Category Archives: Medications

Medications used as part of Veterinary Care

Assessment of Silybin / Which is Pretty Much “Denamarin” (Of Which I Hold a Low Opinion)

Denamarin was a “me too” veterinary preparation of Milk Thistle sold as a ‘proprietary’ answer to the far-more-effective “Urso” which is ‘ursodehydrocholic acid’ and had been working WELL for liver disease, cirrhotic, fibrotic, infectious….But Veterinarians didn’t ‘control’ the drug and there was a generic.

Milk Thistle contains minuscule amounts of UDCA and so it was a “me too” but didn’t work as well. So I stuck with Urso.

Denamarin contains SILYBIN as well, which is a ‘not-inconvenient’ delivery system for flavonoids. Those are ‘oils’ that can come from various thinks like Palmarosa oil, etc. Except Silybin contains SEVERAL Flavonoids.

So, I went out and found a decent study that performed to HUMAN-level stakes of research quality and reviews of thousands of pieces of literature. Thank god I didn’t have to do it LOLOLOL

Here’s the publication, in it’s entirety and not to decrease the economic value of the original document nor use it in a commercial measure. Fair use.

This document is a records review of numerous human studies on Silybin, the active in Denamarin.

How To Get Medicines Online Without a Prescription

How To Get Medicines Online Without a Prescription

Key points: You’re not encouraged to do this because you may get dangerous or illegal compounds. You could be included in a ‘situation’ when and if these online pharmacies are plundered by the authorities. You’re giving your credit card information to “this kind” of people. Past that, this is not a recommendation but instead, an illustration of what I’ve always said: Online Pharmacies are like the ‘kiddie-pool’ version of real pharmacies.

I’ve always maintained that online Pet Pharmacies are a bunch of stoned clowns sitting in a sweaty warehouse somewhere in Florida. Maybe there’s a real pharmacist working from home, with some Bolivian license and nothing to lose. They sure aren’t LOOKING at the prescriptions.

I went online and bought a pack of heartworm pills from the biggest shots and Pet Medicine vendor out there. No prescription, on Autofill.

I called my dog “Diabetes Boy”, and in the field for: “Last heart worm test” I entered “POSITIVE” and no shots.  Surely this real, “person” pharmacist will read this signalment and kick it out or raise an alarm*.

Nope.

That was in September and I got a prescription authorization to approve at the time of the order. It was checkboxes. You could give them YOUR fax number and handle that yourself, they don’t care. I simply didn’t respond and waited. I honestly figured that would be the end of it. Salute: ‘Job well done’, online Pharmacy! You surprised me!

It’s March. My order charged out, and shipped. I have a box of Heartguard from France.

What happens, is that the Autofill is not overseen by anyone either. That so-called “pharmacist” who never looked at the prescription authorization to begin with, never noticed “Heartworm positive, no shots”, or the name “Diabetes Boy” and then the autoship triggers automatically at 6 months.

And the thing is, that’s not using a fraudulent prescription or doing something wherein you share culpability in ‘tricking‘ the pharmacy. That’s just legit pharmacy law violation of the highest order.

I wonder if those clowns would autofill Codeine or something really dangerous? So, sure you’d have to wait 6 months to start getting your prescription medications shipped without a doctor’s visit or prescription, but once it was rolling…..think an actual “person” would ever even look, or care?

I’m sure NOT.

 

*All documentation can be provided to your legal counsel. I’m going to make the investigation into your own quality control cost you something.

*I’m going to try and buy a tylenol-containing therapeutic / medication or perhaps a dog-only flea control for my cat (fatal if given) and see if the “pharmacist” even kicks that out. Remember, I’m not doing this as “me” (a veterinarian). I’m doing this as a regular customer without announcing myself. Just “Erik Johnson” from my home address.

Can you imagine if you could just order some heart medicine for yourself that you guess you need, at the HUMAN pharmacy and they’d just try and get authorization from some fax machine you give them?  Yeah, that’s how it works in pet medicine.

