All Posts tagged Veterinary pharmacy

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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Pet Poisonings Often Happen At Home.

According to veterinary experts, each year hundreds of thousands of our canine and feline friends are exposed to dangerous poisons in the very place where they should be safe.   From corrosive cleaning agents to supposedly healthy snacks, our homes can harbor a wide variety of potentially hazardous materials.

The Animal Poison Control Center of the ASPCA handles almost 200,000 calls every year from worried pet owners.  Additionally, the Pet Poison Helpline reports their call center handles another 100,000 reports of animal poisonings annually.  So, what are the problematic substances in our homes?

Both of these organizations show the number one reason for calls is human medications.   From Tylenol, Advil and other over-the-counter products to prescription antidepressants, pain medications and heart pills, drugs meant for people find their way into our pets far too often.  In some cases, sneaky pets will gobble up tablets dropped by their owners, but in many instances, these drugs are purposefully given to dogs or cats in a well meaning but wrong attempt to treat some illness or pain.

Human medications can and do cause serious problems for our pets.  Their different metabolism and small sizes often means that a common drug like acetaminophen can be deadly.  A single 500 mg Tylenol can actually kill a cat!

Next up on the list are products designed to help our pets, like popular flea medications and other insecticides.  In general, the topical drops are very safe, but when used incorrectly, the consequences can be severe.  Our feline friends are especially susceptible to the mis-use of these products and more than half of the calls to poison hotlines involve cats exposed to insecticides.  Organophosphate products designed to protect plants from marauding insects are often involved in poisonings of both dogs and cats.

We have all heard that feeding “people food” to our pets can be problematic and the number of calls to both poison centers confirms it.  Chocolate can cause serious heart arrhythmias, garlic and onion ingestion can lead to red blood cell abnormalities and the artificial sweetener, Xylitol®, has been implicated in liver failure and death in dogs.  Even supposedly healthy foods aren’t necessarily safe.  Macadamia nuts cause dogs to become weak and unable to walk and grapes and raisins will create kidney failure in some dogs.  Unfortunately, the exact reason why this happens is not known.

Beyond these very common items, household cleansers, automotive products, rodenticides, dietary supplements and even veterinary drugs also have a strong potential for problems.

Pet owners can protect their four legged friends by following a few common sense rules.

First, we are accustomed to “baby-proofing” our homes, why not consider “pet-proofing” it as well?  Make sure that any potentially dangerous chemical is safely secured behind closed or even locked doors.  Antifreeze, kitchen and bath cleansers and drain products need to be kept out of a pet’s reach and spills should be cleaned up immediately.

Next, any medication, human or veterinary, should be kept in a medicine cabinet or area where a pet will not have access.  If you are worried about dropping pills, take your medicine in the bathroom with your pets locked on the outside!

Never give your pets any medication unless ordered by your pet’s veterinarian.  As mentioned above, the wrong dosage or even a seemingly safe human drug can be deadly to your pet.   Always check with your veterinarian, not the Internet, whenever you have questions about medications your pet is receiving.

Finally, take action if you suspect your dog or cat has ingested something harmful.  Calling your veterinarian or an accredited veterinary organization should be the first step.  Both the ASPCA Animal Poison Control Center and Pet Poison Helpline have call centers open 24 hours a day, seven days a week.  These specialists can help you decide if your pet needs immediate veterinary attention or if it’s okay to wait.  Each group charges a small fee, but isn’t that a tiny price to pay for peace of mind and your pet’s well-being?

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Healing Canine Arthritis with…Platelets?

Pet owners don’t want to see their beloved animals in any sort of discomfort, especially if the pain is something the owner can relate to.  Degenerative joint disease, better known as arthritis, affects more than 50 million people in the United States and veterinarians estimate that about 15 million dogs also suffer from this disease.

In an attempt to provide relief for their four legged friends, owners will turn to a variety of treatment options.  Non-steroidal drugs, acupuncture, stem cell therapy or even different types of lasers are all current alternatives in a veterinarian’s arsenal to help these pets.

In recent years, a new type of treatment that has been borrowed from human sports medicine has increased in popularity.  Several high profile athletes, like Tiger Woods and Troy Polamalu, have received remedies consisting of blood concentrates with high levels of platelets.  Also seen in equine athletes, the use of platelet rich plasma could show promise for treating injuries and arthritis in dogs.   Proponents quickly point out that this type of therapy is completely natural, since the only “treatment” comes from the animal’s own body (also known as autologous).  Critics of this type of treatment say that the theory is certainly sound, but good scientific evidence is not here yet.

So, how can “Platelet Therapy” possibly help an arthritic pet?

Most people understand platelets are cells that help blood clot after injury.  However, platelets are also important in injury repair, providing a wide variety of growth factors that attract specialized cells to help fix the problem.  The theory behind platelet rich plasma is that the increased concentration of these essential growth factors helps speed the healing process.

For both dogs and horses, a small sample of blood is taken from the animal and then placed into a specialized filter that helps concentrate the number of platelets.  Once the filtration is complete, this new platelet enriched plasma can be injected back into the affected joint of the pet.  It’s really that simple!

New, “point of care” devices are now available, meaning veterinarians do not need any specialized equipment for this therapy.  In fact, the whole procedure can be completed in about 15 minutes in the veterinary hospital, in the pet’s home or even at the horse’s barn.

Testimonials from pet owners seem to substantiate the success of these treatments.  Many people describe how their pets have demonstrable beneficial changes in range of motion and overall movement and even an improved quality of life.  Other owners express happiness with the “natural” quality of the treatment and the lack of known side effects.

Veterinarians are providing positive feedback as well.  Using highly sophisticated scales to rate lameness, veterinarians report better mobility and even less pain in their patients receiving platelet rich plasma.

But not everyone is convinced that this treatment will be the answer to arthritis or other musculo-skeletal injuries.  Reviews of the literature detailing studies in human medicine have all stated that the evidence for the success of these therapies is not conclusive and large scale studies are needed for more substantial proof.

Additionally, the effective dosage of the concentrated platelets, the appropriate timing and number of applications for effective therapy is not known.  There is even a question as to which types of tissue responds best to platelet rich plasma.

Thankfully, your veterinarian does have a wide range of treatment modalities that can help provide relief for your pet.  Owners can help evaluate the effectiveness of any therapy by keeping a log of the pet’s activity and communicating movement changes, pain or even different attitudes from their pet.  Working together, you and your veterinarian could find the best ways to keep your pets and horses as pain free as possible!

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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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