On The Cover

Elizabeth Briand

Image Courtesy of Chewy, Inc.

Spend 5 minutes on Instagram or TikTok and it is easy to see how much Americans love their pets. From dogs hitting the town in backpacks and strollers to cats with their own sweaters and bedrooms, pets are part of the family—and important ones at that. With that elevation in status in recent years, pets are also receiving more veterinary care, giving rise to an ongoing expansion in pet pharmacy.

Over the last 3 decades, pet ownership in the United States has risen from 56% in 1988 to 66%—or nearly 87 million households—in 2024.

This increase in pet ownership has spurred a significant increase in the amount of money people are spending on their four-legged family members. Over the course of just one year, from 2021 to 2022, Americans spent $136.8 billion on their pets, up from $123.6 billion the previous year—an increase of more than 10%.

According to a MetLife survey of dog and cat owners, people spent an average of $4,800 on their animals in 2023, including a combined average of nearly $2,400 for food, treats, toys, and clothes. The largest expenditure overall, however, was vet visits at nearly $1,250 a year.

“Pets are part of our family today more than they’ve ever been, and that changes how we care for them,” said Kory Muto, PharmD, quality pharmacist at Chewy, an online pet supply retailer.

In fact, Muto said, almost half—46%—of pet parents have spent more on their pet’s medical needs than on their own, according to a 2022 Chewy survey.

Generational differences may be influencing this growth in pet health care and pharmacy. Millennials account for the largest group of pet owners in the United States today with one-third having an animal in their home. They’re followed by Generation Xers at 25% and baby boomers at 24%. Just as younger generations drive change in the human medical and pharmaceutical realms so too are they driving change in the way pet medications are prescribed and purchased.

“Animal owners are seeking ways to find convenient, quality, and cost-effective ways to care for their animals,” said Margo Karriker Reeves, PharmD, FSVHP, DICVP, veterinary clinical pharmacist at the University of California Veterinary Medical Center in San Diego. “Increasingly, they expect the pharmacies they go to regularly to be able to help with their pets’ prescriptions and are looking to online pet pharmacies for the convenience they offer.”

Muto said younger generations represent a larger portion of the pet parent population, meaning there is higher demand for convenient and digital services. “When it comes to medications in general, the expanding market of pet-friendly dosage forms and flavored medications now provide viable options that were previously unavailable for animals,” Muto said.

Those digital advancements translate into ease of accessibility to help the family pet. “As millennials and Gen Zers emerge as the primary pet parents, it is essential for pharmacies to offer digital services to meet high demands and expectations,” said Muto. “These generations are shopping online more and expect a pharmacy with an ‘always-on’ approach.”

The surge in pet ownership during the COVID-19 pandemic also brought about this change. During the pandemic, from May 2020 through February 2022, the number of people who reported getting new pets doubled, rising from 7% to 14%.

“The opportunities for more pet owners to work from home seems to have both brought animals into the lives of more people and helped connect people more closely with their pets,” said Karriker Reeves. “As a result, pet owners are seeking veterinary care more regularly.”

With more veterinary care comes a higher need for medications for the family pet, whether to manage an illness, an allergy, or—like so many humans—conditions such as anxiety and depression.

Lauralei Fisher-Cronkhite, PharmD, clinical staff pharmacist at the University of Illinois Urbana-Champaign Medication Dispensary, agrees that the increased time people found themselves spending with their pets during the pandemic, and the continued closeness that ensued, put pet health more in focus.

“When you spend all day with your pet, you start to notice things that you didn’t when you were gone for a good portion of the day, and [you] take them into the vet to get those things checked out,” she said.

That has led to more people getting involved and active in their pet’s well-being, whether it’s a greater investment in preventative medication or seeking more advanced care for ailments and maladies.

“Pet parents are taking more of a proactive approach to their pet’s health,” said Muto. “They’re doing more research, asking more questions, and seeking out a pharmacy partner they can trust.”

Muto said phone calls, text messages, and emails to pharmacies are on the rise with requests for specific brands, manufacturers, and lists of ingredients for medications. “People are advocating for their pet’s health, and their expectations are high for convenience, transparency, and quality,” he said.

