LTBD, a few months ago our vet switched us from Avantix and separate heartworm pill (has been discontinued) to Trifexis, which is a combo of both in one pill. I hated the topical aspect of Avantix because it left grease marks on the dog forever. there was another topical new one that we tried up in MI, but it was worse. I returned the rest of the six-month supply after the first month. The grease mark never went away till you bathed the dog.
Advantix was a must up north because we lived in dune grass, and there were lots of ticks. Down here in TV (and at the dog park), the ticks are not a problem. Some people do not like to give heartworm and flea protection on the same day, and I have to say... Crosby threw up the day he got the first trifexis dose, but it was 8 hours later, so I don't really know what made him throw up. He usually has a cast-iron stomach. He has never had a reaction to it since. I kind of follow Kitty's plan, which is to feed more soothing stuff on that day to kind of buffer the pill.
Many people are against any kind of flea protection, calling it poison, and rely on washing their dogs off frequently after they've been outside playing. I wish I could do that, but with a 90-lb long-haired dog, that is not so convenient.
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