Pediatric Canine Health & Wellness Plan

Congratulations on adopting your new puppy and welcome to the Healthy Paws Family!


At Healthy Paws, we have developed our Health and Wellness Plan for Puppies with a primary goal in mind- to keep your puppy healthy through this important phase of rapid growth and build a solid foundation for maintaining optimal health throughout your puppy’s life.


What are the basic components of the Canine Pediatric Health Plan?

  • History & Physical exams- usually 3-4  pediatric exams

  • Immunizations- puppy booster series

  • Internal and external parasite control- intestinal, heartworm, fleas, ticks & mites

  • Laboratory screening tests / preoperative blood screening

  • Nutrition counseling

  • Zoonotic disease (conditions that can spread to humans)

  • Spay / neuter / microchip discussion

  • Behavior consultation / house breaking & basic training

  • Management of congenital disease (problems some puppies are born with)

  • Exercise- play recommendations

  • Dental care- starting the discussion of home care


We have carefully developed our program to provide the most current & complete medical care for new puppies to put them on the path for a long healthy life with you.  We will continue to modify the program as superior screening tests, vaccines, or medications are available.  Please look at our Canine Pediatric Health Plan in detail- we are happy to answer any additional questions you may have.  We believe you will agree the program provides the best preventative health care for your newest family member.






  • Core vaccinations - Distemper (DHPP), Rabies

  • Non-Core vaccinations - Leptospirosis, Lyme, Bordetella, Canine Influenza (CIV)

  • 4DX® testing - screens for heartworm disease (mosquito transmitted) and exposure to Lyme, Anaplasma, & Ehrlichia (all tick transmitted diseases)

  • Fecal screen for intestinal parasites


Why Vaccinations for your Puppy are Vital


There are many very serious and highly contagious diseases that your puppy can contract if not properly protected.  Fortunately, safe and effective vaccines have been developed for most of these diseases. Similar to human babies, puppies require a series of vaccines (boosters) given during the first 4 months of life-when maternal antibody protection is wearing off and the puppy’s own immune system is maturing. By following recommended vaccination protocols, you are giving your dog a solid core immunity that will protect them from infectious diseases throughout their lifetime.


Vaccines are typically given in conjunction with the pediatric wellness exams at 8 weeks, 12 weeks, and 16 weeks of age. Depending on the size of your pup and the number of vaccines to be given, your doctor may recommend splitting the vaccines over two sessions.


What are we vaccinating against?


Core vaccinations are vaccinations that should be given to all dogs regardless of breed, size, or where the dog is living. They protect from devastating infectious diseases that are everywhere. Core vaccines are those that are recommended for all dogs and include rabies, distemper, hepatitis, & parvovirus.


Non-core vaccinations protect from diseases that not all dogs are exposed to due to geography. In our area, Lyme and Leptospirosis are two prevalent diseases that affect many dogs. These vaccinations are strongly recommended for all dogs living in the Westborough, MA area. Non-Core vaccines also protect against serious diseases but may not be appropriate for all dogs based on breed or individual lifestyle. Non-core vaccines include Bordetella (kennel cough), Lyme, Leptospirosis, and Canine Influenza (CIV).


Lifestyle Vaccines are those that protect again contagious diseases encountered in unique situations- most commonly in boarding, daycare, busy grooming shops or showing environments where there are large numbers of dogs in close quarters and a constant influx of new dogs who may be carriers of respiratory disease. Bordetella (kennel cough) and Canine Influenza are the two “life style” vaccinations that Healthy Paws has available for individuals at risk.

At Healthy Paws, your doctor will discuss which non-core vaccines are appropriate for your dog and your lifestyle in order to develop a vaccine strategy for each individual patient.

*Vaccination titers: For clients concerned about over vaccination, there is an option to test the level of protective antibody against Parvo virus and Distemper virus in the blood. If the level is high enough to be considered “protective”, then the vaccination booster is postponed until the next year where client again have the option to check titers or give the booster. Ask the doctor for more information if you are interested in titer testing.

