Why we insist on seeing you pet back for prescription checks
Prescription Checks... most of our clients understand that these are necessary check ups to touch base with our veterinary team, to perform a physical health check, to check for any new concerns, to perform monitoring diagnostic tests and to check weight of our pets before the Veterinary Surgeon prescribes more medications. However, on occasion veterinary professionals come up against resistance to revisits despite it being in the best interest of the patient. Why?
At the heart of many complaints in veterinary medicine is money, the NHS has been such a success in human medicine that it has blinded the UK public to the cost of health care. These check ups often do not cost a huge amount of money, the consult fee or prescription fee covers the veterinary time, health check and expertise. To prescribe prescription medication Veterinary Surgeons are obliged to follow a standard protocol outlined in the RCVS Code of Conduct for Veterinary Medicine.
The RCVS Code of Conduct for Veterinary Medicine states:
POM-V medicines must be prescribed by a veterinary surgeon, who must first carry out a clinical assessment of the animal under his or her care. It also states that to be under their care the animal must: Have been seen immediately before prescription or, recently enough or often enough for the veterinary surgeon to have personal knowledge of the condition of the animal or current health status of the herd or flock to make a diagnosis and prescribe
What amounts to 'recent enough' must be a matter for the professional judgement of the veterinary surgeon in the individual case. The crux of the matter is that the Veterinary Surgeon is the professional and has the authority and decision on when they want to see your pet back. It is the Veterinary Surgeon's responsibility to ensure they are prescribing the right medication at the right dose and therefore is at their discretion as to the frequency of visits required. It is not fair to put pressure on them to prescribe a medicine that they do not feel comfortable prescribing without checking your pet. Of course, you as a pet owner may feel your pet is doing outstandingly and does not require a check up but that is for the veterinary surgeon to decide.
Weight needs to be checked
Co-morbidities need to be ruled out
The development of concurrent health issues needs to be checked
The adequacy and efficacy of response to treatment needs to be assessed
Monitoring diagnostic tests may need to be run
When asked on Veterinary Voices UK veterinary professionals highlighted a huge array of coincidental findings they were able to pick up on these routine prescription checks. This ranged from diagnosing lymphoma, splenic tumours, liver tumours, heart murmurs, renal failure, bladder stones (uroliths), hypothyroidism, hyperthyroidism, ear and skin infections, early malignant melanoma, painful dental disease and even an air gun pellet! Furthermore, many noted that changes in doses were frequently required due to weight changes and that often owners had not noticed that their pet's condition wasn't being managed quite as well as we would have hoped. It is often hard to notice subtle changes to our pets when we live with them daily, changes sneak up on us and we attribute it to 'old age'. These prescription checks allow an outsider perspective and an expert eye to see that management is not optimal and we really need extra support. This has led to improved quality of life and better management in many cases.
I've also found a huge splenic mass in a tiny shihtzu on chronic medication at the prescription check up. One uneventful splenectomy later and they felt their dog was years younger!
Frequency: this decision is down to the animal, the case, the disease and the drug prescribed. One member of Veterinary Voices UK highlighted that due to the aging process and metabolism of our pets who sadly live shorter lives that a human being the intervals asked are more than reasonable stating:
...a six month interval equates to around three years for them (dogs, cats, rabbits) and that a LOT can change for them in that time.
Stop the abuse of veterinary staff for abiding to prescribing protocol and legislation