State of Pet Health

2016 Report
 Welcome
Welcome to Banfeld Pet Hospital’s State of Pet Health® 2016 Report— Otitis externa—In the fve years since our 2011 publication, there has been a 6.4 percent decrease in
the frst-of-its-kind to capture and analyze the medical data from 2.5 million prevalence of otitis externa (inflammation of the ear) among dogs to 12.9 cases per 100. The prevalence
dogs and 500,000 cats. As the world’s largest veterinary practice, Banfeld among cats has remained unchanged at 6.6 cases per 100 cats. While otitis externa has decreased in
currently operates more than 925 hospitals in 42* states, District of Columbia dogs, it remains very common in certain breeds, particularly Golden Retrievers with 1 in 4 afected and
and Puerto Rico with 16,000 associates caring for pets—including more than Labrador Retrievers with 1 in 5 receiving the diagnosis.
2,900 licensed veterinarians.
Fleas and ticks—Since 2011, flea infestations in dogs have decreased in prevalence by 8.3 percent
In 2011, we published the frst edition of our State of Pet Health® Report. and have remained unchanged in cats. The abundance of fleas is dependent upon, among other factors,
Because of our size and scale, as well as our ability to capture and analyze the use of a flea preventive, geographic location within the United States and local weather patterns.
millions of electronic pet medical records from pet visits at Banfeld hospitals, The prevalence of fleas in cats (10.9 cases per 100) is almost twice that of dogs (5.9 cases per 100),
we are uniquely positioned to shed light on the health of companion animals indicating the need for greater education about flea control in the feline population. Ticks have decreased
across the United States. Now in its sixth year, this annual publication is just one over the past 10 years for dogs (11.3 percent decrease). Ticks are uncommon for cats, and over the past
way our practice shares our knowledge of pet health with pet owners and the profession at large. 10 years there has been a 9.9 percent decrease.
Internal parasites—Over the last fve years, there has been a reduction of roundworms, whipworms
Our inaugural State of Pet Health Report (2011) analyzed fve-year trends of common diseases, fnding
and tapeworms in dogs, though the prevalence of hookworms has remained relatively unchanged. In
that many were on the rise. This year, we are revisiting these diseases and analyzing 10-year trends.
cats, there has been a reduction of roundworms, hookworms, whipworms and tapeworms. Increased
Data from our 2011 report act as a benchmark, giving us a unique perspective to explore how disease
use of flea prevention in dogs and cats, and increased use of heartworm prevention in dogs may explain
prevalence has changed across the UnitedStates. Another enhancement this year is that, for the frst time
some of these changes. Tapeworm remains the most common parasite in cats (4.9 cases per 100),
since we expanded to Puerto Rico in 2013, we have adequate data from our hospitals on the island to
which is greater than twice the prevalence seen in dogs (2.2 cases per 100). Since tapeworm infection is
include in the 2016 report. We are proud to be able to provide information on pet health on the island
initiated by the ingestion of fleas, this suggests that more cats need to be on flea prevention year-round.
and better serve the pets of Puerto Rico.
We are encouraged that preventive care has helped decrease several common diseases over the past
Disease prevalence is constantly changing—there are several key conditions that are increasing in decade, but there is still a lot of work to be done. As a practice, our focus is making a better world for pets
prevalence and negatively afecting the health of our pet population. Similarly, there are a handful of through preventive care, and we deeply believe that early diagnosis of disease will positively impact a
common diseases that are decreasing in prevalence, indicating pet owners are doing a better job of pet’s health. We hope the information in this report will be useful to both veterinarians and pet owners
partnering with their veterinarian on proactive disease management. as we partner to help pets live healthier lives.
Below is an overview of signifcant fndings from this year’s report:
Diabetes—In 2011, we reported a 32 percent increase in canine diabetes and a 16 percent increase Sincerely,
in feline diabetes since 2006. Unfortunately, diabetes continues to grow in prevalence among dogs.
Canine diabetes has increased by 79.7 percent since 2006, while, in felines, the prevalence of diabetes
has increased 18.1 percent over the same time frame.
Heartworm disease—Heartworm continues to be one of the top three health risks for dogs seen in
Banfeld hospitals in the Southern United States. We are happy to report that since 2011, there has been Daniel S. Aja, DVM
a 33.1 percent decrease in cases, which is likely due to improved heartworm preventive compliance. Chief Medical Ofcer
Data over the past two years show that there has been a 12 percent increase in the use of heartworm Senior Vice President of Medical Operations
preventives by dogs seen at Banfeld hospitals—a step in the right direction.
Dental disease—The most common disease in dogs and cats continues to be dental disease, afecting
68 percent of cats and 76 percent of dogs. Dental disease has increased by 8 percent in dogs and 9.6
percent in cats since our initial report fve years ago. We were pleased to learn that Banfeld saw an
increase in the number of pets receiving dental cleanings in 2015, likely due to a better understanding
by pet owners of the importance of dental health in pets. In this report, you will also fnd information Understanding the data
on tooth resorption, a painful condition afecting nearly 1 out of 100 cats. This is a sharp rise of 1,587
percent over the past 10 years. The cause for this increase remains unknown and warrants further The fgures and graphs in this report are presented as cases per 10,000
research in this area. (diabetes mellitus, heartworm disease, fleas, ticks and internal parasites)
or cases per 100 (dental disease and otitis externa). For example, in 2015
there were 56 positive cases of heartworm disease detected per 10,000
*The 2016 report includes data from 43 states; we closed our single hospital in South Dakota in 2015. For purposes of this report,
tests performed in dogs.
data is included from South Dakota to showcase pet health trends in the state.
2 3
 Introduction Table of Contents

In 2015, Banfeld Pet Hospital cared for nearly 2.5 million dogs and 500,000 cats. Banfeld’s
veterinarians, technicians and paraprofessionals use PetWare®, Banfeld’s proprietary data/electronic
medical records system, to collect data from every pet cared for in Banfeld hospitals. Information is PET HEALTH TRENDS IN 2015
downloaded daily to the medical database at Banfeld’s main campus in Portland, Oregon. Data are
then analyzed by Banfeld’s internal research team, Banfeld Applied Research & Knowledge (BARK). Breed Overview........................................................................... 6
Banfeld’s commitment to providing high-quality veterinary care is grounded in evidence-based Breed Trends............................................................................... 7
medicine—this is supported by BARK’s team of researchers, many of whom are veterinarians and
are dedicated to population-based research. The BARK team analyzes the medical data of more than
Most Common Diagnoses | Dogs............................................... 8-9
8 million pet visits at Banfeld hospitals each year to develop insights into diseases afecting pets. Most Common Diagnoses | Cats ............................................ 10-11
Findings from the studies they conduct are shared with veterinarians and the public through various
avenues, including continuing education materials, scientifc journals and the annual State of Pet
Health Report.
DOGS & CATS COMMON DISEASES
Our commitment also includes forming partnerships that will beneft pets and pet owners. This
philosophy led PetSmart®, the nation’s largest retailer of pet-related products and services, to ask Section One: Diabetes Mellitus............................................. 12-14
Banfeld to bring high-quality care to its customers by opening pet hospitals in its stores in 1994. In Section Two: Heartworm....................................................... 15-17
2007, Banfeld joined the Mars, Incorporated family of businesses with the common goal of providing
the very best in veterinary care and nutrition to companion animals. Section Three: Dental Disease .............................................. 18-21
The State of Pet Health 2016 Report contains details of the most common and medically important Section Four: Otitis Externa .................................................. 22-24
diagnoses afecting dogs and cats in the United States, according to their age, breed and geographical
location. In addition to the most common diagnoses afecting dogs and cats, this report also contains Section Five: Flea & Tick ....................................................... 25-30
details on how select diagnoses have changed over the last 10 years in prevalence and geographical
scope. These diagnoses have been selected because they are either the most common, preventable Section Six: Internal Parasites.............................................. 31-37
and transmittable to humans (zoonotic disease) or medically important due to the efect on a pet’s
overall health and lifespan. The diagnoses include: diabetes mellitus, heartworm disease, dental
disease, otitis externa (ear infection), fleas, ticks and internal parasites (roundworms, hookworms, Conclusion................................................................................ 38
tapeworms and whipworms).
Acknowledgments..................................................................... 39
We hope the information contained within this report will be useful to veterinarians, pet owners and
the public as we focus on raising awareness of important diseases afecting the overall health of pets.
With increased knowledge and education, we hope to successfully decrease the number of pets living
with common diseases.

