Our vet said heartworm meds once per month too. We gave Katie Scarlett her first dose yesterday. She had a major case of the zoomies after eating the chewable. It was hilarious.
As for fleas, that is a good question. I need to ask our vet if I could do half the dose as well since our baby is only 2.8 pounds. We are starting that soon. She had her appointment this past Friday and was flea/tick free.
Thanks for asking this question! I will check back in and see what others suggest as well. I am curious!