When a small animal needs a drug treatment, there is usually a licensed (authorised) medicine available, although it might be licensed for other species or indications. However, there are some circumstances when there is no suitable licensed product to fulfil a clinical need. To solve such a problem, it might be possible to use an unlicensed ‘special’ formulation. Specials are unlike licensed medicines because they are not assessed for safety or efficacy by a regulatory body. So vets must be satisfied there is sufficient evidence or experience to demonstrate safety and efficacy. Here we outline the facts and practical information relevant to prescribing special formulations.
Much of an animal’s medical treatment will be administered by the owner at home. To do this safely and effectively, owners need information about why and how to use the treatments. This module discusses what sort of information owners need, what is required by law, what is available, and how it can be provided in the veterinary practice.
A unique database. Includes all UK authorised products for cats dogs, ferrets and rabbits. Search by parasite/disease, active ingredient(s), brand, species, formulation. Updated every 3 months. Indispensable for getting your head around parasiticide products.
Intravenous lipid emulsion is increasingly being used as an adjunct in the management of toxicity caused by lipophilic drugs that are cardiotoxic (e.g. bupivacaine) or neurotoxic (e.g. permethrin). The Veterinary Poisons Information Service recommends that intravenous lipid emulsion be considered for any animal at risk of serious toxicity after exposure to a lipophilic compound (VPIS 2017). This module summarises what is known about this treatment, the uncertainties, and the practical aspects of using it.
Lidocaine (25mg/g) plus prilocaine (25mg/g) cream is a topical anaesthetic licensed for use in humans but not in animals. However, it is used in veterinary practice – for example, during venepuncture at the jugular or cephalic vein for blood sampling, especially in cats, or the ear veins in rabbits; and when inserting an intravenous cannula preoperatively in cats, dogs and rabbits. This module summarises the published evidence on the efficacy and safety of lidocaine/prilocaine cream in small animals, gives practical guidance on its use, and highlights the gaps in the evidence.
Why do this module?
Lokivetmab is a new treatment for reducing the clinical signs of atopic dermatitis in dogs. It is also a new type of medicine (a monoclonal antibody) for the treatment of animals in the UK. This module explains about monoclonal antibodies, summarises what is known about the efficacy and safety of lokivetmab in the treatment of canine atopic dermatitis, and discusses where it might fit in the management of atopic dermatitis.
When we last reviewed ‘stem cell’ therapy in 2014 there was only one small published clinical trial (in dogs with osteoarthritis) and this did not show a clear benefit. Now some veterinary practices offer ‘stem cell’ therapy for cats and dogs for the treatment of a wide range of conditions, including arthritis, hip dysplasia, tendinopathy, skin disease and inflammatory bowel disease. But how much has the evidence moved on? This module explains the forms of therapy available, why ‘stem cell’ therapy is now considered a misnomer, how the therapy is regulated, and what is known about its efficacy and safety in cats and dogs.
There are many situations in which you might use several medicines at the same time in a companion animal – for example, to treat chronic diseases or multiple conditions in older animals; to achieve broad parasite protection; in anaesthetic protocols; and when anaesthetising animals on long-term drug treatment.
This module covers: the principles of interactions and their potential consequences; interactions with herbal medicines and nutraceuticals; where to find information about interactions and what to do with it; and practical tips on predicting, avoiding and managing drug interactions.
Glucocorticoids are widely used and are an important part of the veterinary therapeutic armoury. However, they cause well-known unwanted effects, including suppression of the hypothalamic-pituitary-adrenal axis (HPA axis), which can lead to problems when the treatment is stopped.This module outlines the rationale and evidence on steroid withdrawal in cats and dogs and includes an example of a withdrawal protocol. It was prompted by a query from a small-animal vet, who asked if there is a standard protocol for withdrawing steroid therapy.
Where's the best place to find information on doses, interactions, use in pregnancy and so on, at the time of prescribing? Do you know the difference between SPCs and data sheets? Where can you find reliable information on unlicensed medicines? Our new module reviews quick-reference prescribing information sources. We've compared the different sources - paper and online - looking at the pros and cons, whether the information is reliable, the costs, and which to use when you need a particular type of information. It's practical and will help you to know if you're using the most up-to-date resources.
Some vaccines used in veterinary medicine contain mineral oil as an adjuvant. Most are vaccines for use in food production animals, but there are a few for use in companion animals. Self-injection can result in serious harm from the mineral oil content and so it is important to know which those products are. This module aims to raise awareness of the potential hazard and what to do to avoid serious harm.
Why do this module?
Reviews the evidence on tramadol’s efficacy in management of postoperative and chronic pain, and on adverse effects. Looks at the legal requirements around the use of tramadol and potential for misuse and dependence. Tackles the dilemma of what to do when NSAIDs are contraindicated, not tolerated or insufficiently effective but evidence on alternatives is weak.
