Filling a prescription for a patient named “Rover” or “Fluffy,” or other animals, is not unusual at The Compounding Center in Leesburg, VA.
Owner Cheri Garvin, BSPharm, told Drug Topics that “we’ve definitely been seeing an increase in requests for veterinary medications.”
While veterinarians still dispense most of the medications they prescribe, things are changing. “Veterinarians are carrying less stock,” Garvin said, so they rely on a local pharmacist to prepare custom prescriptions for pets. Veterinary offices generally don’t carry the ingredients needed to compound medications, she added.
“There’s definitely been a growth in the number of pet prescriptions filled in human pharmacies,” said Elaine Blythe, PharmD, Associate Professor of Veterinary Pharmacology at St. Matthew’s University School of Veterinary Medicine, Grand Cayman Island, British West Indies. “Veterinarians are increasingly outsourcing prescriptions for most chronic and preventative conditions to the local pharmacy. This allows veterinarians to have less of an investment in inventory. The value of a veterinarian is in their diagnostic skill set, not in retailing prescription medication,” she said.
While dispensing veterinary prescriptions allows pharmacists to expand their horizons, prescriptions for animals raise questions. What type of challenges do pharmacists face when their patients are small and fluffy, or big and smooth-haired, for that matter? How are pharmacists satisfying state mandates to provide patient counseling?
Most state pharmacy acts require pharmacists to counsel all patients; this includes pet owners. At The Compounding Center, “We counsel patients who pick up pet medications the same way we counsel those who pick up human prescriptions,” said Garvin. “We ask if they have any questions for the pharmacist.” In some cases, though, she said a sit-down counseling intervention is necessary. For example, if a dose for a Chihuahua is tiny and needs to be measured in a syringe, “we want to make sure the client knows how to correctly do the measuring.”
It’s important that pharmacists understand pet medications before dispensing them, Garvin continued. Feline medications are commonly compounded into transdermal formulations for administration into the cat’s ear, since cats are notoriously hard to get a pill into. But some drugs, such as prednisone, are not effective in this formulation. Additionally, transdermal medication can lead to a thinning of the skin on the cat’s ear. “These formulations are best used short-term, not for long-term chronic conditions,” Garvin said.
At Ladue Pharmacy in St. Louis, MO, pharmacist Jeff Kleine, PharmD, told Drug Topics that pet owners picking up pet meds are counseled no differently than those picking up human meds. Most of the veterinary meds dispensed are compounded.
There is also some seasonality with pet prescriptions. “For example, we dispense a larger number of antianxiety medications for dogs around the Fourth of July,” Kleine said.
While pet meds currently constitute only a small amount of the pharmacy’s overall volume, Kleine said, “It would be helpful for pharmacists to have more training in this area.”
“Many pharmacists feel a gap in their knowledge base–they are educated to counsel patients on human diabetes, but not for canine or feline diabetes,” agreed Blythe.