A Series About Heart Failure: Vetmedin

Posted on May 30, 2014 by Wes Hepker

Why is Vetmedin used in heart failure?

Heart failure is a very complicated disease in dogs and often requires multiple medications. The medications used in heart failure can be difficult to understand. This article aims to address one of the medications used in congestive heart failure, called Vetmedin. Vetmedin is the brand name product for the drug pimobendan but there is no generic currently available. It is important to thoroughly discuss all aspects of Vetmedin and the other medications used in heart failure, so the series will be broken up by class for each article.

Vetmedin belongs to a class of drugs called phosphodiesterase III inhibitors (also known as PDE III inhibitors). Along with the human drug, milronone, it is used in dogs with congestive heart failure. PDE III is an enzyme found in the body that usually degrades cAMP. By inhibiting the breakdown of cAMP, PDE III inhibitors increase the force of contraction the heart has each time it beats, as well as relaxes the blood vessels it pumps blood to. Vetmedin can also slow down the heart so the ventricles can fill with more blood. Vetmedin can help in two different ways; helps the heart get more blood out to the rest of the body and decreases the resistance it has to pump against. By doing this, it helps with the symptoms of heart failure in dogs, but it does not cure it. Vetmedin has a benefit of not increasing the calcium levels inside the heart cells, making it safer compared to other drugs like milrinone. This is why Vetmedin is used much more commonly in dogs, and VetRxDirect does not carry milrinone.

What are some important things I should know about Vetmedin?

Since Vetmedin increases the force the heart has, it can also cause the heart to get off rhythm which is also called arrhythmias. Vetmedin also relaxes the arteries which may cause low blood pressure leading to falling or fainting. Less serious side effects of Vetmedin include hyperactivity, drooling, and constipation, rash, and anemia. There are also a few reports of Vetmedin causing diabetes. As with most drugs, but especially drugs for heart failure, it is important to weigh the benefits and risks of taking the medication. If you are concerned about the side effects of Vetmedin, consult your veterinarian to see if they think the side effects are likely to happen.

How should I monitor my dog while they’re on Vetmedin?

While your dog is on Vetmedin you should monitor their general mood. Often times, owners can tell if their pet isn’t feeling well. Since this could indicate worsening heart failure or side effects of Vetmedin, it is important to keep in contact with your veterinarian about their overall mood. Vetmedin has a narrow dosage range and overdosage can occur somewhat easier than other medications. Signs your dog may be overdosed on Vetmedin include vomiting, diarrhea, and loss of appetite. If your dog experiences any of these symptoms you need to call your dog’s veterinarian.

What’s new about Vetmedin?

Vetmedin is now available in more dosages from VetRxDirect to tailor to more dogs and thier needs. Vetmedin now comes in 1.25mg, 2.5mg, 5mg and 10mg doses!

This article only addresses one of the medications your dog might be on for congestive heart failure. Tune in for articles about all of the other medications used to better understand the medications your dog may use.

Is your dog on Vetmedin? How has it helped with his or her congestive heart failure? Please leave any remaining questions you have by leaving a reply below. Thank you.

Resources

Plumb, D. Pimobendan. Plumb’s Veterinary Drug Handbook 7th ed. Pharma Vet Inc. Stockholm, WI. 2011. Pages 637-638
Vetmedin www.Vetmedin.com. Accessed 05/01/2014.

Pet Dewormers and Preventatives

Posted on May 29, 2014 by Wes Hepker

Warmer weather brings a season of critters including intestinal and heart worms. When your pet has intestinal worms, it can be alarming but there is a wide array of treatment options available to rid the worms from your pet. There are also many preventatives for heartworms and intestinal worms, making it easy to keep the infestations at bay. The large amount of different wormers available can be confusing and hard to evaluate. This article, along with your veterinarian’s recommendations, can help you choose between the various de-wormers and preventative treatments against worms.

The right intestinal parasite ID is key:

An accurate identification of the worm is key in treating your pet’s infestation because most products are selective for certain worms. Heartworms will not be visible to you, but your pet will be experiencing serious symptoms such as cough, exercise intolerance, and abnormal lung sounds. These symptoms warrant an immediate visit to a veterinarian and possible hospitalization. When your pet has intestinal worms, you will likely notice the worms in their stools or surrounding fur. Your veterinarian will probably be able to diagnose the intestinal worm with just a description, but some worms require an exam or stool sample for diagnosis.

Some of the most common worm infestations in dogs and cats include whipworms, heartworms, roundworms, hookworms, and tapeworms. Some of these worms are different in appearance and some are alike, making it hard to distinguish between them. This is especially true for the different types of tapeworms. There is a type called dipylidium caninum and they’re transmitted through infected fleas. They still resemble the appearance of other tapeworms, however these tapeworms are not always killed by the same medications as other tapeworms. It is important to talk to your veterinarian about any intestinal or heartworm infestation, because an accurate diagnosis and treatment is necessary to prevent complications and treatment failure.

