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Prescriptions for Health

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A Newsletter from

SUMMER 2012 current news in

featured PRACTITIONER numeric score for a patient who is experiencing pain. The pain scale standardizes the process and makes you, as a veterinarian, think about the owner and what they’re going through.

VETERINARY medications

Koshland Pharm staff attended the Pacific Veterinary Conference in San Francisco the weekend of June 29th and shared two unique therapeutic options for animals with veterinarians, including:

I think of every pet I see as my own pet, and think about what I would do in each situation. I try to make sure the owners have all the options, so they can make their own decisions. I try to give them the information I would want if I were in a similar situation.

• A thermo-reversible drug delivery vehicle which is applied as a liquid and solidifies at room temperature to coat a wound or infection • A well-studied transdermal cream that gives pet owners and veterinarians the option of administering many medications through the skin rather than as a pill

Current Inspirations Each Prescriptions for Health newsletter features a Bay Area practitioner with a unique approach to health and healing. Dr. Jessica Holliday, DVM, is a veterinarian at Balboa Pet Hospital in San Francisco.

Practice Approach I’ve been with Balboa Pet Hospital since the summer of 2011. It is a small animal veterinary clinic that has been owned by Dr. Paul Clary, DVM, and his wife, Alice Clary, since 1966. It is accredited by the American Animal Hospital Association (AAHA), which helps the quality of medicine by standardizing procedures in veterinary clinics. For example, AAHA accreditation requires that a veterinarian give a

My current inspiration in my work comes from one of my own pets, Tomba dog, who has been my guiding voice throughout my career. Let me tell you a little bit about Tomba. He’s a chow mix, and he is the pet I got when I was eighteen. At the time I got Tomba, my major was still undeclared. I started really focusing on him, and soon knew I wanted to study veterinary medicine. Tomba and I had the fun life; he’d go to parties when I was an undergrad, and he was very social. Then, when I was in vet school, he learned how to play by himself while I studied, then moved with me from Louisiana, where I’m from, to Las Vegas.

cisapride discontinued Interested in receiving an e-version of Koshland Pharm’s newsletter? You can join our mailing list at koshlandpharm.com.

Cisapride, a medication often used to treat gastrointestinal conditions in animals, recently became unavailable in the United States because the Indian government blocked its exportation to the U.S. To our knowledge, India is the sole source of manufacturing for this medication. For more information, or to join a petition effort to make cisapride available again, visit www.koshlandpharm.com/cisapride


featured PRACTITIONER (continued) Now Tomba, who is thirteen, has lumbosacral instability where the spine meets the tail. The problem with that kind of condition is that it’s really hard to treat medically or surgically. It’s not a true arthritis. But it impinges on the nerve. It’s hard to see him be an old man. Because of what my limitations are in treating Tomba, I’m starting to gravitate towards Eastern Medicine.

ask the

PHARMACIST What vitamins and supplements do you recommend for summer travel? The following vitamins and supplements we have found to be the most helpful for this time of year when multiple trips are often planned. We are also including one compounded medication that can be prescribed and used as an effective treatment for nausea that might arise on a cruise: • Paraguard - This supplement from Integrative Therapeutics promotes healthy digestion, especially when traveling to places with questionable water quality. Paraguard helps protect the stomach from any bugs by supporting “good bacteria” that help us digest nutrients effectively.

There’s an institute in Florida called the Chi Institute. My next goal professionally is to take some introductory online courses, to learn how to take care of animals on a different level by doing things like making your own food.

Successful Compounding Story Giving medications to animals can impinge on the relationship that people have with their pets because animals don’t understand why they have to take the medicine. Compounded medications can make it a lot easier for the owners. Many cats, especially larger cats, when they stop eating, they get something called high liver, and really what they need for that is hepatic support, which comes in the form of ursadiol. Koshland Pharm makes a lot of ursadiol for us, because it only comes in a set milligram for humans. There was one

• Probiotics - These are the good bacteria that can be taken as a supplement. They support healthy gut function, and can help address occasional gas and constipation that can arise when traveling. • Melatonin - This supplement can regulate the sleep cycle and promote healthy sleep when traveling by plane, especially through different time zones. • Promethazine Gel - This is a compounded medication that can be prescribed by a doctor as a way to address sea-sickness. This medication is applied through the skin, which is often helpful as an alternative to taking a pill when feeling nauseous.

Check out the supplement brands that Koshland Pharm has carefully selected for quality at www.koshlandpharm.com/ supplements. Feel free to call us at (415) 344-0600 with any questions about which specific products might best fit your needs.

