Plus-Hex CLINICAL
Introduction
Control of parasites is essential in maintaining animal and human health, although some treatment regimens can have a negative impact on the environment and increase the risk of adverse reactions and parasiticide resistance [ 1 ].
Parasites can be vectors for transmitting diseases to the human population. For example, ticks can transmit Lyme disease, with around 1,500 human cases being confirmed by laboratories in England and Wales each year, although there are thought to be an additional 1,000 – 2,000 unconfirmed cases [ 2 ].
Residue from spot-on treatments for dogs accounts for 20 – 40 % of fipronil and imidacloprid found in wastewater. It enters the water system through bathing, washing of bedding and handwashing [ 3 ].
With so many products available, it is important that owners are educated on the safe use of parasiticides, including the frequency of dosing and the potential for environmental contamination. A team-based approach including the veterinary surgeon( VS), veterinary nurse( VN), suitably qualified person( SQP) and receptionist can improve owner compliance, animal welfare and practice – client relations.
The role of the VN
VNs play a crucial role in parasite control consultations, but it is important to remember that dispensing parasiticides legally requires a VS to physically examine the animal and prescribe the product unless there are exceptional circumstances [ 4 ]. This ensures a VS is responsible for diagnosis and prescribing, supporting the safe and appropriate use of medicines.
VNs can be a part of the parasite control consultation by gathering information, completing diagnostic procedures and collaboratively working with a VS to select a product that matches the owner ' s and animal ' s lifestyle, risk and financial constraints [ 5 ]. This approach enables registered VNs to maximise their clinical skills while observing legal and professional requirements. SQPs are able to prescribe POM- VPS( Prescription-Only Medicine – Veterinarian, Pharmacist, Suitably Qualified Person) parasiticides without the need for a VS to examine the animal [ 6 ]. The VN consultation should include carrying out a thorough lifestyle and risk assessment, performing faecal egg counts( FECs) for intelligent worming( see below), and taking an individual approach to communicating with each client to ensure optimal infection prevention and owner compliance.
Risk-based or assessment-based parasite control( also known as‘ intelligent worming’) refers to the use of FECs or coproantigen enzyme-linked immunosorbent assay( ELISA) tests to optimise worming schedules and avoid unnecessary treatment. For dogs with frequent exposure to bodies of water such as puddles, ponds, lakes, streams, rivers or the sea, and cats that are avid hunters, routine FECs every 3 – 6 months are recommended, or monthly checks for particularly high-risk animals. This allows worm burdens to be detected before clinical signs appear, offers a basis for informed product selection and can also be used to measure treatment efficacy [ 7 ].
Although an FEC does not detect all types of parasite, it can be a valuable part of the process when combined with a risk-based approach to parasite control [ 8 ]. Ideally, faecal samples should be collected over a 3-day period, as ova, cysts and larvae can be passed intermittently, with the faeces being picked up as soon as it has been passed to prevent environmental contamination [ 5 ]. Faeces should ideally be brought to the practice each day or should be stored in a sealed container at 4 ° C until it is brought to the practice [ 7 ].
There are a number of methods for completing an FEC, such as the modified McMaster technique, and for larval counts the Baermann technique can be used [ 9 ]( Appendix 1). The McMaster technique is recognised as current best practice, but quantitative assessment of worm egg counts may not always be required. In some cases, detection of the presence of eggs alone may provide adequate diagnostic information to inform the decision regarding parasiticide administration.
An example of a simple faecal flotation technique that could be carried out by a VN in practice is outlined below, for the isolation and identification of the majority of nematode eggs and protozoa [ 10 ].
1. Assemble the required equipment:
• Personal protective equipment( PPE): gloves and apron / laboratory coat
• Sodium nitrate solution at a specific gravity of 1.020, faecal sample, syringes, tea strainer, 15 ml container, disposable wide-mouth cups, wooden spatula( to stir), small weighing scales, microscope glass slide, microscope slide coverslips.
2. Put on the PPE.
3. Weigh 2 g of the faecal sample and place it into a wide-mouth cup.
4. Add 10 ml of the flotation solution into the cup. Stir thoroughly.
5. Filter the suspension through the tea strainer into a clean wide-mouth cup.
6. Empty the contents into a 15 ml container; keep it upright.
Volume 41( 2) • April 2026
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