Why Rx for heartworm meds?

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IndianaOD

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I was hoping someone could help me understand this. Why does it take an Rx to get heartworm meds? Seems to me every canine should be taking them, like people should conisder taking vitamins. I think this keeps a lot of owners from providing this to their pets.

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I was hoping someone could help me understand this. Why does it take an Rx to get heartworm meds?

From the American Heartworm Society's website: "Heartworm preventives are "legend" drugs, which by federal law require a prescription. A doctor-patient relationship must be established before a prescription can be written. The veterinarian should assess the heartworm status of the dog before prescribing these medications. Giving heartworm preventives to dogs having heartworms can lead to severe reactions that could be harmful or even fatal to the dog."

http://www.heartwormsociety.org/index.asp
 
From the American Heartworm Society's website: "Heartworm preventives are "legend" drugs, which by federal law require a prescription. A doctor-patient relationship must be established before a prescription can be written. The veterinarian should assess the heartworm status of the dog before prescribing these medications. Giving heartworm preventives to dogs having heartworms can lead to severe reactions that could be harmful or even fatal to the dog."

http://www.heartwormsociety.org/index.asp


Thanks for the repy, buy I think you missed the point of the question. I prescribe Rx's every day, so I know how that works. Any time a patient self diagnoses there are potential problems. In regards to pets however, I don't understand the need to get preventative checkups yearly just to have access to a preventative med. It seems a lot of pets get a lot better healthcare than most people. In my mind it would be much better overall if the dogs could get the pills in the first place. I doubt there would be a lot of adverse reactions, far more would be saved by the medicine than had problems.

I believe in routing vetrinary care, just don't feel its necessary to get a new Rx every year to take care of my pet.
 
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Thanks for the repy, buy I think you missed the point of the question. I prescribe Rx's every day, so I know how that works. Any time a patient self diagnoses there are potential problems. In regards to pets however, I don't understand the need to get preventative checkups yearly just to have access to a preventative med. It seems a lot of pets get a lot better healthcare than most people. In my mind it would be much better overall if the dogs could get the pills in the first place. I doubt there would be a lot of adverse reactions, far more would be saved by the medicine than had problems.

I believe in routing vetrinary care, just don't feel its necessary to get a new Rx every year to take care of my pet.

Basically if you just one day went to the store and bought you dog HWP you could kill it (meaning your dog)if there is a live infection. The visit to the vet to get the prescription is to make sure it is safe to give the medication. That is why you have to get the dog heart worm tested before getting the prescription. You would be very suprised at how many animals are heartworm positive and the owner never thought of that. So there would actually be a lot of serious reactions if it were to be over the counter.
 
Basically if you just one day went to the store and bought you dog HWP you could kill it (meaning your dog)if there is a live infection. The visit to the vet to get the prescription is to make sure it is safe to give the medication. That is why you have to get the dog heart worm tested before getting the prescription. You would be very suprised at how many animals are heartworm positive and the owner never thought of that. So there would actually be a lot of serious reactions if it were to be over the counter.


Fair enough, but if the pet is prescribed the medicine and has been maintained on it continuously over the past year....is it necessary to get it checked every year to get an Rx? Even two years would be nice. Heck some states require contact lens Rxs to last 2 years. Some days I see 6-8 contact related red eyes from abuse. Probably at least 1 a month that are vision threatening and potentially permanent if not treated effectively. Just being the devil's advocate.

I have patients that have glaucoma or their kids have a vision threatening condition and they don't come back for years, but the dog has heatworm pills! Ya'll are doing a good job it that department.

I currently work 6 days a week and no vets are open when I am free to take my dog in. Therefor its been a couple months off the heartworm pills because I can't just go get them.
 
It's necessary to test every year because, just as with most any other medication, there have been more and more cases where dogs (or more accurately, the heartworms) are starting to gain resistance to the products. This is what happened in the past with the old, now defunct, heartworm preventatives. And just as in human medicine, it takes time to develop new medicines in response to resistance so the research is ongoing and in the meantime we must check tests every year to ensure a negative result.

And if your pet happens to be one who is positive despite being on preventative you have to show a negative test yearly in order for the drug company accept financial responsibility for treatment.

And then there is the question of did you actually physically see your pet swallow the medicine. Some dogs are really sneaky. For instance, in our practice we had a woman whose dog had been on prevention from the time it was a puppy but came up positive when it was 4 years old. The company accepted responsibility and paid for the treatment. When the woman was rearranging her furniture about 6 months later she found a giant pile of Heartgard behind a large bookshelf where the dog would go to spit up his medicine while the owner was none the wiser.
 
And there are always the clients who somehow have only 1 left of a 6 month prescription at the yearly visit or they still have 6 left of the year prescription (easy to forget to give them)...Then you need to retest.
 
In addition to all of the above valid points, its another way to get clients to bring their dog in for an annual check up and vaccines.
 
In addition to all of the above valid points, its another way to get clients to bring their dog in for an annual check up and vaccines.

I think that's probably the true motivation, job security and paying the mortgage. Just like I'm sure very few would go to the OB if BC pills were OTC.
 
IndianaOD said:
I think that's probably the true motivation, job security and paying the mortgage. Just like I'm sure very few would go to the OB if BC pills were OTC.