Do you have an Ask the Pharmacist question you would like answered in a future newsletter? Please write to us at krista@koshlandpharm.com or 301 Folsom Street, Suite B, SF, CA, 94105, Attn: Krista.

cat in particular whose owner was having trouble with the medication, and so she ended up turning the cat over to us, so we ended up with the medication. Koshland Pharm delivered it to us. Now the cat’s with her new family and off the medication. That alone, being able to give that medication, made a big difference. Another example of a compounding success story is a family who had trouble giving their cat medication that she needed for allergies. The cat’s owner, Francis Schwertfeger, wrote about her experience with a chlorpheniramine trandsdermal gel from Koshland Pharm: “Jasmine developed what our vet called an allergy. She had a stuffy, runny nose and sneezed, wheezed, and coughed a great deal. She did not feel like herself. I had to give her pills twice a day, which were difficult for her to swallow. I felt bad because Jasmine would struggle and spit them out. Finally, I heard about Koshland Pharm, where medications are compounded, come in pre-measured doses, and arrive through a delivery service. Jasmine now gets her medication, chlorpheniramine (an antihistamine), in the form of a transdermal gel. I put it on the tip of her ear and no more struggles! Jasmine has not had the terrible allergies for several months.”


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remembrance

compounded ALTERNATIVES for pets In order to give readers a sense of some of the different kinds of delivery forms other than pills that can be used to give animals their medications (such as liquid medications or transdermal gels), we asked pet owners to share their pets’ experiences using compounded medications from Koshland Pharm:

toby’s story About 6 weeks ago, Toby was so sick, it scared me. Out of the blue, he could not walk and had a fever of 104. He was despondent, refusing to eat or drink. As always with such things, it was the weekend. He weighs 64 pounds, so I was grateful to find a home visiting doc and, after an anxious few days, with much effort and a few neighbors, I got him to the vet for a full work-up. My veterinary clinic got a plan together. I was exhausted as I started his drug regimen of 4 pills a day. So tired and emotionally depleted, I almost lost it when

My Bosco was in severe pain with a vicious cancer of the bladder. Koshland Pharm came through by mixing Bosco’s favorite flavor and making a liquid with a syringe (no needle), to squish in her mouth. It can be so tough to get meds into your pets in good times, and Koshland saved us from holding Bosco down and shoving a pill down her throat. She had her dignity and was out of pain. It really came in at a good time, discovering this pharmacy. I’m getting another dog in August, and she’s going to live forever! by Sue Perry

all of a sudden after a few days, Toby refused his meds. I knew he had to be on schedule and felt increasingly anxious as he refused every method and every yummy food I could think of. The counter was covered in melting tablets he had avoided, eaten around, or cheeked. Finally, as instructed, I tilted his head and threw down the pills, shut his mouth, blew his nose, stroked his throat for minutes. But, in the end, Toby stared me down and spit out a soggy puddle. Even the vet tech tried after I called her in tears and acknowledged he was indeed “special.” So when I asked the clinic about compounding his meds, I was relieved and thankful there was an option to the day-long struggle that would stretch over the next month. Using the liquid meds allowed us to bond around his care rather than shatter our relationship with constant battles. Toby is now healthy, his usual playful, energetic, happy Spirit. by Amanda Houston-Hamilton

The staff of Koshland Pharm extends our condolences to Sue in saying good-bye to Bosco, a dear companion. We look forward to hearing about the new friend you meet and bring into your home in August!


301 Folsom St., Suite B San Francisco, CA 94105 P: (415) 344-0600 • F: (415) 344-0607 www.koshlandpharm.com

Koshland Pharm makes prescription medications tailored to a patient’s specific needs. For example, sometimes a patient could benefit from a pain medication in a cream rather than capsule form. To address this kind of specialized need, Koshland Pharm makes high-quality, customized prescriptions and works closely with both patients and their doctors to ensure optimal treatment.

did you

KNOW… ...that Koshland Pharm can support the healthy skin of not only pets, but also of people? Koshland Pharm now carries Rx Skin Therapy, and here’s why we like it • It was developed by pharmacists through extensive research • It promotes cell regeneration • Its formulas are pH correct and do not include irritating dyes or chemical fragrances You can check out Rx Skin Therapy options for all different skin types at www.koshlandpharm.com/ rxskintherapy, or ask for a sample when you pick up your next prescription. Receive a 10% discount with the coupon code healthyskin before August 31, 2012!

hot dog!

Has your dog ever excessively licked her paws? Sometimes dogs can have a condition called “Acral Lick Granuloma” or “Hot Spots,” which might be caused by anxiety, bone or joint pain, boredom, or allergies. The dog starts licking excessively at a spot on her body, creating a raw spot and lesion on the skin. Compounding pharmacies can often help successfully address this condition by making customized medications to stop the excessive licking. Compounded options include topical preparations that can: • discourage licking with bitter tasting compounds (amitriptyline, diphenhydramine or capsaicin) and/or • give pain relief (lidocaine) and/or • promote skin healing (phenytoin, misoprostol or aloe vera) If your dog is having problems with excessive licking, you can ask your vet about these medications or give us a call at (415) 344-0600.


PRESCRIPTIONS FOR HEALTH - Pet Care