Small Talk - Winter 2018

Prescribed Medication 02 small talk However, many pet owners are not aware of why medication is prescribed the way it is, or why the specific guidelines are so important to the success of the treatment. Here are a few examples of the importance of medicating as prescribed to highlight why compliance is so key: Antibiotics: When prescribed ‘twice daily’ it is important to remember this actually means every 12 hours. This is because the antibiotic needs time to kill bacteria. During this time, the antibiotic also needs to be above a threshold quantity to do its job. As time passes after a dose, medications are removed from the body by the liver and kidneys, and at a certain time point there is not enough antibiotic left to kill bacteria. At this time, the next dose should come along as a ‘top-up’. If you wait too long between doses, the bacteria are exposed to a 'sub-lethal' dose, when the hardier bacteria can both survive and develop immunity to the drug. By dosing at the correct interval, we ensure that the bugs don't get a chance to fight back. Pain relief: It may seem obvious to keep pain relief going all the time to provide comfort, but it is also important because as with antibiotics, gaps between doses can cause problems. When pain relief dips, the body becomes hypersensitive to the pain signals we have been trying to control, a phenomenon called 'wind-up'. This results in future doses of pain relief working less well. Likewise, under-dosing has the same effect, and can often contribute to owners feeling that medication is no longer working. Hormonal medications: Treatments such as steroids, or medications for conditions such as Cushing's or Hyperthyroidism all rely on changing the natural hormonal rhythms of the patient. By timing doses to match these cycles, as well as giving the body chances to rest and recover between doses, we achieve effective control while reducing the risk of adverse side effects. There are many other examples of why dosing in the manner prescribed (including giving tablets with or without food) is important. However, the key thing for all owners to remember is to openly discuss their pets' medication with their practice, as understanding your medication, and using it correctly will give the drugs the best chance to work. The importance of compliance Thaddeus Clifton MA VetMB MRCVS PAWS Veterinary Health Centre Almost all of us have heard of the idea of 'finishing the course' when it comes to antibiotic treatments, and with the media spreading the word about the risks of antibiotic resistance, the importance of this mantra has never been greater.