Distemper – A very contagious virus that causes gastrointestinal, respiratory and end stage neurological disease. Approximately 80% of dogs who contract the disease die despite treatment.


Hepatitis (Canine Adenovirus 2) – Causes severe damage to the liver.


Parvovirus – Causes severe bloody diarrhea, vomiting, and suppression of the immune system. There is a greater than 20% chance of fatality despite aggressive treatment and is nearly 100% fatal in dogs not receiving treatment.

Parainfluenza – A highly contagious respiratory disease often mistaken for kennel cough. Symptoms include coughing, difficulty breathing, nasal discharge, and lethargy.


Rabies – A fatal viral disease that can affect any warm-blooded mammal including humans. There is no cure for rabies.  Infected pets must be euthanized and all exposed persons must receive a series of painful rabies vaccinations. Common wildlife vectors include raccoons, bats, foxes, skunks, & woodchucks.


Leptospirosis – A bacterial disease which can be fatal and causes severe liver and kidney disease. The bacteria is spread through the urine of wildlife and causes similar disease in humans.


Lyme disease – A tick transmitted disease communicable to both dogs and humans. In dogs, Lyme typically causes acute lameness, joint swelling, fever, lethargy and occasionally kidney failure. If not treated can lead to Lyme nephritis which can be fatal.


Bordetella - Commonly known as “kennel cough”, these respiratory diseases are highly contagious, causing coughing, tracheitis, bronchitis, and occasionally a severe bronchopneumonia. The intranasal vaccine also includes protection against parainfluenza and type 2 canine adenovirus.


Canine Influenza (H3N8/H3N2) – A new variant strain of Equine Influenza causing widespread respiratory disease in exposed dogs. Although majority of dogs show mild signs and recover fully, approximately 5% of dogs in an outbreak die of fatal pneumonia.



Parasite Control


Protecting the health of your puppy and your family…


At each pediatric visit, we will check for the following:

  • Intestinal parasites via fecal (stool) testing

  • Ear mites

  • Fleas, ticks and other skin parasites

  • Ringworm (fungal infection)


How do we test a stool sample? 


Stool samples can be tested in-house or at our reference laboratory. Typically we send fecal samples out to the lab and receive results by the following morning. In special circumstances we may run fecal tests in-house at our facility. To do this we mix a small amount of stool with a sugar solution that causes the parasite eggs to separate from the rest of the fecal material, float up, and stick to a glass slide which we then look at under the microscope.  Each type of parasite has a unique egg size and shape. Eggs are microscopic and can be missed if the worms are not shedding eggs the day the sample is collected.


Yikes, I see actual worms in the stool!


Sometimes puppies do pass adult worms- especially after a deworming. Roundworms look like spaghetti and tapeworms look like small flat tan grains of rice. Call us if you ever see worms on your dog’s hind end or in feces!


In cases of chronic diarrhea & weight loss in puppies that have negative fecal tests, we may recommend additional testing for more rare parasitic diseases.


Common Tick Diseases in Westborough Ma:

  • Lyme Disease- Borreliosis

  • Anaplasmosis

  • Ehrlichiosis


Heartworm Disease, Prevention & Testing


Heartworm disease is a serious risk to your dog. Heartworms are parasites that live in your dog’s heart and pulmonary vessels. Adults can grow to 1 -2 feet in length and live an average of 5-7 years. It is not uncommon to find more than 30 worms in an infected dog.  When left untreated, infected dogs will eventually develop heart disease and failure


Transmission of heartworm disease is through mosquitoes. The microfilaria (baby heartworms) are injected into your dog when a mosquito bites, so even a dog that is not outdoors a lot can still be infected—it only takes a single mosquito bite.  From there the larva migrate from the skin though tissues and eventually mature into an adult heartworm that resides in the heart. The maturation process takes 6 months, so prevention focuses on killing the immature worms BEFORE they become adults.  Once heartworms become adults they are very difficult to kill. The only effective drug is an arsenic derived compound and the dying worms in the heart can cause significant damage to the lungs and even death. It is both more costly and risky to kill adults compared to prevention.


