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Written by Paul
Dr Paul Manktelow is a vet who’s worked for almost 20 years on the front line in some of the UK’s busiest veterinary hospitals. As Chief Vet in the Charity Sector, he leads a team of vets and nurses that treat thousands of pets every year. Paul also appears regularly in the media as a TV and radio presenter, writer, public speaker and podcast producer.
“Prevention is better than cure.”
For many years, parasite control followed that philosophy closely.
Monthly flea treatments. Worming every three months. Year-round cover, regardless of lifestyle.
But medicine evolves as evidence evolves.
Hazard vs Risk: A Significant Difference
There is an important distinction in clinical thinking:
- Hazard is the possibility that harm could occur.
- Risk is the likelihood that harm will occur in a specific situation.
Parasites are a hazard.
Not every pet is at equal risk.
A rural working dog has a different exposure profile from an indoor cat. A dog that swims regularly has different risks from one who lives in a city flat.
Treating based on hazard alone can lead to over-medication. Treating based on risk requires assessment.
What Does Risk-Based Care Look Like?
A more tailored approach may include:
- Structured lifestyle questions
- Regional parasite awareness
- Regular flea comb checks
- Faecal egg counts where appropriate
- Reviewing frequency rather than defaulting to monthly use
This does not mean under-treating. It means matching intervention to evidence.
In the latest episode of The Consult Room, we discuss how long-standing habits, commercial structures and convenience have shaped parasite prescribing, and how the profession can evolve responsibly.
🎧 Listen here:
The future of parasite treatment is unlikely to be all or nothing. It will be individual, thoughtful and evidence-led.
That is good medicine.
