confused about the cascade regs!

Re: confused about the cascade regs!

Richard Carter — Fri, 17 Apr 2015 12:08:59 GMT

and the few million of rabbits previously given usual ketamine (unlicenced) at well researched dosages with well understood side effects are all doomed to hell?? or just the vet? I remember a ketamine that only had a horse licence but when the other was unavailable mysteriously seemed to work just as well as the other one.

Re: confused about the cascade regs!

Bob Russell — Fri, 17 Apr 2015 11:37:54 GMT

[quote user="Braden Collins"]

[quote user="Joyce Whitehead"]I'm just resurrecting this thread having had our Animalcare rep in this morning. They have just brought out a new ketamine injectable, but interestingly ( and cleverly on their part) they have licensed it for rabbits. So to keep within the cascade, we should be using this one on rabbits, not any alternative. It's a bit disingenuous of them, but no different to licensing of existing drugs for animals. Fortunately it seems very well priced...

[/quote]

A great example of a drug company turning more and more vets against the cascade........

[/quote]

Not in my opinion. Good for them! They have put some effort into getting a licence but have made no effort to profiteer from it! An advantage to them only in as much as vets should use it over existing competitors. They can also add rabbits to the licence should they wish to present the information and pay the fee!

If the licence comes with advice and guidance even better!

Re: confused about the cascade regs!

Braden Collins — Fri, 17 Apr 2015 10:22:00 GMT

[/quote]

A great example of a drug company turning more and more vets against the cascade........

Re: confused about the cascade regs!

Joyce Whitehead — Thu, 16 Apr 2015 14:48:03 GMT

I'm just resurrecting this thread having had our Animalcare rep in this morning. They have just brought out a new ketamine injectable, but interestingly ( and cleverly on their part) they have licensed it for rabbits. So to keep within the cascade, we should be using this one on rabbits, not any alternative. It's a bit disingenuous of them, but no different to licensing of existing drugs for animals. Fortunately it seems very well priced...

Re: confused about the cascade regs!

Robin Grimmer — Sun, 12 Apr 2015 14:24:31 GMT

[quote user="Anthony Todd"]

[quote user="Evelyn Barbour-Hill"]They don't? [/quote]

Don't they?

although many of the practices I locum for do give the obligatory shot of Amox LA -

From a recent thread on the very subject.

[/quote]

Probably the dinovet practices ;)

Re: confused about the cascade regs!

Anthony Todd — Sat, 11 Apr 2015 20:09:42 GMT

[quote user="Evelyn Barbour-Hill"]They don't? [/quote]

Don't they?

although many of the practices I locum for do give the obligatory shot of Amox LA -

From a recent thread on the very subject.

Re: confused about the cascade regs!

Evelyn Barbour-Hill — Sat, 11 Apr 2015 15:58:03 GMT

[quote user="Robin Grimmer"]I'm glad now that mod vets as you call them don't give unnecessary injections just to make the owners feel better or throw antibiotics at everything when they are not needed.[/quote]

They don't?

Re: confused about the cascade regs!

Anthony Todd — Sat, 11 Apr 2015 14:46:09 GMT

[quote user="Robin Grimmer"]unnecessary injections just to make the owners feel better[/quote]

They always relieved animal suffering which, I've always believed as did most dinovets, was more important than getting a diagnosis which, even modvets would agree, often made very little difference to the subsequent but eventual treatment .

We just gave it at the start, not the end.

[quote user="Robin Grimmer"]throw antibiotics at everything when they are not needed.[/quote]

And how many of you give antibiotics to routine "sterile" operations still, in 2015?

Most of the young graduates I employed did.

No dinovet I know ever did, even 40 years ago; I never did, nor did any of my colleagues.

Re: confused about the cascade regs!

Robin Grimmer — Sat, 11 Apr 2015 13:05:52 GMT

[quote user="James Laidlaw"][quote user="Anthony Todd"]

[quote user="Martin Atkinson"]what would you have done if the EU had banned corticosteroids?[/quote]

Never mind about me, what about all those animals tearing themselves apart whilst modvets withheld treatment until they had a definitive diagnosis.

And then all they had were antihistamines or an elizabethan collar....

On reflection, just don't give the VDS the idea!!