 

99% of Microbiome Germs Are Mysterious

99% of Microbiome Germs Are Mysterious

Science has discovered, by identifying the tiny pieces of DNA from bacteria in our brains and muscles and organs, that we are absolutely swarming with germs that we depend on to live (Microbiome). We also know that antibiotics kill some of those germs, and we don’t even know what their function is. But we do know that there is one particular germ in the microbiome that influences the liver to produce anti-cancer enzymes. The purpose of this recording is to explain to you what they’ve learned about these mystery germs and what the impact is, in the discovery that we cannot grow or study 99% of the germs that make up our microbiome.

99% of Microbiome Germs Are Mysterious

99% of Microbiome Germs Are Mysterious
We thought if a germ didn’t grow, that it didn’t exist. Now we know that 99% of germs won’t grow on a dish.

Robitussin DM (Guaifenesin) For Dogs

Robitussin DM (Get it)

Has been recommended for your dog. (Printable version)

There’s good news, by the way. Robitussin DM is available in a pill form. When you’re dosing that, there are two parts: Guaifenesin and dextromethorphan. You dose based on the Guaifenesin. So the dose for Guaifenesin in dogs is 3-5mg per kg up to every 4 hours. (wow!)

If you have a tablet that’s 100mg Guaifenesin, you leave the Dextromethorphan out of the equation and just calculate the guaifenesin.

So if you have a 14 pound dog, that’s 6.6 kilograms. So the dose could be as low as 19mg up to 35mg.

Guaifenesin is VERY safe for dogs. So you could either dose 1/3rd tablet to hit the 33mg dose. Or, just use a half tablet to give 50mg and don’t worry about it. There are practically no cardiac effects.

This advice is definitely not for all coughing dogs. Heck, it’s probably not even appropriate for the majority of coughing dogs. This (guaifenesin) is a poor choice for dogs with congestive heart failure. It’s a poor choice as monotherapy for respiratory infections. It’s a poor choice as monotherapy for pulmonary allergies without also addressing the inflammatory component of said allergies.

This has worked well for “real” kennel cough, and (surprisingly) for pulmonary hypertension and ‘hyperinflation’ in very old dogs where “nothing else worked”. I have only a vague idea why and how that works.  No matter, as long as it does.

The dose is 2cc per 20 pounds every 8 to 12 hours IF NEEDED (don’t give it if the dog doesn’t even need it)

You’ll see:

  1. Less coughing
  2. Less gacking
  3. Easier breathing.

It is CRITICAL that you do not ACCIDENTALLY buy

  1. Off-brand
  2. Something OTHER than the “DM” formula
  3. Anything with phenylephrine or phenylpropanolamine

Here’s the “finesse” of dosing, and the reason for this ‘article’

Dosing Robitussin DM For Dogs

Start with 1cc per ten pounds. You’ll need a dosing syringe from the office or Amazon.

If you “don’t see anything” (No effect of sedation OR control of cough / gack) then increase dose to 2cc per ten pounds.

A 10 pound dog starts out at 1cc every 8 to 12 hours “as needed” for cough / gack.

If you “don’t see anything” (good or bad) after a dose or three, double up to 2cc every 8 hours as needed. As the dog’s overall weight is higher and higher, the amount you give scrolls up a little bit, not even in a linear fashion, see chart.

Robitussin DM For Dogs
Robitussin DM For Dogs

DHEA 2019

DHEA

So there are hormone systems in the body which involve testosterone in males and estrogen in females. Those hormones are vital in the performance of the young male or young female dog or cat, reproductively, as well as for strength, endurance, overall health, muscle mass bone density fitness. Very solid studies have demonstrated that sex-hormones a protective for many cancers, decreasing the odds of cancer in people and animals (when present) by 8-10%.

In people these crucial hormones are produced in the “gonads” which are the testicles or the ovaries.

People and animals also synthesize DHEA in their gonads. Humans (not animals) can also produce DHEA in their adrenal gland and that matters as you will soon see.
But let’s stick a pin in that.
Science has discovered another hormone called “DHEA” which functions at the cellular level very much the way our sex hormones affect us. High levels of DHEA in male tissue can elicit some of the same changes as testosterone. In females high levels of DHEA may function beneficially as estrogen. In humans, DHEA is produced in the adrenal glands at a certain basic level.