More importantly, prevention:

The most important principle with worm infestations is preventing them from happening in the first place. There are several ways to keep worms at bay including keeping stools picked up, avoiding infested areas/pets, proper flea control, etc. You can also choose to use a preventative medication. These medications are usually administered monthly to your pet and can prevent and/or treat certain worm infestations. Heartworm preventative medications are necessary in almost all dogs because of the serious nature and frequency of heartworm infestation. All of the worm preventative medications work against heartworms for this reason but the products vary in what other worms they prevent or treat. You should also initiate worm prevention after an active infestation in your pet to reduce the chance of them coming back. Talk to your local veterinarian about specific ways to prevent worm infestations in your pet.

The two tables below display the various de wormers carried at VetRxDirect and what they are labeled to treat. The first table is the treatments we carry for pets with active intestinal worm infestations. Please note there are no heartworm treatment options from VetRxDirect because it’s an infestation requiring immediate and serious medical attention by your veterinarian. The second table shows the preventatives we carry for heartworms and intestinal worms. These tables can be used to supplement your veterinarian’s recommendations for purchasing worm treatments and preventatives.

Oral Dewormers for Active Parasite Infestation in Pets:

Oral Dewormers for Intestinal Parasites in Dogs and Cats

Click Anywhere on Table to Enlarge

Prescription Monthly Preventatives/Dewormers for Heartworms and Intestinal Parasites:

Prescription Monthly Preventatives/Dewormers for Dogs and Cats

Click Anywhere on Table to Enlarge

Take-home message about dewormers:

Prevention of worm infestations is one of the most important components for your pet’s healthy lifestyle. When prevention fails, the most effective way to treat your pet’s worm infestation is to have your veterinarian diagnose and prescribe medications specifically for your pet. OTC medications can be used with veterinarian approval or they may suggest a prescription product for your pet. Once the worms have been rid from your pet, it is important to initiate preventative measures or medications. Your veterinarian is a great resource to contact about preventing a re infestation in your pet.

What dewormers and worm preventatives have you given your pet? Did they work well? Let us know by leaving comments below or by clicking the ‘Reviews’ tab on any the dewormers or preventatives included in this post. Thank you.

Pet Eye Medications: Glaucoma

Posted on May 21, 2014 by Wes Hepker

Courtesy of Eric Schmuttenmaer/Flickr

What is inflammation in your pet’s eye?

Many animals can suffer from allergies or diseases that affect their eyes. As a result, they may suffer from inflammation of the conjunctiva, the moist tissue that covers the eye. Eye inflammation can be caused by many different sources such as bacteria, viruses, allergies, cancer, and others. Conjunctivitis, or eye inflammation, can affect dogs and cats and may be detected according to many symptoms: squinting or frequent blinking, redness, discharge from the eye, swelling, etc. Talk with your veterinarian if you believe your pet may be suffering. There are many treatment options available depending on the source of the inflammation.

Blepharitis, inflammation of the eyelid, can also occur in pets. It can be detected as scaly, flaky skin near the eye with intense itching and scratching. Watery mucus or pus may drain from the eye. This can be seen with or without conjunctivitis and has similar causes.

What is glaucoma in the pet’s eye?

Glaucoma is different than eye inflammation but also can occur in dogs and cats. Glaucoma is a disease of the eye with excess pressure in the eye. Excess pressure is a result of too much fluid known as the aqueous humor within the eye. Aqueous humor is a fluid that the eye makes in order to transport nutrients and to maintain the shape of the eye. Glaucoma may be caused by a blocked drainage of the fluid which can lead to a buildup of pressure within the eye. Bulging eyes are often a sign of this pressure buildup. Other signs may include excess squinting or rubbing, watery discharge that is usually clear, or a cloudy or bluish color to the eye. Unfortunately, glaucoma is not a curable disease. Glaucoma often begins in one eye and may spread to the other eye over time and eventually may lead to blindness if the pressure isn’t reduced. Contact your vet immediately if you notice any bulging or signs of glaucoma in your pet’s eyes.

What tests will your pet’s veterinarian perform?

It is important to talk to your veterinarian if you suspect your pet is suffering from inflammation of the eye. They can help determine the cause of inflammation by doing a full examination of your pet’s eyes. The veterinarian can detect foreign materials, test any discharge for bacteria, and also detect any scratches to the eye using a fluorescein stain. He may also need a biochemistry profile, urinalysis, and complete blood count to rule out certain infections. Glaucoma is detected by measuring the intraocular pressure (IOP) within the eye and an internal eye examination using special instruments. There are many treatment options available.

What treatment options are available for your pet?

The treatment option will be selected after the source of the inflammation is determined and will be based on the cause of inflammation. If your pet has a bacterial infection, the veterinarian may prescribe antibiotics. If the source of inflammation is due to allergies, avoidance of the allergen is the recommended solution. If there is a blockage causing increased pressure in your pet’s eye, surgery may be necessary to reverse the cause. Below are some of the common medications used to treat numerous types of inflammation.

