All Posts tagged online pet pharmacy

What’s Wrong With My Cat’s Mouth?

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Ask any cat owner about how they care for their feline’s teeth and most will reply that “he eats dry food” or, more commonly “I really don’t clean her teeth”.  While most veterinarians will acknowledge that brushing a cat’s teeth is a challenge for many owners, they will stress the importance of routine oral assessment of your cat’s mouth.  These exams help find preventable problems and even some very concerning issues.  One of those concerns we are seeing more frequently is called Feline Tooth Resorption.

Tooth Resorption, or “TR” as it is commonly called, is a condition seen in a growing percentage of cats over the age of six years. The same strange condition is also seen in dogs and in people, but it is not nearly as common.

In the past, this disease has been called “neck lesions”, “cervical line lesions” and even the cumbersome “Feline Odontoclastic Resorptive Lesions (FORLs)”.  Whatever the name, we know that this condition is seen in cats who often appear normal.  The process will continue to develop, causing extreme pain because of the exposure of the root canal.  This can even lead to behavior changes and lack of normal appetite.

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Dr. Brett Beckman, a noted board-certified veterinary dentist, says that an exact cause for TR has not been determined yet.  Theories about exposure to certain viruses, breed prevalence and chronic inflammation of the mouth and gums have all been proposed as root causes.  According to Beckman, a single study suggests that high levels of Vitamin D in cat foods could be linked to resorptive disease, but that research is still ongoing.  Interestingly, there has even been evidence of TR in cat skeletons that are 800 years old!

Clinically, most cats will appear normal, but observant owners may note that their cat prefers to chew food on just one side or that the cat stops grooming.  They may “toss” dry food into the back of their mouth.   As TR progresses, some pets will even develop sullen or aggressive attitudes, as if they are mad at the world!

Eventually, your veterinarian may point out how some of your cat’s cheek teeth are showing lines of inflamed, fleshy material right near the base of the tooth.  At this point, the erosion has exposed the tooth to the bacteria of the mouth and this is when affected cats become extremely painful.  Even under a general anesthetic, a slight touch of these teeth will cause a cat to “chatter” their jaw, indicating very serious pain!

Dental x-rays are the only way to diagnose TR.  When the radiographs are taken, if TR is present, your veterinarian can see changes in the density of the roots and crowns of the teeth.  All teeth can be affected, but the major “signal” tooth is the first one in the lower jaw.  Some teeth can be partially affected, while others may have completely dissolved away leaving a “ghost image”.

Unfortunately, there is no effective treatment that can save the pet’s teeth.  A normal cleaning and polishing will not work!  Veterinary dentists have even tried root canal therapies (endodonics), but they fail, as this resorption occurs on a microsopic basis.  A tooth that is showing any signs of resorption needs to be extracted.  Some cats will need full mouth extractions.  All cats with a known history of TR should be x-rayed every six months to a year. It is likely other teeth are affected and they must be monitored.

The good news in all of this is that once your veterinarian knows about the disease, several things can be done to keep your cat comfortable.  Experience has shown that cats who were once not eating well or even aggressive will often have a positive behavior change in just a matter of weeks.  It is surprising how the removal of these painful teeth can often bring back your affectionate feline friend.

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Owners are often unaware that their pets are experiencing such discomfort.  But, regular visits to your veterinarian can help identify the issue and start work that will make your cat feel better.  Contact your veterinarian to have a comprehensive oral examination for your pet, including dental x-rays and regular dental cleanings.

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Pharmacy Mistakes Can Harm Our Pets!

When national surveys are done, pharmacists continually rank high when it comes to trust, honesty and ethics.  Whether it’s your pharmacy professional at the locally owned corner store or the one at the corporate big box store, this profession consistently out ranks doctors, engineers and even the clergy!  Like veterinarians, pharmacists are viewed as compassionate and caring by the general public.

However, increasing numbers of news reports detailing mistakes made by human pharmacies dispensing pet medications has both professions concerned.  In some cases, there was no noticeable effect and the pets were fine, but serious illnesses, severe complications and even deaths have occurred.  How widespread is this issue?

