Novartis has recently temporarily halted production of the following products: Sentinel, Interceptor, Program, Clomicalm and Deramaxx. Since these products may be in short supply until the manufacturer resumes production, pet owners should begin to discuss appropriate alternative medications with their veterinarian.
For heartworm prevention, alternative products including oral Heartgard Plus and topical Revolution can be discussed with the veterinarian. Topical Frontline Plus and Advantage II are also excellent first line topical products effective for flea and tick control in lieu of Program. Clomicalm is a commonly prescribed behavioral drug in veterinary medicine; however there are other alternatives including Prozac and Amitriptyline that can be discussed as options with the veterinarian. Clomipramine, the generic version of Clomicalm, is still available. Finally, other non-steroidal anti-inflammatory medications such as Rimadyl or Metacam may be used in lieu of Deramaxx, depending upon the clinical situation.
| A common question I get in the veterinary clinic is about whether it is okay to give a dog or cat aspirin for pain, or for reduction of fever or inflammation. The answer to this question will vary depending upon the clinical history and age of the pet, as well as whether other prescription drugs are being used.
If there is any history of digestive upset, bleeding tendencies or kidney/liver disease then it is important to have a full veterinary medical exam, in addition to possibly blood and/or urine testing before starting aspirin for even a short period of time. |
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In healthy adult dogs not on any other prescription cortisone or non-steroidal anti-inflammatory drugs (i.e. Rimadyl, Previcox, or Deramaxx), then aspirin at a dose of 5 mg per pound once to twice daily with food for a few days may be used for pain, inflammation and fever management. If there is no improvement in clinical signs within a few days, then veterinary consultation is recommended before aspirin therapy is continued.
One must be much more careful with cats in dosing aspirin or any other non-steroidal anti- inflammatory medication. Because of the feline unique liver drug detoxification pathways, I do NOT recommend animal guardians dose cats with any aspirin unless they first consult with a veterinarian. If a cat is cleared of health problems, than a small dose of 1/2 baby aspirin every 3 days may be used. It is important to recognize that even very low doses of Tylenol can kill a cat, and therefore Tylenol should never be used in any cat.
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Often my clients will ask me about my thoughts on generic medications and if I feel they are just as effective as brand names. As far as I know in human medicine, generic drugs are as effective in most cases as more expensive name brands, and pharmacists indeed will fill generic alternatives whenever possible. In my opinion in most cases generic medications are also equally as effective but I have found that in some cases name brand medications still seem to outperform generic options on occasion. |
Two common examples include the name brand thyroid medication Soloxine, which I have found has given better clinical results in my practice than less expensive generic levothyroxine alternatives. Another example includes the name brand drug Atopica. I have yet to see the generic cyclosporine medications perform as well in the field.
In most other cases, including heartworm medications I have found generic drugs economic and safe alternatives for clients. However, I would advise pet owners to check with their veterinarian on how they feel generics have performed for them in the field before making the change.
Posted by admin on July 21, 2011 – 8:07 am
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| Inhalant and contact skin allergies are indeed frustrating for many pet owners. Symptoms of allergies may include chronic itchy feet, face and ears, as well as secondary infections leading to increased patient discomfort. In years past it was often only prescription Prednisone that offered these pets significant symptomatic relief. However, the use of long term Prednisone or cortisone can lead to unwanted side effects including: |
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- Suppressing the immune system and thus the development of secondary infection
- Thinning of bones
- Premature aging
- Predisposing pets to diabetes if used long term.
Pets may also develop increased thirst, appetite and urination, as well as unwanted behavioral changes. Several years ago Atopica came on the market and offered animal guardians a Prednisone alternative that truly worked, and without all of the side effects.
The main ingredient cyclosporine has a powerful anti-inflammatory and anti-allergy effect. Side effects do occur in approximately one third of treated pets and most commonly includes digestive upset and vomiting. Sometimes giving Atopica with a meal and/or with other prescription medications to prevent vomiting can help with this side effect.
Another major concern of clients is the high cost of using Atopica long term. Some veterinarians will prescribe the antifungal Ketaconazole at the same time as Atopica, which can help lessen the dose of Atopica needed. There is also a generic now available, however, I have not found results consistent with the cheaper generic.
I have found Atopica affective in approximately 65% of treated pets, and often the dose can be tapered after several weeks to help lower the cost for those allergic pets who need allergy medication long term. Using supplements such as omega 3 fatty acids may also help lower the dose of Atopica needed to control clinical signs.
| Managing pain is a concern for many pet owners of senior or aging pets. One of the newest nonsteroidal anti-inflammatory drugs in recent years is known as Previcox. This product works by selectively inhibiting COX 2 enzymes which are responsible for much of the pain and inflammation associated with joint and other inflammation. |
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Side effects of Previcox are rare, but may include digestive tract bleeding, as well as liver or kidney inflammation. It’s for these reasons that I always recommend blood work before using products like Previcox, as well as periodic blood work if a dog stays on this medication long term. Response to this prescription medication is often very rapid. Usually client concerns are in regard to the side effects as well as and whether they can use Previcox with supplements such as Super Joint Enhancer or other joint supplements. In most cases the answer is yes, but a client should always consult with their veterinarian.