Prednisolone is a corticosteroid used for short periods of time to reduce inflammation, itching, and redness in the eyes of dogs and cats. Long-term topical application of this medication may result in glaucoma. Only use this medication as directed by your veterinarian. It comes in many forms: tablets, oral liquid, eye drops, or injections. Some side effects seen when using prednisolone ophthalmic solution may include blurred vision, eye irritation, and excess discharge from the eyes.

Flurbiprofen is a non-steroidal eye drop that can be used in dogs and cats to treat certain kinds of eye inflammation by reducing puffiness in your pet’s eyes. This medication is not used for the treatment of glaucoma.

Latanoprost can be used to help reduce eye pressure caused by glaucoma. It helps by increasing the drainage from the eye and reducing excess pressure. It is important to use this medication as directed because overuse can lead to development of tolerance. Tolerance to latanoprost may make the medication ineffective in treating glaucoma.

Diclofenac sodium is a product used to treat inflammation of the eye belonging to the nonsteroidal anti-inflammatory drug class, also known as NSAIDs. It inhibits an enzyme called cyclooxygenase (COX) which is needed for the production of prostaglandins. These prostaglandins can cause excess inflammation and pressure buildup in the eye. Damage to the tissues can lead to the production of prostaglandins, but by using diclofenac sodium, you can inhibit this overproduction.

Some pets may experience a large amount of discharge coming from the eyes. Before using any products, gently clean your pet’s eyes. If using multiple products, it is important to wait a few minutes between each application in order to ensure the medication remains in the eye and is not washed out by the next medication or excess tear production. Apply any ointments after applying solutions. Ointments may make it difficult to get the solution into the eye and allow the drug to reach its target area.

When will your pet’s veterinarian prescribe other pet eye medications?

The medications listed above are just a few of the options available for inflammation of the eye. Your veterinarian is the expert about what medication option is best for your pet. If you notice any changes in your pet’s eyes, schedule an appointment today with your veterinarian.

How to apply eye drops and eye ointments to pets?

Eye Solutions and Suspensions:

Wash your hands.
Shake your container. Suspensions need to be shaken in order to assure uniform distribution of the drugs in the container. Suspension tend to settle over time.
Tilt your pet’s head backwards.
Hold the dropper tip directly over the eye. Make sure not to touch the dropper tip to your pet’s eye. It will help to keep the medication sterile and to prevent contamination.
Gently pull the lower lid away from the eye to form a pocket.
Place 1 drop into the pocket.
Release the eyelid slowly.
Wait several minutes before administering a second drop or medication. If drops are placed too quickly into the eye. Most of the medication will be blinked out of the eye. The medication will not be as efficacious as needed for the treatment.
Replace the cap on the container and store according to the package guidelines. Some medications may need to be refrigerated or protected from light. Contact your veterinarian regarding storage requirements.

Eye Ointments:

Wash hands
Gently pull the lower lid away from the eye to form a pocket.
Gently squeeze a small amount of ointment inside the lower lid. Do not touch the tip of the tube to the eye or your fingers.
Close the eye gently.
Replace the cap on the container and store according to the package guidelines. Some medications may need to be refrigerated or protected from light. Contact your veterinarian regarding storage requirements.

Helpful tip when applying multiple pet eye medications:

If your pet is using multiple eye products, solutions and suspensions are generally applied first. Applying an ointment before a solution or suspension product will make it difficult for the drop to come in contact with the eye. It is important to remember to always follow the directions given to you by your veterinarian.

What pet eye medications are you currently giving your cat or dog. Can you share any secrets with us on how you manage to apply the medications? Please let comments below or leave a product review on any of our pet eye med product pages. Thank you.

Erika Bitschura

Student Pharmacist

Ocu-GLO Rx Giveaway from VetRxDirect.

Posted on May 14, 2014 by Wes Hepker

Ocu-GLO Rx, the natural canine vision supplement containing an optimal blend of antioxidants not previously available until veterinary ophthalmologists developed this high quality nutraceutical, is now on sale for first time users. Enter our Facebook contest by clicking the image below to acquire your coupon code and start your dog on Ocu-GLO Rx today!

When you enter our contest, you are automatically signed up for a chance to win a year’s supply of Ocu-GLO Rx for your dog. Increase your chances of winning when your referred friends sign up for the giveaway through your contest invite.

Ocu-GLO Rx Giveaway Brought to you by VetRxDirect

OFFICIAL OCU-GLO Rx® GIVEAWAY CONTEST RULES

Contest Name: Ocu-GLO Rx Giveaway

NO PURCHASE NECESSARY. A PURCHASE OR PAYMENT OF ANY KIND WILL NOT INCREASE YOUR CHANCES OF WINNING. This Promotion is in no way sponsored, endorsed or administered by, or associated with Facebook, Inc. The information you provide as detailed below will only be used for promotion administration purposes. This Contest is open only to legal residents who are at least fourteen (14) years old at the time of entry. Odds of winning depend upon the number of eligible entries collectively received during the Contest Period.

