I just couldn't afford the vet's flea and tick stuff, she recommended over the counter brands, my dogs are inside most of the time. She also said as long as I got testing regularly, they didn't have to have heart worm meds. That makes me nervous so I may put them back on that. Neither needs meds for anything else. Vaccines and physicals are pretty high. I've read articles that older dogs do not need or benefit from all the same vaccines as younger dogs. Bernice is 13 but the vet felt she needed everything