Angiostrongylus vasorum, one of the five main parasites affecting dogs in the UK, can cause severe illness and even death in infected dogs. This module provides answers to key questions about the biology, epidemiology, clinical impact, diagnosis and management of canine angiostrongylosis. It will enable veterinary professionals to discuss confidently the risks with clients and reach a fully informed decision about preventive therapy.
This module will bring you up to date with developments in the evidence-based veterinary medicine (EBVM) movement. It includes a summary of key messages from the Veterinary Evidence Today conference in Edinburgh in November 2016. Includes links to practical resources for those who want to develop skills in EBVM and/or want to get involved in practice-based research.
Noise aversion is common in pets. Management of noise aversion usually involves a combination of interventions, including behaviour therapy, pheromones, drugs and nutritional supplements. Alpha-casozepine (Zylkène capules) is one such supplement. This module looks at whether there is any evidence that alpha-casozepine is effective in helping cats and dogs with noise aversion.
Parasite specialists ESCCAP UK & Ireland strongly advise the use of a tick preventive product for dogs in areas where Babesia has been reported, to reduce the risk of disease transmission, and they recommend using a product that either repels or rapidly kills ticks. This module explain what is meant by repellent and rapid killing effect and lists the products that meet these criteria.
Otitis externa is one of the most common canine disorders seen in primary care veterinary practice Most cases of acute otitis externa can be managed using topical therapy. This module reviews and compares the available antibacterial products for acute otitis externa, to help with choice of treatment in individual cases, or when creating a practice antimicrobial policy.
Tea tree oil is widely advocated as a home remedy for skin infections and for controlling flea infestations. Vets may therefore see animals that have been treated with tea tree oil, or owners might ask for advice about its use. This module sets out the evidence on the benefits and harms of tea tree oil in companion animals, and describes what can be done if tea tree oil has caused harm to a pet.
UK veterinary professionals have to deal with an increasing number of parasite threats to companion animals and a very large and growing range of parasiticide products with which to control them. A practice parasiticide policy will help ensure that there is a consistent message about parasite protection from every member of the practice team, that parasite risk is reliably assessed for each animal, and that the products best suited to the animal’s needs are chosen. This module walks you through the steps to creating your own practice policy. Includes downloadable client questionnaire.
This module covers the five main parasites that affect cats in the UK : roundworm, fleas, ticks, tapeworm and lungworm. It outlines the different approaches to parasite control and discusses product choice. With the integrated Parasiticide Guide, it will help you choose products suited to your clients.
Roundworm control is the most important consideration in kitten parasite management. Outlines lifecycle of roundworm in cats, rationale for deworming kittens and product choice.
This module covers the five main parasites that affect dogs in the UK: roundworm, fleas, ticks, tapeworm, lungworm. Discusses different parasite control strategies, focusing on a risk-based approach and product choice. Together with the integrated Product Guide it will help you choose products suited to your clients.
Roundworm control is the most important consideration in puppy parasite management. Refresh your knowledge with this module. Beautifully simple slide show reminds you of the lifecycle of roundworm. Outlines rationale and current recommendations for deworming puppies and discusses choice of deworming products.
Outlines the risk-based approach to parasite control and helps you get to grips with the overwhelming range of parasiticide products by looking at what's available in terms of active ingredient, and what products need to demonstrate to get a marketing licence.
Whether you’re discussing the evidence on a drug treatment with a company rep, or evaluating a randomised controlled trial report yourself, or reading a summary of clinical trial evidence (e.g. in a Veterinary Prescriber module), it’s essential to understand the terms used and the key features of randomised controlled trials, including the potential sources of bias. Here is a guide to help you.
This module gives you key facts about the drug and the evidence about its efficacy to help you make a rational decision about its use.
The international guidelines on the management of canine atopic dermatitis received their first update in August 2015 (the first minor 5-year update; the guidelines will receive a major update every 10 years). In this module, we highlight the main changes to the guidelines (which concern the use of oclacitinib, antihistamines and masitinib), and comment on how the new recommendations relate to UK practice.
There is a large and confusing range of products on the market for the management of parasites in horses and donkeys. This unique product guide aims to help with the comparison and selection of products. It contains all equine endoparasiticide and ectoparasitide products authorised as veterinary medicines in the UK. Search by active ingredient, drug class, brand name, formulation and parasite/disease coverage.
- ABCB1 mutation
- Angio Detect Test
- Angiostrongylus vasorum
- BSAVA formulary
- Baermann test
- British National Formulary
- European Public Assessment Report
- European medicines agency
- Hany Elsheikha
- NOAH Compendium
- P glycoprotein
- Plumb's Veterinary Drugs
- RCVS Knowledge