And that's not really recommended either. Because there are dangers with the pill that an OB can recognize. It really is best to get your animal's health checked once a year (humans should do it to, just because they don't that doesn't mean they shouldn't). The dangers of giving a pet heartworm preventative without testing for heartworm are very real. Also, what if, as your dog got older, it developed a murmur? Or another problem you might not have noticed? It's easy for that to happen with pets because sometimes they just can't tell us they're not doing right.

I think it's a prescription to prevent the death of positive animals that were not tested, and to cover the butts of the company producing the meds.
 
I think that's probably the true motivation, job security and paying the mortgage.

Let's not forget that pets age a lot faster than humans... Asking someone to bring their pet in for a yearly physical isn't about "job security" necessarily. One physical a year is like you getting one once every seven years (roughly), which I don't think is going overboard.
 
are even things like Advocate and Revolution prescription drugs?

Not here!!
 
are even things like Advocate and Revolution prescription drugs?

Not here!!

No those are not RX items in the US either. Only the heart worm preventative.
 
Revolution is a prescription here, it has not only flea, parasite and mite control but contains Selamectin for heartworms as well.
 
Actually, how many people end up getting pregnant while on birth control? (I think they say about 1%) Same with heartworm preventative. Nothing is ever 100% and even the most compliant clients forget a pill every now and again, so we have all our clients get a heartworm test annually. Also, if you get your pet tested regularly and they become infected while on a preventative, companies like merial will pay for treatment if the product was purchased through a licesned veterinarian (ie not an internet company).
 
Actually, how many people end up getting pregnant while on birth control? (I think they say about 1%) Same with heartworm preventative. Nothing is ever 100% and even the most compliant clients forget a pill every now and again, so we have all our clients get a heartworm test annually. Also, if you get your pet tested regularly and they become infected while on a preventative, companies like merial will pay for treatment if the product was purchased through a licesned veterinarian (ie not an internet company).

I was wondering if 1800petmeds got under your skins as much as 1800contacts gets under ours (ODs). They grossly abuse the law and allow significant CL abuse.
 
There's a whole thread about it in the Pre-vet forum. I just bumped it. Yeah, there are a lot of problems with expired meds, etc. I just don't trust them.
 
For every educated and honest client, I've met others that are not as well informed and who *seem* to feel the need to lie about whether their pet has been on a preventive (heartworm for example) as prescribed.

Not a 'lie' story, but an honest 'confused' one that I had recently:

We had a client present a dog for his annual checkup. He told me that the dog was getting heartworm meds regularly, every month. Said he didn't need a refill yet. He declined the heartworm test, but he did bring in stool.

The next day, I got a call from the wife. She asked me if the stool test results were back yet, because she wanted to know if she could re-start the dog on his heartworm pills.

Easily recalling the case from the day before, I asked, why did your husband tell me that your dog gets his heartworm pill every month and hasn't missed? (And I told her, yes, stool was fine, but that was checking for intestinal parasites... not heartworm infection).

She said, he didn't know any better. He thought she was giving the dog his pill, and she thought HE was giving the dog the pill.

The truth? The dog hadn't gotten a heartworm pill in 4 or 6 months, I can't recall that part of the story now.

I like to play devil's advocate too. What if I am the vet that authorizes a refill for heartworm meds on a dog that the owner swears he's been giving it for the past two years (which is when, perhaps in this case, the last test was done)? The dog has a reaction and dies.

I don't want to be the vet having to defend my license on that, for such a simple measure as neglecting to require a blood test.

The day we eliminate the risk of positive heartworm infection causing reaction with a preventive is perhaps the day the medication can become OTC. Until then, it's in the pet's best interests, and yes, the prescriber's, to cover all bases.

Not sure how strict other practices are, but in my own, we have the policy of annual heartworm testing, but, like many policies, there's always exceptions made. It's up to the doctor whether making the exception to what is known to be the generally accepted standard is worth the risk in these situations.
 
For every educated and honest client, I've met others that are not as well informed and who *seem* to feel the need to lie about whether their pet has been on a preventive (heartworm for example) as prescribed.

Not a 'lie' story, but an honest 'confused' one that I had recently:

We had a client present a dog for his annual checkup. He told me that the dog was getting heartworm meds regularly, every month. Said he didn't need a refill yet. He declined the heartworm test, but he did bring in stool.

The next day, I got a call from the wife. She asked me if the stool test results were back yet, because she wanted to know if she could re-start the dog on his heartworm pills.....

You just reminded me of a kinda sorta similar situation in which our tech ran a fecal on a cat when their reason for the appointment was "possible ringworm" oooops.... getting our "worm" parasites confused.
 
I had a PM asking me what was bad about 1800contacts. I could write pages on it, but I'll try to summerize:

1. Filling expired CL Rx's
2. Allowing Pts to buy multiple years worth of CLs on a 1 year Rx
3. Intentionally sending Rx verifcations on the weekends and filling the Rx when the OD didn't respond in 8 hours.
4. To get around CL companies who refused to sell them CLs they shipped them in from other places. Once they were selling knock off CLs of name brand ones that caused some problems.
5. They tried to pass legislation mandating what CLs ODs could fit. Basically trying to limit patient's options and controlling what the DOCTOR could do.

Most OD offices will sell CLs at basically the same price. I'm sure once you guys get into vet practice you will feel similar distain for 800petmeds. Please support your local private OD by avoiding these abusive corporations. I refuse to order heartworm pills online because I like to support the local vets. I don't trust any of the 1800whatevers to take care of patients, they are only in it for $$.
 
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