I was absolutely appalled by the actions of the veterinarian who helped me after my dog had gotten attacked at the dog park, requiring surgery to place stitches to a laceration on his scalp. Being th... Read More
I was absolutely appalled by the actions of the veterinarian who helped me after my dog had gotten attacked at the dog park, requiring surgery to place stitches to a laceration on his scalp. Being that this is an emergency clinic, I expected there to be high costs for care, which there were (it was ~$600 for the examination/surgery, and this was considered to be their "low estimate"). I did not expect for there to be so much disrespect and lack of consideration from the veterinarian after the surgery was complete. I am very fortunate that I am a clinical pharmacist, and know a lot about medicine- both human medicine and veterinary medicine, as I have studied both, and practiced both in hospitals, retail pharmacies, and compounding pharmacies. I have filled hundreds of commercially available medications for pets throughout my career, and had requested that I be able to for my own pet, as I have in the past, and it tends to be much more affordable. Dr Emery Enger said she recommended Clavamox (Clavulanate/amoxicillin- at first I thought this was a shortened name for augmentin, also claunanate/amox) and I had agreed with this recommendation, as it is the equivalent to Augmentin (amox/clav), which is the first line antibiotic used in dog bites in humans to cover the anaerobic gram negative bacteria common in canine mouths, Pasteurella (which also makes me wonder why she used IV ampicillin during surgery for my dog, as it doesn't cover anaerobes, instead of augmentin's IV equivalent, unasyn, which does-inappriopriate treatment perhaps?). She questioned me multiple times, as she was hesitant that I would be able to get an equivalent medication, but having the experience I do, I assumed I would have no problem taking it to the pharmacy where I work. Upon getting there, the pharmacy did not have the augmentin in stock which is an equivalent product to brand Clavamox (then had the 875/125mg tabs, a 7:1 ratio; whereas Clavamox comes as 300mg of amox to 75mg of clavulanate, a 4:1 ratio). the pharmacy called to see if she would mind if they used this formulation, she refused, insisting that Clavamox was used. I then called and asked to speak to her personally, to which she called me nearly 3 hours later. I asked why she was being such a barrier to my pets care, and she said the ratio available was not the same. I then informed her that there is a 500/125mg tablet, and 250/62.5mg oral suspension available that is the same ratio as Clavamox, so I didn't see why this could not be used....She then quipped back that human Augmentin hasn't been FDA approved for use in animals. Again, I informed her that not only has my dog taken it in the past, that I personally have filled this perscription for hundreds of dogs, cats, horses and other animals, and that that these drugs are first tested, IN ANIMALS, before being available to humans, so there is absolutely NO reason why she couldn't prescribe it to my dog! Additionally, in the three hours while I was waiting (unbeknownst to her), I called over to Blue Pearl Emergency clinic and spoke to a veterinarian there, who said it is very common and safe for pets to take this medication. After telling her this, she then said it might put my dog at risk for "Side Effects." As a pharmacist and doggy parent of three dogs, I am well aware of side effects of medications, especially antibiotics, so I asked her which she was worried about- she replied "Gastrointestinal upset and loose stools." I educated her that this is normal in dogs and humans (my pets have had loose stools after antibiotics in the past, as a matter of fact, I probably have too), as whenever you take an antibiotic, you kill the good gut flora/bacteria, resulting in loose stools, and so long as it's not bloody and prolonged, that it's still safe and not a justifiable reason to avoid antibiotics, as you can also remedy this by giving the medication with food and supplementing with other probiotic sources. Again, she refused to write for augmentin, and then said if my dogs have had loose stools in the past that they should try cefpodoxime (another antibiotic which causes loose stools in patients (animal and human), and is quite costly even at retail pharmacies). I asked her why she would recommend this antibiotic alone, as it doesn't have great anaerobic coverage, especially in a dog bite when you want to cover the anerobic organism, Pasteurella, and other mouth anaerobes- she just replied that they use it often (which in my opinion, without an anaerobic agent is inappropriate treatment. I told her no, and again, I would prefer to use human augmentin, the 500/125 version or the 250/62.5mg suspension (either would be interchangeable). She finally agreed to write this prescription, but only if I come in to the clinic &sign a paper (during a snowstorm) that she was doing so against her medical recommendation, and so that she would not delay further initiation of antibiotics more than she already had.#moneyhungry Read Less