Banfeld Applied Research & Knowledge

Banfeld Pet Hospital employs a team of skilled researchers to help our veterinarians
deliver the best care possible based on the latest medical evidence—this team is called
the Banfeld Applied Research & Knowledge (BARK) team. BARK analyzes the medical data
of the more than 8 million pet visits at Banfeld hospitals each year through Banfeld’s
proprietary data medical records system, PetWare. The team then conducts research and
shares its fndings with veterinarians and the public through a variety of formats. For the
State of Pet Health 2016 Report, the BARK team analyzed the medical records of the nearly
2.5 million dogs and nearly 500,00 cats cared for in Banfeld hospitals in 2015.

4 5
 Breed Overview Breed Trends
Dogs and cats can be prone to certain diseases based on their breed. For dogs, The most common dog breeds cared for in Banfeld hospitals have remained similar over the past
Breed Icon breed size can also put them at an increased risk for certain diseases. As such, breed decade. We have seen an increase in the popularity of Chihuahuas (+35 percent), Yorkshire Terriers (+95
Banfeld sees and breed size have become important in veterinary medicine to understand the percent), Shih Tzus (+39 percent), Maltese (+87 percent), Pit Bulls (+24 percent) and Boxers (+6 percent)
1 cat per every diseases or conditions to which a dog may be predisposed. and a decrease in the popularity of Labrador Retrievers (-17 percent), German Shepherds (-7 percent),
5 dogs Dachshunds (-9 percent) and mixed breeds (-11 percent).

Top 10 Dog Breeds in 2015

Cat – average weight: 10 lbs
Common Breeds Common Diagnoses Common Names
Chihuahua 1
Domestic Shorthair Feline respiratory virus Kitty
Domestic Medium Hair Kidney disease Bella
45%
of dogs seen
Domestic Longhair Tapeworms Luna Labrador Retriever 2
at Banfeld
Toy/Small – weight: <20 lbs
Common Breeds Common Diagnoses Common Names Yorkshire Terrier 3
Chihuahua Dental tartar Bella
Maltese Patellar luxation Max
Shih Tzu
Yorkshire Terrier
(kneecap pops out of place)
Retained baby teeth
Coco
Daisy
Shih Tzu 4
16%
Medium – weight: 20 - <50 lbs
5
of dogs seen
at Banfeld
Common Breeds Common Diagnoses Common Names
Pit Bull
Border Collie Conjunctivitis (eye infection) Bella
Pit Bull* Cystitis (bladder inflammation) Max
Cocker Spaniel
Schnauzer
Underbite Buddy
Lucy
German Shepherd 6
Large – weight: 50 - <90 lbs
36% Common Breeds Common Diagnoses Common Names
Maltese 7
of dogs seen German Shepherd Gastroenteritis (GI upset) Bella
Golden Retriever Otitis externa (ear infection) Max
8
at Banfeld
Labrador Retriever
Boxer
Overweight Bailey
Buddy
Mixed Breed
Giant – weight: >90 lbs
Common Breeds Common Diagnoses Common Names
Dachshund 9
Great Dane Arthritis Bella
3% Great Pyrenees Lameness Zeus
of dogs seen
at Banfeld
Mastif
St. Bernard
Skin tumor Bear
Max
Boxer 10
* The weight range for Pit Bulls covers both medium and large breed categories. They have been
defned in this report as medium breed.

The most common cat breeds have remained consistent over the past 10 years. They include:
6 Domestic Shorthair, Domestic Medium Hair and Domestic Longhair. 7
 Most Common Diagnoses | Dogs










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(0 - <1 year) (1 - <3 years) (3 - <10 years) reinforces that pet owners should bring their pets to the veterinarian for preventive care, as well as when their pets are sick or injured. Reasons for a “Healthy Pet” visit include physical
8 examinations, routine vaccinations and blood work or nutritional counseling, among others. 9
 Most Common Diagnoses | Cats

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10 physical examinations, routine vaccinations and blood work or nutritional counseling, among others. 11
 Section One: Diabetes Mellitus
Diabetes mellitus is a serious medical condition Bottom line: Diabetes Mellitus | Dog | 10-Year Trend (2006-2015)
in which a pet cannot control blood sugar levels Cases (per 10,000)
The prevalence of diabetes mellitus in dogs
due to problems with insulin production or
increased from 13.1 cases per 10,000 in ˜°
function. Pet owners’ most common concerns are
2006 to 23.6 cases per 10,000 in 2015—a
when pets display polyuria (excessive urination),
79.7 percent increase.
polydipsia (excessive thirst) and weight loss ˜˛
despite a good appetite. Diabetes mellitus is a The prevalence of diabetes mellitus in cats
chronic disease, requiring lifelong treatment and

Cases (per 10,000)

increased from 57.2 cases per 10,000 in
monitoring. There are two main types of diabetes 2006 to 67.6 cases per 10,000 in 2015. ˝°
mellitus: Type 1 (insulin dependent) and Type 2 Although this represents only an 18.1
(non-insulin dependent). Type 1 diabetes mellitus percent increase, diabetes mellitus is much
occurs when there is very low or no production of more common in cats than in dogs. This ˝˛
insulin by the pancreas. This is similar to the form increase occured from 2006-2011 with little
of diabetes seen in children. change in prevalence since 2011.
°
Type 2 diabetes mellitus occurs when the pancreas In 2015, Nevada, Montana, Iowa, Wisconsin
produces adequate amounts of insulin but the and Kentucky had the greatest prevalence of
body is resistant to it. This is similar to the form diabetes mellitus in dogs, while New Mexico, ˛
of diabetes that develops in adult humans Delaware, District of Columbia, Wisconsin and ˜˛˛˙ ˜˛˛ˆ ˜˛˛ˇ ˜˛˛˘ ˜˛˝˛ ˜˛˝˝ ˜˛˝˜ ˜˛˝ ˜˛˝ ˜˛˝°
and can be treated with insulin, diet and other Arkansas had the greatest prevalence in cats.
medications. Cats can sufer from either form
Year
of diabetes mellitus, but are more commonly
afected by Type 2; dogs are more commonly Key takeaway: Since 2006, there has been a 79.7 percent increase in canine diabetes. Regular
afected by Type 1. veterinary visits can help identify the disease process early and begin appropriate therapy to
reduce the risk of diabetic complications.
Afer confrming a diagnosis of diabetes mellitus
and determining whether a pet has other health
concerns, a veterinarian will most likely begin Preventive recommendations: Diabetes Mellitus | Cat | 10-Year Trend (2006-2015)
treatment with diet modifcation and insulin Twice-a-year examinations help Cases (per 10,000)
injections. Management of a diabetic pet can be veterinarians detect clinical signs of ˝°
challenging for both veterinarians and pet owners, diabetes mellitus early and reduce
as every pet responds diferently to treatment. complications associated with the ˛°
disease.
Ongoing management of the disease requires ˜°

Cases (per 10,000)

regular trips to the veterinarian to assess how the Keeping cats from becoming
pet is doing, monitor blood glucose levels and overweight or obese through ˙°
decide whether modifcations to the treatment proper exercise, nutrition and
plan are necessary. dietary management can reduce ˆ°
the risk of diabetes mellitus and
other serious diseases. ˇ°

