A primer on tapeworm prevention and flea control

Dear Sinéad, Siouxsie and Thomas:
We need help with the speed of a vet's tapeworm treatment on a cat and how to keep everyone else free from infection. My girls are all rescues and love to go outdoors. I thought the flea prevention and vaccinations were enough until my youngest furbaby came down with tapeworm by eating the fauna caught by my oldest furbaby.

I have plans to build an enclosure, but the lawn we have is too narrow. Big windows with birdfeeders and play time with wand toys do not seem to be enough. Any suggestions for cats that have been rescued from free roaming lifestyles would be greatly appreciated, too.

The kitty clan of Luna, Tilly, and Jezebel, as well as their humans thank you for any help you can give from your deep well of wisdom and experience!

Dear Sinéad, Siouxsie and Thomas:
I have three cats, one who goes outdoors and her 3-year-old daughters who live indoors. They have all had some problems with fleas, and now one of my indoor kitties has started balding on her back end, the backs of her legs and part of her stomach. She also has scabs all around her neck and her head, some from fighting with her sister, some I'm sure from flea bites, and some it seems just from scratching herself raw. We haven't had much luck with flea treatments ... they don't tolerate anything other than the collars, and at the moment I haven't been able to bring her to the vet until I get some more money in. What do you think is causing this balding, and do you think its something serious? I have read a little about mange and thought that was a possibility, but was unsure what the treatment would be, and if its very serious. She has had this for a few months now and it is only very slowly getting worse, and I would like to know what steps I need to take to take care of this before it BECOMES serious. I would appreciate as quick of a response as you are able to make, since I'm sure you get a lot of e-mails!


Sinéad: Oh, yes, tapeworms. Yuck! 'Tis the season.

Siouxsie: Tapeworms and fleas go hand in hand, and as the weather gets warmer, animals get exposed to both.

Thomas: Let's answer your first question first, and then we can get into how to control tapeworm and prevent reinfection. How fast does the vet's tapeworm treatment work? If you get a prescription dewormer, it should work almost instantly to kill and dissolve the adult tapeworms currently living inside your cat's intestines. Usually, you will get two doses per cat, with instructions to give the second dose a week after the first. This will kill any adult tapeworms that have hatched after the first dose did its job.

Sinéad: To prevent reinfection, it's important to clean all litterboxes. Dump out all litter, even if it's brand new, and clean each box with a bleach solution to kill any worm eggs that may be living in it.

Siouxsie: Also, it's crucial that you practice flea control at the same time, because cats (and dogs, and sometimes humans, too, by the way) get infected with tapeworms by swallowing flea larvae that have swallowed tapeworm eggs. It's thought that contact between flea larvae and tapeworm eggs occurs most commonly in contaminated bedding or carpets.

Thomas: So the flea larvae eat the tapeworm eggs. Then the cat chews or licks its skin as a flea bites, and swallows the flea. As the flea is digested within the intestine, the tapeworm hatches and anchors itself to the intestinal lining. Yuck!

Sinéad: We mentioned that sometimes humans get tapeworms, too. It's possible that a human could swallow a flea accidentally, and the same process could occur within a human's intestines. This happens more often with very young children than with full-grown adults, though.

Siouxsie: Humans can't get tapeworms from handling fleas with their hands, particularly if they wash their hands after touching any fleas. If humans didn't have hands, they'd probably have a lot more tapeworm problems, but since you humans pick fleas off rather than lick them off, you're safe in most cases. Fleas have to be swallowed whole, whether by animals or by humans, for the tapeworm life cycle to continue. The egg sacs (those little things that look like moving rice grains around an infected cat's anus) are pretty gross, but the eggs are not directly infective. Tapeworm eggs do last a while in the environment (maybe as long as 15 months) so vacuuming well and throwing out the vacuum cleaner bag each time for a couple of times is a good idea.

Thomas: If there are no fleas, the tapeworm cannot complete its life cycle. That is why flea control is so critical. Most veterinarians recommend spot-on flea treatments (such as Frontline or Advantage) for animals living in high-flea areas. These prevent fleas from breeding and are quite safe if used as directed. We're not sure if any one of these treatments is best overall; different vets have different preferences, some are more waterproof than others, and so on. So talk to your vet about spot-on flea control to see which product is best for your area and your cat's lifestyle.

Sinéad: If you already have fleas in your home, you're going to have to embark on a pretty labor-intensive flea control regimen. We do not recommend that you use "bug bomb" sprays or other insecticides, because these products can be toxic to your cats as well. Recently a reader wrote to us about his cat getting poisoned by a supposedly safe pest-control product, which just confirmed our belief that these indoor insect-control sprays can do more harm than good.

Siouxsie: Cats can also develop flea allergies, which manifest as bald patches and excessive scratching -- which is what we think is happening to Alicia's cat. And some cats can't tolerate spot-on flea control products due to sensitive skin. What's a cat lover to do in this case?

