A well-rounded pharmacist: Veterinary medicine and community pharmacy

James Craddock is a second-year PharmD candidate at the Shenandoah University Bernard J. Dunn School of Pharmacy.

Shadowing and assisting a veterinarian at a locally owned small-animal clinic recently reshaped the way I think about pharmacy practice regarding veterinary patients. I first had this idea when looking for a service-learning opportunity that might step me outside of my comfort zone, but the experience turned out to be quite valuable and worth sharing.

Veterinary pharmacotherapy is not simply a niche curiosity. It intersects with community pharmacy practice on a regular basis, and a pharmacist well-versed in veterinary health can be an invaluable asset to their patients, both human and not.

Interesting medication takeaways

One of the most striking takeaways was how often veterinarians rely on human medications to provide care for their patients: Per my vet, approximately 50% of medications used for canines are off label, and the figure for felines is even higher at 75%. Meaning that only around 25% to 50% of all medications used for pets were designed and labeled explicitly for them. Common medications such as amoxicillin, cephalexin, doxycycline, levothyroxine, and furosemide are routinely prescribed for pets, and while most vets stock their own, there are certainly instances where they will need to outsource to their friendly neighborhood pharmacists.

Furthermore, a number of OTC medications that can be found on pharmacy shelves may be recommended by vets. To name a couple: diphenhydramine for allergic reactions or famotidine for reflux might be recommended to a worried dog mom over the phone without needing a full visit and evaluation. A stressed owner may easily confuse the details of verbal instructions, so a savvy pharmacist here could help immensely with a widely trusted resource such as Plumb's to ensure appropriate, safe dosing, and owner counseling.

Knowledge that can save a pet’s life

Perhaps the most critically important aspect of my shadowing experience involved toxicities associated with pets and medications designed for humans. For example, xylitol, commonly found in chewable tablets and flavored formulations, can cause rapid hypoglycemia and acute liver failure, coma, and death in dogs. Likewise, acetaminophen is quite dangerous for cats due to their limited metabolic capacity for glucuronidation, leading to methemoglobinemia and hepatotoxicity. There are many medications community pharmacists deal with daily, yet a lack of veterinary awareness could result in catastrophic harm.

Another important area of discussion that my vet touched on were the anatomical differences between species that influence pharmacotherapy. Cats have a relatively delicate esophagus, so administering dry tablets without water or food can lead to esophageal injury—this is particularly the case with more caustic medications like doxycycline. Gastrointestinal transit times differ between species and breed considerably, making extended-release formulations designed for the human digestive tract unreliable or totally ineffective.

Finally, consider how frequently pet owners seek informal advice for their pets. Questions about vomiting, limping, excessive thirst, or flea treatments sometimes reach pharmacists before vets. Recognizing red flags—such as persistent vomiting, lethargy, or sudden behavioral changes—can prompt timely referral and potentially save a life.

An evolving responsibility

This experience highlighted an important truth: Pharmacists are medication experts for all species, not just humans. As veterinary prescriptions continue to appear in community settings, greater awareness of species differences, toxic excipients, and common disease states is essential. Even small interventions such as verifying weight-based dosing, screening for harmful inactive ingredients, or recommending veterinary referral can profoundly impact outcomes.

My time in the clinic shifted my understanding: Knowledge of veterinary medicine is not optional; it is an evolving responsibility of modern pharmacy practice.