Sunday, February 24, 2013

MANAGING YOUR PET'S MEDICATIONS




Well, we got one of those winter snow storms that I mentioned last week, although only about half of the expected accumulation showed up.  We're still a bit behind our yearly average but there's still the big month of March awaiting.

EOB-10....

Helpful Buckeye still remembers the lecture back in 1971 when one of our clinical medicine professors told us that one of the major stumbling blocks in achieving success in healing our patients would be...the owners of those animals.  At the time, it didn't make any sense to any of us but he went on to explain that the medicines we'd be prescribing had to be given to the animals for any results to occur.  Then, the light bulb went on as we realized that this could be a problem to be reckoned with.  So, with that in mind, let's consider this week's topic:

Managing your Pet’s Medications
Ann Hohenhaus, DVM
The Importance of Compliance
On a daily basis, the veterinarians at The Animal Medical Center prescribe pills, capsules and tablets to cure, control and prevent diseases. We have pockets full of prescribing information, access dosing online and carefully follow guidelines to use medications safely and wisely.
Correct prescribing by the veterinarian is critical to medication success, but the other half, administering medications as prescribed is equally important. Pet owners, upset by the illness of their pet often misunderstand directions or adjust medication dosing without consulting their pet’s veterinary healthcare team. If you think no one would do this, here is summary of this week’s medication conversations.
Becky
Poor Becky had major dental surgery this week, including eight extractions and resulting in a prescription for pain medications. Becky, a dachshund, belongs to an employee of The AMC and I stopped by her office the next day to check on the dog. It just happened to be medication time and Becky’s owner was worried Becky was in pain (highly likely given eight extractions) and she thought she would give only half the prescribed dose of pain medications. I reassured her that the amount prescribed had been carefully calculated for Becky’s size and pain level and that the entire dose should be given.
Montana
Montana is getting chemotherapy and also some anti-nausea pills. When I reviewed his prescriptions, his owner reported she was giving half a pill twice daily rather than one pill once daily. She thought the anti-nausea effect would last longer if she gave the pill more often. The problem with this logic is the anti-nausea medicine stays around a long time, hence the once a day dosing recommended by the manufacturer. By giving half a dose, Montana may not have gotten a high enough level of anti-nausea medicine in the bloodstream to have a full effect.
Harvey
Finally, there’s Harvey and his chemo pills. He started a new regimen of treatment and I called a couple days later to see how it was going. Harvey felt great. I should have listened to my inner doctor voice saying, “Hmm, seems too good to be true.” Turns out his owner made an honest mistake, misread the label and was giving only one pill instead of two. Now he is on the correct dosage and is feeling better than ever since his tumor is shrinking.
Medication Pointers
Read the label. Read it again and if you have questions, call your veterinarian’s office.
Give the medication as prescribed on the label. Don’t adjust the amount, frequency or duration of administration without talking to your veterinarian.
If you are having trouble administering medications, stop by your veterinarian’s office for a lesson in administration.
If the medication schedule does not fit with your schedule, ask your veterinarian if there is an alternative drug with a different schedule.
If your pet won’t take a pill, ask if the medication comes in a liquid or can be formulated into a liquid to ease administration, or perhaps administered with a pill gun.
 
If you think your pet is having a bad reaction to the medication, stop the medication and call your veterinarian immediately.
For after-hours trips to the animal ER, be sure to take all the medications with you and show them to the ER staff.
 
Ask the Vet: Managing medication for your pet
Dr. Ray Cahill
Sitting in my own doctor’s office the other day I saw pamphlets for a variety of drugs from Tylenol to Lipitor. It made me think about how complicated it can be to keep track of medications, especially those for our pets.
Multiple times a week I find myself reviewing medication protocols with clients that have either stopped giving their pet’s medication too soon or were not giving it as directed. This can happen because it becomes difficult for owners to remember the details of their pet’s condition and exactly what the medications are doing to help.
In vet school, we’re taught that clients typically remember the first and last 5 percent of what we tell them at an office visit. What we blab on about in between may or may not stick, and the notes we send home may or may not get read. That said, it is important that the pet gets treated appropriately, and that remains a shared responsibility between the owner and the vet.
Contact your vet’s office for help understanding your pet’s health issues and medications, even if you’re unclear about commonly used products such as heartworm, flea and tick preventatives. Give your pet’s medications as directed for the full length of the prescriptions (i.e., don’t stop early because your pet is feeling better). Call in advance for medication refills to avoid running out and risking your pet’s health. This applies especially to prescription diets; it’s easy to think that a day or so off a prescription food is OK, but the reality is that the diet is the medicine.
Fortunately I left my doctor’s office without any prescriptions. One less thing to confuse me!

