Dear Dr. Forsythe: The online pharmacy seems always to have better prices; I can’t believe veterinarians can get away charging as much as they do. Why haven’t the costs of medications gone down at the local level? I’m so surprised and relieved pet medications are more affordable now. If it weren’t for the online pharmacy, I wouldn’t be able to afford the medication for my dog and still take my vacation to Hawaii.
Max’s Dad
Dear Max’s Dad: You are not alone in singing the praises of the online pharmacy. No doubt many people rely on them due to the lower prices. While I do script out for some clients, we also make it a point to let clients know there have been many documented problems with the online pharmacy system. A vast and varied number of reported problems have been amassed, from improperly dosed medications arriving at a person’s door to medication that had short date expiration. There even have been documented cases where some medications were tested at outside labs which were found to have far less active ingredient than what was labeled.
Most small-animal veterinarians receive our medications directly from the manufacturers and from a few drug distributors who come to our practices in person and guarantee the dating and the quality of our pharmacy inventory. This allows us to assure top quality medications for your pet. We are backed up by the pharmaceutical representatives at Bayer, Mariel, and Novartis in case there is ever any problem with respect to a medication. However, online pharmacies, which often purchase their medications overseas or from bulk wholesalers or discounters, do not have the same manufacturers guarantee if a medication causes an unwanted side effect or has any other problem.
There is a reason why many of the medications offered online cost the consumer less than the veterinarian pays wholesale. Perhaps it is simply because they are purchased in huge amounts, like the Walmart model. However there have been instances where people have purchased Heartgard and when the six doses arrived they were due to expire in three months, and were non-refundable and non-returnable. Such problems do not occur on the level of the veterinarian, so there is an element of “let the buyer beware” when purchasing from an online clearing house. In addition, chromatography has been done on some of the “online” products manufactured and labeled in China which looked identical to the American counterparts but contained roughly 1/10 of the active ingredient of actual medication when analyzed. I am a believer that quality is value, and I’m not willing to cut corners with my children, so why should pet owners do it with their pets?
The things I’m mentioning above may be in the minority, but I still feel they are worth mentioning, so at my practice, clients who insist on using outside pharmacies must read a brochure which outlines these possible concerns and also sign waiver regarding the possible risks associated with using such pharmacies.
In your case, I hope your pet is doing well and getting the medication he needs. If you really feel you are benefiting from the relationship you have begun with this distant business, and you are able to help your pet more because of this company, that is great. I worry about the fact online pharmacies really only exist to send a product and take a credit card number: there are some things missing in this transaction, mainly the human-animal bond, and secondly the animal deserves the proper medication when it’s ill. Is it the proper medication, is it genuine, has it been stored properly? Is it of the concentration and quality it should be? If there is a problem, will the telephone operator who took the order be there to help answer questions about the medication if your pet is vomiting or having a problem with the drug? In my opinion, something much more important is at play here: the doctor-patient bond, and the importance of doing what is best for your pet. It is true that money talks, and clearly, it talks much louder than pets do sometimes!!
Thanks for your question and aloha.
Dr. F.
Dear Dr. Forsythe: My dog has a wound which has taken FOREVER to heal. As my dog suffered one complication after another, the vet told me it was probably a completely resistant form of infection that no drug can take care of; I am concerned they might have to take her leg off. Please tell me more about this infection. It started out as an abscess. Now it has been going on for six weeks. I just wonder if it will ever go away now. Why haven’t they come up with a medication that works against this by now?
Barbara S. Santa Rosa
Dear Barbara S., It sounds like you could be describing a Methicillin Resistant Staph Aureus which is a very serious resistant bacterial infection also known as the “flesh eating bacteria.” It is dangerous because it is resistant to almost every antibiotic. It often appears on the skin at the site of a wound or puncture or a suture line after surgery and complicates and delays healing. I had a friend who developed such a problem after nasal surgery and almost lost all the cartilage in his nose to just such an infection. I’ve also assisted in a case of a cat that had suffered a terrible bite wound and a culture of the wound came back positive for a Methicillin Resistant Staph Aureus which was completely resistant to every antibiotic except for Amikacin – a potent amino glycoside antibiotic used intravenously. The pet had to be hospitalized for several days and receive IV antibiotics in order to recover. Without this treatment, I believe an amputation of his leg would have been necessary.
It sounds like you’re experiencing firsthand a lot of frustration with this wound, and both you and your pet must be very courageous. I urge you to try and remain strong and know although it is difficult, you can have a positive outcome in most cases with proper bacterial identification, culture, which allows your vet to properly target the specific organism involved. There is a lot of research going on surrounding this field right now in order to overcome resistance to this bacterium, and researchers are making steady progress towards that goal. In the meantime, keeping pets free from injuries, bite wounds and lacerations is a good way to start. Remember the saying, “An ounce of prevention is worth a pound of cure.” It is really true when it comes to germs we are slow to cure. Take care and best of luck to you and your pet!
Dr. F
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