Participation:  The Ocu-GLO Rx Giveaway Contest is open to everyone. You may participate in the contest by completing the information fields on the entry form. After submitting the data, you will be given a promo code to use for 20% off your next purchase of Ocu-GLO Rx.

Winning:  By June 12th, 2014, the winner will be chosen at random. The winning entry will receive a year’s supply of Ocu-GLO Rx (max of 4 bottles — $300 value) to be supplied by VetRxDirect.com. Winner will be notified two days after the winner has been selected. Winners will be informed via direct message or email, and prizes will be released within two weeks of announcement.

Thank you in participating in our Ocu-GLO Rx Giveaway and good luck!

Feline Asthma – What is it, and how can you help?

Posted on May 5, 2014 by Wes Hepker

Feline Lower Airway Disease (FLAD)

Feline lower airway disease is used to describe conditions that affect the lower respiratory tract in cats. These conditions include bronchial diseases, chronic bronchitis, feline asthma, bronchial asthma, and allergic asthma. Distinction between the conditions can be done by specific testing available at your veterinarian clinic.

What is feline asthma?

It is estimated that 1% of cats suffer from asthma which occurs more frequently in female cats.[1] Asthma is reversible inflammation of the small airways in the lungs (i.e. bronchioles). It is similar to asthma in humans and begins with a mild cough. If not treated, it may progress to your cat being in distress with coughing, wheezing, loud and rapid breathing, and exercise intolerance. Symptoms, generally noticed between the ages of 2 to 6, are often overlooked and mistaken for hairballs due to the coughing and wheezing. Asthma is often associated with inflammation due to irritants or allergens in the environment which causes an increase in mucus in the lungs constricting the small airways. As a result, your cat will have trouble breathing.

What triggers a feline asthma attack?

Asthma attacks can be caused by a variety of sources. Allergens in the air, temperature changes, and exercise can all trigger attacks. Some allergens that are frequently associated with asthma include grass, tree pollen, fumes, cigarettes, dust, smoke, perfumes, and various sprays. Attacks may also be worse in cats that are overweight.

How is asthma in cats diagnosed?

It is important to take your cat to the veterinarian if you think your cat may have asthma. The veterinarian can listen to your cat’s lungs using a stethoscope to detect crackling and whistling due to excess mucus or inflamed airways. They will also need to know as much information about your cat and his environment as possible. The veterinarian may identify the cause or trigger of your cat’s asthma with the information you provide him. A chest x-ray can also be done to view the chest wall and lungs of your cat.

Preventative measures to decrease the chance of asthma attacks in cats

There are many changes that can be made to your home to prevent an asthma attack in your cat. Dust-free cat litter is a great first step in removing a source of allergens. Replacing filters on heating units and air conditioners can also help keep the air in your home clean. The winter season can be troublesome for your cat’s asthma due to the extreme temperature and dry air. Limit outdoor exposure during winter months in order to avoid these and use a humidifier inside during dry seasons to help prevent attacks. Many cat owners never identify the allergen responsible for triggering asthma attacks. If you can find the trigger, try to remove it as best as possible, but there are treatment options available if needed.

How to treat feline asthma

The goals of treating feline asthma are to reduce inflammation, airway constriction, and mucus production while trying to identify and remove the allergen(s) causing the asthma symptoms in order to prevent airway damage.[2] Feline asthma is often treated with bronchodilators and corticosteroids.

Bronchodilators

Aminophylline and terbutaline are two medications that are taken by mouth which act as bronchodilators to open the airways in the lungs. Albuterol (Proair^® or Ventolin^®) are popular inhaled bronchodilators. These medications are fast-acting and can help relax the muscles causing the closed airways. These are often used when your cat is having an asthma attack.

Albuterol will help your cat during an asthma attack within 5 to 10 minutes of use. If the attack reoccurs, the medication can be used every half-hour or as needed for your cat. Albuterol can cause increased heart rate, excitability, weight loss, and tremors; however, these occur infrequently in most cats. If your cat is having asthma attacks often, your cat may need a medication such as a glucocorticoid to prevent or reduce the frequency of asthma attacks.

Glucocorticoids

Glucocorticoids are used to decrease the inflammation in your cat’s lungs in order to prevent asthma attacks. Prednisone, prednisolone, and methylprednisolone are common examples of oral glucocorticoids. Fluticasone (Flovent^®) is an example of an inhaled corticosteroid.

Fluticasone is commonly used every 12 hours to maintain healthy airways in your cat. It is used with a breathing mask, such as an AeroKat Feline Aerosol Chamber, to ensure the medication is inhaled. Fluticasone can be found as 44, 110, and 220 mcg per actuation, but the 110 mcg strength is most commonly used in feline asthma. Unlike albuterol, fluticasone can take 10 to 14 days to achieve the full benefits.¹ Prednisolone can be given during this time until the fluticasone is fully effective.

Why use inhaled medication for feline asthma?

