[Erin]

I am by no means an expert but I'll try to help. I would honestly find a new vet who will explain all of this to you!
------
Drontal 22.7mg - This is a de-wormer, I'm not familiar with the product
Flotation Fecal Exam - Checks for intestinal worms (different from heartworm)
Bordetella, 2nd, IN - Kennel Cough vaccine, he doesn't need this unless you are boarding him somewhere that requires it.
DA2PP, 3rd - This is his 3rd series of Distemper Vaccine, this is OK

Then these two meds:
Iverhart Plus - Heartworm Prevention (My dogs take Interceptor, I'm not familiar with this product)
Advantage Dog - Flea Prevention, I don't do flea prevention but we live in IL

Then at the bottom of the sheet it says Reminders for Wrigley:
3-4-09 Boretella Booster - You can skip this unless you are boarding or feel you really need it
3-4-09 Fecal Exam - Normal
11-22-08 Heartworm Test - I thought they normally did this @ 1yr old?
9-24-08 DA2PP+L, 4th - I would seriously reconsider the Lepto vaccine (If that is what +L is) The Lepto vaccine has a higher incidence of an adverse reaction than the other ones so unless you have Lepto in your area it's better to skip this one. Your vet should have explained this to you, which is why you need a new one.

The 6 in 1 is Distemper, Hepatitis, Leptospirosis, Parainfluenza and Parvovirus - Don't do it. It's too many things for them to handle all and once. I would NOT go to the clinic for these shots.

Also, I didn't see Rabies on your list of things he has had. He should get a 1 yr rabies and then in a year he should get a 3 yr rabies. No need to do rabies every year. Also, there is nothing wrong with getting the DA2PP and Rabies on different days so you don't overwhelm their tiny bodies. A good vet will offer this option and accommodate it.

Here's the bottom line, small dogs are very different than big dogs. You have to use different medications, different anesthesia... You have to find someone who is used to small dogs (and neurotic small dog owners) who will cater to you and answer your questions. My vet's office has 3 doctors and I refuse to see 2 of them not because they aren't good doctors but because they will not explain every detail of what they are doing like my vet does. It's very important to me to know exactly what's going on.

Good luck!!!