An evolving field

For most people, the commonalities between human and pet medications are something rarely considered, usually not until they’re standing in line to pick up their dog’s medications at the same family pharmacy where they pick up their BP prescription.

“There is a surprising amount of overlap between pet pharmacy and human pharmacy,” said Fisher-Cronkhite. “Many of our companion animals suffer from diseases that we’re familiar with in our human patients, such as hypothyroidism, diabetes, and heart disease. Many of the medications we use in veterinary pharmacy are, in fact, human medications.” 

That does not mean, of course, that owners can simply share their allergy medications or pain relievers. For example, medications that are relatively safe for humans, such as acetaminophen, can be lethal to cats. “Doses and frequency can also vary widely from humans due to differences in pharmacokinetics,” said Fisher-Cronkhite.

Karriker Reeves also noted that there is a lack of drug information data for some animal species, which “can make drug therapy challenging.”

Despite those challenges, there have been significant advancements in pet pharmacy with the goal of improving day-to-day wellness and lengthening lifespans for just about every kind of animal companion, from dogs and cats to guinea pigs and reptiles.

“Many advancements seem to parallel what’s happening in human medicine,” said Fisher-Cronkhite. 
“For example, there are new SGLT-2 inhibitors for diabetes that are veterinary-specific.” Prior to this, most cats, for example, had to be treated with insulin for their diabetes. Another newer cat medication includes oral treatment for feline infectious peritonitis.

Fisher-Cronkhite noted a new option that pet parents are looking at to treat one of the most serious diagnoses for an animal: cancer. “People are interested in cancer-immunotherapy to treat tumors,” she said. 
“Chemotherapy, surgery, and radiation therapy have been our only options for the last 20 years, and this gives owners a new way to fight cancer.”

Overall, there is a heightened focus on preventative health care for pets, using nutrition and wellness as well as the advancement of drug technologies to address chronic and previously debilitating conditions.

“In veterinary medicine in general, there is an increased focus on ‘one health,’” said Karriker Reeves. “This concept recognizes that the health of animals, humans, and our environment is closely connected, and health care that advances the well-being of one often benefits all.”

Beyond the discovery of new medications, there also has been significant progress made in the way medications can be administered to animals, making it easier for people to take part in the care of their pets. Muto said they are seeing medication options that are chewable, transdermal, or extended release.

There also have been innovations surrounding the palatability of medications and the combining of multiple medications into single doses—all things that people who have wrestled a pill down the throat of a frightened cat or dog are welcoming with open arms.

Veterinarians are appreciative of the ongoing efforts to make medications easier to administer, including the availability of suspensions and long-acting injections, noted Fisher-Cronkhite. “The downside to this is that stability can change with formulations changes, and we don’t always know if transdermal medications are reaching therapeutic concentrations without further research.” 

Veterinary pharmacists are also embracing the rise of 503B compounding pharmacies, which are adding security and convenience to the field.

“Because they are required to follow cGMP practices, we can be sure that narrow therapeutic index drugs are at the correct potency and also in a strength or form that is acceptable to our animal patients,” said Fisher-Cronkhite.

The future of pet pharmacy

As pet parents continue to find ways to enrich the lives of their four-legged loved ones, the field of veterinary pharmacy will grow in tandem with veterinary care. That includes the introduction and expansion of pet insurance, which is allowing more people to afford treatments, including medications to care for emergent and preventative needs.

According to the North American Pet Health Insurance Association, the number of insured pets in the United States grew by 17% from 2022 to 2023 to cover nearly 6 million animals. Overall, the pet insurance market is expected to more than triple over the next 10 years.

Muto believes there will be continued investments from both pharmacies and pharmaceutical companies to expand their catalog of veterinary offerings, too. “Pharmacies are compounding more to meet the specific needs of pets and branching out in a variety of innovations,” he said. “Pharmaceutical manufacturers are
churning through abbreviated and new drug applications, and as those medications hit the market, it will be interesting to see the effects.”

There is hope as well that veterinary pharmacy becomes just as intertwined with veterinary medicine as human pharmacy is with health care.
“Veterinary pharmacists can be a great resource for veterinarians with complicated cases and multiple medications,” said Karriker
Reeves. “We can also help with stability and compatibility questions and help develop
compounding formulas for patients that aren’t able to take commercial medications. I hope we’ll be seen as part of the medical team.”