Medications given by mouth are not ideal for the treatment and prevention of asthma in cats due to the increased risk of side effects. Oral medications can alter blood sugars, which may be problematic with cats who have diabetes. They can also increase the risk of inflammation of the pancreas and are poorly tolerated. Inhaled medications help avoid some of these side effects by acting directly on the lungs and airways.

Courtesy of www.todaysveterinarypractice.com

Optimize your cat’s treatment using the AeroKat Feline Aerosol Chamber

AeroKat Feline Aerosol Chamber for cats is an easy-to-use device that helps deliver medications for the treatment of asthma, allergic rhinitis, or chronic bronchitis. The chamber is used with a metered-dose inhaler like albuterol or fluticasone. The chamber is used to hold the puff of medication while your cat breathes normally to inhale all of the medication. Without the chamber, the medication can be lost in the air, and your cat may not get the full benefit of the medication needed. The AeroKat Feline Aerosol Chamber can help your cat get the medication he needs to feel better and breathe normally.

References:

[1] Tasi, A. (2014, April 13). Another furball? It might be feline asthma.

[2] Sharp, C. (2014, March/April). Treatment of feline lower airway disease. Today’s Veterinary Practice, 4(2), 28-32.

Dog Grooming: The Dirt on Dog Fur

Posted on April 30, 2014 by Wes Hepker

Soft and white. Red and curly. Smooth and brown. Your dog’s fur is its most distinctive feature. It’s the reason we love petting our dogs and it’s the attribute that makes them so darn cute.

But your dog’s coat is about more than just good looks. It protects her from the environment, microorganism and foreign objects. Fur also acts as insulation keeping her cool in the summer and warm in the winter. Dogs also use their coats to communicate. Ever seen the fur on a dog’s back stand up when it’s mad? That’s its fur talking!

So your dog’s coat serves a purpose, but it can also cause some problems. Fur gets pretty dirty because it traps dust and pollen that can cause allergic reactions for you – and your pet. Fleas and ticks take cover in fur. And let’s not forget the “s” word: shedding.

So, what’s the best way to keep your pet’s coat clean and healthy? It depends on the type of coat.

Here are a couple of pointers on dog grooming based on common coat types.

Smooth, short coats:

Brush weekly with a rubber or bristle brush
Bathe as needed but at least every three months

Dense, short coat:

Brush weekly with a slicker brush to work out tangles and mats
Bathe as needed but at least every three months

Long, smooth coat:

Daily brushing with a slicker brush will keep the coat neat and tangle free
Some dogs will need regular, light trimming to maintain shape
Bathe as needed but at least every three months
Courtesy of Landon/Flickr

When it comes to bathing, you can let the pros handle it for a price or do it yourself. Summer time is ideal for outdoor doggy baths because it’s less messy. If you choose to bathe your dog in the tub, be sure to use a non-stick mat to keep your dog from slipping. Don’t use too much water (a few inches is enough) and rinse thoroughly avoiding the dog’s eyes, ears, and nose. Avoid using too warm of water as this can exacerbate any skin irritation your dog may have.

Which dog shampoo should you use?

Antiseptic, deodorizing, conditioning, antimicrobial – there are lots of great shampoos on the market. Choose the type that matches your pet’s needs or have your veterinarian recommend a shampoo.

We stock a wide range of shampoos for dogs. So order one up, grab your dog and just add water! Which dog grooming shampoo do you use? Let us all know by leaving a reply below. Thank you.

Happy bathing,

Wes

PCAB Reaccreditation from National Board

Posted on April 29, 2014 by Wes Hepker

PCAB recognizes pharmacy’s excellence and commitment to quality standards

Coralville, IA–The Pharmacy Compounding Accreditation Board (PCAB) today announced the reaccreditation of VetRxDirect Pet Pharmacy in Coralville, IA. The reaccreditation is awarded in recognition of the pharmacy’s commitment to meeting and/or exceeding national quality standards.

“Our renewed PCAB^® Accreditation status and our continued designation as a PCAB Accredited^® Compounding pharmacy lets our community know VetRxDirect ranks among the best for commitment to quality,” said Shawn Roe, Pharm.D.

“We are honored by this renewed accreditation. It confirms our continued commitment to providing safe, personalized solutions that meet the medical needs of our patients – and the needs of the pet parents who rely on us for these specialized medicines,” said Tom Swegle, Director. “We believe this will further strengthen the bond of trust between our pharmacy and the veterinary community.”

Compounding medications is an integral part of the practice of pharmacy and the demand for these customized medications are increasing every year. Yet many people may not even be aware of its role. Compounded medications are prescriptions written by veterinarians and prepared for an individual patient by a specially trained pharmacist.

About VetRxDirect Pet Pharmacy

Through excellent customer service and fast home delivery, VetRxDirect has been a leading, nationwide pet pharmacy since 2007. As the first Vet-VIPPS pharmacy, they have shown a history of commitment to pets and the veterinary community. While compounding is an important part of their pharmacy, VetRxDirect also specializes in prescription and over-the-counter pet meds and home medical devices.