˘°

°

°
˘°°˜ ˘°°˛ ˘°°˝ ˘°° ˘°° ˘° ˘°˘ ˘°ˇ ˘°ˆ ˘°˙
Year

1212 Key takeaway: Diabetes is nearly three times more common in cats than dogs. Maintaining a 13
normal weight in cats can reduce the risk of developing diabetes.
 Section One: Diabetes Mellitus Section Two: Heartworm Disease
Heartworm disease is a serious but preventable Bottom line:
2015 Diabetes Mellitus | Dog condition caused by Diroflaria immitis—long,
Heartworm disease shows a distinct geographic
Cases (per 10,000) slender parasitic worms that can reach up to
trend, with states in the Southeast having the
12 inches in length. Heartworm disease afects
WA highest prevalence of positive tests. In 2015,
˛˙ dogs, cats and ferrets, and is potentially fatal.
ME 4.1 percent of heartworm tests performed
MT
ND Diroflaria immitis is transmitted from one pet
OR
ˆ˘ in Mississippi were positive; 3.9 percent in
MN VT MA to another by mosquitoes. Both indoor and
˙
˛˙ NH ˛˙ Louisiana; 3.6 percent in Arkansas and 1.6
ID
NY
 outdoor pets are at risk for heartworm disease.
˝ SD
˛˜
WI
˙
RI
˛˛
percent in Puerto Rico and Alabama.
°
WY MI
˜ CT Afer infection, heartworms migrate to the blood
IA PA ˙ˆ Based on our data, the odds of a dog contracting
NV NE ˆ ˇ vessels of the lungs and to the right side of
˛ OH NJ heartworm disease in Mississippi are 171 times
ˆ°
UT
IL IN ˛
ˇ
MD ˛˝ the heart. Heartworms are capable of causing
CA  CO ˛ˆ ˜
DE those of contracting the disease in Nevada, the
˘
WV VA permanent damage to the heart and lungs before
˛ KS MO KY ˛˛
˛˜
state with the lowest prevalence of the disease.
˛ ˛˛ ° DC a pet shows any signs of disease. While there
NC ˛˜ This is followed by Lousiana, where the odds
are treatment options for heartworm disease
AZ OK TN ˛˝ ˙ˆ
are 165 times greater than those of contracting
AR SC in dogs, there is currently no safe treatment for
 NM ˛
heartworm in Nevada.
ˆ ˛°
GA
˛˝
heartworm disease in cats or ferrets.
MS AL
˛ˇ
˜° ˛˜ The prevalence of heartworm disease in dogs has
Risk Level TX
LA Clinical signs most commonly observed in pets
˛˘ decreased from 92.6 cases per 10,000 tests in
High Risk
˛˜ with heartworm disease include coughing,
PR ˜ 2006 to 54.2 cases per 10,000 tests in 2015—
Medium Risk lethargy, difculty breathing and sometimes
FL a 41.5 percent decrease. This decrease is likely due
Low Risk ˛˝ hemoptysis (coughing up blood). Sudden death
No Banÿeld Hospital to increased heartworm preventive administration.
occurs rarely in dogs, but occurs more commonly
States with Highest Prevalence Over the past two years at Banfield, there has been
in cats. Treatment for heartworm disease is
a corresponding 12 percentincrease in heartworm
neither simple nor risk free. The most common
preventive administration.
post-treatment complication is the development
2015 Diabetes Mellitus | Cat of pulmonary thromboembolism (clots within the Although heartworm disease is more common
Cases (per 10,000) lungs), caused by a combination of inflammation during the warmer months, it is a year-round
in the blood vessels, an increased ability to form condition and has been diagnosed in every
WA
˛˜ blood clots and the die-of of worms. Some month and every state where Banfeld has
MT
ND
ME degree of pulmonary thromboembolism will a hospital.*
˛
OR
MN VT MA occur whenever heartworm disease is treated.
˛°
˝ NH ˝
Widespread blockage of pulmonary arteries can *The American Heartworm Society reports that
ID ˘ˇ
˜ SD WI NY RI dogs testing positive for heartworm disease have
° ˙˛
MI
ˆ˘ ˜ˆ occur when worms die in great numbers. been identifed in all 50 states.
WY
˜˛ CT
IA PA ˘˜
NV NE ˇ ° Exercise afer treatment can increase the chances of
˛° OH NJ
ˇ
UT
IL IN ˘
°˘
MD ˛ˇ complications due to pulmonary thromboemboli,
CO ˘˝ ˜
CA ˆ
ˆ
WV VA
DE
ˆ˙
which is why exercise restriction is so important
˘˝ KS MO KY
ˇ ˇ ˜˝
˛˙
DC
during and afer treatment.
NC
˜˝
˝ Preventive recommendations:
AZ OK TN ˆˇ
˘ NM ˝˜ AR SC Heartworm tests for dogs,
ˆ˙ ˇ˜ °ˇ
AL GA including dogs receiving year-
MS ˘˘
LA
˜° ˛° round preventive medication,
Risk Level TX ˆ should be performed annually.
High Risk
˘˜
PR ˙
Did you know?
Medium Risk
FL Companion pets are not the only animals Year-round preventives should be
Low Risk ˛˘
No Banÿeld Hospital susceptible to heartworm disease. given as either a monthly medication
States with Highest Prevalence
Certain wild animals can become (topical or pill) or twice-yearly
infected as well, providing other potential injection for dogs. Cats in heartworm-
sources through which mosquitoes might endemic areas should receive a
1414 transmit heartworms to pets. monthly preventive medication. 15
 Section Two: Heartworm Disease

Heartworm Disease | Dog | 10-Year Trend (2006-2015) 2015 Heartworm Disease | Dog
Cases (per 10,000) Cases (per 10,000)
˜°° WA

MT ME
 ND
OR
˛° ˝ MN
˜ˆ
VT
NH
MA
ˆ˜
ID ˆˆ
˝ SD WI NY RI
Cases (per 10,000)

ˆ ˜ ˜˙ ˝˙
WY MI
ˆ˝ CT
˝° IA PA ˆ
NV NE ˙ ˛
˘ OH NJ
ˆ IL IN ˜° ˜˜
UT ˜ ˝˘
˜ MD
CA  CO WV DE
VA
˙°  ˜˝ KS
ˆ˘
MO KY ˆˇ
°
˝° ˜ˆ DC
NC ˝˙
˜˙˜
AZ OK TN ˜ˆ°
AR
ˆ° ˛ NM
˛

˝°˘
SC
˜˝˛
AL GA
MS ˘˘
ˇ˜˙ ˜°˛
Risk Level LA
TX ˝˘ˇ
° High Risk
˜˝
PR ˜ˇ
ˆ°°˝ ˆ°°ˇ ˆ°°˛ ˆ°°˘ ˆ°˜° ˆ°˜˜ ˆ°˜ˆ ˆ°˜ ˆ°˜˙ ˆ°˜ Medium Risk
FL
Low Risk ˙
Year No Banÿeld Hospital
States with Highest Prevalence

Key takeaway: There has been a 33.1 percent decrease in heartworm prevalence since 2011.

Heartworm in Puerto Rico

Puerto Rico is ranked among the top fve states and territories for heartworm disease in dogs.
While we cannot be certain, the high prevalence may be due to the tropical climate, which
creates unique challenges for pets on the island. The climate favors sustained levels of disease
transmission year round, which may account for the above-average prevalence of infectious
diseases. Puerto Rico is also ranked among the top fve states and territories for otitis externa,
ticks, roundworms, hookworms and whipworms in dogs and cats. Conversely, for reasons
unknown, Puerto Rico ranked the lowest for prevalence of diabetes and dental disease.

Heartworm disease in cats

Heartworm disease does afect cats. Although there is no safe treatment for infected
cats, heartworm testing is still important in determining whether a cat has heartworm
disease in order to rule out other medical conditions that may present similar clinical
signs as heartworm disease, such as asthma. Indoor cats, particularly in endemic
areas, are also at risk since mosquitoes can enter the home. These cats should receive
monthly preventive medication.