Prevention is easy, safe and effective. We start puppies on heartworm prevention at their first pediatric visit, but testing is usually first done at the 1 year visit. Healthy paws generally prescribes the following preventatives:

  • Oral monthly coverage (chew tab) - Tri-Heart Plus® (containing Ivermectin and Pyrantel, the same major ingredients as Heartgard) - Ivermectin interferes with the parasite's nerve transmission, causing paralysis and death of the immature heartworms (larvae). Pyrantel pamoate, also interferes with the parasite's nerve transmission, causing paralysis and death of intestinal worms.

  • Oral monthly coverage (chew tab) - Sentinel® (containing milbemycin oxime, lufenuron, and praziquantel) - Sentinel Spectrum protects dogs against Heartworm, fleas and 6 different parasites including tapeworms.

  • Injectable 6 month coverage (oral tab) - Proheart6® (containing Moxidectin).


All three brands are safe and 100% guaranteed effective when given consistently.


Testing for heartworm disease is recommended yearly starting at the 1st year Canine Adult Wellness Exam. At Healthy Paws we use the 4DX snap® test which not only tests for adult heartworms, but also tests for exposure to Lyme disease, Anaplamosis, and Ehrlichia- the latter three are bacterial diseases carried and transmitted by ticks. By testing annually, we not only get important information on exposure to ticks and the common tick related diseases, but also make sure none of our patients go undiagnosed with heartworm disease should a failure with the preventive occur.


Flea & Tick Prevention

Ticks and the diseases they carry are a HUGE problem in this area. Healthy Paws currently recommends the following preventatives:

  • Oral monthly coverage - Bravecto® 1-Month  (containing Fluralaner)

  • Oral 12 week coverage  - Bravecto® (containing Fluralaner) 

  • Topical monthly coverage - Provecta® (containing Imidacloprid, Permethrin and Pyriproxyfen) - kills ticks and also repels ticks so that they are not attaching to your dog. Provecta also kills adult fleas, and prevents flea eggs and larvae from developing so that the flea life cycle is broken.

  • Topical 12 week coverage - Bravecto® (containing Fluralaner) 

  • Collar 8 month coverage - Seresto® (containing Imidacloprid and Flumethrin) - this collar is an  easy and effective way to protect your dog from ticks. Put a Seresto Collar on your dog and within 2 to 3 weeks of continuous wear, your dog gets proven, 8 month tick protection.


The recommendation in the state of Massachusettes is to treat year round due to the increased risk in our state. This follows the AVMA recommendations (American Veterenary Medical Assosiation) as well as Healthy paws veterinary center. Ticks, fleas and mosquitoes in New England are out in weather 45 degrees F the questing for a blood meal. So check your dogs carefully on those “unseasonably” balmy winter days for ticks if you choose to treat seasonally.

Treat for the following:

  •  Intestinal parasites (strategic deworming)

  • Prescribe more intensive treatment for any identified parasitic infestation

  • Prescribe topical Flea/Tick prevention based on age


Age of Puppy


6-8 weeks

(Doctor visit)

10-12 weeks

(Doctor visit)

12-14 weeks

(Tech visit)


14-16 weeks

(Doctor visit)

16-18 weeks

(Tech visit)


6 months

6-12 months


1 year

Core Vaccination


DHPP #1 booster

(Distemper-Hepatitis-Para influenza-Parvo Virus)

DHPP #2 booster




DHPP #3 (final) booster

Rabies vaccination




Spay surgery for female dogs;

Neuter for male dogs



Canine Adult Wellness Exam

Non-core Vaccination


Bordetella *recommended for all pups for baseline immunity

Leptospirosis #1 booster *recommended for almost all patients



Lyme #1 booster *recommended for most patients

Canine Influenza (CIV) #1



Leptospirosis #2 (final) booster


Lyme #2 (final)booster

CIV #2 (final) booster


Parasite Control


Fecal testing

Strategic deworming

Start monthly heartworm prevention

Strategic deworming

Repeat fecal test if initial test was positive

Start monthly flea & tick control



Strategic deworming (final)