In the dog however, DHEA is produced ONLY in the gonad.

So here’s the thing, in a dog or cat when you spayed or neutered them, you are removing their sex hormones as well as their DHEA because they do not produce DHEA in their adrenal gland. The “adrenal” is the gland we leave behind when we performed ‘gonadectomy’ for a pet.
So your animal has no hormonal support of any kind, for its lifetime, not even DHEA. And there is a price to be paid (long-term) for that.
So a recent “fad – bandwagon” in television / Youtube Vet practice is administering DHEA to animals hoping to appreciate some of the benefits of hormones support on those animals. And in fact the results are initially encouraging.

DHEA
This is the DHEA that I take on the daily. It has the Keto-7 metabolite and regular DHEA for a total of 125mg

However, when you put DHEA into an animal system, you are giving a signal for tissue building, and the activation of a lot of activity,  metabolically. In other words the body suddenly needs the building blocks for the processes that the DHEA is calling up. Sadly there is not a limitless supply of these building blocks and so certain enzyme systems such as nADP and nADPH are exhausted with time, as
DHEA is given. Does it matter in a year? Probably not.

But for long-term use of DHEA, or high dose DHEA, research has been done to determine what enzymes and compounds become deficient metabolically in animals given DHEA; and research is forging ahead to try to bring a product (of a safer nature) to market in 2019. In the meantime supplement of high-dose DHEA to dogs should be endeavored only when the benefits outweigh the negative side effect of metabolite exhaustion.
In my opinion any dogs that is ill, very old, suffering a deteriorating quality-of-life, have little to lose in the effort to gather the benefits of DHEA therapy versus the eventual exhaustion of certain metabolic
processes. Anti-cancer benefit have been noted with DHEA supplementation, research on that is continuing.
Weight Dose Times Per Day
< 10 lb give 5 to 10 mg – 1-2x daily
10-20 lb give 25mg – 1x daily
20-30 lb give 25mg – 2x daily
30-50 lb give 50mg – 2x daily
50-80+ lb give 100mg 2x daily

Some dogs experience agitation. (That’s been 2-3 cases in as many years. Which is why MORNING dosing is good.
Some dogs can have a very untoward reaction to DHEA. That is uncommon, but it looks like this: Fever, joint pain, skin rash and even sores around the mouth and eyes. That’s CRAZY rare and may not even happen in dogs. It happens in people sometimes, and they don’t know why. (Stevens-Johnson Syndrome)

Obtaining DHEA can be simple, but there are caveats. For this to be even worth it, you might want to get a pharmaceutical grade DHEA which are available on Amazon.com and here are the names of two
laboratories that will produce and sell pharmaceutical grade: “Douglas Labs” and “Pure Encapsulations”. Both are commonly relied upon by medical professionals in the human field.
As with any promising nutritional supplement, the FDA has not had time to evaluate the many assertions made about DHEA, and we know there are some karri = a reckoning risks in terms of a reaction among certain dogs as well as eventual deleterious effects latently and possibly sub clinically. In the meantime the benefits probably outweigh those risks. If your pet is weak, very old, sick, or experiencing a deterioration in quality-of-life, which is the reason this information is being provided for you and this recommendation is being made.

What follows is my 2019 Review of DHEA and canines, felines. It’s based on case experience and has some revised dosing and precautions.
canine dhea impact

https://drjohnson.com/wp-content/uploads/2019/12/DHEA-REVISIONS-BASED-ON-CLINICAL-EXPERIENCE-2018.pdf

© 2018 Dr Erik Johnson – johnsonvet.com/DHEA

 

Heartworm Prevention for Twelve Dollars! @ Bill’s Pharmacy

I found my heartworm prevention for twelve dollars at Bill’s Pet Supply. (He’s a veterinary technician who steals Heartworm pills from the office he works at, and doesn’t have a pharmacy license. He sells them on Craigslist.)  I need a prescription to make this “legal”

666PetMeds will sell me “heartworm prevention” (which they CANNOT buy from the manufacturer –  it is 100% second hand through grey market avenues –  this is fact!) For ten bucks. I need a prescription however.

