Providing your animals with prescription medications at an affordable price is becoming a challenge. Keeping all of the medications that your animal may need in stock in our clinic pharmacy leads to increasing costs for us and for you. In order to continue to provide you and your animals with the best care at affordable prices, we are going to make some simplifications in the way we provide medications and prescriptions for your animals.
Many of the medications that we use are also used for people and are available at the pharmacy. For these medications we have called in or written prescriptions to the local pharmacies. We utilized the neighboring MediCap pharmacy for many medications. Since MediCap Eldorado closed its doors last month, that convenience is gone.
Our experience with the chain store pharmacies in Santa Fe has become quite frustrating over the past two years. When calling in your prescriptions and refills, we’ve discovered that customer service and record keeping are lacking, leading to hours spent on the phone by our staff repeating and verifying prescriptions that have been mis- recorded, mis- understood or lost by the pharmacy staff, and leading to repeated visits and long waits for you to pick up your animal’s prescription medications.
We also cannot compete with the prices offered by the large national pharmacy chains who use some medications as loss leaders and who get huge volume discounts from suppliers. Nor can we compete with the internet- based pharmacies who also get large volume discounts on medications that they order in quantities much larger than we do.
In order to provide the best care for your animals, we will continue to stock those medications not readily available at the human pharmacies as well as those medications that we commonly need to begin giving without delay.
For all other medications we will provide you a printed and/ or emailed prescription that you can take to the pharmacy of your choice to have filled. This will eliminate the inconveniences that you and we are experiencing when calling in prescriptions. You will be able to use a local or on-line pharmacy that you trust and that you feel can give you the best price. We will continue to provide you with the best veterinary care possible at a reasonable cost.
Supplements, Nutraceuticals and Unapproved medications?
There are an increasing number of over-the-counter supplements and medications available for every ailment for your animal. These are advertised heavily in trade magazines and on the internet. Why don’t we commonly use these medications in our practice? Let me provide some answers here.
Many of the medications that we use for your animals are approved by the FDA specifically for that use. For example a drug called KinaVet is FDA approved to treat Mast Cell Tumors in dogs. What does this FDA approval mean? It means that the drug has been tested in a species and for a specific disease and has shown to be effective at treating that disease in that species. It has also been shown to be safe, the doses, side effects and adverse effects are known. So generally, we know the good and bad of what we are getting.
Approving every drug for every use in every species of animal that we treat would be cost prohibitive and take an endless amount time. Veterinarians have the ability to use a drug in an “extra-label” manner, meaning that we can use a drug in a species or for a disease that it hasn’t been approved in if we have reason to believe it will work for the intended purpose and that it will be safe. Most drugs that we use in an extra-label fashion have been researched and tested in clinical trials by veterinarians at research centers or in clinical practice. These trials are important, as they help us know that a drug will work on a specific disease in that species and that it will be safe for that species at the established dose.
What about these life-saving supplements that you read about in the back of your horse magazine or find on the internet when searching for a solution for your dog’s illness? Those who sell them may be well-intentioned. The supplements may actually be effective. They may be safe. But we don’t know.
We have had the personal experience of using such compounds on a few patients after nothing “tried and true” was working. In one case, we were assured by the maker that “there were no side effects!” With some trepidation, we proceeded to use the treatment, but with stipulations to the client. We were going to administer the substance in the clinic. We were going to monitor the patient closely and stop administration if we felt it was unsafe. The animal’s heart rate rose significantly and his temperature rose above pre-treatment levels. We stopped administration and the vitals would return to normal. Every time we restarted administration of the substance they would again rise. Eventually, he got the whole treatment but it did have side effects, which could have caused a real problem for the animal had we not recognized them and let them resolve. It did not cure the condition as the maker said it would.
Some supplement makers are using laboratory “bench chemistry” to make a compound and a claim, not doing trials in the species or diseases they intend to treat. Some are using research into past publications as a basis for their new claims. Some are simply conjecturing. Some do have good science behind their treatment but are looking to you to finance their research and clinical trial on your pet.
When it comes down to these supplements and treatments, ask lots of questions before you consider buying them:
Has it been used in this species? (cats’ metabolic processes are very different from dogs’ or people’s.)
Has it been used for this specific condition? (squamous cell carcinoma and not just “cancer”. Acute pancreatitis and not just “inflammation”?)
Is there data to show that it is effective?
Is there data to show that it is safe?
What are the side effects? What are the adverse effects? What is an overdose? (If the claim is “no side effects” that is a red flag. It means they haven’t looked or paid attention. Even water has side effects and adverse effects if overdosed.)
Who is making this stuff?
Where are they making it?
Are manufacturing processes and ingredients consistent, standardized and safe?
What is the maker’ s background, training and experience?
How long has this been out on the market? (Have enough others tried this first to support claims that it is safe and may be efficacious?)
The long and the short of it is, “Let the buyer beware.” We use medications and supplements that we know have been studied, that we know are safe and that we know will provide our patients some benefit.