You could always do a fecal float first (usually about $20), to see if there are any parasites. You would also likely know if your dog had tapeworm, as the egg sacks tend to hang around their bum and bedding.
If your dog is an avid eater of dead things though, I would deworm regularly - more like quarterly, not annually.
I think it's true that most vets are prone (like most doctors) to rely on accepted wisdom. Having said that, I don't think they're conspiring with the drug company to give excessive medication. Personally, I'd rather give an unnecessary treatment (to my dog, my kids, or myself) that to end up with a serious illness, so I'm not a great fan of restraint in that field. Darwin's had worms before and it's not a pretty sight. Unlike the story in that thread, I'm on pretty good terms with my vet, and he knows I'm in the field, so we discuss treatments before starting them.
Here in Israel we have big worm problems. Unfortunately, we also have a lot of Spirocerca lupi, although there doesn't seem to be any evidence that Drontal is of any use against it.
Does anyone else's dog have a rough time with Drontal?
If your dog is not at risk for tapeworms, you could use a different dewormer. The medication to kill the tapeworms can have an effect on some animals, and has recently been made rx only here in BC for that reason.
Discuss the effects of the Drontal and see if he can recommend another medication.
Also in some parts of the world there are worms with zoonotic potential that are serious business. If that's the case where you are more drastic treatments could be justified to keep the dog parasite free. On the other hand, there are multiple medications these days -- I'm certain with a little consultation, drugs that are targeted for different parasites could be selected, and I bet a cocktail could be developed for your dog that got the job done w/o side effects.
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