Examples of sterile veterinary preparations that can be compounded by prescription order include:
- Methocarbomol
- Mitomycin C
- Guaifenesin
- Ophthalmic Preparations*
*see more info below
Ask us about combinations to meet specific needs or medications that are currently unavailable or have been discontinued for non-safety reasons (such as when a newer therapy reduces the need and therefore decreased use results in the medication no longer being profitable to manufacturer).
Pluronic Gels Enhance Platinum Drug Sensitivity
Platinum based chemotherapy drugs (cisplatin, carboplatin, oxiliplatin) are frequently used in the treatment of neoplasia and other solid tumors in both humans and animals. In spite of positive results achieved in these cases, therapy is often limited by serious systemic adverse effects (nephrotoxicity, myelosuppression) and also by emergence of tumor resistance. By delivering these drugs locally through intratumoral or regional administration, systemic toxicities have been reduced, but the problem of drug resistance remains a major issue.
Thermoreversible pluronic gels (liquid at cold temperatures and solid gels at body temperature) have desirable properties that would facilitate local infusion of antineoplastic drugs to limit systemic toxicity, and are also amphiphilic allowing incorporation of many drug moieties. An investigation in 2001 discovered that pluronic polymers interact with resistant cancer cells sensitizing them to various antineoplastic agents and alter drug efflux transporter and detoxification systems. Because tumor cell resistance to the platinum drugs is thought to be mediated by elevated glutathione, a pathway also affected by pluronic polymers, the combination of platinum drugs and pluronic is a potentially useful construct. A group of investigators recently demonstrated that pluronics enhanced the cytotoxicity of carboplatin two-fold in an in vitro experimental cell culture of colorectal carcinoma cells.
One potential area of application for this concept is in equine sarcoidosis. Traditionally, equine sarcoid cells have been injected with a 1:1 mixture of either carboplatin or cisplatin in sesame oil and injected directly into the sarcoid masses. As injection of oily vehicles can result in local irritation and restrict the bioavailability of anti-neoplastic agents, veterinary clinicians are beginning to consider replacement of the sesame oil vehicle with pluronic gel polymers which can be prepared by compounding pharmacists
Br J Cancer. Dec 2001;85(12):1987-1997.
Mechanism of sensitization of MDR cancer cells by Pluronic block copolymers: Selective energy depletion.
Click here to access the PubMed abstract of this article.
J Control Release. 2005 Aug 18;106(1-2):188-97.
Enhancement of carboplatin toxicity by Pluronic block copolymers.
Click here to access the PubMed abstract of this article.
Veterinary Ophthalmic Preparations
Many agents used in veterinary ophthalmology are no longer or never were commercially available. Examples of agents that are commonly used by veterinarians but are no longer commercially available currently include oxytetracycline ophthalmic ointment, idoxuridine ophthalmic solution and ointment, vidarabine ophthalmic solution, miconazole solution, trifluridine ophthalmic solution, tetracycline ophthalmic solution, rose bengal solution, and chloramphenicol ophthalmic ointment. Even if commercially available, products may be of inappropriate concentration to achieve a therapeutic effect in a given patient (e.g. cyclosporin A) or may have agents and excipients that have adverse effects in animal patients (e.g. neomycin sulfate in cats). In other cases, no product is commercially available and the needed preparation must be compounded from other non-ophthalmic drugs (e.g. acetylcysteine ophthalmic solution and disodium edetate ophthalmic solution) or from pure chemicals. For these reasons, pharmacists are frequently called upon to compound sterile preparations for use in the animal eye. To ensure adequate stability, uniformity, and sterility, both the American Society of Health-Systems Pharmacists and the United States Pharmacopoeial Convention have published guidelines for pharmacy-prepared ophthalmic preparations. These guidelines address the following areas of concern:
- Validation of Formulation
- Documentation
- Sterility and use of Preservatives
- Clarity
- Tonicity
- Buffering and pH
- Viscosity Enhancers
- Quality Control
- Packaging
- Expiration Dating
Considerations for use of ophthalmics in veterinary patients
- General Principles of ocular penetration
- Corneal penetration
Key points for corneal penetration of drugs:
-
- lipophilic
- equilibrium between ionized and non-ionized forms
- small molecular weight (<350)
- high local concentrations
- Intravitreal penetration
Topical Mitomycin C Adjunct Therapy for Equine Ocular Squamous Cell Carcinoma
During surgery for SCC, many equine ophthalmologists also treat the eye with a topical solution of mitomycin C at a concentration of 0.4mg – 4mg/ml applied to the eye for 1-5 minutes. Following surgery, some clinicians will apply mitomycin C 0.4mg/ml topical solution to the affected eye three times daily for 7 days in repeating cycles until tumor resolution. Mitomycin C is a potent anti-neoplastic, cytotoxic agent and should be handled and disposed of accordingly.