HPVC- Canine Pediatric Wellness Program Schedule


Age of Dog


year 1

(Doctor visit)

years 2-3

(Doctor visit)

year 4

(Doctor visit)

years 5-10

(Doctor visit)

Core Vaccination


DHPP - 3yr vaccine

Rabies - 3yr vaccine

DHPP - 3yr vaccine

Rabies - 3yr vaccine

Boosters as needed

Non-core Vaccination









Annual boosters

Lifestyle Vaccination








Annual boosters

Adult Canine Health & Wellness Plan


At Healthy Paws, your dog’s health is our main focus. We have developed our Health and Wellness Plan for Adult Dogs using the most updated clinical information and recommendations of specialists as well as tailoring our program to address problems seen in our geographic location such as Lyme disease and Leptosporosis. Our goal is to give you more healthy years with your canine companion!


What are the basic components of the Adult Canine Health Plan?


years 1 to 8-10 yrs - Annual Examination Appointment

  • Complete physical examination

  • 4DX® snap test- screens for heartworm disease and 3 tick borne diseases- Lyme, Anaplasma, & Ehrlichia

  • Fecal parasite screen- check a stool sample for microscopic eggs of intestinal worms

  • Urine protein screen- for early detection of kidney disease which is especially important for dogs who have previously tested positive for Lyme disease, Anaplasma, or Ehrlichia on the 4DX® snap test

  • Appropriate vaccinations or checking vaccine titer levels

  • Tick/Flea control- Canine Bravecto® (or other appropriate product)

  • Heartworm prevention- year round – Tri-Heart Plus®, Sentinel®, Proheart6®


At 4 years - Baseline blood work- CBC, Chemistry screen, & thyroid level – similar to your physician running baseline blood work on you when you turn 35. In future years, as your pet’s chances of developing problems increases, we have a baseline to refer back to. If your dog stays healthy with no problems, then the next “screening blood work” would be at 8 years of age.


At 8 years - large breed dogs (over 50 pounds) become “Senior Canine Citizens” and transition to our senior wellness program.


At 10 years - small and medium breed dogs (<50 pounds) become “Senior Canine Citizens”.


Dental Care


Dental care is very important for dogs. Dogs can have cavities and broken teeth just like people.

  • We recommend brushing your dog’s teeth daily with a pet safe toothpaste like C.E.T brand.

  • Every year at your dog’s annual exam we will perform a visual exam of the mouth and teeth.

  • If we feel there are problems that may need a more thorough dental assessment and treatment plan (Comprehensive Oral Health Assessment and Treatment COHAT) we will discuss the need for dental cleaning and x-rays under anesthesia.























HPVC- Adult Canine Wellness Program Schedule

Vaccination Schedule


Senior Canine Health & Wellness Plan

At Healthy Paws, we have developed our Health and Wellness Plan for Senior Dogs with a primary goal in mind- giving your dog the best quality of life for as long as possible. At 8 years, large breed dogs (over 50 pounds) become “Senior Canine Citizens” and transition to our senior wellness program. At 10 years, small and medium breed dogs (<50 pounds) become seniors.


The basic components of the Senior Canine Health Plan:

  • Semi-Annual Physical Exams

  • Senior Laboratory Screening (blood & urine sample)

  • 4DX® screen (blood sample)

  • Fecal parasite screen (stool sample)

  • Appropriate vaccinations or vaccination titer testing

  • Flea/Tick control

  • Heartworm prevention- year round

  • Dental care


Core vaccines: DHPP (Distemper-Hepatits-Parvo-Parainfluenza) & Rabies

Non-Core Vaccines: Lyme & Leptosporosis

Lifestyle Vaccines: Bordetella (kennel cough) & Canine Influenza


Routine Wellness

4DX® screen

Fecal Screen

Heartworm Preventative

Flea and Tick Preventative

Senior Wellness Blood Work

CBC (Blood Count)


