I thought I should add that I am very minimal when it comes to vaccines -- Jackson had his puppy shots and one year old boosters and he's now 5 1/2 and I'm unsure if I'll ever vaccinate him again, besides rabies per the law every 3 years.
I only use flea/tick topicals when necessary, maybe 3-4 months out of the year. I use heartworm meds monthly/yearly because I don't feel the risk of heartworm is worth not giving the preventatives.
I think vaccines are extremely important, but NOT year after year, or even every 3 years. Any vet giving yearly vaccines would be crossed off my list immediately. I still think 3 years is too much. An every 5 year protocol would be more ideal IMO.
I try to feed a decent food, and Jackson just happens to look better and do better on grain free foods which is the main reason I feed it. I have no problem with some Purina foods, Science Diet or Royal Canin like a lot of people on internet forums do (and I used to). And I in fact have become very distrusting of a lot of the newer holistic companies. Good luck trying to find out if they have vets on staff, who formulated their foods, their quality control process, what their factory is like, finding exact numbers, ash content, things like that. That's why I'm feeding Farmina right now because it has the ingredients that I like but it also has the quality control and testing in check.
But I have seen some very scary things on the internet regarding heartworm, raw food, even homecooking. People not balancing things right, people feeding raw and then people online telling them their vet is basically ALLWRONG!1! and stupid and it's normal to go through 'detox' and lose hair, have bloody stool, get a broken tooth, etc... quite scary. Or people want to homecook and don't realize you can't just cook chicken and rice for their dog year after year without nutritional deficiencies.
And then folks have a sick dog and are so terrified to feed it an RX food because of what they read on the internet about these brands. They have a sick dog that is finally feeling better on an RX food and then they want to go and change it because 'RC is soooo bad!'
But yeah I would say I am somewhere in the middle overall. I like a little bit of both, and prefer a lack of chemicals when possible, etc, but am not going to stress about giving my dog heartworm meds every month that could potentially save him from getting heartworms, etc.