Thankfully, in the vast majority of prescriptions sent to pharmacists from veterinarians, the dosage and medication is delivered as expected and the pet gets exactly what is needed.  It’s only when drugs are changed, generics substituted or dosing altered that problems occur.

In a recent survey completed by the Oregon Veterinary Medical Association (OVMA), more than 1/3 of the veterinarians surveyed reported incidents of pharmacists from either retail or online pharmacies changing the prescription.  In a highly publicized case from Los Angeles, an 8 year old Labrador was euthanized after the drug store altered the dose of a veterinarian’s prescription, changing the “cubic centimeters” (or “cc”) to teaspoons.  This pet ended up receiving almost 4 times the amount of medication needed which compounded his other, already serious health issues.

In the Oregon survey, veterinarians also reported that insulin brands were changed, dosages for anti-seizure medications were altered and antibiotics substituted for chemotherapy drugs.  Other news reports have shown that pet owners were told to give human pain relievers, such as Tylenol® or Ibuprofen®, to their pets.  This seemingly harmless advice can lead to serious liver damage in dogs or even death in cats.

Executive Director of the OVMA, Mr. Glenn Kolb said that ““Together, veterinarians and pharmacists work hand in hand to meet the needs of the client and the best interests of the patient.  The bad news is the rare occurrence when a pharmacy steps out of its scope of practice by making determinations and adjustments.”

Even the Food and Drug Administration (FDA) has taken notice.  In a 2012 Consumer Update, the FDA mentions how veterinarians and pharmacists are taught different systems of medication dosing abbreviations, leading to confusion.  In addition, transcription errors and product selection mistakes can lead to the wrong drug or the incorrect amount being given to your pet.

Both professions and the FDA are taking these reports very seriously.   Carmen Catizone of the National Association Boards of Pharmacy says that pet owners “”primary concern should always be whether or not the pharmacist is knowledgeable in the area of veterinary medications” and cautions that price should be a secondary consideration when looking for pet or human drugs.

In the FDA alert, consumers are urged to ask questions of both the pharmacist and the veterinarian if your pet’s prescription is filled at an online or retail pharmacy.  Glenn Kolb takes it one step further and flatly states that “veterinarians need to raise awareness among pet owners by telling them, “If a pharmacist suggests changing to a different drug or different dosage, please contact me right away.’”

Be familiar with your pet’s regular medications and take time to review any written prescription.  If what you receive doesn’t match your expectations, do not give the drug and contact your veterinarian.

Veterinary experts also recommend that pet owners shopping for the best price on pet medications have an open conversation with their primary veterinarian.  In many cases, the veterinary hospital will have the right medication available at a price that matches or is close to the online costs once you figure shipping and convenience.  Plus, you get the added peace of mind that your veterinary team understands your pet’s unique needs.

Just like in human medicine, prescription errors happen with our pets too.  The important thing to remember is that both your veterinarian and your local pharmacist are interested in what’s best for your four legged friend.

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The Confusing World of Pet Parasite Prevention

According to PetsAndParasites.com, a website devoted to tracking the occurrence of parasites in our pets, the prevalence of deadly heartworms continues to cause problems.  More than 1% of dogs tested will be positive for heartworms in the US every year.  That’s almost a million pets suffering from a preventable disease!  Rates are even higher for parasites like roundworms, whipworms and hookworms!

Thankfully, we have had safe and effective parasite treatment and preventive products available for many years.  So, why are we still seeing so many cases? There are many theories.

Despite the claims of Internet sites who say rising resistance among heartworms or massive failure of preventives is to blame, the reality is probably a little closer to home.   Dr. Sheldon Rubin, a past president of the American Heartworm Society is quoted as saying that human error or forgetfulness is probably the biggest reason for pets developing heartworm disease.  His comments are echoed by research in Mississippi, Arkansas and Louisiana that reviewed cases of presumed heartworm preventive failure and found that owner compliance was actually much lower than originally reported.

