Dear Dr. Fox:

I have an 8-year-old teacup Yorkshire terrier that was diagnosed with encephalitis more than four years ago.

He began walking in circles whenever he was awake. I took him to our family vet, who referred me to a neurologist. The neurologist performed a spinal tap and a CAT scan, which confirmed encephalitis. The prognosis for my Yorkie’s survival was one week.

In spite of this, the neurologist prescribed cyclosporine and prednisone, to be given twice daily. I took my dog home with little hope he would survive. He has been on these medications ever since. He stopped walking in circles one day after beginning the drug combination. His health and quality of life have been mainly quite good. He does what “well” dogs do: barks at the cat, plays, interacts with my other dogs, follows commands and does tricks. He has a sweet disposition.

I want to share this with your readers: Just as with humans, it is possible to shop around for reasonably priced prescription medications for your pets. It is important to keep your dog on medications without going bankrupt. For example, prednisone is frequently given to humans, and it is inexpensive. I get a prescription for it from my family physician, and then I cut the tablet down to the correct dosage for my dog.

If I’d had to buy cyclosporine locally, the cost would have been $500 a month. I would have had to put my dog down years ago, because I could not afford that. Instead, I get it for $30 a month from a mail-order place out of state that specializes in veterinary drugs.

L.R., Montgomery County

 

DF: I am glad that this drug combination helped your dog overcome his inflammatory brain disease, which might well have been an adverse reaction to a vaccination that in the future would probably best be avoided.

Yes, the cost of pharmaceuticals has really gotten out of hand, and veterinarians are being wrongly blamed for this drug industry profiteering and monopolistic, cartel-like business practices.

Readers will appreciate your diligence in finding less costly sources for the human medications, generally prescribed in the category of “off-label” by veterinarians when they are not specifically approved by the government for animal use.

A veterinarian friend of mine, Dr. Ron Gaskin of Shakopee, Minn., who has been investigating this issue, sent me the following statement, which I ask all readers to pass on to their congressional representatives:

“Pet owners of America might have noticed that the prices of medications for their pets are increasing. Many of these drug price increases are astonishing! Over the last three years, our veterinary clinic has seen an increased frequency of manufacturers back-ordering drugs. When — and if — the drug returns to the market, a huge price increase usually follows.

“This has happened to doxycycline, a powerful antibiotic used to treat tick-borne diseases found in Minnesota. The human generic doxycycline tablet price has increased at least 600 percent. Generic doxycycline tablets from some human drug wholesalers have gone up by as much as 1,800 percent.

“Another example of stratospheric drug price increases is phenobarbital, a human anti-seizure medication used to control epileptic seizures in cats and dogs. Phenobarbital has been a frontline drug for extra-label use in my patients for over three decades. Phenobarbital tablets were on a manufacturer back order for eight months. When the tablets finally came back into the market, we had a 600 percent price increase.

“If these human generic drug price increases continue at this rate, veterinarians will not be able to economically treat our nation’s pets within five years. Some pets will go without treatment or have to be euthanized.

“Human doctors are seeing the same problem. Senior citizens are often unable to afford their digoxin tablets, a formerly cheap but very effective drug used to treat congestive heart failure. When a senior citizen cannot afford the digoxin and is forced to go without it, he will likely end up in urgent care struggling for his life.

“Why is this happening in America today? We are seeing human generic drug manufacturers increasing their prices just because they can. The drug powder or active pharmaceutical ingredient (API) price has not gone up, nor has an API shortage been a problem. It comes down to one cause: human greed. There used to be six manufacturers of phenobarbital; now there are only two, and they set the price. Small, independent, competing generic drug manufacturers are being acquired and shut down or incorporated into larger drug manufacturing corporations, which then control the price of the generic drug.

“The American Veterinary Medical Association’s top brass, in a private conversation, stated that the human generic drug price increases are ‘free-enterprise-driven.’

“When the price of a human generic drug gets high enough, this could entice our veterinary generic drug manufacturers to apply for and get approval to manufacture economical generic veterinary drugs. Our veterinary generic drug manufacturers appear to be holding the line on their generic drug price increases; however, the writing is on the wall.

“What is the federal government doing about this? Stringent Food and Drug Administration regulations and an aging drug manufacturing infrastructure have resulted in many small generic drug manufacturers being shut down or becoming more easily acquired by larger, predatory generic drug manufacturers.

“The Federal Trade Commission is allowing this monopolistic process to happen. Why is this happening? Money. There is a huge amount of money involved. A recent Senate oversight committee investigation has become silent about the exorbitant generic drug price increases.

“Pet owners should be aware it is not usually your veterinarian making the ‘big money.’ Our veterinary practice has started to write a lot more pet prescriptions to be filled at local pharmacies because the drugs are too expensive for us to inventory, or we just want to help the pet’s owner find the most affordable option they can. Sadly, almost always our pet owners find out what the real, and unanticipated, costs of human generic drugs are — for them and their pets.”

LEAPS AND BOUNDS

Dear Dr. Fox:

Our 6-year-old female tortie cat is showing some disturbing behavior.

We got her three years ago from the Humane Society, and she was just fine up until recently. The first incident was while she was fast asleep: She leapt up, almost knocked the lamp over and wouldn’t go back to her normal sleeping blanket for quite a while. She acted as though something had startled or scared her.

She has since had several of these sudden leaping incidents, and the vet said it might be that she is getting a shock. It has been very dry lately. Now she will leap up like this, whether on our lap or elsewhere, and there is no indication of a shock. She has done this several times, her eyes totally black, and it takes a while for her to settle down. We are very concerned and don’t know what to do.

She is a totally indoor cat, and she has three people in our household who adore and spoil her. She eats good-quality cat food.

B.F., Wahpeton, N.D.

 

DF: This condition in cats is not unusual when they are relaxing, going into deep sleep, and suddenly experience a pain impulse or abnormal brain activity.

The latter may be a kind of seizure, sometimes associated with feline hyperesthesia, which might be helped by giving your cat supplements such as melatonin, tryptophan, L-theanine and taurine. The former could arise from sudden arthritic pain and associated muscle spasms, impacted anal glands or other pain-producing conditions.

Discuss these options with your veterinarian or a feline specialist in your area, and be sure you are not applying any anti-tick and flea drugs on your cat, which can cause a host of problems, or on any dog in your home with whom the cat has contact. Let me know how this turns out after more detective work.

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Michael W. Fox, author of a newsletter and books on animal care, welfare and rights, is a veterinarian with doctoral degrees in medicine and animal behavior. Send letters to animaldocfox@gmail.com or write to him at United Feature Syndicate, 1130 Walnut St., Kansas City, Mo. 64106.

2015 United Feature Syndicate