[Geez, back in the day at West Drayton I'd have had 5 people waiting by 5.30 and I'd already have given B12 and Bets to the first 10 or so.

You modvets don't know you're alive!!]

[/quote] I'm so glad our jobs are totally free of such stress now and the suicide rate has pretty much dropped to zero.

[/quote]

I'm glad now that mod vets as you call them don't give unnecessary injections just to make the owners feel better or throw antibiotics at everything when they are not needed.

Re: confused about the cascade regs!

James Laidlaw — Sat, 11 Apr 2015 11:04:05 GMT

[quote user="Anthony Todd"]

[quote user="Martin Atkinson"]what would you have done if the EU had banned corticosteroids?[/quote]

Never mind about me, what about all those animals tearing themselves apart whilst modvets withheld treatment until they had a definitive diagnosis.

And then all they had were antihistamines or an elizabethan collar....

On reflection, just don't give the VDS the idea!!

[Geez, back in the day at West Drayton I'd have had 5 people waiting by 5.30 and I'd already have given B12 and Bets to the first 10 or so.

You modvets don't know you're alive!!]

[/quote] I'm so glad our jobs are totally free of such stress now and the suicide rate has pretty much dropped to zero.

Re: confused about the cascade regs!

Bob Russell — Sat, 11 Apr 2015 10:56:19 GMT

I interpret some laws with a degree of flexibility. If I get caught using a bottle of stuff on day 30 I will pay for it to be analysed for contamination!

We have ketamine in our PTS box that has gone over the 28 day period for those nightmare euthanasias. I can assure everyone that it works fine! we have a very informal register for that stuff so it can be accounted for and it is not added to the owners bill.

Re: confused about the cascade regs!

Anthony Todd — Fri, 10 Apr 2015 17:33:06 GMT

[quote user="Martin Atkinson"]what would you have done if the EU had banned corticosteroids?[/quote]

Never mind about me, what about all those animals tearing themselves apart whilst modvets withheld treatment until they had a definitive diagnosis.

And then all they had were antihistamines or an elizabethan collar....

On reflection, just don't give the VDS the idea!!

[Geez, back in the day at West Drayton I'd have had 5 people waiting by 5.30 and I'd already have given B12 and Bets to the first 10 or so.

You modvets don't know you're alive!!]

Re: confused about the cascade regs!

Martin Atkinson — Fri, 10 Apr 2015 16:11:12 GMT

[quote user="Anthony Todd"]

Sorry, but the obvious, to me, baloney of the VDS just gets me going so I over react to anything remotely related to drug safety and the VDS.

[/quote]And you don't even have to put up with it as you're retired, what about us poor sods? If you think the cascade and 28 rules are bad, what would you have done if the EU had banned corticosteroids?

Re: confused about the cascade regs!

Anthony Todd — Fri, 10 Apr 2015 12:32:50 GMT

Sorry, but the obvious, to me, baloney of the VDS just gets me going so I over react to anything remotely related to drug safety and the VDS.

Re: confused about the cascade regs!

Luca Poddighe — Fri, 10 Apr 2015 10:41:32 GMT

[quote user="Martin Atkinson"]

[quote user="Anthony Todd"][sigh] I'll spell it out...[/quote]At risk of prolonging the agony it still doesn't answer the question which was: 'What is it about European air that is more contaminating'? You've lost your ability to spot sarcasm Anthony (and I clearly have too much time on my hands)!

[/quote]

may be it's my fault

Re: confused about the cascade regs!

Martin Atkinson — Fri, 10 Apr 2015 10:20:02 GMT

Re: confused about the cascade regs!

Anthony Todd — Thu, 09 Apr 2015 17:55:08 GMT

[quote user="Martin Atkinson"]That's not the answer to the question asked![/quote]

[sigh] I'll spell it out...

USA and NZ are not governed by the 28 day rule by which the Europeans are. The European rule is a copy and paste from the medical regs. which do not allow any [?] multidose containers of injectibles anyway.

The drug companies here must have been devastated when the VMD introduced the "chuck after 28 days" rule based on absolutely no evidence at all except, I wager, the evidence provided that showed that after 28 days the drug was safe and at full potency.

This may well be the case at 28000 days but, of course, why would any drug company want to show that....

