January 1st, 2012 Issued by: Rood and Riddle Equine Hospital Compounding Pharmacies: The Real Truth Bart Barber, DVM

“Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health [and] the relief of animal suffering…….” Veterinary oath

The ability of the veterinarian to relieve animal suffering has made enormous advances in the past 50 years. Our understanding of disease processes, the development and refinement of surgical technique and our diagnostic abilities have been vastly improved over recent decades. Imagine what James Herrriot would think of digital radiography or MRI. It’s a great day to be a veterinarian!

The advancement that has probably had the broadest affect is the improvement in our drug arsenal. Diseases that were death sentences for animals a few years ago are now cured by a few simple injections or a course of tablets. What can currently be done with pharmaceuticals is nothing short of a miracle. It seems certain that the greatest improvements that lie ahead of us will also come from this avenue.

One of the resources that we have for obtaining medications is through compounding. Compounding is defined as the manipulation of one or more drugs to form a new one. Many times an animal may require a medication that is not commercially available in the appropriate strength, in a flavor for maximum palatability, or a suitable method of administration. Compounding encompasses everything from something as simple as mixing two injections, to far more complex formulas. It is an essential part of our own human health care system as well as veterinary medicine. Without this resource many of the tools we have to combat disease and suffering would be unavailable to us and we would, in fact, be no better off than we were 50 years ago.

One truth in compounding is that not all compounding pharmacies are equal. Compounding pharmacies are not subject to the same oversight and regulations that drug manufacturers are. There have been some who, because of this lack of oversight, have produced compounded medications of poor standards, or have produced compounds to make a profit rather than to fill a legitimate need. These bad practices have given compounding in general a black eye. It has also left many wondering who they can trust and what is legal and ethical in compounding. The issues are broad and there are many interpretations. Those who are very familiar with compounding talk about the black and white issues as well as the gray ones. For the casual observer it can be very confusing and time consuming to sort out the issues.
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