SCSHP 2014 Annual Meeting Introduction to Canine and Feline Dispensing Clay Sprouse, BA, CPhT Piedmont Technical College A house is not a home without a pet. Unknown Animals are such agreeable friends they ask no questions, they pass no criticisms. George Eliot The problem with loving is that pets don t last long enough and people last too long. Aeschylus Our Furry Friends Disclosure I do not have a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this continuing education activity, or any affiliation with an organization whose philosophy could potentially bias my presentation Neonatal: 0 2 weeks Infant: 2 4 weeks Pediatric: 3 weeks 1 year Adult: 1 to 8 years of age Geriatric: >8 years *Life expectancy of most breeds of dogs is 12 15 years *Cats average 15 years and above Defining the Age Identify the most commonly prescribed pet medications at the local pharmacy Discuss diabetes and its effects on pets Describe challenges we face when dispensing prescriptions written from a veterinarian List and describe common diseases found in dogs and cats List toxicities and contraindications for cats and dogs Objectives Interactive Discussion How many pet owners are present? How many take their pet to a vet regularly? Have you ever had to get a prescription for your pet filled at a pharmacy? 1
Cats & Dogs (Humane Society Statistics) 83.3 million dogs owned Average of $231 spent on routine vet visits for dogs 95.6 million cats owned Average of $193 spent on routine vet visits for cats Retrieved from humainesociety.org Furosemide (most commonly used to remove fluid in cardiac disease) Levothyroxine (hypothyroidism in dogs) Metronidazole (bacterial and parasite infections) Phenobarbital (seizures) Amoxicillin Ampicillin Cephalexin Doxycycline Commonly Prescribed Antibiotics Prednisone (inflammatory conditions, immune suppression, pain) Metoclopramide (for pets, usually used for vomiting and diarrhea) Methimazole (hyperthyroidism in cats) Theophylline (respiratory conditions) Other Medications Prescribed Amitriptyline (separation anxiety, general anxiety, itching) Chlorpromazine (nausea and vomiting) Cimetidine (stomach acid) *commonly only prescribed if there is a suspected or known ulceration Dexamethasone (inflammatory conditions, immune suppression, pain) Diazepam (seizure control and/or anxiety) Hydroxyzine (allergies) 2
Pets with Diabetes Diabetes is on the rise in the US among cats and dogs Overweight cats are six times more likely to develop diabetes than thinner cats Symptoms may include excessive urination, increased thirst, and weight loss Type 1 is normally associated with dogs and type 2 is normally associated with cats OTC Medications (cont.) Vitamin B (appetite stimulant) Buffered Aspirin (pain relief, anti inflammatory) Mineral oil (constipation) Kaopectate (diarrhea) Retrieved from the Mayo Clinic Insulin Treatments for Pets According to Dr. Ruthie Buist, DVM, of Piedmont Technical College, almost all insulin for dogs and cats are from human sources Glargine (Lantus ), detemir (Levemir ), NPH Use standard human syringes Specialty insulin not dispensed in human pharmacies Safety Note The guardian/owner of the pet should consult their veterinarian before administering any OTC medication. Diphenhydramine (allergies) Bacitracin/Neomycin/ Polymyxin ointment (minor skin infections) OTC Medications Pharmacists and pharmacy technicians have very little to no training with the physiology of the species being treated Many pharmacy schools offer pharmacy veterinary education, but it is normally an elective Dispensing Issues 3
Dispensing Issues (cont.) Medication errors including dosage change and medication substitution (pharmacy personnel should DAW) Abbreviations (many vets use SID for daily when most community pharmacies are used to QD Commonly Diagnosed Diseases Hypothyroidism (dogs) and hyperthyroidism (cats) Pain Issues Fleas and ticks Allergies Diabetes Seizures Dispensing Issues (cont.) Owners sharing medications with other pets in the household (should warn pet owners about this issue) Hypothyroidism Commonly found in dogs Symptoms may include hair loss, loss of interest, weight gain Levothyroxine used as the main treatment option Diseases Hyperthyroidism Usually found in older cats Weight loss, heart murmur, excessive talking could be symptoms Interactive Discussion What other challenges may we come across when filling and dispensing medications for animals? Seizures Phenobarbital is usually the first line treatment Potassium bromide used in combination with phenobarbital in canines (not usually given to felines) Gabapentin Diseases (cont.) Allergies Antihistamines (usually dosed higher for our pets) Recommended dose is 2 4mg/kg q8 12 hours for both dogs & cats A 75 lb. dog would could receive up to 136 mg tid Sedation is the most common side effect but can have the reverse effect on felines 4
Diseases (cont.) Pain Control NSAIDs (meloxicam) COX 2 Inhibitors Tramadol Fleas and Ticks NEVER give a cat Permethrin (it may cause death) Most medications dispensed by the veterinarian What s Off Limits for our Dogs & Cats? Cats have shown the ability to easily overdose on opiates Benzodiazepines may accumulate in the liver if given long term Acetaminophen in any dose (if not treated, death could occur within 18 hours) Good Advice Build a relationship with your pet patients as you would your human patients Do not change or substitute the script Call the vet with any questions Be flexible Exercise humility we must recognize that animal care is not within our realm of training for most of us Competency comes with time and experience 5