Client taking the dog's drugs!

Re: Client taking the dog's drugs!

Stephen Courtney — Tue, 19 Mar 2013 21:29:21 GMT

It's B12, not a controlled drug.

I'm not a policeman and I don't think, in the great scheme of things, it matters. I am a great believer in personal freedom, the client is an adult and can make her own choices, assuming she is considered legally responsible for her actions. How it could be considered the VS's responsibility is beyond me, yet I am aware of unfairness in the way the law is applied.

So put it another way - could the client prove that the VS knew what she was doing with the drug, and thereby by omission either condoned her actions, or gave the impression that they were condoned?

Re: Client taking the dog's drugs!

Rob Loxley — Tue, 19 Mar 2013 18:04:52 GMT

[quote user="Michael Woodhouse"]Once we dispense a drug with instructions it is outside of our control[/quote]

Indeed, but if you know misuse is happening should you just stick you head in the sand?

Re: Client taking the dog's drugs!

Michael Woodhouse — Tue, 19 Mar 2013 13:51:54 GMT

[quote user="mariette asselbergs"]Interesting that you give people who inject their dogs/cats at home a sharps container. Do farmers need to have a sharps container? Good idea, but never seen one on farm. On the contrary: often seen syringes with uncapped needles lying around in the milking parlour or sheep shed. Once made the mistake to say something about it. Farmer promptly moved to other vet......[/quote]

Pretty much all our farmers have sharps bins - I believe a requirement for farm assurance. Despite the fact that the cost of the bin includes disposal I'm not sure I've had a full one back yet!

Diabetic dogs owners return syringes to us for disposal. Next one will be sold a sharps bin. It's a PITA - especially as the needle attached to the syringe.

Once we dispense a drug with instructions it is outside of our control.

Re: Client taking the dog's drugs!

Rob Loxley — Mon, 18 Mar 2013 23:08:15 GMT

Having been made aware of this, why not dispense 4x weekly injections in preloaded syringes every month?

Re: Client taking the dog's drugs!

Nicola Lawlor — Mon, 18 Mar 2013 22:13:03 GMT

As suggested further up the post I think you need to contact the VDS (or whoever your liability insurer is) to ask them this question as ultimately if something goes wrong they are the ones with whom the financial impact will lie. Perhaps also a call to the VMD for advice too as then if needs be you can justify your position to the RCVS about why you made the decisions that you did in this specific case.

Re: Client taking the dog's drugs!

mariette asselbergs — Mon, 18 Mar 2013 21:31:39 GMT

Interesting that you give people who inject their dogs/cats at home a sharps container. Do farmers need to have a sharps container? Good idea, but never seen one on farm. On the contrary: often seen syringes with uncapped needles lying around in the milking parlour or sheep shed. Once made the mistake to say something about it. Farmer promptly moved to other vet......

Mariette

Re: Client taking the dog's drugs!

An On MRCVS — Mon, 18 Mar 2013 16:32:16 GMT

Thanks for suggestions,

However the issue is more re dispensing these drugs as it is a pom-vps and how would RVNs stand if the suggestion of the owner injecting herself (which has been admitted to VS) became a problem??

Thanks

Re: Client taking the dog's drugs!

Stephen Courtney — Mon, 18 Mar 2013 14:04:14 GMT

We include the cost of the sharps disposal with the cost of the syringes and needles - this mainly applies to caninsulin syringes these days.

the price includes disposal, if clients want to get their syringes off the interweb then disposal charged separately.

Re: Client taking the dog's drugs!

Utlendigur — Sat, 16 Mar 2013 15:14:21 GMT

Does she get a whole bottle at a time? Presumably she throws it away after 28days aswell

Re: Client taking the dog's drugs!

Rob Loxley — Sat, 16 Mar 2013 14:47:44 GMT

[quote user="Martin Atkinson"]Do you charge your clients for their sharps container and presumably if your are following 'elf and safety rules to the letter you seal up their container and get it collected for disposal - do you then charge back what it costs you to the client?[/quote]

And presumably the attendant paperwork unless you have an agreed exemption from the EA... ?

Re: Client taking the dog's drugs!

Martin Atkinson — Sat, 16 Mar 2013 11:51:01 GMT

[quote user="Stephen Courtney"]ALL my clients who home inject - B12, insulin, or anything else, get a sharps bin. Recapping needles is a significant source of needle injuries in human medicine, and i think it is better clients don't do it.[/quote] Overall I would agree with your main answer. As for this specific quote: my clients are told to store their sharps in a rigid container then they bring them in for us to dispose and they are tipped straight into the main sharps bin. Do you charge your clients for their sharps container and presumably if your are following 'elf and safety rules to the letter you seal up their container and get it collected for disposal - do you then charge back what it costs you to the client?

Re: Client taking the dog's drugs!

Stephen Courtney — Sat, 16 Mar 2013 10:46:04 GMT

You prescribe it for the dog, not the client. What the client does with it is not under your control. If the dog needs the product then you have to continue to supply it, otherwise the dog may suffer.

I would advise the client that as a VS you are not allowed to prescribe for humans, and would not recommend that she takes the medication. I would record that advice and take it no further. If you start discussing risks like injection abscesses, septicaemia etc it might raise questions over the safety of home injecting the dog, and then by extension, that same injection being given by a VS or VN in the surgery...

The other issue is where does she get the needles and syringes from? if she is using vet prescribed sharps on herself, that is also an issue, but again it is something you have no personal control over. does she have her own sharps bin? I would not like a client to return recapped needles to our staff if she had injected herself with them. ALL my clients who home inject - B12, insulin, or anything else, get a sharps bin. Recapping needles is a significant source of needle injuries in human medicine, and i think it is better clients don't do it.

I believe that for humans the dose of B12 is 1ml per week, given by IM injection into the thigh with an insulin type syringe. Using anything larger would add to pain and discomfort and possibly increase the risk of morbidity, as vets usually prescribe it subcut, and the needles and syringes we use in animals are more appropriate for this.

Re: Client taking the dog's drugs!

Hanna Bennett — Fri, 15 Mar 2013 20:28:17 GMT

contact the VDS for advice?

Re: Client taking the dog's drugs!

Mark Rowland — Fri, 15 Mar 2013 19:23:10 GMT

You have to refuse to prescribe if you think there is abuse surely.

Re: Client taking the dog's drugs!

james herriot lied — Fri, 15 Mar 2013 19:23:05 GMT

Simple. Vit B12 preps are generally VPS, so point the lady at your local seed merchant's and hey presto, let them worry about it.