By Christie Keith

Wednesday, April 16, 2008 - I hear it all the time: Pet owners grousing that their vets are ripping them off with high prescription drugs prices, and veterinarians worrying that the shift to Internet and chain pharmacy use by their clients is threatening their ability both to survive economically and to protect their patients' health.

Ten years ago, while a doctor handed patients a prescription to take to the drugstore, a veterinarian sold drugs for pets directly. But things are different now. "I write prescriptions left and right. I must have written five prescriptions today," Florida veterinarian Dr. Patty Khuly told me. "That never used to happen."

Behind the change is an explosion of new places to buy both human and veterinary drugs: Internet pharmacies, 800 numbers, catalogs and chain stores that offer some drugs free or for a few dollars just to get you in the door. Those changes have left many veterinarians overwhelmed and pet owners confused.

Some pet owners believe the reason vets are resistant to the changes is that they don't want to lose the revenue from drug sales, but that's an over-simplification of a complex issue. Caught like everyone else in rising costs, a weakening economy and staggering amounts of student and start-up debt, veterinarians are also struggling with the loss of some bedrock revenue streams, including sales of prescription drugs and "vet-only" products.

And just like in human medicine, there are plenty of unscrupulous businesses using the Internet to sell mislabeled, expired and outright fraudulent medications to consumers . Veterinarians worry that their patients won't get the right drugs or dosages if the pet owner isn't savvy enough to avoid those sources — something pet owners should be equally worried about.

What's making this even harder is that today's veterinarians didn't create the old system of vet-as-pharmacist; they inherited it. Plenty of them would love to be out from under the burden of maintaining an expensive inventory of drugs. And like the corner drugstore, they frequently have to pay more wholesale for drugs than chain pharmacies charge for them retail, leaving the veterinarians at a sharp disadvantage on pricing.

But pet owners are caught in a squeeze, too. They are affected by the same weakening economy and rising costs, and to add to the problem, increasingly sophisticated — and expensive — veterinary diagnostics and therapies are pushing the ceiling of what can be done for their pets ever-higher.

Because changes are happening so fast, there's no one-size-fits-all answer to where to get your pet's medications today. The best source for drugs is going to vary from pet to pet, from veterinarian to veterinarian, and even from day to day. Here's a guide to help you make your decision.

Your veterinarian

This is the traditional source of veterinary drugs, and in many ways, the most familiar and hassle-free for everyone involved. Your vet examines your pet, works out with you what testing will be done, and packages and dispenses any prescribed medications. You pay for everything on your way out the door.

But there are reasons other than habit and convenience to get your pet's medications from his vet. Unlike your local pharmacist, your vet is an expert in animal health. She can give you information on side effects, contraindications and how to administer the drug that a human pharmacist is not likely to have. (If you've ever picked up a prescription for your pet from a human pharmacist and read the sticker warning about not operating heavy machinery or drinking alcohol while taking the medication, you'll know what I mean.)

Your pet's veterinarian will also be able to ensure that the drugs she's dispensing are properly stored, handled and labeled, and that they're not expired. While that's certainly also true of a reputable human pharmacy, it's not something you can take for granted when shopping online, from an 800 number, or through a catalog.

A few notes on pharmacy laws: Your veterinarian, like your physician, cannot dictate where you fill her prescriptions. Nor can she charge you a fee for writing a prescription unless she charges that same fee for her clients who buy their drugs directly from her. And no, your vet can't fill a prescription written by another vet; the law only allows her to dispense drugs to her own patients. And while some veterinarians may take back dispensed medication and refund your money as a courtesy, they can't re-sell those drugs — even if the package was never opened.

Also, veterinarians cannot legally prescribe medication for pets they have never examined, nor pets they haven't examined in a long time. That's not their sneaky way of getting an exam fee out of you before prescribing your dog's heartworm preventative; it's the law.

Christie Keith is a contributing editor for Universal Press Syndicate's Pet Connection and past director of the Pet Care Forum on America Online. She lives in San Francisco. http://sfgate.com/cgi-bin/article.cgi?f=/g/a/2008/04/16/petscol.DTL

How much is that pet drug in the window?...........

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