1616 17
 Section Three: Dental Disease
Dental Disease | Dog | 10-Year Trend (2006-2015)
Dental disease is the most common disease Of the most popular dog breeds, the highest Cases (per 100)
in dogs and cats, afecting 76 percent of dogs prevalence of dental disease was observed in ˙°
and 68 percent of cats. Dental disease includes Dachshunds (85 percent), Yorkshire Terriers
any health issue afecting the mouth, including (80 percent), Shih Tzus (79 percent) and ˝°
inflammation, tartar, gingivitis and periodontal Maltese (79 percent).
disease, among other issues. ˛°

Cases (per 100)

Periodontal disease is classifed by the severity °
of its impact on teeth and gums. It is divided
into four stages, ranging from mild tartar and °
gingivitis (inflammation of the gums), to gingival
recession and degradation of the periodontal Preventive recommendations: ˘°
ligament, to signifcant inflammation and loss Regular dental examinations by a
of teeth. Periodontal disease, when severe, can veterinarian and annual professional ˜°
lead to bacterial infections and abscesses, as dental cleanings beginning at 1 year
well as signifcant oral pain. of age for cats and small to medium ˇ°
breed dogs, and 2 years of age
Risk factors for developing dental disease in for large and giant breed dogs are °
dogs include increasing age and small breed recommended. ˜°°˛ ˜°°˝ ˜°°˙ ˜°°ˆ ˜°ˇ° ˜°ˇˇ ˜°ˇ˜ ˜°ˇ˘ ˜°ˇ ˜°ˇ
size. Dental disease can occur at any age, but
Year
the risk increases as pets age. Prevention early in Tooth brushing once daily to every
life may help reduce the frequency and severity other day is best to help mitigate the Key takeaway: Since 2006, the prevalence of dental disease in dogs has increased by 23.3
of dental disease later in life. Professional progression of periodontal disease. percent. At-home dental care, such as teeth brushing and ofering dental chews, can help
dental cleanings under general anesthesia Avoid using human toothpaste as this slow the progression of dental disease.*
are vital because they include measures pet contains high-foaming detergents
owners can’t take at home. These measures and abrasives that may be harmful
Dental Disease | Cat | 10-Year Trend (2006-2015)
include a thorough examination of a pet’s teeth to pets.
Cases (per 100)
and gums as well as the use of special tools to
Dental chews, water additives and ˝°
remove tartar from the teeth below the gum
line. Dental radiographs can also be taken at specially formed dry pet food may
also be used to help prevent tartar ˛°
this time to evaluate the entire tooth and check
for bone loss or abscesses. buildup.
˜°
Bottom line:

Cases (per 100)

˙°
Since 2006, there has been a 23.3 percent rise
in the prevalence of dental disease in dogs, ˆ°
with steady growth each year.
ˇ°
There has been a 23.1 percent rise in the
prevalence of dental disease in cats in the last ˘°
10 years.
°
In 2015, Minnesota, Nevada, Iowa and
Nebraska had the greatest prevalence of °
dental disease in dogs, while Minnesota,
˘°°˜ ˘°°˛ ˘°°˝ ˘°° ˘°° ˘° ˘°˘ ˘°ˇ ˘°ˆ ˘°˙
Wisconsin, Nevada and Washington had the
greatest prevalence in cats. Year

Key takeaway: Since 2006, the prevalence of dental disease in cats has increased by 23.1
percent. Cats have also had an increase in other painful dental conditions, including a 68.8
1818 percent increase in stomatitis and a 1,587 percent increase in tooth resorption. A dental 19
procedure under general anesthesia is needed to address both of these conditions.*
* Graphs are age-adjusted to allow for accurate comparison across years, and therefore difer from the overall prevalence rates
reported in the text.
 Section Three: Dental Disease

2015 Dental Disease | Dog What would be the impact on cat health if periodontal disease were eliminated?
Cases (per 100) There are two dental conditions afecting cats that
WA have seen very signifcant increases in prevalence
˛
MT ME over the past 10 years that are worth noting: tooth
ND
OR
˙ˆ
MN VT MA
resorption and stomatitis. Although we can’t say Did you know?
˛˙
ID ˙˜ NH
˛
˛ for certain why these diseases are on the rise,
SD WI NY There is a link between periodontal disease
˛˙
˘ˆ ˙ˆ ˘˙
RI
˘ˆ
we do know that a thorough oral exam as part
WY MI and chronic kidney disease in cats?
˙ˆ CT of a professional dental cleaning under general
IA PA ˜˘
NV NE ˙ ˛˜ anesthesia is necessary to identify the extent of
˙ ˙
IL IN
OH ˛˘
NJ
˘ these disease conditions. Appropriate treatment Periodontal disease in cats, dogs and
UT ˛˛ MD
CA ˛ CO ˛ ˛ˇ
WV DE may also be provided at this time. humans has been associated with
˙ˆ VA
˛ KS
˙ˆ
MO KY ˙ˆ
˛°
increased risk of developing chronic
˛ ˛ DC
NC ˛ Tooth resorption is a painful condition in cats kidney disease, a severe and debilitating
AZ OK TN ˛ˇ ˛˝
where the tooth is broken down by the body illness.
NM ˛˛ AR SC
˛˛
˛ ˛ˆ ˛° beginning at or below the gum line. It is most
AL GA easily identifed during a dental cleaning under BARK research has shown that if periodontal
MS ˛˘
LA
˜° ˛˜
general anesthesia and is treated by extraction of disease were eliminated, there could be up
Risk Level TX
˛˘
˘˙
the afected tooth. Tooth resorption has increased to 15,000 fewer cases of chronic kidney
High Risk
PR ˜ˇ dramatically in cats from 5.4 cases per 10,000 in disease in cats nationwide.
Medium Risk
FL
Low Risk ˛ 2006 to 91.6 cases per 10,000 in 2015—a 1,587
No Banÿeld Hospital percent increase. It is uncertain why such a dramatic
States with Highest Prevalence
increase in this condition has been observed.

Stomatitis in cats is generalized inflammation

2015 Dental Disease | Cat and ulceration of the oral cavity. The disease is
treated with a partial or full mouth tooth extraction
Cases (per 100) and, if needed, anti-inflammatory medications.
WA Although this condition can occur in any cat, it has
˙˛
ME
been linked with Feline Immunodefciency Virus
MT
˙˝ ND (FIV) and certain bacterial infections. Stomatitis
OR
˙ˇ MN VT MA in cats has increased by 68.8 percent from 37.7
˙ˆ NH ˙
ID ˇ˘
˙° SD WI NY
ˇˆ
RI cases per 10,000 in 2006 to 63.7 cases per
˜ˇ ˙˘ ˇ˝
WY MI 10,000 in 2015.
˙° CT
IA PA ˜ˇ
NE ˛˘
NV
˙˝
˙
OH NJ Cats do not always show outward signs of oral
ˆ IL IN ˛ˆ ˛
UT ˙ ˛
˛˘ MD
pain, making it difcult for owners to know there
CA ˙ˇ CO WV DE
VA
˛˛ ˙ˇ KS MO KY ˙˜
˙° is a problem. The exact cause of tooth resorption
˙˝ ˙ ˛°
NC
DC
˛ˆ
and stomatitis is not well understood. Therefore,
AZ OK TN ˛˝ ˛˝ it is difcult to know the best preventive measures
˛˘ NM ˛˘ AR
ˇ˙
SC
˛˛
for these diseases. Regular professional dental
˛˙
MS AL GA cleanings with a thorough oral exam is warranted
˛˜ ˛˛
Risk Level LA
˜° to detect these diseases early and provide
TX
˛ˇ
˜ˆ appropriate therapy.
High Risk
PR ˝˘
Medium Risk
FL
Low Risk ˛ˆ
No Banÿeld Hospital
States with Highest Prevalence

2020 21
 Section Four: Otitis Externa
Otitis Externa | Dog | 10-Year Trend (2006-2015)
Otitis externa is inflammation of the outer ear The prevalence of otitis externa in dogs peaked Cases (per 100)
canal. Otitis externa is an important disease in 2010 at 14.3 percent. Since that time, the
not only because it is common, but because prevalence has decreased by 9.8 percent. ˇ
it causes signifcant discomfort and can
become a lifelong problem that is expensive to In 2015, Puerto Rico, Alabama, Florida,
ˇ˜
treat. Dogs are twice as likely to develop ear Michigan and South Carolina had the greatest
infections than cats. prevalence of otitis externa in dogs, while
Puerto Rico, Kentucky, Indiana, Ohio and ˇ°

Cases (per 100)

Clinical signs of ear problems exhibited by Florida had the greatest prevalence in cats.
dogs and cats include: odor, scratching or ˙
rubbing of ears and head, discharge in the ears, Of the popular breeds, Golden Retrievers
or redness or swelling of the ear flap or canal. and Labrador Retrievers are at the greatest ˛
Some pets may show discomfort by shaking risk of otitis externa, with 1 out of 4 Golden
their head or tilting it to one side, reacting with Retrievers and 1 out of 5 Labrador Retrievers

pain dramatically when touched around the receiving this diagnosis.
ears or showing changes in behavior such as
˜
depression or irritability.