As with other prescription drugs of this type, cost can be a factor when using his medication long term which is why using other products like Proanthozone and omega 3 fatty acids may help cut down on how frequent Previcox is used to control pain and arthritis symptoms.
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Animals who present needing Tramadol are those dogs and cats that are in pain from any illness. Veterinarians are increasingly recognizing the role pain management plays in helping our pets recover from illness more rapidly and comfortably. While being used for years in human medicine, veterinarians have only recently started to use Tramadol, which is an economic product in pain management in our animals. |
From pets with cystitis (inflammation of the bladder) to lameness/joint/back pain, or to pets with digestive tract or pancreatic pain, Tramadol can often help alleviate symptoms. Side effects are very rare and include mainly sedation. The only situations I would tend not to use this product if is a pet has any liver disorder.
If prescription Tramadol is not adequate to address your pet’s pain, than you can ask your vet for another prescription pain medication such as nonsteroidal anti inflammatory medications or perhaps amantadine. For joint or back pain, pet owners may also try all natural Yucca Intensive, which can be obtained without a prescription.
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One of the most commonly prescribed heartworm preventatives for dogs that I’ve used for years in practice is Interceptor, whose main ingredient is milbemycin. This wonderful chewable product not only prevents mosquito-transmitted heartworm disease, but also prevents and controls the most common intestinal parasites of dogs including whipworms, roundworms, and hookworms. |
Side effects of Interceptor are rare, but may include digestive upset, skin eruptions or rare neurological reactions. The only occasional client concern I have seen with this product is when their pet won’t eat it, which is rare in my experience. When used regularly (year-round), this product is nearly 100% effective. If for any reason a pet may become heartworm or parasite positive while on this product year-round, I have heard reports that the manufacturer will offer a refund on the product to those guardians. But if you purchase Interceptor from 1-800-PetMeds, they will pay for the diagnostic & treatment costs if your pet contracts heartworms. More information on this is covered in the 1-800-PetMeds product guarantee.
The other options for clients include chewable Heartgard Plus or a generic equivalent Iverhart Plus. Often times clients will ask – Do I have to give heartworm prevention even in the winter? The answer to this question is yes and that’s because winters are becoming milder making it difficult to predict when mosquitoes will be active in many states. In addition, this pill prevents and controls other parasites that can also affect humans; so it is indeed wise to use these types of heartworm preventatives each month.
| Hypothyroidism (low thyroid) is one of the most common hormonal conditions seen in dogs. While this condition can be seen in any mixed or pure breed, common symptoms include:
- Weight gain (without an increase in appetite)
- Lethargy
- Cold intolerance (heat seeking)
- Dull/dry hair coat
- Hair loss
- Recurrent skin or ear infections
- Problems with the nervous or musculoskeletal system |
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Diagnosis of this condition is usually made by a full thyroid profile performed at the veterinary office, including measurement of T4, Free T4, and thyroid autoantibodies. It is important for veterinarians not to just routinely run a T4 when screening dogs for hypothyroidism, as one can over diagnose this condition when measuring only T4.
Once properly diagnosed, treatment is usually with the prescription medication levothyroxine (name brand Soloxine). In my experience and opinion Soloxine usually offers superior results in normalizing thyroid levels than the cheaper generic brands. Side effects of Soloxine are rare but may include diarrhea and/or vomiting. This is usually seen only when dosing is too high as determined by measuring thyroid blood levels at follow-up visits.
If Soloxine is not helping a pet’s skin condition, than it is important to have a full veterinary follow-up evaluation to see if dosing is appropriate, as well as to evaluate for other diseases such as allergic skin disease or other hormonal conditions.
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One of the most overlooked topics in veterinary medicine surrounds the issue of drug interactions and the side effects of medication. In the middle of a busy veterinary practice, many veterinarians often fail to take the time to discuss these possibilities. For example, many commonly prescribed nonsteroidal anti-inflammatory medications (NSAIDs) can sometimes cause digestive upset and/or liver/kidney problems in some sensitive pets. Corticosteroids like Prednisone can cause similar problems in some pets, as well as predispose pets to diabetes with prolonged use.
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While a topic of debate, these risks are increased if Prednisone and nonsteroidal anti-inflammatory drugs are used together. While potentially life saving, antibiotics can also cause allergic reactions from digestive upset to skin eruptions. Some pets are sensitive to topical flea and tick medications, and in my practice I always use flea and tick medication on a separate day from heartworm preventative medication administration or vaccinations, in order to lessen the burden on a pet’s immune system.
Whenever multiple drugs are prescribed it is always important for clients to ask questions and/or veterinarians to make them aware of these issues, as veterinarians not only prescribe medication but are also dispensing medications in private practice much like pharmacists do for humans and at 1800PetMeds.