About PCAB

The Pharmacy Compounding Accreditation Board (PCAB) is a nonprofit organization that provides a voluntary accreditation program for compounding pharmacies nationwide. Formed by eight of the nation’s leading pharmacy organizations, PCAB promotes, develops and maintains principles, policies and standards for improving the quality of pharmacy compounding nationwide. For more information, visit www.pcab.org.

A Review of Potassium Supplements for Dogs and Cats

Posted on April 22, 2014 by Wes Hepker

What are potassium supplements in pets used for?

Potassium supplements can be used in cats and dogs if they have a potassium deficiency, urinary stones, and other diseases. Common causes of low blood potassium levels (hypokalemia) include chronic kidney disease (CKD), some medications, inadequate nutrient intake, and many more. Diuretics are a common medication that can cause low potassium levels, and using a diuretic may require potassium supplementation. Potassium supplements can be used long or short term, depending on what is causing low potassium levels. If diarrhea, chronic dehydration or decreased intake is causing hypokalemia, the treatment may be short term, until your pet’s symptoms have resolved. When chronic diseases are affecting your pets potassium levels, the treatment will likely be long term. If your pet has been diagnosed with kidney disease, is currently on blood pressure medications or has been experiencing vomiting or diarrhea, then it may be beneficial to have your veterinarian monitor their blood potassium levels.

When should potassium supplements in pets not be used?

Potassium supplements should not be used in pets with hyperkalemia (high blood potassium levels), renal failure, severe renal impairment, untreated Addison’s disease, acute dehydration, or in pets with GI motility impairment. They should also be avoided when your pet is currently taking and ACE inhibitor, Digoxin, NSAIDS (Rimadyl, Norocarp, Previcox, and others), or potassium sparing diuretics such as spironolactone. Your trusted pharmacist at VetRxDirect can assist you if you’re concerned about adding potassium supplements to your pet’s current medications.

What kind of potassium supplements for pets are available?

Potassium is an ion, meaning that it is charged, and is hard to absorb into the bloodstream by itself. To neutralize the charge, it is bound to another ion which makes it easier to absorb. There are three potassium salt supplements available for pets: potassium gluconate, potassium citrate, and potassium chloride. All three can be used for potassium deficiency.Potassium citrate is also used to help prevent kidney stones, because it’s salt
form can increase urine pH. There are a wide variety of oral potassium supplements available, and some require a prescription. Some of the potassium supplements also have cranberry extract in them, which is beneficial if your pet is prone to urinary tract infections. The cranberry makes bacteria less likely to attach to the bladder wall and grow. At the end of this article is a comparison table of the products that we carry at VetRxDirect and what they are used to treat. You can use this to compare the different products that are available to the one that your pet might use.

How to monitor your pet while on potassium supplements:

If your companion requires potassium supplements, it is important to keep all follow-up appointments with your veterinarian because their potassium blood levels should be watched closely. You should consult your veterinarian especially when purchasing and administering the non-prescription products because incorrectly dosing your pet with potassium supplements can be dangerous.Your veterinarian will be able to recommend the correct dose, and help you decide which product is best.

Regardless of what kind of product you are using, you should be aware of signs that your pet may have too high of blood potassium levels: if your pet seems abnormally weak, has a very irregular heartbeat, or if they seem depressed. These side effects of potassium supplements are serious and indicate your pet should be seen by your veterinarian. It is important to only use the potassium supplement for as long as your veterinarian recommends, especially if it is intended as a short term treatment. Treating your pet with potassium supplements for longer than your veterinarian recommends could cause your pet’s potassium levels to get too high. You should also watch your pet’s fluid intake because they will need to be well hydrated to keep their potassium levels steady.

With proper monitoring and regular administration of potassium supplements, low blood potassium levels can be corrected and/or maintained. The key to a safe and effective treatment is to develop a close relationship with your veterinarian. Not only is it important for your veterinarian to check up on your pet regularly, but you should also be monitoring your pet’s mood and overall health. Awareness of health changes can prevent your pet from overdosing on their potassium supplements. With knowledge about potassium supplements, you should be better able treat your pet’s low blood potassium safely and effectively.

Medication	Prescription Required?	Potassium Form	Other active Ingredients?	Dosage Form(s)	Indications
Tumil K+	Yes	Potassium Gluconate	None	Tablet, Powder, and Gel	Potassium deficient states
RenaKare	Yes	Potassium Gluconate	None	Tablet, Powder, and Gel	Potassium deficient states
Renal Essentials	No	Potassium Gluconate	Yes- multiple extracts, vitamins, amino acids, and fatty acids.	Chewable Tablet and bite-sized chews	Support and maintain proper kidney function and mineral balance
Renal K+	No	Potassium Gluconate	None	Powder and Gel	Potassium deficient states
PotassaChew	No	Potassium Gluconate	None	Chewable Tablet	Not listed in Package insert
UroCit-K	Yes	Potassium Citrate	None	Extended Release Tablet	Help stop kidney stones and crystals from forming and reduce urine acidity
CitraVet	Yes	Potassium Citrate	None	Chewable Tablet	Reduce formation of bladder stones, and support overall urinary health
Potassium Citrate+ Cranberry	No	Potassim Citrate	Yes-Cranberry Extract	Chewable Tablet and Granules	Prevent urinary stone formation and enhance urinary health
K-Cit-V	No	Potassium Citrate	Yes- one formulation has cranberry extract	chewable tablet	Adjust urinary pH

Does your pet take a potassium supplement? Which ones have you tried, and have they worked well? Feel free to leave any remaining questions about potassium supplements for dogs or cats in the comments below or utilizing the Q&A feature on the respective product pages.