Otitis externa in dogs and cats can be triggered °

by many diferent causes. Problems associated ˜°°˛ ˜°°˝ ˜°°˙ ˜°°ˆ ˜°ˇ° ˜°ˇˇ ˜°ˇ˜ ˜°ˇ˘ ˜°ˇ ˜°ˇ
with otitis externa include food allergies, ear
mites, bacterial or yeast infections, or irritation
Preventive recommendations: Year
from foreign bodies such as pieces of plants, Ear cleaning at least one to two times Key takeaway: An ear infection may become a chronic or recurrent problem, which can be
shrubs and trees. Diagnosis of otitis externa weekly; using proper techniques is frustrating and expensive to treat. Lef untreated, the infection can spread to the middle and
is made using an otoscope to look into the ear essential for maintaining healthy inner ear, ultimately resulting in hearing loss.
canal and assess the amount of inflammation ear canals in dogs that have been
present, whether the ear drum is involved, and diagnosed with ear infections (or Otitis Externa | Cat | 10-Year Trend (2006-2015)
whether there are any foreign bodies, tumors or are at risk for ear infections).
Cases (per 100)
other potential causes present. Swabs of the ear ˛
canal can be examined under the microscope for Certain pets, such as dogs with
bacteria, yeast and mites. A thorough history and allergies, may be predisposed to
recurrent ear infections. Partnering °
physical examination may help to determine the
cause of the problem, especially in the case of with your veterinarian to manage
underlying conditions contributing ˜
allergies.

Cases (per 100)

to ear infections can help reduce
˝
Bottom line: the frequency and severity of ear
infections.
Otitis externa is in the top 10 diagnoses for ˙
both dogs and cats.
ˆ
In 2015, 12.9 percent of dogs and 6.6 percent
of cats were diagnosed with otitis externa. ˇ

There has been a 30.1 percent increase in the ˘

prevalence of otitis externa in cats, with all
of the growth occurring between 2006 and 
2010. The prevalence has remained steady ˇ˜ ˇ° ˇ˛ ˇ ˇ˘ ˇ˘˘ ˇ˘ˇ ˇ˘ˆ ˇ˘˙ ˇ˘˝
since 2010.
Year

Key takeaway: Ear infections are about half as common in cats compared to dogs, with 6.6
2222 percent of cats diagnosed in 2015. Feline ear problems can be caused by food allergies, 23
parasites or from foreign bodies such as peices of plants, shrubs or trees. Bacterial or yeast
infections commonly occur secondary to inflammation of the ear canal.
 Section Four: Otitis Externa Section Five: Flea & Tick

2015 Otitis Externa | Dog Fleas Bottom line:

Cases (per 100) Fleas are common external parasites of mammals In 2015, fleas were among the most common
WA
°
across the globe, and the prevalence of fleas is parasites found in both dogs and cats.
MT ME highest of all the external parasites. Fleas (as
ˆ ND
well as ticks) are important external parasites to Overall, the prevalence of flea infestation in
OR
° MN
°
VT
NH
MA
°ˇ prevent; their bite causes a great deal of irritation, dogs has increased 5.6 percent since 2006,
ID
°° SD WI NY
°˛
RI and they can transmit disease to both animals with a peak increase in 2012 at 7.5 cases
ˇ ° ° °˛
WY MI and humans. per 100 and a decrease to 5.9 cases per
°˜ CT
IA PA °˝ 100 in 2015.
NV NE ° °˛
° °˛
IL IN
OH °˛
NJ
°˛
Flea allergy dermatitis is one of the most common
UT
CO ° °˛
°ˇ MD
skin conditions in dogs and cats. As fleas bite to Since 2006, cats showed a 9.9 percent
CA ˘ WV DE
ˆ VA ° increase in the prevalence of flea infestation,
°˝ KS
°˛
MO KY °˝ eat, they inject saliva under the skin causing an
° °˝ DC
° irritation that can lead to scratching, hair loss and with a peak increase in 2012 at 12.2 cases
NC
OK TN °˛ °˛
infections. In addition to the irritation caused by per 100 and a decrease to 10.9 cases per
AZ
°˙ NM °˙ AR SC the bite, fleas can also transmit tapeworms and 100 in 2015.
ˇ °˙ °˜
MS AL GA spread certain infectious diseases.
˜ °ˆ °˛ The prevalence of fleas in cats is twice that of
Risk Level LA
TX °˙ Large numbers of fleas can even consume so dogs, indicating that more cats need to be on
°
High Risk
PR ˙ much blood that a puppy, kitten or a small pet flea prevention.
Medium Risk
FL can die as a result of blood loss (flea anemia).
Low Risk °ˆ In 2015, Louisiana, Alabama and Florida
No Banÿeld Hospital
States with Highest Prevalence Ticks were among the top fve states and territories
with the greatest prevalence of fleas in cats
Ticks are small arachnids (relatives of spiders) and dogs.
that live by sucking blood from mammals,
including humans. They are found in most parts There was an 11.3 percent decrease in tick
2015 Otitis Externa | Cat of the United States and can transmit diseases infestations in dogs over the past 10 years.
Cases (per 100) such as Lyme disease or Rocky Mountain
WA spotted fever to dogs, humans and other In both dogs and cats, Puerto Rico, Arkansas
˙
mammals. These diseases can potentially be and Massachusetts were among the top
MT ME
ˇ ND life-threatening. fve states and territories with the highest
OR
˙ MN VT MA prevalence of ticks.
˝ NH ˛
ID
˙ SD WI NY
˜
RI One of the greatest risks that ticks pose to
WY
ˇ ˘
MI
˙ ˛
pets is the transmission of Lyme disease. Lyme Among the popular breeds, large breed dogs,
° CT including German Shepherds, Golden Retrievers,
IA PA ˛ disease has been identifed across the country
NE ˝
NV
˜
˝
OH NJ with the highest prevalence in the Northeast Pit Bulls and Labrador Retrievers were more
˛ IL IN ˛ ˙
UT
CO ° 
 MD
and the Great Lakes region. likely to have ticks than small breed dogs. This
CA ˇ WV DE
ˆ VA ˜ may be due to a more active outdoor lifestyle of
˝ KS MO KY °
°° ˝  DC Clinical signs most commonly observed in pets large breed dogs.
NC ˛
TN ˛ ° with Lyme disease include: red area where tick
AZ OK
˝ NM ˙ AR SC was attached (ofen unnoticed), fever, shifing
ˇ ˆ °
AL GA leg lameness, joint swelling, enlarged lymph
MS ˝
˜ ˘ nodes, anorexia and general depression.
Risk Level LA
TX ˙
˛
High Risk
PR ˇˆ
Lyme disease can be a long-term, painful and
Medium Risk potentially debilitating disease, which is much
FL
Low Risk 
No Banÿeld Hospital
easier to prevent than treat.
States with Highest Prevalence

2424 25
 Section Five: Flea & Tick

Fleas | Dog | 10-Year Trend (2006-2015)

Cases (per 10,000)
Preventive recommendations: ˙°°
Many suitable products are available for the prevention and treatment of fleas. These ˝°°
are available in the form of shampoos, rinses, sprays, mists/fogs, chewable tablets
and spot-on treatments. Before selecting a product, pet owners should work directly ˛°°
with a veterinarian to ensure the selected product is appropriate for their pet’s lifestyle

Cases (per 10,000)

and health.
°°
Pet owners should only use flea and tick preventatives that have been registered and
approved for use with the EPA or FDA. °°

Prevention of tick infestation involves environmental management (such as building ˘°°

fences and cutting grass to reduce access to tick habitat) and application of approved
products to animals or the environment. ˜°°
When returning from outdoor activities, a pet’s skin and coat should be inspected in ˇ°°
order to identify fleas and ticks.

Some ingredients in flea and tick preventives are not safe for use in cats. Pet owners °
with both dogs and cats in the home should discuss proper preventive medications ˜°°˛ ˜°°˝ ˜°°˙ ˜°°ˆ ˜°ˇ° ˜°ˇˇ ˜°ˇ˜ ˜°ˇ˘ ˜°ˇ ˜°ˇ
with their veterinarian to eliminate any health risks to cats. Year

Key takeaway: Since 2006, the prevalence of fleas in dogs has increased by 5.6 percent.

Did you know?

Fleas live in areas frequented by animals and humans Flea | Cat | 10-Year Trend (2006-2015)
and seek out dark, warm, humid places—usually carpets, Cases (per 10,000)
bedding, under furniture or in garden debris.
ˇ˛˜˜
˙˜
Physical removal of a tick using tweezers within 24 to 48 hours is thought to prevent
ˇ˜˜
˝˜
transmission of most tick-carried diseases.

