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Thursday, May 21, 2009

Do What The Doctor Says

In the last couple of years a major topic in veterinary medicine has been owner compliance. Surveys have been done and have shown that pet owners don't follow the doctor recommendations far more frequently than vets believe. And that's not with whether or not they authorize services. The surveys looked at how compliant owners have been with giving prescribed medications or following treatment directions. And surprisingly, half or less of owners follow veterinarians' instructions. Often times they don't give medications as often as recommended or for as long as recommended. They also don't manage bandages, restrict exercise, and otherwise do what the doctor has said.

Why does this happen to this degree? Part of it is that people have busy schedules. It can be very difficult to give medications three or four times per day. Heck, I've forgotten to do that myself on my own pets and kids. Sometimes it may be because certain pets don't allow you to give medications easily. A lot may be that owners don't understand the necessity of proper medication. Whatever the reason, it's a frequent topic of discussion in veterinary journals. Most vets assume that the directions will be followed exactly or closely, and it's a real eye-opener when we find out it isn't happening. So let me try and help out a bit and explain some things to you pet owners.

Medications take a certain amount of time to reach effective levels in the body. This can be minutes to days. The body also metabolizes and eliminates medications at different rates. And the medications must stay at therapeutic levels for an adequate period of time to be effective. For medications that are given twice daily, you must give it this often to keep the blood levels high enough. The reason why some medications are given once daily and others are given more often has to do with how each chemical is metabolized. They are NOT all the same.

Antibiotics must be given for a long period of time to be fully effective. Many people stop giving the antibiotics as soon as the symptoms go away. Time and time again I have seen infections return because the owners didn't finish out the course of antibiotics. As the medication works, it will reduce the population of bacteria. There will be a point where the numbers of bacteria are low enough that you don't see clinical signs, yet the bacteria are not eliminated. If you stop the antibiotics too soon, you could see a quick return. Some infections require antibiotics to be given for 1-2 weeks after the symptoms have resolved! Just because you no longer see the problem doesn't mean that it is actually gone.

Many treatment plans are difficult, such as keeping an active dog on restricted activity. Some are time-consuming such as most behavioral therapies. Some are inconvenient, such as feeding a special diet to one pet in a multi-pet household. But your vet is going to recommend what is best for your pet, and you as a pet owner have a responsibility to do what is best for your pet. If you have questions or concerns about the treatment plan, bring it up before you leave the vet's office. But if your vet tells you to give a medication on a certain schedule for a given length of time, please do it. Failing to do so could prolong problems with the pet.

Don't contribute to this epidemic of non-compliance in pet owners. And don't complain if a problem doesn't go away because you didn't follow directions.