Abigail Maas

-VetRxDirect Pet Pharmacy Pharmacist Intern

Reference: “Hypokalemia.” Cornell University. Cornell University, n.d. Web. 12 Apr. 2014.

A Word About Pancreatic Enzyme Supplements

Posted on April 18, 2014 by Wes Hepker

If you’re a companion to a pet that requires supplementing pancreatic enzymes, then you probably understand how confusing and expensive the pancreatic enzyme supplements can be. The large investment in pancreatic enzyme supplements, alone, is a motivation for the desire to have them to be efficient but their activity is crucial for your pets to be healthy and happy. This article is aimed at helping you understand the enzymes, the cost of them, and the disease behind them, so you can get the best results from them while possibly saving money.

Why are pancreatic enzyme supplements for dogs used?

Normally, the pancreas produces enzymes that digest food and allow nutrients to be absorbed. Sometimes the pancreas can’t produce the enzymes needed to help your pet digest their food.The formal name for this disease is Exocrine Pancreatic Insufficiency and it is often abbreviated as EPI. It can be more common in German Shepherds, Rough Collies, and Chow Chows. The medication used to treat EPI is often a supplement of pancreatic enzymes that act like the ones your pet would usually make themselves.

What are pancreatic enzyme supplements for dogs?

The pancreas produces three major enzymes: amylase, lipase, and protease. Amylase breaks down carbohydrates, protease breaks down protein, and lipase breaks down fats. This breakdown is necessary for all three of these dietary nutrients to be absorbed and put to use in the body. The majority of prescription pancreatic enzymes are extracts from pigs. They can come in tablets and in powders. Some products also contain vitamins A, D3, and E. Your veterinarian will decide if your pet needs the extra vitamins or not.

Are there differences between brands of pancreatic enzyme supplements for dogs?

There are two main categories of pancreatic enzyme products: ones that contain the enzymes only, and ones that contain enzymes and vitamins. They can be further divided into tablets and powders which both contain the same ingredients when made by the same manufacturer, but in different ratios. Many questions have been raised about if the tablets and powders are equally effective and if you should pre-incubate the pancreatic enzymes (let them come to room temperature before feeding them). The American College of Veterinary Internal Medicine reports that pre-incubating the enzymes has no statistical significance in studies, and may be unnecessary. They also state that tablets and enteric coated products may have decreased efficacy. This is likely because the powders can coat the food better, which is the whole point of the enzymes; They need to be in contact with the food to break it down, and a tablet doesn’t reach a large volume of food, as compared to the powder. You could think about trying to flavor popcorn: shaking a flavored powder over the bowl of popcorn will coat more pieces and make it more flavorful, whereas putting a tablet of flavor will only coat a few pieces. This isn’t to say that all pets are candidates for powder pancreatic enzymes but if you have tried the tablets with no success, it may be beneficial to try the powder. It is ultimately the veterinarian’s decision which is best for each case, just be informed about the options.

How do the prices compare between the pancreatic enzyme supplements available through VetRxDirect?

Powders containing pancreatic enzymes only: Pancrezyme Powder, Viokase-V powder, and Epizyme powder: All three of these contain 71,400 units of lipase, 388,000 units of protease, and 460,000 units of amylase per teaspoonful. VetRxDirect’s current cost per teaspoon for each of these medications are:

Epizyme 8oz = $0.92
Epizyme 12oz = $0.95
Epizyme 4 oz = $1.20
Pancrezyme 12 oz= $1.57
Pancrezyme 8oz = $1.65
Viokase –V 12oz = $2.10
Viokase-V 8 oz= $2.18

Tablets containing pancreatic enzymes only: Pancrezyme tablets : These tablets are similar to the powder above, but they contain 9,000 units of lipase, 57,000 units of protease, and 64,000 units of amylase per teaspoonful. VetRx Direct’s current price per tablet is:

Pancrezyme tablet: $0.26

Powders containing pancreatic enzymes and vitamins: PancrePlus powder, Panakare Plus powder, and PancreVed powder. All three of these contain vitamins and 71,400 units of lipase, 388,000 units of protease, and 460,000 units of amylase per teaspoonful. VetRx Direct’s current price per teaspoon is:

PancreVed 12oz: $0.99
PanaKare Plus 12 oz: $1.01
PancreVed 8oz: $1.04
PanaKare Plus 8 oz: $1.04
PancrePlus 12oz: $1.07
PancrePlus 8oz: $1.13
PancreVed 4 oz: $1.14
PanaKare Plus 4 oz: $1.26
PancrePlus 4oz: $1.28