Indoor-only pets are also at risk for fleas and ticks since these parasites can unknowingly ˇ°˜˜
˛˜

Cases (per 10,000)

be on people, other animals or materials that enter the pet’s environment. Therefore, it is
important to continue using flea and tick preventives on indoor pets. ˇ˜˜˜
˜

˙˜˜
˜

˛˜˜
˘˜

Flea allergies ˜˜

°˜

Flea allergy dermatitis (FAD) is an inflammatory reaction in response to proteins in flea °˜˜
ˇ˜
saliva. Clinical signs vary in severity and can include generalized itching or biting at the skin,
redness, inflammation and alopecia (fur loss exposing the skin below). ˜
°˜˜˛ °˜˜˝ °˜˜˙ °˜˜ˆ °˜ˇ˜ °˜ˇˇ °˜ˇ° °˜ˇ˘ °˜ˇ °˜ˇ
“Hot spots” or moist dermatitis is common with FAD. Ear infections (otitis externa) and foot
infections (pododermatitis) may also develop. Treatment requires aggressive flea therapy Year
and control of the inflammation, generally with a steroid such as prednisone. Antibiotics
2626
26 or antifungal medications may be warranted if a secondary skin or ear infection is present. 27
Key takeaway: Since 2006, the prevalence of fleas in cats has increased by 9.9 percent.
 Section Five: Flea & Tick

Tick | Dog | 10-Year Trend (2006-2015) 2015 Fleas | Dog

Cases (per 10,000) Cases (per 10,000)
ˇ˛˜
˙˜ WA
˙˜˙
MT ME
ˇ˜
˝˜ ˆ ND
OR
˙˝° MN VT MA
ˆˆ NH °°˙
ˇ°˜
˛˜ ID
ˇ° SD WI NY
°˙˘
RI
Cases (per 10,000)

° ˘˙ ˇˆ °˙˝
WY MI
ˇ˜˜
˜ IA
°
PA
CT
°˜
NV NE °ˆ° ˘˛
˝˝ OH ˙
NJ
˜
˙˜ ˆˇ IL IN °˙˛
UT ˘˝ ˆ˝ˇ
˝˜° MD
CA °˛ CO WV DE
ˆ˝ VA ˆ°˘
˛˝° KS MO KY ˆˇ˘
˘˜
˛˜ ˜ˇ ˝˛˛ ˆ˜˘ DC
NC ˙˙
˛˝˙
TN ˜˜˝
°˜
˜ AZ OK
˘˝° AR SC
 NM
˙˙ ˘ˆ ,ˇ˘˛
GA
ˇ˜
°˜ MS
˜˜°
AL
,ˇ˙ ˙˙ˆ
Risk Level LA
TX ,ˇ˜°
˜ High Risk
˙˜
PR ˜˘°
°˜˜˛ °˜˜˝ °˜˜˙ °˜˜ˆ °˜ˇ˜ °˜ˇˇ °˜ˇ° °˜ˇ˘ °˜ˇ °˜ˇ Medium Risk
FL
Low Risk ,ˇˇ
Year No Banÿeld Hospital
States with Highest Prevalence

Key takeaway: Since 2006, tick prevalence has decreased by 11.3 percent.

2015 Fleas | Cat

Cases (per 10,000)
Tick | Cat | 10-Year Trend (2006-2015)
Cases (per 10,000) WA
˜,ˆ˝
˙˜
˜ MT ME
˘ ND
OR
MN VT MA
˝˜
˘ ˜,ˆ˛
ID ˜˜ NH
˜˜
˛˛ˆ
ˇ˙ SD WI NY RI
˘ ˜˙˘ ˆ˜ ˙˛
˛˜
˘˜ WY MI
 CT
Cases (per 10,000)

IA PA ˘˛
NV NE ˝˙ ˆ˘
˜
°  ˙˝
IL IN
OH ˛
NJ
˛
UT ˝˙˜ ˆ˜
˜,˜˜˘ MD
CA ˙˛ CO WV DE
˙ VA ˇˇ˛
˜
°˜ ˜,˝˛˘ KS
ˇ˙˝
MO KY ˛ˆ˛
ˆˇ ˙ DC
NC ˜˘˜
˘˜
ˇ AZ OK TN ˜,˙˜˝ ˜,˙ˆˇ

 NM ˜,˘ AR SC
˙˜˘ ˆ˝ ˜,˛˝
°˜
ˇ˜ MS AL GA
˜,ˇ˝˜ ˜,˝˙˘
˜,˜˛˝
Risk Level LA
TX
ˇ˜
 ˜,˙˜
˜,˛˛
High Risk
PR ˜,˝˜
Medium Risk
˜ Low Risk
FL
˜,ˇ˜
°˜˜˛ °˜˜˝ °˜˜˙ °˜˜ˆ °˜ˇ˜ °˜ˇˇ °˜ˇ° °˜ˇ˘ °˜ˇ °˜ˇ No Banÿeld Hospital
States with Highest Prevalence
Year

2828 Key takeaway: Ticks remain an uncommon problem in cats and have decreased 9.9 percent 29
over the last 10 years.
 Section Five: Flea & Tick Section Six: Internal Parasites

2015 Ticks | Dog Internal parasites are important to diagnose Whipworms

Cases (per 10,000) as they can cause vomiting, diarrhea and poor
Whipworms live in the intestines of dogs,
absorption of nutrients from the food pets eat.
WA coyotes and wolves. Cats may also become
ˇ˘ Additionally, some of the most common internal
infected with whipworms, but it is more
MT
ND
ME parasites carry a zoonotic risk because they can
˛ common in dogs. Adult whipworms are
OR
MN VT MA be transmitted from animals to humans.
˝ˆ
ˆˆ NH ˛˝° shaped very thin at the front and become
ID ˆ˝
˝˛ SD
˝˛
WI NY

RI Roundworms and hookworms wider toward the rear. As with roundworms
ˆ ˘˛
WY MI
CT
and hookworms, many pets infected with
IA
˛
PA °ˆ Roundworms and hookworms are zoonotic whipworms will initially show no sign of
NV NE ˇˆ ˛ˇ˘
parasites that inhabit the intestinal tract of
ˆ˜ OH ˛˙˙
NJ infection. However, whipworms can cause
˛ IL IN ˛˛°
UT
CO ˜ ˝˛
˝ MD
dogs and cats. While most common in puppies mild to extreme illness in pets and, in some
CA  WV DE
˛ VA ˜ and kittens, infection can occur in dogs and
°˜ KS
˘
MO KY ˛ˇ˘ cases, lead to death. Whipworm infection can
˛˙ ˜
NC
DC
°
cats of all ages. The mouthparts of hookworms lead to bloody diarrhea, severe weight loss,
AZ OK TN ˛˛ ˛˙˛ attach to the pet’s small intestine allowing dehydration and severe anemia.
˛ˇ NM ˇ˙˝ AR
˛˙
SC
°ˆ
them to feed on the pet’s blood. Roundworms
˛˙˛
MS AL GA and hookworms can cause mild to extreme Whipworms can cause disease in humans;
˛˙°
LA
˜° ˛˝˙
illness in pets and even death in some cases. however, there is no evidence that they are
Risk Level TX
°
˘
transmitted from animals to humans.
High Risk
PR ˛,˜˘ Most pets infected with roundworms and
Medium Risk
Low Risk
FL
˛ˇ
hookworms show no signs of infection. Some Who in the family is at risk?
No Banÿeld Hospital pets, especially puppies or kittens, become
All human family members are potentially at
States with Highest Prevalence noticeably ill from roundworms and hookworms.
risk from zoonotic parasites. The presence
Clinical signs most commonly observed in
of dogs in a household, especially puppies,
pets severely infected with roundworms and
increases this risk due to their soiling habits.
hookworms include: vomiting, severe weight
2015 Ticks | Cat loss, loss of appetite, distended abdomen, Cats can also transmit zoonotic parasites, but
Cases (per 10,000) severe anemia and even death. due to their tendency to defecate in one area
WA and bury their feces, exposure is less likely.
˝ Tapeworms
Children run a higher risk of contracting a
MT ME
˘° ND Tapeworms are long, flat, segmented parasites parasite due to their play habits, attraction to
OR
 MN VT
NH
MA
ˇ
that live in the small intestines of dogs, cats, pets and pica (eating dirt, most commonly). In
ID ˘ˆ
˜ SD WI NY
ˆ˙
RI domestic animals and wildlife. Tapeworms do addition to regular deworming of pets, proper
˜ ˝ˇ
WY
˜
MI
°˛
not have a mouth; instead, they attach to the hygiene (such as handwashing afer handling
˙ CT
IA PA ˆ˙ inside of the intestines with suckers. Some also stool) is one of the best ways to reduce the risk
NV NE ° ˙
° 
IL OH ˆ˝
NJ have hooks to aid attachment. Pets infected of zoonotic diseases.
UT IN ˘˜ MD ˝
CA ˜ CO  ˘˝
WV DE
with tapeworms may not show any clinical
VA
ˆ ° KS MO KY ˆˇ
ˆˇ
signs; pet owners usually notice tapeworm
˘ˆ ° ˛ DC segments around the anal area or on the
NC ˜

