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 outranks 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 have 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 are 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, “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.
By Dr. Melanie Marsden