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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 9683
Experience:  Over 20 years of experience treating dogs, cats, mice, rats, rabbits, guinea pigs, hamsters, & iguanas
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I am in California - is somebody out there in a state where

Resolved Question:

I am in California - is somebody out there in a state where it's legal to write a prednisone prescription for my dog without actually seeing him? He is a 13-yr-old, 80 lb mixed breed with mast cell cancer. An oncologist put him on prednisone in February for palliative care, and it reduced the swelling around the tumor on his jowls. He's been off prednisone a couple months, and happily he has lasted longer than I thought and seems to be in no serious pain -- but the tumor is getting bigger again. But the resident he saw is no longer at that cancer clinic, and his regular vet is on maternity leave so both clinics say that I have to drag my poor dog in to SEE a vet before they can renew a prescription for prednisone. I DON'T WANT TO put him through that - he has always been extremely scared and anxious with vets. I just want him to be more comfortable as he is dying, and I'm extremely unhappy that his own vet clinics are putting us both through this. Can somebody out there in cyberspace help with this?!!??
Submitted: 11 months ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 11 months ago.

Hello, my name isXXXXX and I have over 20 years of experience as a veterinarian.

I am so sorry to hear that Reeses is in the palliative stages of Mast Cell tumor cancer and you are unable to get medication for him any longer.

 

I know that this is frustrating and painful for you to see him this way but you must understand all veterinarians licensed in the United States are bound by strict rules that each state enforces. If we do not follow those rules we can lose our license to practice and thus our ability to make a livelihood. We cannot write prescriptions for an animal we have never physically examined or haven't seen within a specific amount of time. That time varies from state to state but in most states it is within 6 months to one year.

I think you can understand that as much as we may empathize with a pet or owner we must protect ourselves too.

 

I can understand not wanting to put your fellow through the trauma of a car ride and the stresses of a veterinary clinic. How about having a mobile veterinarian come to him in the comfort of his own home? Here is a link to help you find one in your area:

http://www.vetlocator.com/

 

There are some things that you can do for him in the meantime to help counter act the effects of a mast cell tumor and the histamines it releases.

 

1) Benadryl (diphenhydramine only don't use the combination products with decongestants and acetaminophen as they can be toxic to dogs) at 1mg to 2mg per pound or one 25mg capsule per 25 pounds of dog orally every 8 hours. Antihistamines block the systemic effects of the histamines a mast cell tumor releases.

 

2) Pepcid-ac (famotidine) at one 10mg tablet per 20 to 40 pounds of body weight
every 12 hours.
OR

Prilosec (omeprazole) at one 10mg tablet per 20 to 40 pounds of body weight
every 24 hours.
These will reduce stomach acid, which tends to increase in response to the histamines released by the mast cells. They should reduce nausea and gastrointestinal ulceration formation.

 

I know that these over the counter medications aren't as helpful as prednisone would be, and they won't affect the primary size of the tumor, but they should decrease the side effects of the tumor for him and make him somewhat more comfortable.

Best of luck with your boy, I'm sorry that you and he are in this position.

Customer: replied 11 months ago.

While I really hate it that circumstances beyond my control/knowledge-to-control have landed Reeses in this predicament and that you didn't give me an answer that I WANTED... I appreciate your time and kindness in your response. So I am giving you a positive response for your efforts, thank you.

Expert:  Dr. Kara replied 11 months ago.

Thank you for appreciating my effort.

I know that it isn't what you wanted to hear, but I saw that you had waited a while for an answer and I didn't want you to feel you were being ignored. I wanted you to know why you were getting the request to have him seen before prescriptions could be given. It stinks that we have no leeway for cases like his, but we must follow the law.

Please take care, Dr. Kara.

Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 9683
Experience: Over 20 years of experience treating dogs, cats, mice, rats, rabbits, guinea pigs, hamsters, & iguanas
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