I wonder whether more perfectly fine drugs are chucked than are ever used after these regulations were introduced?

Re: confused about the cascade regs!

Martin Atkinson — Thu, 09 Apr 2015 11:31:28 GMT

[quote user="Anthony Todd"]USA and New Zealand aren't in the EU........[/quote]That's not the answer to the question asked!

Re: confused about the cascade regs!

Anthony Todd — Wed, 08 Apr 2015 19:52:23 GMT

[quote user="Fenella"]

Also, why does Convenia have a 28 day rule on it's EU data sheet, but a 56 day rule in other countries like USA and New Zealand? What is it about European air that is more contaminating??

[/quote]

USA and New Zealand aren't in the EU........

Re: confused about the cascade regs!

Fenella — Wed, 08 Apr 2015 17:01:49 GMT

Also, why does Convenia have a 28 day rule on it's EU data sheet, but a 56 day rule in other countries like USA and New Zealand? What is it about European air that is more contaminating??

Re: confused about the cascade regs!

Anthony Todd — Wed, 08 Apr 2015 16:24:46 GMT

[quote user="Bob Russell"]The 28 day rule [/quote]

I think it is a copy and paste from the human European regs., as has been discussed before.

Funny how injections could be used for yonks before the VMD then, overnight, after 28 days they became unsafe.

Re: confused about the cascade regs!

Bob Russell — Wed, 08 Apr 2015 15:48:39 GMT

The 28 day rule is an arbitrary number, plucked out of the air. Can any bottle be guaranteed free from contamination for 28 days? Are they suddenly contaminated on day 29?

I believe this is a bandwagon that the pharmaceutical companies have been more than delighted to jump on! Perhaps there is more logic in stating a maximum number of times a vial should be broached before being discarded!

A product with preservative is likely to cope with more broaches than one without.

Re: confused about the cascade regs!

Thomas Johnson — Wed, 08 Apr 2015 15:14:13 GMT

[quote user="Martin Atkinson"]

[quote user="Thomas Johnson"]I understand what you're saying, but these aren't donations, they're the fees charged by the VMD to process an application for a drug license. Who else is going to pay for the license application other that the company that wants the license?[/quote]This may be so but there still needs to be some clear daylight between the receiver of the fees and the maker of the rules.

It wouldn't smell so bad if the 28 days rule wasn't so random and so clearly not considered in purely scientific terms. And the main reason for the cascade wasn't to protect the interests of pharmaceutical companies not the patient. And if companies weren't allowed to register generic drugs we have been using for decades through the back door of the cascade, re-badge them POM-V then sell them for several times the price.

Perhaps you can see why we may be a little sceptical of conflicts of interest.

[/quote]

Is the situation not similar to the RCVS and new vet schools? The remit of the VMD is to make a judgement on whether the drug does the job the manuafacturer claims it does, not whether there is a need for the drug.

You'd need a change in legislation to stop pharmaceutical companies being able to license generic drugs for veterinary use, or to make changes to the cascade.

I would however very much like to know where the 28 day rule comes from. If Cartrophen is okay for 3 months why aren't other drugs as well?

Re: confused about the cascade regs!

Martin Atkinson — Wed, 08 Apr 2015 14:41:47 GMT

Perhaps you can see why we may be a little sceptical of conflicts of interest.

Re: confused about the cascade regs!

Bob Russell — Tue, 07 Apr 2015 16:39:55 GMT

Many of the human equivalents used to be really cheap compared to the licenced equivalents. Many of these now fall into the category of 'orphan' products, only manufactured by one or two companies. They are then able to charge whatever they like!

For all my adult life I have been on medication that was made by Pfizer and cost less than £30 a month. It is now manufactured by a company in Ireland (now the only company that makes it). It costs between £300-400 a month! Not bad for a change of outer packaging, the capsules still have the old name printed on them!

I am not a fan of cascade, I think we should be professional enough to control what we dispense but it should be a requirement that owners have things explained to them.

I think cast should be a consideration and owners allowed to decide if they want to give a 10p capsule or a £1.00 tablet with the same ingredients. Abuse would be someone selling the 10p capsule at the £1 price!

Human fucibet is half the price of fuciderm/isaderm even through the veterinary wholesalers.