Tablets containing pancreatic enzymes and vitamins: PancrePlus tablets, PanaKare tablets, and PancreVed tablets. All three of these contain vitamins and 9,000 units of lipase, 57,000 units of protease, and 64,000 units of amylase. VetRx Direct’s current price per tablet is:

PancrePlus 500ct: $0.16
PanaKare Plus 500ct: $0.16
PancreVed 500 ct: $0.18
PanaKare Plus 100 ct: $0.22
PancrePlus 100 ct: $0.23
PancreVed 100 ct: $0.25

It’s all in the math for pancreatic enzyme supplements:

To find the difference in prices between the tablets and powders, a comparison between their concentrations must be made. The powders are much more concentrated than the tablets. In the enzyme only products and the enzyme plus vitamins, the powder-to-tablet enzyme concentration ratios (powder:tablet) for lipase, protease and amylase are 7.9:1, 6.8:1, and 7.18:1, respectively. So one teaspoonful is approximately 7 time more concentrated than one tablet. You could also think that it would take approximately 7 tablets to equal 1 teaspoon of the powder. If you multiply the price of the tablets by seven, then you get a rough comparative cost of the tablets to the powders.

For example:

Pancrezyme tablets = $0.26 x 7 = $1.82
Pancrezyme 12 oz powder = $1.57

By using the Pancrezyme powder instead of the Pancrezyme tablet you could save $0.25 per teaspoonful that you use. Let’s say that you are supposed to give one teaspoonful three times a day: you would save $0.75 per day. That could be $273.75 per year. Over ten years you could save $2,737.50, all because you were informed and proactive about your pet’s pancreatic enzyme supplements.

The take-home message about pancreatic enzyme supplements:

While the decision on what product to use is ultimately up to your veterinarian and you, it is important to be informed about the options out there. It is important to discuss the efficacy of the powder and tablets with your veterinarian, and what they think would the best option for your pet. The money that can be saved by switching to a cheaper product or by switching to powder form can save a large amount of money. However, you should be aware that some veterinarians like to start with more expensive products to stabilize your pet and then try the cheaper options, and there may be clinical differences between different manufacturers and how they get the enzymes.The purpose of this article is to educate pet owners about the pancreatic enzyme products and the long term costs that can accumulate from purchasing the more expensive products. We hope that reading this article has informed you about pancreatic enzymes, and that you (and your pet) can both be happy.

Is your dog on Pancreatic Enzymes? Does your dog take the powder? Which brand do you prefer? Please leave any comments below. Thank you.

Abigail Maas

VetRxDirect Pet Pharmacy Pharmacist Intern

Reference

“Exocrine Pancreatic Insufficiency (EPI).” American College of Veterinary Internal Medicine. American College of Veterinary Internal Medicine, 9 Jan. 2013. Web. 29 Mar. 2014.

Hypothyroidism in Dogs: What to Look For

Posted on April 9, 2014 by Wes Hepker

One day you notice it: your furry companion is a little less furry and a little less companionate. In fact, he seems pretty “down” and lethargic. That combination of symptoms might point to a common clinical condition called hypothyroidism.

The thyroid gland, located in your dog’s neck, produces hormones that control key bodily functions including metabolism, growth, reproduction, oxygen consumption and immunity. If the butterfly-shaped thyroid doesn’t function well – or stops working all together – your dog can suffer from a variety of symptoms that can harm your dog’s health and reduce his quality of life. (The condition is relatively rare in our feline friends who are more susceptible to hyperthyroidism.)

What types of dogs get hypothyroidism?

Larger dogs that are between 4-10 years old are more prone to the condition. Some breeds are more likely to have hypothyroidism including: Doberman pinchers, Golden retrievers, Great Danes, Irish Setters and Airedale terriers.

What are the causes of hypothyroidism in dogs?

Changes in the thyroid gland can cause hypothyroidism. In some cases, an immune system disorder attacks the gland causing it to overproduce thyroid hormone and then become totally depleted. In other cases, age and biological processes stop the thyroid gland from producing enough hormones.

What are the symptoms of hypothyroidism?

Look for a combination of these symptoms:

Thinning or loss of fur on the trunk of the body
Thickening, darkening skin
Weight gain
Lethargy
Mood changes – depression, aggression and anxiety

Blood work is required to diagnose the condition and determine what level of treatment is required.

How is hypothyroidism in dogs treated?

Dogs with hypothyroidism require hormone replacement therapy for the remainder of their lives. Fortunately, there are many excellent hormone replacement medications that regulate canine hormone levels and help the body function normally. We stock many of the leading thyroid medications.

As always, the first person you should talk to about your pet’s condition and any required treatments is your veterinarian.

If you’d like to read more about hypothyroidism, check out this comprehensive article by researchers at Washington State University.

Thank you for reading. We’re here to help you keep your pet healthy and happy!

Wes