Graphic of various pillsBut, an uncertainty among pet owners about which product to use (market confusion), as well as economic factors, are fueling at least some of the issue.  Generic heartworm preventives can now be found in many human pharmacies and online pet pharmacies are offering six to ten different medications to the public.  It’s frankly hard for a pet owner to choose.

Experts from the American Heartworm Society recommend giving heartworm preventive year round.  Just be sure you are using a prescription product that contains one of these known compounds; ivermectin, milbemycin oxime, selamectin or moxidectin.  Then your pet needs to receive a dose once monthly, every month, all year long.

Some of these medications are also effective against intestinal parasites, such as roundworms, hookworms, and whipworms.  A few of these preventives are also now using compounds to treat tapeworms in addition to the other parasites.  It’s even possible to get heartworm preventive that also includes means to help control fleas!!

Part of consumer confusion is whether to buy the least expensive product or the one that covers every possible parasite.  Veterinarians do understand how this can be such a confounding problem.

In fact, certain parasites are less common in some areas of the country and your pet’s risk factors vary quite a bit.  These risk factors also include exposure to parasites through trips to dog parks, hiking or camping, interstate travel or even the presence of other animals in the household.

Veterinarian with petVeterinarians follow these trends every year.  They couple this information with their understanding of the different life cycles, knowledge of your pet’s specific medical conditions, the reputation of the drug manufacturers and your region of the country.  They are ideally equipped to help you more fully understand exactly which product provides the best parasite protection for your pet and your family.

Also it is so important for you not to fall for advice in online forums that recommend odd-ball alternative methods of protecting your pets against any parasite, but especially heartworm disease.  Many of these simply fuel speculation about diminishing effectiveness of heartworm preventives and they are not well researched.  These sites often misinterpret data or are actively promoting products that have not gone through proper testing and safety research.

This is an area of pet care where we have made great advances, but bad advice and a confusing market have created unnecessary risks and vulnerabilities. Trust your pet’s healthcare advice to your family veterinarian and team.  Trusted products from Deerfield Veterinary Hospital can be found at our hospital.  Our pharmacy is price competitive with most online and local big box retailers.  Call the hospital today to setup your account with Deerfield.

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Generic Pet Drugs…Good or Bad for Your Pets?

According to data from the IMS Institute for Healthcare Informatics, consumers in the US spent almost $4 billion on retail prescriptions in 2010 and a large portion of that business was in the form of generic medications.  Generics now make up more than 80% of all prescriptions filled at human pharmacies.  In addition, pet owners are now asking about generic alternatives for their animals.

So, what is a generic drug and are there concerns about using them for our four legged family members?

Drugs that contain the same active ingredient as a brand name medication are known as generics.  These products become available after a pharmaceutical company loses their patent protection on the specific drug molecule.  Since the necessary clinical testing that is so important for new drugs does not need to be repeated for generics, these medications are sold at a much lower cost.  In addition, many consumers are already familiar with the drug and advertising costs can be greatly reduced.

Medicines that are brought to market as generics must contain the same active ingredients, have the same route of administration, same dosage or strength and the same conditions of use.  But, many people still have serious worries about how well these medications perform or their overall safety.  News reports about poor manufacturing standards and contaminated ingredients have raised alarm in the minds of many individuals.

FDA Generic Drug Review processHowever, the FDA has an extensive overview process that not only creates a system for evaluating quality standards for manufacturing, but also significant testing to show that the drug performs just like the original product.  This assessment of the generic’s performance is known as proving bioequivalence.

Still, it is important to remember that all people, and pets, are individuals and there is always the possibility that a unique response can occur to either the original drug or the generic equivalent.  In addition, inert ingredients used in the manufacturing of the generic product may differ from the brand name.  This could also lead to abnormal or adverse reactions to the medication.

Knowing all of this, does it make sense for pet owners to spend extra time at a retail pharmacy picking up pet medications or parasite preventives?