Answer #1:   No, you don’t. They will fill ANY prescription typed up on your computer and followed with a scribbled name with a fictious clinic name. The exception is controlled substances like narcotics but most of the time they fail to verify those, too.

Answer #2: I will prescribe through almost ANY brick and mortar pharmacy I can drive up to and inspect.

Answer #3: MOST online pharmacies show “precription on file” and DO NOT honor “No refills after xx/xx/xxxx” which is both illegal and irresponsible and THIS is the primary reason I won’t prescribe to online pharmacies. Honestly, my heart cannot go out protectively for a dog whose owner will buy anything, anywhere. I just cannot get involved. But I can protect MY part in it. And I do.

Answer #4: I do NOT require my clients to buy from me.

Answer #5: I may charge a recording fee for prescriptions called or written in because in order to have a complete medical record, I need to record your shots and where and when you got them AND JUST AS IMPORTANTLY we have to record your medications list and where and when you got them. Frankly that’s a pain in the ass.

Just Another Mind Boggling Scam:    There used to be an “accrediting” regulatory organization for Online Vet Pharmacies. This organization was crazy about the integrity of 800Petmeds and PetcareRx even while those companies were being fined to death by Florida Board of Pharmacy and they were trying to extradite the then-President of the company back to china –  The accrediting organization was called NAPP –  National Association of Pet Pharmacies. PetMed and PetcareRx plastered the accrediting organization ALL OVER their websites: (archive.org) and guess what. GUESS WHO STARTED AND CONTROLLED the National Association of Pet Pharmacies?    Yeah. Petmed and PetcareRx.

“They Won’t Know Unless You Tell Them”

  • Most veterinary drug manufacturers limit the sale of their products directly (only) to licensed veterinarians. Heartworm and flea and tick preventatives are typically acquired from online pet pharmacies illegally.
  • Did you know that all human pharmacies, like CVS, Walgreen and Walmart have regular inspections on the medications they stock to ensure that there are no expired drugs on their shelves, that they are filling legitimate prescriptions, and following all the state board regulations? Online pet pharmacies don’t have to follow these same regulations.
  • Drug manufacturers only guarantee products purchased directly from a veterinarian. For example, heartworm prevention given every 30 days carries a guarantee that if properly used will prevent heartworm and parasite infection. If your pet is diagnosed with one of these parasites and you purchased the product from your veterinarian, your veterinarian will treat your pet at no cost to you. However, when purchased from an online pet pharmacy, you must pay for treatment yourself.
  • Counterfeit medications are a common issue for both human and pet online pharmacies.
  • Certain medications must be shipped and stored at proper temperatures. Inappropriate handling, storage, and shipping could render your pet’s medication ineffective.
  • Expiration dates may be short-dated and cannot be exchanged. For example, if you purchase a six-month supply of heartworm prevention it could expire in three months.
  • Source of bullet points: Dr Anna Coffin

See Pharmacy Safety expose at the conclusion of this article

800petmed800petmedsis 800petmed legitimate

online pharmacy

pet pharmacies safe pet pharmacy safe 800petmed 800petmeds is 800petmed legitimate

Video:

What’s it take to get a dot-pharmacy domain name? A business license as “a pharmacy”. That’s all.

No one goes onsite. No one checks their books. No one examines the legitimacy. The city or state government grants the business license. Not the Board of Pharmacy. Not the FDA.

The fact of the matter, the VERY MOST BASIC fact of the matter is that the drugs sold online by pet pharmacies are safer than my license is, with these ‘toy’ organizations.

I’m not as worried about the safety of your pet as I am about the abuse of my DEA number or Vet License-number being used for twenty different prescriptions for Clomicalm or Diazepam going home with employees of the so-called “pharmacy” or for other customers who don’t have a prescription.

The impact on ME for entrusting my credentials to these “Fisher Price Pharmacies” is greater for me than for a pet that gets expired or ruined heartworm pills. At least for the pet, there’s a chance the medicine’s actually real and not destroyed by heat in transportation over seas.

