Posts Tagged ‘Dr. Patty Khuly’

Finding the Cure for Drug Delivery Ills

November 29, 2010

While I’m busy recovering from some back surgery, you have the good fortune of reading posts from some of my favorite doggie bloggers!  Today’s post comes from Dr. Patty Khuly whose writes the Fully Vetted blog at www.petmd.com/blogs/fullyvetted.  Please make her feel welcome by posting your wonderful comments.  Be back soon! 

Best wishes,

Dr. Nancy Kay

Getting pets to pop their pills is a huge issue. So huge, in fact, that a drug’s delivery method often informs veterinary decision making, sometimes more than the drug’s other properties. Side effects, for example, matter far less when the alternative is no treatment at all.

 

The “drug delivery” issue is getting more play recently, what with the growing list of drugs we’re now prescribing for our patients. This, coupled with issues of accessibility, availability and price fuels a sizable niche industry created specifically to meet the needs of pets who won’t — or can’t — tolerate drugs and supplements designed to treat and/or prevent their ills. After all, pets can be picky about what we put in their mouths or mix into their meals. And you would be too if you didn’t understand why you needed to take that multivitamin, glucosamine, or fatty acid gelcap on a daily basis.

This is why compounding pharmacies exist. For the modern veterinarian, being able to access our favorite compounding pharmacy’s expertise in the formulation of new versions of the same-old drugs that line our shelves is a boon to our profession. But few veterinary clients fully understand what it is our compounding pharmacies do for us. To help unmuddy the waters, here’s a brief list of how these places help us bring better care to our patients:

1. Delivery, delivery, delivery

As for the real estate and location truism, so too does the veterinary drug industry rely on the “D” word.

As a pet owner, you know how it is. We try everything to get meds into our pets. Some of us hide our pets’ pills in foodstuffs or treats: cream cheese, peanut butter (chunky works best, IMO), ham, chicken breast, pill pockets, filet mignon …

As veterinarians, we also do whatever it takes to get the meds into our patients. And, yes, sometimes it takes a lot of trial and error.

More than anything else, what we all want is a cure that requires no daily discomfort, wriggling, stressing, in-the-towel-burrito-ing or the potential for biting, scratching or generalized inter-species strife. This is where the compounding pharmacy comes in with their ability to turn…

a.    chalky to chewy
b.    bitter to tasty
c.    oral to topical

Yes, topical. So it is that sometimes compounding pharmacies can manage the seemingly impossible.

2. Availability

Is your drug on back-order? Discontinued? Supply chain hassles? Never fear. You don’t have to compromise your pet’s care if you can find a compounding pharmacy willing to make it for you. That’s what lots of veterinarians are doing now with drugs like ophthalmic cyclosporine. When the supply goes dry, compounding pharmacies’ production ramps up.

3. Safety

I’m not big on doing chemotherapy in-house. I’d always rather send my patients to the specialists where the required drugs are more safely housed. Yet I have plenty of clients who prefer that I administer these drugs personally, citing their pets’ greater comfort in a place they already know well.

This is where compounding pharmacies come in. They’ll ship pre-measured doses to me, already in their syringes and ready to inject. Safer for me, my staff, and my patients.

4. Convenience

Want your meds shipped directly to you? Your vet can arrange for that. Pharmacies will ship monthly, on cue, if that’s what you need.

It’s hard to quantify, but we suspect that non-compliance resulting from an inability to administer meds is among the biggest drivers of poor clinical outcomes in veterinary medicine (if not the biggest). Then there’s the issue of antibiotic resistance to deal with when antibiotics are started. The pill is found under the sofa … started again … spit out again … repeat …

Given this setup, is it any wonder that compounding pharmacies are finding veterinary medicine a lucrative place to invest their time and money?

But the take-home message here is not about building new businesses with our pet-dedicated dollars; it’s more about the willingness to meet our pets’ needs by making medications work through any means necessary.

Trouble is, clients don’t always inform us when the meds aren’t going down the gullet. Not every pet owner is educated enough about drug choices to know they can ask us for alternatives. And, truth be told, we don’t always pointedly ask whether an unhappy outcome might be the result of poor drug compliance. (It just seems kind of rude to ask, you know?)

However, now that you’ve read this, you know what you need to do. When you come across a tidy stack of tablets your dog has hidden under the bed, or your cat drools for hours after taking her pill, consider asking for another method. No one needs to suffer when so many other options are available.

Dr. Patty Khuly

www.petmd.com/blogs/fullyvetted

Patty Khuly VMD, MBA is a small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

_____________________________________________________

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller. 

Free Christmas or Chanukah guft wrap with books purchased between now and December 25th (www.speakingforspot.com/purchase.html).

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Breed Profiling

March 13, 2010

Racial profiling is considered taboo, and for good reason.  Breed profiling, however, is fair game for those of us in the veterinary profession! We breed profile on a daily basis particularly pertaining to health issues.  Name just about any breed of dog or cat and I can provide you with a laundry list of potentially inherited diseases.  Patty Khuly, VMD (the “VMD” means her veterinary degree is from the University of Pennsylvania) has created a wonderfully comprehensive list of canine breed related diseases (the feline list is in the works).  I encourage you to check it out at www.embracepetinsurance.com/PetHealth/default.aspx. Not only does she list the most common maladies for each dog breed, she rates the risk for disease inheritance (low, medium, or high), describes each disease, and provides the approximate (emphasis on approximate) cost to diagnose and treat each disease. Hats off to Dr. Khuly for creating such a useful tool!  And if all of this weren’t enough, Dr. Khuly also manages to find the time to pen a witty and informative daily blog (www.petmd.com/blogs/fullyvetted).    

So how might Dr. Khuly’s information about breed-specific diseases be useful for you?  Certainly, if you are thinking about adopting a purebred pup, what you learn might sway your opinion about a particular breed.  If you already have your heart set on a specific breed, the disease-specific information will empower you to ask the right questions of the breeder to learn if the litter’s dam, sire, grandparents, and aunts and uncles have been affected.  A word of warning: don’t dare rely on the proverbial, “None of my dogs have ever had that problem.”  A conscientious breeder will offer forth official paperwork rather than verbal reassurances. Finally, if you already share your heart and home with a particular breed or think you know what breeds have gone into the “making of your mutt” being informed about the diseases that may arise will allow you to better be on the lookout for early symptoms. Timely detection and intervention can favorably affect the long-term outcome.     

Official White House Photo

Now, just for kicks, let’s check Dr. Khuly’s list of inherited diseases pertaining to Bobama (the name I’ve affectionately bestowed upon the newest dog in the White House).  According to the list, Portuguese Water Dogs are at medium risk for hip dysplasia (instability of the hip joints that results in arthritis), and at high risk for Addison’s disease (a hormonal imbalance) and follicular dysplasia (a hair follicle issue resulting in abnormal hair growth).  President Obama might be interested to know that one of his predecessors in the White House had Addison’s disease- none other than the late John F. Kennedy!  I wish Bobama a lifetime of good health, not only for the sake of the first family, but for the sake of the White House veterinarian as well!   

Best wishes to you and your four-legged family members for abundant good health,   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook    

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.