First and foremost, it is important to understand that your veterinarian is crucial to answering that question.  A physical examination of the pet and a veterinarian/client/patient relationship are necessary in order for the veterinarian to write any prescription.  In other words, don’t expect to get a prescription if your pet hasn’t seen their doctor in more than a year.

Next, lab work is often needed to keep your veterinarian up-to-date on your pet’s health status and to monitor any disease process.  For medications like heartworm preventives, it is vital that your dog have a negative heartworm test before continuing the medicine.

Finally, with many brands and alternatives on the market, it’s easy to become confused about the exact product that your pet requires.  Your veterinarian and his or her team can help you find the one that matches the medical needs of your pet as well as one that is safe and effective.

Be wary of online websites that promise absurdly low prices on pet medications.  Far too often, these are simply scams designed to take your money.

Many veterinarians keep a well-stocked pharmacy right in their hospital or allow their clients to order drugs online.  Getting the medications directly from your veterinarian could save you time and hassle.  But, in either case, your veterinarian will want to help you get the right drugs at a price that fits in your budget.  That is their commitment to you as their trusted client.

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Online Pet Pharmacies – Saving Money or Risk to Your Pets?

With record numbers of families enjoying the benefits of pet ownership and online shopping, it should come as no surprise that the amount of money spent on our pets is huge.  Experts are forecasting that pet owners will spend more than $50 billion dollars annually.  A significant percentage of those expenses include veterinary care and prescription medications.  So, is it any wonder that buying your prescription medications online may also look like a good deal?

At first glance, online pet pharmacies would seem to be a great option.  The promise of lower prices and having the medication shipped to your door is a big selling point for busy, budget conscious people.  But, there are some pitfalls when relying on Internet based sources for your pet’s medication needs.

First, they all say you can “save a trip to the vet”.  Unfortunately, this is only partially true.  In order to prescribe and dispense medication to your pet, most states require that there is a valid veterinarian-client-pet relationship or VCPR.  This is usually defined as a veterinarian having examined your pet within the last 12 months.  If the VCPR does not exist, medication cannot be dispensed.

Some websites will offer to sell the drugs without a prescription. This is not only illegal but not in the best interest of your pet!  Websites that sell without needing prescriptions are most often based outside of North America, where pharmacy and drug laws may not be as strict.

The requirement for this professional relationship insures that you and your veterinarian have good, up to date facts about your pet’s health. Plus the medical records and history for your pet are all in one place.  The veterinary staff also knows your whole pet family and can help prevent problems when there are multiple pets present in the household.

Since pets are unique individuals, some may have unexpected reactions to certain drugs and some medications can even be deadly if given incorrectly.  Others may need a special formulation for ease of administration.  The online pharmacies will not know this information and this could be a problem if your pet is on several medications or has secondary conditions.

If a life-threatening emergency happens with a medication, your veterinarian is only a phone call away.  Some online pharmacies only allow contact through email and this will not help you if your pet needs assistance immediately!

Finally, despite many good businesses online, there will always be a few who are looking for a quick buck at your expense.  Avoid sites that offer dramatically lower prices than competing sites or your veterinarian.  Likewise, if you have ordered medication online, check the drug to make sure it looks similar to what you have given before.  If it looks different in any way, do not give it to your pet.

Illegal "Bootleg" product manufactured for Australia was purchased by a client from major online retailer.

The FDA is so concerned about this, it is now warning pet owners to be aware of shady online companies.  The National Board of Pharmacies has instituted the  e-Advertiser Approval Program to help you find properly licensed and compliant online pet pharmacies.  Only Eighteen companies nationwide have earned the right to display the e-Advertiser seal of approval, including Deerfield Veterinary Hospital.

Check with your veterinarian about online pharmacies.  Many veterinary hospitals now offer their very own store on their websites.   Often prices are competitive, and they are the same medications you purchase at the hospital.  Orders can ship directly from the hospital to your door, or you can choose to pick them up at the hospital without the hassle of waiting in line.

In addition, you will know who you are talking to in case of any problems or concerns.  Honest and open communication with your veterinarian about cost concerns will prevent misunderstandings about money and help you do what’s best for your pet.

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