Aust Vet J. 2006 Jan-Feb;84(1-2):43-6.
The use of mitomycin C as an adjunctive treatment for equine ocular squamous cell carcinoma.
Click here to access the PubMed abstract of this article.
Stanozolol
In a study conducted at the Animal Health Unit and Gastrointestinal Sciences, University of Calgary, Alberta, ten healthy, intact, adult male sled dogs received either stanozolol tablets, 2 mg/dog PO, q12h, for 25 days or an intramuscular injection of stanozolol 25 mg on Days 7, 14, 21, and 28. A 15N amino acid (5.27 mmol) was infused intravenously into each dog on Day 0 (before stanozolol treatment) and on Day 31 (after stanozolol treatment). Both oral and injectable stanozolol resulted in significant increases in amino acid nitrogen retention compared to pretreatment values. Oral stanozolol increased nitrogen retention from 29.2 +/-8.2% to 50.3 +/- 9.2%, while stanozolol injection increased nitrogen retention from 26.6 +/- 9.9% to 67.0 +/- 7.5%. The nitrogen retention action of stanozolol may be beneficial in dogs under stress of surgical trauma and chronic disease.
In a separate blinded crossover trial at the College of Veterinary Medicine, Kansas State University, 22 castrated Beagles with experimentally induced chronic renal failure were treated with stanozolol. Cowan et al. concluded that for dogs with mild-to-moderate, nonuremic, experimentally induced, chronic renal failure, stanozolol had positive effects on nitrogen balance and lean body mass. Stanozolol did not have a significant effect on body fat, bone mineral content, or food consumption per kilogram of body weight.
Anabolic steroids such as stanozolol have been used to treat geriatric dogs. These drugs can increase nitrogen and mineral retention so that the body can better utilize dietary protein. As a result, the dog’s appetite may improve, resulting in more strength, energy, and weight gain. There is one reported case of the use of stanozolol (0.5 mg/kg, SQ, BID, PRN) to stimulate appetite in a rabbit. However, this class of drugs is not without potentially serious side-effects which must be considered before using them. Anabolic steroids should be used with caution in animals with heart, liver, or kidney problems, or in animals with breast or prostate cancer. Stanozolol should not be used in pregnant animals, during lactation, in young animals, or in male breeding animals. Anabolic steroids may increase the effects of warfarin and other anticoagulants.
In dogs, reported side effects are mainly androgenic, including increased aggression, increased activity, weight gain and mood alterations. However, in cats with and without chronic renal failure, there are reported cases of hepatotoxicity that appear to be related to the use of stanozolol.
J Am Vet Med Assoc. 1997 Sep 15;211(6):719-22
Effect of stanozolol on body composition, nitrogen balance, and food consumption in castrated dogs with chronic renal failure.
Click here to access the PubMed abstract of this article.
Can J Vet Res. 2000 Oct;64(4):246-8
The effect of stanozolol on 15nitrogen retention in the dog.
Click here to access the PubMed abstract of this article.
Veterinary Forum. April 1999
Effect of stanozolol on body composition, nitrogen balance, and food consumption in castrated dogs with chronic renal failure.
Click here to access the PubMed abstract of this article.