I could lose my license if the so-called “pharmacy” scratches out the customer’s name on a photocopy and puts down someones dog in Poukeepsie. Which they do.

 

Finding Real Phycox on Amazon.com

Finding Real Phycox on Amazon.com

I can’t swear that I’ve doped out all the variations from both manufacturers but one is real and the other is fake. And the manufacturers of “Phycox” has been going after the fakes for a long time.

phycox

So what I did was put together a document that shows you obvious fakes and then the green question marks are VERY probably viable, real product.

http://https://drjohnson.com/wp-content/uploads/2019/12/counterfeit_phycox_50.jpg

Finding Real Phycox on Amazon.com

Phycox has

  1. Three natural antioxidants
  2. A potent multivitamin
  3. Glucosamine/Chondroitin and MSM

For less money than Dasequin or Cosequin

Phycox is the answer to supplementing arthritis with glucosamine but there’s SO much more to it.

 

Aspirin Use In Dogs Is “Just Okay”

There is a period of time in the life of a dog where it has arthritis but not very severely. It just needs “a little help.
Keeping in mind that dogs are aging seven times faster than we are, you realize that the period of time where they just need a little help is kind of brief. But during that time there are two things you can do that are:

  1. Safe
  2. Over the counter
  3. Not very expensive

For mild arthritis.

One of those is glucosamine chondroitin sulfate. There are lots of products out there including human version is that your dog could take, across the board to premium priced Cosequin and Dasequin. As well as the superior Phycox product.

Phycox is superior because it contains multivitamins and anti-inflammatories along with a hearty dose of glucosamine chondroitin.

Another thing you might consider doing is using some CBD, or cannabidiol, cannabis therapy which over the course of three or four weeks will bind up certain pain receptors and inflammatory cytokines in the body and reduce the impact of inflammation and arthritis. I have a ton of information on my website about Cannabidiol. CBD.

Finally, the intent of this article is to step you through the potentially safe use of aspirin for dogs.

First let me say that “aspirin” is inherently not safe for dogs. It will almost always burn the stomach. Therefore I strenuously recommend that if you use a SPECIFIC form of aspirin, that it would be a BUFFERED type of aspirin (Click).

And I do NOT mean enteric coated. The dog’s GI Tract is half as long as yours and by the time the ‘enteric coated’ aspirin is through the system, it’s barely dissolved.

DO NOT USE ENTERIC COATED ASPIRIN!!

Finding buffered aspirin is harder and harder all the time. You need to see THIS on the label:

Aspirin for dogs should be "buffered" with carbonates.
Aspirin for dogs should be “buffered” with carbonates.

Aspirin Use In Dogs – How Much?

An effective dose of aspirin for dogs is 5 mg per pound per day.

That means a 60+ pound dog would get one adult 325mg aspirin per day.

A 5 pound dog would get less than half of a baby aspirin.

A baby aspirin is 81 mg. (Not available at all, in buffered)

An adult aspirin is 325 mg. (Click)

Aspirin Use In Dogs – How Often?

It is important NOT to give aspirin more than four days a week because aspirin decreases the quantity AND quality of platelets in the dogs body which may contribute to stomach ulceration as well as easy bleeding.

When we had my dog Buster on aspirin, we used it on Friday Saturday Sunday and Monday and left him off that medicine Tuesday through Thursday. He was his most active on the weekends so that made the most sense.

It will not be long before aspirin compounds are inadequate to control arthritis. It is true for humans as well, and they eventually end up on Aleve or Celebrex or something stronger.

Dogs are no exception, usually aspirin is “enough“ for a year or less.

Then, we start some stronger medicines on an “as needed basis” and then eventually as they age we use more and more medicine of more and more kinds. Nothing particularly expensive, most things are very safe, we can get a dog walking comfortably out to 18 years old most of the time.

All of the above is predicated on the dog not being fat.

Fat dogs are simply going to suffer with arthritis whether you give them medicine or not. It is just physically and mechanically painful to carry a lot of weight when you are old.

It is rare to find an owner who will acknowledge that their pet is overweight, let alone do something about it. Therefore, medications to combat arthritis are always extremely in demand.