Thyroid Level Urinalysis


Dental Health

Oral Exam to evaluate:

1. Caries (Cavities)

2. Fractured Teeth

3. Periodontal Disease

*For more information about vaccines speak with a technician or see our Adult Wellness Program


Senior Wellness Blood work and Urinalysis


Once your pet is a senior pet we recommend annual blood work and a urinalysis to monitor for changes that might give us early warning of treatable disease—after all, 1 dog year is equal to 7 human years and a lot can happen in 7 years! Early diagnosis and treatment will extend and improve your pet’s quality of life and allow you to enjoy your relationship with your pet well into their senior years. Why would you wait?  Ask us for more information- we are happy to discuss all the benefits of annual lab screening for senior pets or see pamphlet for more detailed information

  • Complete Blood Count (CBC) - Blood test to evaluate the number and type of red, white, and clotting cells. Abnormal values can be associated with bacterial or viral infection, anemias, clotting diseases, and certain types of cancers.

  •  Chemistry Profile (Chemistry) - Blood tests to evaluate the function of many internal organs. Abnormalities can indicate systemic disorders including diabetes, kidney or liver disease, and electrolyte abnormalities.

  • Thyroid Level (T4) - Blood test to measure the amount of circulating thyroid hormone. Deficiency is common in dogs resulting in lethargy, weight gain, and dermatological problems. Increased levels are common in senior cats resulting in weight loss, increased appetite and thirst, and heart problems.

  • Urinalysis (U/A) - Urine samples provide valuable information about kidney function as well as screening for infections, tumors, or bladder stones.


Common Problems that Senior Canines Face


There are many health problems associated with old age, so it’s important to keep an eye on your dog’s eating and drinking habits, attitude, and activity level.  Even subtle changes can be associated with an underlying health issue, so it’s important to report any abnormal activity to your veterinarian.

Indications of Disease in Senior Pets:


Change in Appetite - A change in your dog’s appetite (an increase or decrease) can be the result of several different problems. If your dog is suffering from dental problems, they will most likely eat less and start to lose weight, simply because it hurts to eat. Metabolic diseases, such as diabetes, kidney, liver and thyroid diseases can also affect your pet’s appetite. Simple blood tests can screen for these diseases if they are suspected to be the cause of your dog’s change in appetite.

Weight Loss - Any gradual or sudden loss of weight can be caused by any number of ailments. Some of the most common causes of sudden weight loss in older dogs includes neoplasia (cancer), kidney, liver, and heart disease.


Frequent Drinking and Urination - Increased drinking and urination are also symptoms of common metabolic diseases, such as diabetes and Cushing’s disease. Increased drinking can also occur as the result of a bladder infection or fever. Blood and/or urine tests can screen for these diseases.


Lumps and Bumps - It is common to find new lumps and bumps on your senior canine. Always let your vet know if you’ve found any new lumps or bumps on your pet so that the doctor can determine whether she wants to do further testing to determine exactly what the lump is.


Arthritis - If you notice that your dog is slowing down or having trouble getting up or laying down, he may be suffering from arthritis.  Arthritis is very common in senior pets.  When arthritis is suspected, x-rays are usually recommended in order to assess the severity and to rule out other problems, such as tumors.  Tick diseases can make your pet’s arthritis worse.  Obesity also makes arthritis worse, so it’s important to monitor your senior’s diet and keep them at a healthy weight.  There are different options for treating arthritis, which depend on your dog’s age and the severity of the disease.


Heart Disease - Heart disease is another common problem that older pets face.  If you notice that your pet gets winded easily, heart disease may be the cause.  As part of your dog’s semi-annual exam, the vet will listen to your dog’s heart and check for heart murmurs.  Medication can be prescribed to help your dog deal with its heart condition.

HPVC - Senior Canine Wellness Program