I remember one day my Aussie, Levi, began to behave strangely. He was having trouble standing, seemed to have lost muscle strength, and was shaking. His eyes appeared glassy and unfocused. He was dazed and confused and was salivating profusely.
I had never seen this happen before but it was obvious he was having a seizure. Levi's veterinarian confirmed that he had epilepsy.
This would mean that Levi would have to be on medication to control his symptoms. We got his medication (Phenobarbital) directly from our vet so we had good assurance that Levi was getting the right drug at the correct dosage.
There can be serious consequences if the medication you get is not the correct kind or the correct dosage. If your veterinarian dispenses drugs directly there is a better chance that it is correct as your vet has control over what you get.
But there is the perception among some that vets will charge much more for meds than they would otherwise cost if the prescription were filled at the pharmacy. This may or may not be true. Of course you can easily check by asking a pharmacist what it would cost for the same medication.
Just as with prescriptions dispensed for humans mistakes can occur when dispensing for pets. Actually, the chances may even be greater.
Of course, mistakes can always happen but due to the differences in the ways veterinarians and doctors write prescriptions errors in interpretation can occur. Another problem can be with pharmacists not being familiar with the drugs or the differences in dosage.
While their training helps them advise customers about dosage and alternative drugs this does not always translate well to veterinary medicine. Dogs are not just little people.
One of the main problems is human error and misinterpretation. Veterinarians and doctors may use initials instead of writing out instructions long-form. They may even use different initials which only leads to confusion. Some things are less likely to be misinterpreted like the initials "s.i.d." (once daily), "b.i.d." (twice daily) and "q.i.d." (four times daily), but transcription errors can still occur.
Another serious error that can affect dosage is mixing up "mcg" (microgram) and "mg" (milligram). But more likely are errors that arise from not using leading zeros and from using trailing zeros. For example, if the prescription reads ".5 mg" it could be easy to miss the decimal point and read it as "5 mg." Or reading "5.0 mg" as "50 mg." These would result in 10 times too little or 10 times too much dosage, which would be either ineffectual or dangerous—even fatal.
Interpretation and transcription errors aside, there is another way for serious mistakes to be made. If the pharmacist relies on his/her knowledge of human medicine and tries to apply it to veterinary medicine it can result in incorrect advise being given.
For example, a pharmacist may recommend an alternative, perhaps less expensive option, that may work perfectly well with humans. But without specific veterinary knowledge this may lead to a tragic mistake.
In one example I read about a pharmacist advised the customer to cut the pills in half for the epilepsy pill Phenobarbital if their dog appeared lethargic. This isn't the kind of decision you should be making with your pharmacist. You need to consult with your veterinarian first.
I know with Levi we had to take him in for frequent blood level tests to begin with. It was important that the vet know we were giving him what he had prescribed so we could arrive at the safest dosage as soon as possible.
Just being aware of this potential problem is the first step. So many times, even for our own meds, we are in a hurry and drop off the prescription without ensuring that the pharmacist completely understands the order. Then we pick it up assuming everything is right.
So take the time first with your vet—understand what your vet is saying. Know the full name of the medication, write it down. Know the exact dosage and how many times a day it has to be administered.
Ask your vet ahead of time if you should be experimenting with the dosage (like cutting pills in half). Your vet may say it is fine so long as you log the dosages so he knows exactly what is going on—or he may say not to. Also ask if alternatives are okay.
Make sure you understand what your vet is prescribing. Ask him to write out the prescription more clearly if necessary.
When you drop off the prescription point out explicitly that it is for a dog, not a person. Make sure the pharmacist understand everything correctly. If the pharmacist suggests something your vet has not approved be sure to clear it first.
When you pick up your order double check it. Read the label. Is it the right medication? Is it the right dosage? Is it the right frequency? Take a look at the pills (if they are pills) and confirm that the dosage matches the label and that they are both correct.
Of course, all of this applies to any pet and there has been progress as pharmacists, veterinarians and pet owners become more aware of the problems that can arise and what to do to prevent them from happening. The best thing you can do is to stay informed and communicate with both your vet and your pharmacist to make sure that everything is correct and your pets get the treatment they need.
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