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  Yes maybe so but you can say the same for Frontline, Advantix & other topicals from the reviews on Amazon...there are hundreds & hundreds of 1 star review from customers with nightmarish results from Frontline (491) to be exact.  Just like everything else, some had grave results with Trifexis but not nearly as much as Frontline. And by ten folds there are many happy and successful use of Trifexis. 
 I'm more afraid of taking mine to Vet for dental cleaning as I've also heard hundreds of stories about their dogs not waking up from anesthesia but what are you going to do? not get their teeth clean and let them suffer in discomfort or pain?
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