M.D.
Hi, Lindee, I have 4 dogs. They are 17, 10, 3 and 2 years old. We don't do any annual shots. I strongly believe it does more harm then good! Heartworm prevention tablets, yes(need to do more research on this one). They eat raw dog food and going to holistic doctor when need it. Completely different approach for better health. My oldest dog had one problem after another(side affects from meds)when we were seeing regular vet. Not anymore!
For ticks and flea try this: http://tagfoot.com/M./bookmarks/mosquito
Good luck!