So often I am scrolling through my Facebook “home” page and I see a post about someone’s dog that took a medication and it died and how that owner is warning everyone to stay away from that medication cause “it kills dogs”. Of course their post has been shared hundreds if not thousands of times. The thing that bothers me the most, is not that this person has an opinion or that they posted their concern. The part that concerns me the most, is that all those people that read it and shared it, will likely never really question it. They will automatically assume the truth of that statement without really looking into the facts of the case. Was it truly a reaction? Was it actually the drug they think it was? Was their some other factor that they have not considered? The truth of the matter is that animals, as well as people, have reactions to drugs all the time. Most of which are not fatal and there many situations that are not the drug’s fault at all, but some individual sensitivity of which the owners (and the vet) are completely unaware.
As veterinarians we prescribe medications nearly a hundred times in a day. Each time we do, there are many factors to consider: age, hydration status of the patient, heart conditions, other health problems, drug interactions, and of course, potential side effects. Sometimes the best drug for the job is not a good choice for the patient due to a underlying condition. Sometimes the animal simply has an allergic reaction to a medication that we could not predict. Just because an animal has a reaction to a medication does not mean that it is a bad drug. That is like saying penicillin should never be allowed to be used by anyone in any situation because penicillin “kills people”. Penicillin has saved countless lives since its introduction to the medical world. Without it, modern medicine as we know it would not exist.
We take the decision of which medications to use very seriously. As a practice owner, I also have the added pressure of which medications I will carry in my practice. We are a small practice for the most part and we cannot afford to keep every drug out there on our shelves. I have to choose which ones make the most sense. There are some obvious choices, but many drugs have subtle differences that make it necessary to carry multiple drugs of similar action. Take heart worm prevention for example. I could chose to carry one kind of heart worm prevention, but that would not allow for people to choose the product that best serves their needs. If I had to choose a heart worm prevention that had no potential side effects and never had a reported reaction, I would carry ZERO products on my shelf. That does not mean that most heart worm prevention drugs do not save the lives of millions of dogs each year by effectively and safely preventing fatal heart disease. I still must choose which ones to carry. It is not feasible for me to carry every type of heart worm prevention on the market. I choose which products have the best combination of safety, efficacy, versatility, and cost efficiency available. There are products that I will not stock in the clinic because I believe them to be too risky from a safety standpoint or they simply overlap a product we already stock that works just as well. Antibiotics and pain management medications can be just as difficult to streamline. They are not all created equal and there are many factors to consider. Overlap is unavoidable in these areas.
I can tell you from personal experience that having a patient react negatively to a drug is something that sticks with you. You have a knee jerk response to stay away from that drug. You become gun-shy to it. Unfortunately, that limits the good that drug can still do for other patients that will not react negatively to its use. It’s one of those unique scenarios that I can go a whole lifetime without ever seeing a negative reaction to metronidazole until my new associate uses it and it happens. Up until that moment, I knew it COULD happen, but I had never SEEN it happen. Not with my own eyes. Metronidazole is a commonly used medication for diarrhea in dogs. It is likely used in hundreds of thousands of vet practices on a daily basis and most never have an issue, but see it one time and you will never forget it. I have no doubt that you could go on Dr. Google and find a report that shows how DEADLY that drug could be. I also have no doubt that penicillin has killed more animals than metronidazole will ever dream about.
You may not think about the medication your veterinarian prescribes in these terms. Or you may question every thing your veterinarian gives your animal right down to the ear cleaner they use. Truthfully, you are probably somewhere in the middle. Either way, we want you to know that we truly have your animal’s health as a priority. We would not recommend a medication unless we felt that the benefits did not out-weigh any potential side effects. It is our responsibility to weigh all the potential outcomes and sit down with you to come up with the best plan and how to proceed. We welcome your questions and will do our best to help choose the medications that best help your pet be healthy and happy
Please do not think for a minute that I take ANY negative response, allergic reaction, or side effect from a medication or procedure acceptable. That is FAR from the truth. However, I do accept that bad things happen even when we do our absolute best to anticipate or identify risk factors. On some occasions, we are limited through financial constraints of the owners from performing pre-medication lab testing (CBC or blood chemistry) that might have alerted us to a potential problem, but we work with the information we have available at the time. We never ever want to have something we prescribed or recommended have a negative or life threatening complication occur to your pet. We want to help them. Always.