AZ OK TN ˆˆ ˝˙
surface of the stool. The segments may move
ˆ NM ˆ AR SC or appear as grains of rice caught in the hair
 ˇ° °˜
MS AL GA
°ˆ
around the rectum. They may also be found in
°˛
Risk Level LA
˜
places where infected pets rest and sleep.
TX °˘
˛
High Risk
PR ˛ˇ
Medium Risk
FL
Low Risk ˘˙
No Banÿeld Hospital
States with Highest Prevalence

3030 31
 Section Six: Internal Parasites
Internal Parasites | Dog | 10-Year Trend (2006-2015)
Bottom line: Puerto Rico had the highest prevalence of Cases (per 10,000)
roundworms, hookworms and whipworms ˝°°
There has been a 10 percent decrease in
in dogs and cats.
hookworm prevalence in dogs and a 20.9 ˜˛°
percent decrease in prevalence in cats since In 2015, Alabama, Arkansas, Louisiana and
2006. There has also been a decrease in South Carolina were among the top fve states ˜°°
roundworm infection in dogs by 15.7 percent

Cases (per 10,000)

for tapeworm prevalence in dogs and cats.
and in cats by 18 percent over the same ˙˛°
time period. This may be due to increased Florida was among the top fve states for
prophylactic deworming and, in the case hookworm, whipworm and tapeworm infection ˙°°
of dogs, increased heartworm preventive in cats.
administration, which also protects against ˆ˛°
these parasites. Among popular dog breeds, internal
parasites are more common in large breed ˆ°°
Over the past 10 years, there has been dogs compared to small breed dogs. This
a 36.1 percent decrease in whipworm may be due to large breed dogs having a ˛°
prevalence in dogs. Whipworm infection more active outdoor lifestyle compared to
remains uncommon in cats at 3.3 cases per small breed dogs. °
10,000 in 2015. ˙°°ˇ ˙°°˘ ˙°° ˙°° ˙°ˆ° ˙°ˆˆ ˙°ˆ˙ ˙°ˆ˜ ˙°ˆ˝ ˙°ˆ˛
Year
Tapeworm remains the most common
parasite in cats (488 cases per 10,000) Tapeworm Roundworm Hookworm Whipworm
and dogs (215 cases per 10,000). The
Key takeaway: With dogs in the household, especially puppies, there is a greater risk of
prevalence of tapeworm infection in cats is
Preventive recommendations: transmitting zoonotic parasites due to canine soiling habits. Roundworm and hookworm can
more than twice that of dogs.
cause mild to extreme illness in pets and, in some cases, death. All four internal parasites
Deworming medication, administered can infect humans under certain conditions.
or dispensed by a veterinary
professional, is the recommended Internal Parasites | Cat | 10-Year Trend (2006-2015)
way to prevent internal parasites. Cases (per 10,000)
The recommended frequency of ˇ°°
Did you know? deworming varies depending on the
Tapeworms are transmitted to dogs and life stage and individual environment
cats through the ingestion of fleas. The of the pet. ˜°°
prevalence of fleas and tapeworms in
Quickly clean up pet waste afer pets

Cases (per 10,000)

cats are twice that of dogs, indicating ˛°°
to remove potentially infective eggs
the need for better flea control
from the environment.
in the feline population. This can
subsequently reduce the prevalence ˝°°
Children should be discouraged
of tapeworms. If a tapeworm infection from eating soil. Sand boxes should
is diagnosed, it is important to ensure be covered when not in use and ˙°°
that appropriate flea prevention is potentially contaminated areas
being used, in addition to tapeworm should be avoided.
treatment, to prevent reinfection. ˆ°°
Practice good hygiene, such as
regular handwashing afer handling °
pets or cleaning up waste, in order
˙°°ˇ ˙°°˘ ˙°° ˙°° ˙°ˆ° ˙°ˆˆ ˙°ˆ˙ ˙°ˆ˝ ˙°ˆ˛ ˙°ˆ˜
to reduce the risk of zoonotic
Year
transmission of parasites.
Tapeworm Roundworm Hookworm Whipworm
3232 Key takeaway: Tapeworm continues to be the most prevalent intestinal parasite in cats, even 33
though there has been a decrease of 8.1 percent over the past 10 years.
 Section Six: Internal Parasites

2015 Roundworm | Dog 2015 Hookworm | Dog

Cases (per 10,000) Cases (per 10,000)
WA WA
˝°ˇ ˆ°
MT ME MT ME
˙ ND ˘ ND
OR OR
ˆ° MN VT MA  MN VT MA
˛˘ NH ˛° ˜ NH ˝˛
ID ˙° ID ˝
˛ˇ SD WI NY RI ˙ SD WI NY RI
˘° ˝˜˜ ˆ ˙˙ ˇ° ˇ ˇ˝ ˜˘
WY MI WY MI
˝˜˛ CT ˜ CT
IA PA ˛ IA PA ˝ˆ
NV NE ˘ ˝˜ˆ NV NE ˇ ˇ˘
ˆˇ OH ˝°˘
NJ ˘° OH NJ
˜˜ IL IN ˘ˇ ˇ IL IN ˇ˛ ˜ˇ
UT ˘ˆ ˝˜
˝˙ˇ MD UT ˜° ˙˝
˛˙ MD
CA ˛ CO WV DE CA ˘ CO WV DE
ˇ˙ VA ˝˜˝ ˆˇ VA ˇ
˝°˝ KS MO KY ˝˜˙
˘ KS MO KY ˆˆˇ
˝°ˆ ˝˛˝ ˝˘ ˛˛  ˆˆ
DC DC
NC ˝˛ NC ˆ°
˜˜˘ ˝˛˙
AZ OK TN ˜˝˘ AZ OK TN ˝ˆ˘
˝ˆ NM ˝˘˛ AR SC ˘ NM ˜˜ˆ AR SC
˜˙ ˝˘ ˜°˛ ˇ ˆ˘ ˜°˛
AL GA AL GA
MS ˜˝˛ MS ˝°ˆ
˜˙ˇ ˜˙˜ ˜ˇ ˜˘ˇ
Risk Level LA Risk Level LA
TX ˝˙ˆ TX ˝°
˝° ˆ˘˜
High Risk High Risk
PR ˇ˜ PR ˆ,°°ˇ
Medium Risk Medium Risk
FL FL
Low Risk ˛ˆ Low Risk ˝˘°
No Banÿeld Hospital No Banÿeld Hospital
States with Highest Prevalence States with Highest Prevalence

2015 Roundworm | Cat 2015 Hookworm | Cat

Cases (per 10,000) Cases (per 10,000)
WA WA
˘˜ ˇ
MT ME MT ME
˜ˇ˙ ND  ND
OR OR
˘ MN VT MA ˆ MN VT MA
˜˙ NH ˛ˆ ˙ NH ˝
ID ˜˙° ID ˙˝
˛ SD WI NY RI  SD WI NY RI
˜˙˝ ˝˘ ˝ˇˇ ˜ˇ   ˜ ˙˜
WY MI WY MI
˝ CT ˙˛ CT
IA PA ˜˛˘ IA PA ˜
NV NE ˝˝° ˝ˇ˛
NV NE ˙ˇ ˙˛
˜˝ OH ˜
NJ ° OH NJ
ˇ IL IN ˜˛˘  IL IN ˙ˆ ˙˜
UT ˜°˛ ˜°˜
˝°ˆ MD UT ˘˘ MD
CO CO ˛ ˛
CA ˇ WV DE CA  WV DE
˝˜ VA ˜˙ˆ ˙ VA
˙˝ KS MO KY ˜˙ˆ ˆ KS MO KY ˙˙

