I have just taken my new pup to vet for 2nd vaccination and come home somewhat freaked as she has told me they have had 2 young dogs die from lungworm at the practise in last year and they are recommending monthly treatment for all young dogs now. either advocate or milbemax. which is the better drug?
rather upset too as one site I have read said lungworm can cause seizures and I am now wondering if that is what killed my beloved weimaraner.  I am not taking any avoidable risks with this new pup.

I prefer to do a worm count  using either wormcount  , or feclab. You can test as frequently as you wish and then treat if needed. Apart from not wanting to use chemicals unless needed it is almost impossible to prevent only treat so my dog would be having regular chemicals for no reason  .

It is possible to do a snap blood test and most vets suggest one before an operation / dental to make sure the dog is clear and there shouldn't be any bleeding problems during an op. |Not so practical on a frequent basis although possible

https://www.feclab.co.uk/

http://www.wormcount.com/

There is an alternative to Advocate or Milbemax - which is good old Panacur 10% (fenbendazole).  This is effective against lungworm and is non-prescription and arguably much gentler as a product than either Milbemax or Advocate. 

The only downside is you need to give it for 5 consecutive days, which some might not like.

As I understand it panacur is the treatment if your dog is affected, but only monthly worming with milbemax will prevent lungworm.  It's incredibly difficult to know if your dog has lungworm before it's already done some damage. I've spoken to my vet about it several times, at the moment I don't think there is a need in my area to go down the monthly preventative but I certainly would if I lived in the South of England say, and I will if/when lungworm becomes more prevalent here.

You can check your own area and make your own risk assessment here... Lungworm map

Panacur 10% is my choice every time. 

In all my years of using it, its never let me down.

>As I understand it panacur is the treatment if your dog is affected, but only monthly worming with milbemax will prevent lungworm.

This is not correct, chaumsong.  ALL lungworm preventatives don't actually 'prevent' infection - they just kill off any larvae which the dog has ingested in the previous month.  The same with any worming product - whether it's for heartworm or roundworm or tapeworm.  None of these stop your dog picking up the worm in the first place, they just kill off any eggs or larvae before they can develop.

Panacur is no different to Milbemax or Advocate - except it does not have a huge Bayer marketing plan behind it to plaster posters all over vet offices.  It is a relatively cheap drug.

> they just kill off any eggs or larvae before they can develop

Thats preventative in my book, it prevents the lungworm damaging internal organs if it's killed before it can develop surely

Technically, a 'preventative' must prevent infection in the first place - anything else is a 'treatment'.

If you read Noah Compendium it states at least for Advocate that it treats Lungworm not prevents it. Not checked the others on there because Advocate is the one most vets have posters up for claiming it as a preventative

> There is an alternative to Advocate or Milbemax - which is good old Panacur 10% (fenbendazole).  This is effective against lungworm and is non-prescription and arguably much gentler as a product than either Milbemax or Advocate.  <br />

When there was a general panic about Lungworm a few years back, I remember it was Panacur that was the treatment of choice?

thank you all.   panacur for 5 days is that at full dose or other? 
I will be treating frequently as having looked at map there were 2 reported cases in my road.  just need to figure which is the most suitable drug.

weimed here you go, from the datasheet for Panacur 10%:

"For the control of lungworm Oslerus (Filaroides) osleri in dogs administer 1 ml per 2 kg bod yweight daily for 7 consecutive days (= 50 mg fenbendazole/kg body weight daily for 7 days)."

http://www.noahcompendium.co.uk/?id=-455815

I know that doesn't mention Angiostrongylus vasorum on the datasheet itself (which is what people mean when they say 'lungworm'), but there are loads of studies showing that it is effective against this:

See here:  https://www.sciencedirect.com/science/article/pii/S0304401707002385  In this study they compared Advocate spot on directly with fenbendazole in terms of efficacy and found them equally as good, although they did use a really long treatment with the fenbendazole. 

This paper is also useful - see 2nd from last paragraph:  "fenbendazole can be administered at different doses for varying periods (i.e., 20 mg/kg q24 h up to 100 mg/kg q24 h for seven to 21 days; [10,1]), case 2 and 3 were managed by different clinicians and received varying treatment regimens due to this wide variation in the literature. Benzimidazoles [fenbendazole] and ivermectin certainly result in zero faecal larval counts, but it is not known if they are adulticidal"  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113816/   [But you're not treating to kill adult worms anyway, if you're using it as a preventative.]

I think I did basically the giardia dosage with Panacur, for 5-7 days, when I used it.  (I no longer live in an area with lungworm.)