When Dixie, a black Labrador retriever, had a skin lesion that wasn’t improving, her veterinarian put her on antibiotics. After the first round didn’t work, a second round of antibiotics was started, but Dixie’s veterinarian still couldn’t figure out why the “little rash” wasn’t responding.
“I went to go clean out our guest bathroom one day and I found seven red pills in the corner,” said Catherine Foret, DVM, Dixie’s owner and the owner of University Veterinary Hospital in Shreveport, Louisiana. “Every day, she was going and spitting out the pills. Even veterinarians have trouble medicating their pets.”
That’s why Dr. Foret stresses the importance of open communication with pet owners any time a new medication is prescribed.
“My first priority is prescribing the best drug, but a pet’s willingness to be medicated plays a huge role in selecting a medication format,” she said.
Options Galore and More
If a client struggles to medicate a pet, the answer might be a chewable version of the drug. Which medications are chewable? The answer: a variety of NSAIDs, antibiotics, parasiticides, anti-anxiety medications, supplements and dewormers. Also, many medications not manufactured as chewables can be compounded into chewable formulations, although pill wraps and similar products have made compounding into a chewable less common.
“If you’re thinking of compounding [into a chewable medication], you’re getting into potentially $1 to $5 more per day to medicate your pet than you would pay for a liquid compounded medication,” Dr. Foret said.
For Dr. Foret, who has an in-house pharmacy but also works with compounders in the Shreveport area, the additional cost to the pet owner does not mean added revenue for her practice because clients complete the financial transaction with the outside pharmacy rather than her hospital. But, she said, the benefits of offering options that help clients take better care of their pets outweigh the potential lost revenue.
“We’re a 15-doctor practice, and it’s only several times per month that we need to get a drug compounded into a chewable or a liquid,” she said. “We see hundreds of patients, and most of the medications we prescribe are available in our hospital’s pharmacy.
“It’s really about giving the client options of easier ways to medicate their pet, and if that means offering a compounded medication, we’ll do that. Clients appreciate it.”
Given so many drug options, veterinary teams can choose medications that pets will be more likely to tolerate and that pet owners will be better equipped to administer.
“There’s no one size that fits all,” Dr. Foret said. “The veterinary team has to start the conversation and find out how the owner medicates their pet. If you find out that they have to go through four gallons of peanut butter to get one tablet down, then you know a chewable, liquid or injectable form could be a better option.”
Four benefits of offering chewable medications include:
1. Strengthening the Veterinarian-Client Relationship
Boaz Man, DVM, the owner and medical director of Boca Midtowne Animal Hospital in Boca Raton, Florida, typically offers a medication’s chewable version first when available.
“That way we don’t have to have a conversation about whether or not it’s easy to give a pet pills,” he said. “Most clients are happily surprised when we tell them we’re sending them home with a chewable medication that’s easier for a pet to take. Why make it more difficult than it has to be?”
2. Nurturing the Human-Animal Bond
A pet owner’s struggle to medicate an animal can put a strain on their relationship.
“I find that chewable medicines are much more tolerated and more of a reward for pets and their owners because people love rewarding their pets,” Dr. Man said. “If the pet likes the medicine, and the owner doesn’t have to feel as if they’re shoving it down the pet’s throat, it’s a better experience for them both. The owner is happy, the pet is happy, and the two become more bonded.”
3. Improving Compliance
“If a pet enjoys being medicated, and the pet owner enjoys that experience, they’ll be more likely to follow through with the prescription,” Dr. Man said.
4. Boosting Practice Revenue
A practitioner who builds a strong client relationship, nurtures the human-animal bond and improves compliance will enjoy increased revenue. Clients will be more likely to administer medications as recommended, and they’ll be more likely to continue those medications when needed.
In-House Choices
When Dr. Foret diagnoses an arthritic canine patient, she’ll typically prescribe an NSAID for the pain and inflammation.
“There are a few generic human medicines that can be used on certain weights of dogs, so I could write a script for that and it could potentially save the client money,” she said. “But the medication is human and it’s not flavored.
“So, in that instance, it is so much easier for me to grab a medication off my shelf that’s already flavored and is labeled and approved for use in dogs, and the owner can go home with that. This way, the owner has an easier way of medicating the pet because it’s already flavored, and it’s chewable.”
Pet owners might feel guilty when they can’t administer prescribed medication.
“If we can help the pet get the medicine they need and provide an option that makes it easier for the pet owner to administer it, then that’s a win-win,” Dr. Foret said. “You get a patient whose health improves and an owner who feels they are able to help their pet.”
What to Watch For
While offering multiple drug formulations is a positive, veterinarians need to recognize potential drawbacks. They include:
- Toxicity: Some chewable medications can be so palatable that food-motivated pets will do just about anything to get to them. Pet owners should be advised to keep all medications in a secure place out of reach of household pets. “Pets will smell through the label, through the bottle, through the lid and try to eat the whole bottle and ingest too much of the medication,” Dr. Foret said.
- Pill theft: Another concern is one pet consuming another’s medication. “If you have more than one dog and you’re giving a chewable medication with food, separate the pets while they eat and ensure that the medication is consumed entirely by the pet it’s intended for,” Dr. Foret urged.
- Missed doses: While a chewable medication can improve compliance, a pet owner might forget to give it. For this reason, both Drs. Foret and Man sometimes prescribe injectable versions, like with heartworm prevention, to eliminate potential human error and to take compliance out of the owner’s hands.
- Incorrect dosage: Some pet owners might assume that cutting a chewable medication in half means that each half includes half of the original dose. Be sure your clients are aware that unless a medication is scored, the active ingredient might not be evenly distributed.
- Continued difficulty with administration: Some clients might pay more to have a medication compounded into a chewable formulation only to find that the pet still doesn’t want it. In non-urgent cases, Dr. Foret said, the compounding pharmacies in her area will send a foil pack of different-flavored chews, giving a pet the opportunity to taste-test them before the owner commits to a flavor.
- Allergies: “Occasionally, a pet may have an allergy to something, like the protein that’s used to make a chewable medication,” Dr. Man said.
Keep All the Options Open
Dr. Foret doesn’t automatically recommend a chewable.
“It takes two to tango,” she said. “The pet owner has to remember to give the drug, and the pet has to want to take the drug. So, if it’s a difficult dance, which one is it? Is the owner not remembering to give the drug, or is the pet difficult to medicate?
“Once I know the answer, I can offer alternative options, and a chewable may be the right option for a pet who is difficult to medicate.”
For Dixie, whom Dr. Foret estimated ingested only about half of the recommended antibiotics for her skin lesion, a topical therapy was the answer.
“It eventually cleared up,” Dr. Foret said. “And I learned that Dixie doesn’t like to take pills.”