Thomas: Have no fear. You can control fleas and not poison your kitties in the process. We have had good luck using more natural methods of flea control, although these tend to be much more labor-intensive. When we got fleas a few years back, we used a combination of baths using an herbal flea shampoo, picking fleas off and drowning them, and vacuuming and laundering EVERYTHING in the house to get rid of flea eggs. Here's our chemical-free, collar-free, all-natural flea control program, in a nutshell:

Sinéad: First, purchase some natural flea control shampoo. We used a product called Flea-B-Gone, from Avena Botanicals of Rockport, Maine, although there are certainly many other natural shampoos available. It contains pennyroyal, which is a natural insect repellent, and other herbs and natural ingredients. Bathe each cat once a week, using this flea control shampoo, and pick off any half-drowned fleas you see crawling around on their heads or in their fur.

Siouxsie: As a note, pennyroyal can be toxic in large quantities, so don't go crazy with the shampoo. A teaspoon or two per bath should be plenty, and rinse the cat very thoroughly after each bath.

Thomas: The second step is to vacuum, vacuum, vacuum! This is crucial, because fleas and flea eggs fall off cats and into carpets, bedding, and even cracks between boards in old hardwood floors. We cats hate vacuum cleaners, but we hate fleas even more!

Sinéad: Dispose of your vacuum cleaner bag immediately, in an outdoor location (even if it's not full) because you don't want those fleas to find their way back out of your vacuum cleaner and into your house again. If you have a bagless vacuum cleaner, empty the receptacle outdoors and dispose of the material from the receptacle in an outdoor location. Don't forget to vacuum your furniture, taking off cushions as needed to reach all parts where fleas and flea eggs may be hiding out.

Siouxsie: After you've vacuumed, sprinkle flea-killer on carpets and furniture. We use a chemical-free flea-killer consisting of half ordinary table salt (doesn't have to be iodized salt) and half baking soda. It works because the fleas are attracted to the salt and then the baking soda clogs their "spiracles" (the holes in their sides that they use to breathe). Sprinkle this stuff on your carpets and furniture and let it sit for about 20 minutes. Then vacuum again. Do this once a week for 3-4 weeks (the flea life cycle, from egg to adult, is about 2 weeks, so this should take you through two hatchings). You can also place saucers of this salt and baking soda mixture under your couches and other furniture.

Thomas: Step three is to launder everything. Quilts, sheets, decorative furniture blankets, duvet covers, throw rugs ... the whole works. Do this on a weekly basis for 3-4 weeks, too.

Sinéad: Drown the fleas. Whenever you are going to spend some time sitting down, bring a small jar containing water and a small amount of dish soap. Let the dish soap form a slick across the top of the water. When your kitties come to hang out with you, be prepared to pick off any fleas you see and put them in the soapy water. Fleas can move pretty quickly, and it's hard to crush them because they have tough skin, so plucking them off before they can hop away and then drowning them in the soapy water is an easier solution.

Siouxsie: This process is, as you see, quite labor-intensive, but it works! We had a flea outbreak in our house about five years ago, and it was completely stopped by using this technique.

Thomas: You can help prevent flea infestation by improving the quality of your cats' diet. Cats are exposed to fleas quite a lot, but the ones that become infested with them are typically weaker, possibly due to pre-existing health conditions or allergies, or because of a poor-quality diet.

Sinéad: Buy the best-quality and most natural food you can afford. Artificial colors and flavors, chemical preservatives, and poor-quality source meat can cause allergies in sensitive cats, just as they can in humans. If you knew what kind of awful stuff goes into most low-priced commercial cat food, it would make you sick! It's really worth it to spend a little more and buy hypoallergenic or natural foods. Most supermarket-quality dry foods contain corn, which is a fairly well-known allergen for cats and dogs.

Siouxsie: Cats that develop flea allergies may be experiencing a high "toxin load" due to other factors in their environment as well. You can help your sensitive cat by switching to unscented laundry detergent and cat litter (if you're currently using scented versions of these products) and avoiding the use of air-freshener sprays or plug-in air fresheners.

Thomas: Cats tend to be very sensitive to these products, and if they have any tendencies to allergies at all, these products can exacerbate the allergic reaction. Also, if anyone in your household smokes, it would be a good idea if they would limit their smoking to outdoors or to one well-ventilated room.

Sinéad: Some people believe that feeding garlic can help control fleas and even kill worms. We're not entirely sure about that. Besides, it'd be pretty hard to get a cat to eat garlic. And again, garlic is a member of the lily family, and most lily-type plants are toxic to cats, so in the best interest of your cat (and your relationship with your cat) we'd recommend against this.

Siouxsie: As for the question Luna, Tilly, and Jezebel's human family has about how to help formerly outdoor cats adjust to indoor lifestyles: It's never easy for cats to go from free-roaming outdoor cats to indoor-only cats. There may be territory issues that result in fighting, and your cats may start acting depressed. If it's at all possible for the cats to go out into a screened patio area, they might enjoy that. They could get fresh air there and enjoy all the benefits of outdoor life without the risks. At the very least, open some windows (screened windows only, please) so they can catch a breeze and watch the action outside.

Thomas: Don't forget to grow a nice, big pot of cat grass for the kitties to munch on. This will help keep their digestive systems working properly and go a long way toward preventing hairball problems.

Sinéad: Time and lots of love, play and attention are the best cure for any feline angst about the transition to indoor-only life. If your cats are fighting or having other behavior problems as a result of the transition, you might try a feline pheromone analogue such as Feliway to help them feel more content and stable in their newly limited territory.

Got a question? Need some advice? E-mail us at None of the advice in this column is meant to be a substitute for regular veterinary care.