The support of pharmacists

With more and more pet prescriptions coming to the pharmacies of Walgreens, Costco, and other retail pharmacies, there are opportunities for pharmacists to support the work of their veterinary counterparts and ensure the safety and well-being of their pet patients.

Knowledge is key to that partnership. Fisher-Cronkhite noted that pharmacists have access to veterinary pharmacy continuing education opportunities. In addition, “the best thing that retail pharmacists can do is make sure that they have a basic knowledge of veterinary pharmacy and have appropriate drug resources on hand,” she said. “There are veterinary pharmacy drug handbooks readily available both in print and online.”

Karriker Reeves agreed. “Pharmacies that fill prescriptions for pets should always have access to a veterinary drug reference book,” she said. She suggested Plumb’s Veterinary Drugs, which can help pharmacists interpret and double-check the prescriptions they receive.

It is also important for prescribers to include—and pharmacists to check for—details specific to each animal. For example, all prescriptions for pets should include their weight, as many drugs, especially for dogs, are dosed based on their current weight.

“Pharmacies should also consider using their software to add warnings and safety information for certain species. For example, dogs should not have xylitol, as it can cause acutely dangerous hypoglycemia,” said Karriker Reeves.

When in doubt, the best option remains reaching out to peers for answers. “Reach out to the veterinarian if they have any questions,” said Fisher-Cronkhite. “Never assume that animals can be treated like small humans. Human over-the-counter medications should never be recommended by a pharmacist for an animal. They should only be given by the order of a veterinarian.”

The ongoing growth in pet pharmacy and the promise it holds for longer, healthier, and better lives is a welcomed development for most pet parents. This seems the least humankind can do in exchange for the love, devotion, and joy animals bring each day.  ■

“You want me to do what?!” Giving medications to pets

Unless a person is blessed with a pet that swallows pills like treats, giving furry friends their medication is rarely easy. Here is a series of expert tips pharmacists can pass along to their patients to make the job a bit easier:

• Stay calm—When it comes to humans and pets squaring off over medications, the phrase “show no fear” is key. Relax and stay calm so your pet can, too.
• Set yourself up for success—Prepare everything you will need and have it close by before reaching for your pet. Find a spot where you feel comfortable and where it might be a challenge for your pet to escape. For example, putting cats on a slippery surface where they cannot get traction might help prevent flight (just make sure they won’t fall). Also, be kind. If your pet might feel safer wrapped in their favorite blanket or sitting next to their other favorite human, try it.
• Make that medicine tasty, if you can—Tablets, capsules, and powders can be hidden in food, especially foods with strong odors such as meat. Just be sure to check with your vet to make sure the food options are safe—some medications should not be given with cheese, for example. For pills, coating it in something slippery like butter or anchovy paste (for cats) can help pills glide down the throat. Pill pockets are also available for dogs.
  • Flavorings can be added to liquid medications with everything from shrimp and bacon to marshmallow available, depending on the species of animal and their preferred diet.
• Get it in their mouths—and keep it there—For both dogs and cats, hold them and gently tilt their heads back, get their mouths open, and slide the pill as far back in the mouth as possible, making it less likely they can spit it out.
  • For dogs, gently lower their heads and keep their mouths closed until they swallow. Gently rubbing or blowing on their noses can also stimulate swallowing.
  • For cats, to prevent choking, administer a teaspoon of water by dropper or syringe immediately after dosing. Do not tilt their head back for liquids.
  • Other medications can be crushed and mixed with water immediately before administration and given to pets by oral syringe.
• A few don’ts—Adding medicine to a pet’s food—especially one who’s already a picky eater—can cause the pet to associate their food with a bad taste or experience. If dietary restrictions permit, use a different type of food to prevent rejection of their normal, everyday food.
• When putting medication on food, use as little food as necessary and make sure the pet has consumed the entire portion to ensure they have taken all of the medication hidden in it.

Tips provided by Kory Muto, PharmD; Lauralei Fisher-Cronkhite, PharmD; and the Cornell University College of Veterinary Medicine Consumer Clinical Care Guidelines for Animals.