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A Spoonful of Sugar ….

September 19th, 2012

In the course of daily veterinary practice, few things have the capacity to upset a client like a refusal to supply medications without a consultation. So why do we do it?

I thought a little bit of an exploration of this issue might help.

The supply of scheduled medicines is controlled by law. If you think this is poppycock the sad fate of Michael Jackson should persuade you otherwise, or witness the stories in the press about human patients visiting multiple doctors in an effort to obtain pain relievers or sedatives from each.

Vets are in the same position as GPs – we must be able to  justify all the scheduled medication we dispense, if required to do so by regulatory authorities or our professional board. Failure to do this could mean a loss of our right to prescribe scheduled medicines, and thus the loss of our livelihood.

Sounds pretty scary to me. Fortunately, as with most things, a little common sense comes in handy.

If you are a regular client whose dog or cat has a chronic illness you are likely to be visiting us frequently anyway. There is no hard and fast rule as to how often we need to examine a particular patient but, in general, we would like to examine that patient no less frequently than every four to six months. Remember that one of these examinations will occur at annual vaccination and the requirement is likely to be for one or two additional consultations only over the year. That doesn’t seem so onerous.

So why do things get fraught? A case in point might be the dog with an ear infection that occurred at the same time last year, but we haven’t seen the dog since. We can hand you some ear cleaner over the counter but any of the other ear medications will contain schedule four (S4) drugs and so I’m sorry but we’ll have to see the dog. And, in truth, the nature of the problem may have changed and so different treatment may be required.

Case 2 might be a dog with arthritis on long term non steroidal anti-inflammatory drugs (NSAIDs). These medications can make a huge difference to the patient’s quality of life but they can have side-effects and I need to watch for those and also assess the progress of the patient to adjust treatment as necessary.

As often happens, it’s the most infrequent visitor to the clinic who seems most easily offended. We are not trying to be difficult, I promise you.

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