This product is very convenient, combining heart worm prevention with other worms and fleas. It's easier than giving the heartworm chew, then treating topically for the rest. However, it is missing something... ticks. In addition to the hearworm chew, the product I used previously was flea and tick. When they can add prevention of ticks to the heartworm, fleas and other worms, I will add that fifth star. Still a good product. I'm confident using it on my dog. Check your dog for ticks!