Accidentally Got Liqiud Antibiotic in Morty's Eye

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Lynx
Celebrate!!!

Post   » Fri Jan 15, 2021 7:39 pm


Depending on the dose and form of the Vetmedin, it is possible you might be able to compound it yoursel - if they are crushing a number of pills and putting them into a suspension.

Here is a topic about a member (who happened to be a nurse) who compounded a heart medication for her guinea pig:
https://www.guinealynx.info/forums/viewt ... =3&t=18899

amberkenn2016

Post   » Sat Jan 16, 2021 12:30 am


Thank you for the reference! Apparently they're getting the Vetmedin in as a special order because the kind they have is for dogs, is what I was told. I figure it's the same drug, just at a higher concentration, so why couldn't they just put a smaller dosage to it? But I digress. Morty seems to be doing pretty good this evening, so I'm willing to wait to get that Vetmedin. I will definitely look more into it though if I can't get a hold of the Vetmedin from the vet within a reasonable time frame.

User avatar
Lynx
Celebrate!!!

Post   » Sat Jan 16, 2021 9:59 am


I believe enalapril is a human med so available in pill form for prescription - and then that would have been compounded. The dog form if a liquid (and not available as a pill that is compounded) could be made easier to measure by simply doubling the volume of the suspension liquid. Perhaps you can talk to your local human pharmacist to see what is available over the counter.

Here is an exhaustive explanation of compounding, when it is done and who does it according to the AVMA (American Veterinary Medical Association):

Compounding FAQ for pet owners
https://www.avma.org/resources-tools/an ... pet-owners

They describe when a drug might be compounded, specify it should be done by a compounding pharmacy, and note that a compounded drug may not work quite the same as the original form. There is even accreditation for veterinary compounding by http://www.pcab.org/ , the Pharmacy Compounding Accreditation Board, for example (I think there are other accreditation boards).

One online pharmacy notes:
https://bcpvetpharm.com/products/suspensions
Suspensions
When compounding a medication it is the solubility of drug that determines whether it is a suspension or a solution. If a drug is insoluble yet stable in a liquid, it can be compounded into a suspension. In a suspension, the drug is first coated, preventing it from adhering together, then it is added to the liquid. This process enables even dispersion of the drug throughout the entire volume and more accurate dosing. If a drug is soluble and stable in a liquid, it is compounded into a solution.
Shelf life may be as short as two months. Suspensions should be shaken well before each use. This site requires a veterinary prescription (they appear to be a compounding pharmacy).

Oh, and I stumbled on a cool study evaluating the potency of enrofloxacin in three different suspensions, stored at room temperature in amber vials:

Stability of three commonly compounded extemporaneous enrofloxacin suspensions for oral administration to exotic animals
https://pubmed.ncbi.nlm.nih.gov/23786194/
Abstract
Objective: To evaluate the stability of 3 extemporaneous oral suspensions of enrofloxacin mixed with readily available flavoring vehicles when stored at room temperature (approx 22°C)...

Procedures: On day 0, commercially available enrofloxacin tablets were compounded with a mixture of distilled water and corn syrup (formulation A) or cherry syrup (formulation B) flavoring vehicles to create suspensions with a nominal enrofloxacin concentration of 22.95 mg/mL, and 2.27% enrofloxacin injectable solution was compounded with a liquid sweetener (formulation C) to create a suspension with a nominal enrofloxacin concentration of 11.35 mg/mL. Preparations were stored in amber-colored vials at room temperature for 56 days. For each preparation, the enrofloxacin concentration was evaluated with high-performance liquid chromatography at prespecified intervals during the study. The pH, odor, and consistency for all suspensions were recorded at the start and completion of the study.

Results: Relative to the nominal enrofloxacin concentration, the enrofloxacin concentration strength ranged from 95.80% to 100.69% for formulation A, 108.44% to 111.06% for formulation B, and 100.99% to 103.28% for formulation C. A mild pH increase was detected in all 3 suspensions during the study.