Helpful Buckeye said M-E-D-I-C-A-T-I-O-N...not, M-E-D-I-T-A-T-I-O-N....
 
OK, now we know that even though the pet owner is supposed to be able to give medicines to their pet when needed, it doesn't necessarily work out that way all the time.  Veterinarians understand that most pet owners are very sincere in their efforts to comply with instructions on medicating their pets; however, when you consider that a lot of pet-owning humans are less than attentive to medicating themselves the proper way, who knows what they'll do when Fido or Tabby bares their teeth at treatment time?
Another problem with medications and your pets goes in the other direction...pets getting hold of medicines that can cause them problems.  Helpful Buckeye has discussed this in the past but a current reminder is well-intentioned: 
Human medicines are pets' biggest poisoning
danger
By Maryann Mott, HealthDay
When John D'Amato arrived home early from work one day, he found an empty bottle of ibuprofen on the living room floor — and one very sick pet.
His Great Dane puppy, Otis, had knocked the pain-reliever container off the coffee table — where D'Amato had left it the night before — and devoured dozens of the pills.
"My heart dropped through the floor," he said of the discovery.
D'Amato rushed the 85-pound puppy to a veterinary clinic near his home in Manchester, N.H., where the staff immediately induced vomiting and began administering IV fluids. Had D'Amato arrived home much later, Otis might not have survived.

Ingestion of over-the-counter and prescription drugs formulated for humans are by far the most common cause of pet poisonings in this country, veterinarians say.
Since the ASPCA's Animal Poison Control Center (APCC) in Urbana, Ill., began keeping statistics in 2002, human medications have consistently topped its annual list of the most toxic substances pets ingest.
Of the 98,000 calls received so far this year, about one-third involve dogs and cats consuming human medications, says Camille DeClementi, a veterinary toxicologist with APCC.
Non-steroidal anti-inflammatories, such as Advil, Aleve and Motrin, are among the top offenders, the APCC finds. Other drugs commonly eaten by dogs and some felines include antidepressants (Prozac), acetaminophen (Tylenol), anti-anxiety drugs (Xanax), sleep aids (Ambien) and beta-blocker blood pressure medications (Tenormin or Toprol.)

"The most toxic things in our homes are the medications we take," she said. "Animals are inquisitive, and get into things they're not supposed to."
Pets knock vials off countertops and nightstands, or owners mistakenly think they're helping their pets by giving them human medication to alleviate some sort of ailment.
That's a big no-no.
"Dogs' and cats' metabolisms are different from ours, so they can't always process the same drugs we can," explains Silene Young, a former emergency room veterinarian who works for Veterinary Pet Insurance (VPI) in Brea, Calif.
Just one extra-strength Tylenol, for example, can kill a cat. And the anti-cancer topical treatment, Fluorouracil, can be fatal in dogs, even in the tiniest doses ingested — say, from chewing on the discarded cotton swabs used to apply the cream, according to veterinary toxicologists.
Medication mix-ups cause unintentional poisonings too. By grabbing the wrong bottle, some owners inadvertently give their pet medication that's really meant for them or other humans.
Keeping animal and human medications in separate drawers or cabinets is the simplest way to prevent those types of mishaps from occurring.
It's also a good idea, veterinarians say, for owners to take their medication in the bathroom with the door shut. That way, if a pill drops on the floor, they have time to retrieve it before the dog does.
Luckily, a good portion of pet poisoning cases are treatable at home if caught right away, says the DeClementi. The center runs a 24-7 hot line staffed by veterinary toxicologists who give diagnostic and treatment recommendations for poison-related emergencies in animals.
And if a trip to the veterinary hospital is warranted, you'd better take along your credit card. Treating a pet that has ingested a human medication costs owners, on average, $791 before insurance reimbursement, according to VPI.
As for Otis, the Great Dane, he pulled through just fine after three days of intravenous fluids and close monitoring by veterinarians.
The sheer number of pills he gobbled — at least 35 — could have caused gastric ulcers or kidney failure, both of which can cause death.
Quick action taken by his owner, though, saved the young dog's life and stopped internal damage from developing. "He's been back for check-ups since (the incident)," says D'Amato, "and he's a very healthy dog."
 
Don't forget, if you have any questions and/or comments, send them to Helpful Buckeye at: dogcatvethelp@gmail.com  or submit them in the comment section at the end of this issue of Questions On Dogs and Cats.

~~The goal of this blog is to provide general information and advice to help you be a better pet owner and to have a more rewarding relationship with your pet. This blog does not intend to replace the professional one-on-one care your pet receives from a practicing veterinarian. When in doubt about your pet's health, always visit a veterinarian.~~

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