˜˝ˇ ˜˝ ˝ˇˇ ˆ
DC ˙° ˙˜ DC
NC ˝˘˛ NC 
˝˝˛ ˛˝
AZ OK TN ˝°˝ TN ˆ˙
AZ OK
˜˙ NM ˜˙° AR SC  NM ˙ˆ AR SC
˜° ˜˛ ˜˘˛  ˆˆ ˇ
AL GA GA
MS ˝ˇˆ MS AL
˜°˛ ˝˜˙ ˜° ˜ˇ
˙˜
Risk Level LA Risk Level LA
TX ˜ˇ˛ TX ˘˝
˘ ˆ˝
High Risk High Risk
PR ˝˛ PR ˘˘
Medium Risk Medium Risk
FL FL
Low Risk ˘ Low Risk ˝˝
No Banÿeld Hospital No Banÿeld Hospital
States with Highest Prevalence States with Highest Prevalence

3434 35
 Section Six: Internal Parasites

2015 Tapeworm | Dog 2015 Whipworm | Dog

Cases (per 10,000) Cases (per 10,000)
WA WA
˙ ˘
MT ME MT ME
ˆˇ ND ˇ ND
OR OR
˙°˛ MN VT MA ˆˆ MN VT MA
˛˘ NH ˘ˇ ˆ˙ NH ˙˛
ID ˇ˛ ID °
ˇ SD WI NY RI ˛ SD WI NY RI
˜° ˆ˘ ˇ˘ ˙˙˜ ˆ˘ ˛˝ ˙ ˙°
WY MI WY MI
ˆ˘ CT °˜ CT
IA PA ˝ IA PA ˘
NV NE ˇ ˙˜ NV NE ˆˆ ˜ˆ
˛˘ OH ˙°
NJ ° OH NJ
˜ IL IN ˆ˘ ° IL IN ˜˙ ˙˜
UT ˝˜ ˙°˙
˙°˘ MD UT ˙˜ °
˛˛ MD
CA °˜ CO WV DE CA ˘ CO WV DE
˝˙ VA ˙˙˜ ˘ VA ˜
˙˘ˆ KS MO KY ˙˜ˆ
˘ KS MO KY ˛ˆ
˙˘˝ ˙˝˛ ˜˙˜ ˛ˇ ˘˘ ˘˙
DC DC
NC ˙˜˛ NC °˘
˜˛˝ ˘
AZ OK TN ˜˘ˆ AZ OK TN ˘
° NM ˜˝ AR SC ˙ NM ˘˝ AR SC
˙ °˝˛ °°˜ ˙ ˜ ˛˙
AL GA AL GA
MS ˜ˇ˝ MS ˛˛
˜°° °˝˛ ˜° ˛˝
Risk Level LA Risk Level LA
TX °˜ˇ TX ˙˝
°˙ ˆ˘
High Risk High Risk
PR ˜˝ PR ˝
Medium Risk Medium Risk
FL FL
Low Risk ˜°˘ Low Risk ˆ˜
No Banÿeld Hospital No Banÿeld Hospital
States with Highest Prevalence States with Highest Prevalence

2015 Tapeworm | Cat 2015 Whipworm | Cat

Cases (per 10,000) Cases (per 10,000)
WA WA
˝˜ ˜
MT ME MT ME
˙˝˘ ND ˜ ND
OR OR
ˇˆ MN VT MA ˆ MN VT MA
˜ NH ˆˇ˘ ° NH ˆ
ID ˛°ˆ ID ˜
ˇˇˆ SD WI NY RI ˜ SD WI NY RI
˙˙ ˝° ˆ˙° ˆ˜ˆ ˜ °˜ ˜ ˙˝
WY MI WY MI
˙˜˝ CT ˆ CT
IA PA ˙ IA PA ˝
NV NE ˘ˆ˙ ˆ˛ NV NE ˜ °
ˇ° OH ˙ˇ˝
NJ ˜ OH NJ
˜˛ IL IN ˙°˘ ˜ IL IN ˙ ˝
UT ˇ˙ ˆ˘ˇ
ˆ˝ MD UT ˙ °
˝ MD
CA ° CO WV DE CA ˜ CO WV DE
˘ VA ˆ˙ ˜ VA ˜
˜ KS MO KY ˆˇ˙
˙ KS MO KY ˇ
˛ˆ˛ ˛°˛ ˛˙ˆ ˆ ˙ ˛
DC DC
NC ˇ˙ NC ˜
˛˝˙ °
AZ OK TN ˜˘˘ AZ OK TN ˛
˛˙ NM  AR SC ˜ NM ° AR SC
˜˙ ˙˛ ˘ ˜ ˜ °
AL GA AL GA
MS ˘ˇ MS ˝
˜°˛ ˙ˆ ˜ ˜
Risk Level LA Risk Level LA
TX ° TX ˜
˘˙ˇ ˙
High Risk High Risk
PR ˛°˜ PR ˙˘˙
Medium Risk Medium Risk
FL FL
Low Risk ˘˘˜ Low Risk ˛
No Banÿeld Hospital No Banÿeld Hospital
States with Highest Prevalence States with Highest Prevalence

3636 37
 Conclusion Acknowledgements
Conclusion
Our hope is that the State of Pet Health 2016 Report will be benefcial in educating pet owners and Chief Medical Ofcer
veterinarians about the risk and prevalence of diseases afecting dogs and cats, and ultimately help Daniel S. Aja, DVM
improve the overall health of pets in the United States.
Senior Director of Research
Over the past 10 years, there has been success in reducing certain preventable diseases. For Elizabeth Lund, DVM, MPH, PhD
example, in dogs we have seen a reduction in the prevalence of heartworm, roundworm, hookworm
and whipworm infestations. Similarly, in cats there has been a reduced prevalence of roundworm,
Project Sponsors
hookworm and tapeworm cases. While we cannot be certain, the decrease in dogs could be due to
Elizabeth Lund, DVM, MPH, PhD
increased heartworm prevention, which targets these internal parasites. In cats, routine deworming
Marta Monetti
and flea prevention may be contributing to this decrease.
Jeannine Taafe
Flea prevalence increased in dogs and cats from 2006 to 2012, but has been steadily decreasing
since then. The rise of other diseases such as diabetes and dental disease in dogs and cats, and Program Director
otitis externa in cats, indicates the need for continued education of clients about these diseases Kim Van Syoc
and their preventive strategies. The sharp rise of tooth resorption and increase of stomatitis in cats
necessitates more research to understand the root causes of this trend and potentially identify Project Manager
more efective preventive measures. The continued rise of some of the diseases in this report Julie Heade
demonstrates the need for frequent medical care to ensure the highest quality of life for pets.
Project Leads
To help reduce the risk of diseases in both dogs and cats, Banfeld is committed to working in Molly McAllister, DVM (Research, Data and Medical Content)
partnership with pet owners to focus on preventive care. We believe preventive care improves Kelly O’Brien (Print Report)
the quality of a pet’s life by reducing the risk for contracting serious, costly and sometimes fatal Kate Scheofsky (Digital Report)
diseases. This is why Banfeld emphasizes the importance of routine veterinary care at least
twice a year, which allows for early disease diagnosis and helps pets remain healthy during all
Applied Research & Knowledge
life stages.
Molly McAllister, DVM
Looking forward, we hope that future State of Pet Health Reports will fnd a decrease in many Kirk Breuninger, VMD, MPH
of the preventable diseases highlighted, as well as an increase in the number of cats receiving Nathaniel Spoford, MPH
preventive care. Mike Yang, BVMS
Rosalie Trevejo, DVM, MVPM, PhD, DACVPM (Epidemiology)
Visit stateofpethealth.com to learn more about common diseases, download past reports and
explore the geographic prevalence of other diseases afecting pets in the United States. Medical Content Experts
Karen K. Faunt, DVM, MS, DACVIM

Editorial Content Management

Nina Silberstein
Leeza Castle
Lindsay Murphy

Creative Director
Michelle Slater-Young

Production Designers
Jake Givens
Bryan Wolf

Production Manager
Leeza Castle

38 39
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