Most veterinarians treating exotic animals use formularies to select drug dosages without consistently checking their sources

Abstract

OBJECTIVE To assess what information sources veterinarians use to select drug dosages for treating exotic animals and how they implement this information. SAMPLE 936 veterinarians from Europe, Asia, Australia, Africa, and the Americas. PROCEDURES An anonymous, online survey was used to collect data on information sources used for dosage decisions by veterinarians treating exotic species. Logistic regression models were built to identify associations between individual characteristics and primary outcomes. RESULTS Respondents reported their single most common source for establishing drug dosages as formularies (682/936 [72.9%]), followed by scientific journals (96 [10.3%]), other textbooks (68 [7.3%]), colleagues (47 [5.0%]), or continuing education notes (38 [4.1%]). Over two-thirds of the respondents (645, 68.9%) consulted a specific exotic animal formulary for establishing drug dosages in most situations. Of the 936 respondents, 407 (43.5%) reported that they sometimes (318 [34.0%]) or never (89 [9.5%]) checked the source of a dosage in a textbook or a formulary, 503 (55.3%) reported that they sometimes (399 [42.6%]) or never (104 [11.1%]) searched the original publication on a dosage, and 486 (51.9%) reported that they would base their dosage decision on the abstract of an article if they had no access to the full-text. Several respondents’ reported characteristics were significant predictors of primary outcomes. CLINICAL RELEVANCE Considering our findings, we recommend authors of formularies and textbooks should focus on evidence-based information and state clearly when information is anecdotal. Tailored strategies to educate veterinarians treating exotic animals on the importance of primary sources are also recommended.

Drug prescription pattern in exotic pet and wildlife animal practice: a retrospective study in a Spanish veterinary teaching hospital from 2018 to 2022

“…Specifically, in the case of the different groups of exotic animals, both companion and wild ones, their anatomy and physiology may vary enormously, and also the way in which disorders manifest themselves. This makes the selection and prescription of medicines for these patients a complex process, as pharmacokinetic, efficacy, and safety data are often lacking in exotic animal medicine ( 8 ). In many cases, this often leads to the use of drugs in an extralabel manner ( 9 ) and, consequently, to an increased risk of adverse effects.…”

“…More recently, Spanish regulations have had set a deadline to start the collection of pet data on 31 January 2025 (RD 666/2023) ( 33 ). As for exotic animals, information is scarce and scattered, often only as guidelines to manage a certain animal species, disorder, or pharmacological group ( 9 , 34 , 35 ), or related to common practice of veterinarians with a certain type of animals ( 8 , 36 ) but not about the current consumption of drugs. Therefore, this study aimed to describe the prescription patterns of medicines in exotic pets and wildlife animals attending the Veterinary Teaching Hospital of the University of León (HVULE).…”

Comparison between Carprofen and Meloxicam for Post-Neutering Pain Management in Pet Rabbits

“…When dealing with exotic animals in clinical practice, the choice for drugs and dosages is often based on the consultation of formularies, and a specific one (Exotic Animal Formulary) [ 18 ] is the most selected [ 19 ]. However, reported dosages ranges can be extremely wide, and the references in this formulary often do not cite primary resources [ 19 ]. Therefore, the selected dosage for a drug could be quite different among colleagues, and the effects could not always be predictable.…”

Response to “Limits to relying solely on pharmacokinetic/pharmacodynamic studies for an exotic animal formulary”

“…We are certain that the editors of this formulary understand the significant risks involved when prescribing a drug that is not supported by validated research. However, based on a survey including many formulary users (Di Girolamo et al 2022), it appears that the community employing this formulary is not fully aware of these risks. Not every busy clinician has the time to check whether dosages reported in the formulary originate from a randomised controlled trial, a review article or personal experience.…”