Revolution gets most things it does not take care of tapeworms (same goes for Advantage/Comfortis/Frontline/etc).
posted by Anonymous at 4:54 PM on October 28, 2014

I know you aren't looking for additional treatments, so this is not for the cat per se. It's for deflea-ing your house, and it is extremely satisfying and effective.

Actually, there are several ways to make a flea trap, but the first one listed is the one I always used. Five Ways to Make a Flea Trap

Repeat until you catch no fleas overnight.
posted by caryatid at 6:35 PM on October 28, 2014

Yes, Nthing Capstar, with vet guidance. It actually kills the parasites.
posted by amtho at 7:42 PM on October 28, 2014

Response by poster: Just wanted to follow up in case this information might be useful for people reading this question later. We DID give the cat a dose of Frontline and it killed most, if not all, of the remaining fleas within 48 hours. The cat did not have any side effects at all. My vet's office said that they recommend Advantage used in conjunction with Frontline (doses separated by 2 week intervals) on a regular basis because in their experience, this is much more effective than Revolution. I guess I must live in an area where Frontline is still an effective flea treatment (Maryland).

Thanks all for your help.
posted by Librarypt at 10:56 AM on October 31, 2014 [1 favorite]

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