Conclusions and clinical relevance: Results indicated that, when stored in amber-colored vials at room temperature for 56 days, the enrofloxacin concentration strength in all 3 formulations was retained within acceptance criteria of 90% to 110%. Subjectively, cherry syrup flavoring was better at masking the smell and taste of enrofloxacin than were the other mixing vehicles.

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ItsaZoo
Supporter in 2023

Post   » Sat Jan 16, 2021 11:48 pm


There have been supply problems with VetMedin for quite a while, something to do with paperwork at the manufacturer, which is based in Mexico. My vet has me reordering 3 weeks before I run out. And there is no alternative or generic available. It was developed and approved for dogs, so the use in cats and other animals is off-label. It is also difficult to compound because it doesn't mix with liquids very well, so it's tricky to get the dosage right. And if you have to syringe the liquid, particles may cling to the inside of the syringe.

User avatar
Lynx
Celebrate!!!

Post   » Sun Jan 17, 2021 8:36 am


That is interesting information. Sounds like not all drugs are easy to compound! In the link I found above to a compounding pharmacy, and quoted material mentioned that some drugs are coated before being put in a suspension.

amberkenn2016

Post   » Thu Feb 04, 2021 9:45 pm


As I type this, Morty has been hooting for about 2 hours now. He's had an episode like this before, but it went away by the morning. We haven't changed his meds other than adding in the Vetmedin 2x a day at 0.2 cc. We don't have any 24/7 vets nearby to head to, and the closest one is about an hour and a half away. I don't know if it would be worth stressing him out and risking him dying on the way.

I don't know what to do? We've been doing great with his meds and I don't know if I should increase them to help him get through the night. I want to do what's best for him and right now I can tell he's having trouble breathing because of the hooting he's doing. Does anyone have advice, please?

User avatar
Lynx
Celebrate!!!

Post   » Thu Feb 04, 2021 10:43 pm


Besides the hooting, is he struggling to breath? Are his lips pale or bluish?

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ItsaZoo
Supporter in 2023

Post   » Thu Feb 04, 2021 11:51 pm


If his lips are pink and he is not gasping or rocking as he breathes, it’s possible that he inhaled some dust or a small bit of hay into his nostrils. Many times that causes hooting and it can go on for a couple of hours, then they cough a bit and clear it away.

This is an especially scary situation since you’re treating heart issues. I hope it clears.

amberkenn2016

Post   » Fri Feb 05, 2021 12:39 am


His lips are still pink as ever and I hear a small bit of rasping. I've also noticed that he's kind of dribbling at the mouth, which is usually a sign to me that he's not improving. The hooting is still happening unfortunately, but he's still as active and interested in food as he always is.

I've always housed him on a combo of paper bedding and fleece, the paper being in high traffic areas that gets soiled very easily. I wonder if changing this will help him?

ClemmyOddieIndy

Post   » Fri Feb 05, 2021 1:23 pm


I'm sorry to hear about your pig. I had a pig in heart failure, but it's been a long time ago. I think she died in 2013. She was on furosemide and something else (maybe Vetmedin, but it's been so long I can't remember). I think she lived about a year if I remember right, but it wasn't the heart failure that got her it was cancer. I had a dog in severe heart failure for years. She had many bad days, but we lived for the good days. She eventually had a stroke and died on the way to the vet.

amberkenn2016

Post   » Fri Feb 05, 2021 1:50 pm


Thank you for sharing that. It's been 5 months since his diagnosis, so I would think you're very lucky to have had yours for that long. Right now he's been hoot free for the past, maybe 6 hours? So I'm holding onto hope that he's slowly improving. I've practically been living just outside the cage keeping an eye on him while I go about my day. Hopefully I'll be able to update with more good news!

amberkenn2016

Post   » Fri Feb 05, 2021 10:36 pm


Okay, very dumb question here, but we just got a new bottle of liquid enalapril. It's quite the drive to get there and back, so I thought it'd be smart to get a bag of ice and keep it near the bottle to keep it cold because we were told to keep it cold. I noticed that once we got home, I think I saw a small part of the solution frozen. Is this going to affect the medication?

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