It’s a huge issue. So big it fuels a sizable niche industry created specifically to meet the needs of pets who won’t––or can’t––tolerate drugs and supplements designed to treat and/or prevent their ills.

It’s nearly every day we access our favorite compounding pharmacy’s expertise in the formulation of new versions of the same-old drugs that line our shelves. After all, pets can be picky about what we put in their mouths or mix into their meals. (You would be too if you didn’t understand why you needed to take that niacin, glucosamine or Centrum Silver on a daily basis.)

I hate taking pills. The physical act of downing the trio of tablets I take every day is an uncomfortable, abhorrent one for reasons I can’t even explain. I just don’t enjoy downing a glug of chalky solids. So why would our pets?

Some of us hide our pets’ pills in foodstuffs or treats: cream cheese, peanut butter (chunky works best, IMO), ham, chicken breast, pill pockets, filet mignon... In vet school I even spent time devising a protocol for getting fish to take their Baytril (I soaked brine shrimp in 100mg/ml solution for 3-5 minutes). As veterinarians, we do whatever it takes to get the meds into our patients. And, yes, sometimes it takes a lot of trial and error.

Others switch to liquid meds (readily available through compounding pharmacies) hoping these will make all the difference. And sometimes they do. But more than anything else, what we all want is a cure that requires no daily discomfort, wriggling, stressing, in-the-towel-burrito-ing or the potential for biting, scratching or generalized inter-species strife.

It’s for this reason we seek solutions requiring once-daily dosing (instead of two to three doses per day). It’s why Pfizer’s Convenia makes us jump for joy (one painless subcutaneous shot equals two weeks of antibiotic coverage). It’s another reason we believe radioactive iodide treatments will always best methimazole for hyperthyroidism. It’s why topical medications are so revered when they’re found to work as effectively as the oral or injectable versions. And it’s also what keeps compounding pharmacies in business.

It’s hard to quantify, but we suspect that drug non-compliance as a result of an inability to administer meds is among the biggest drivers of poor clinical outcomes in veterinary medicine (if not the biggest). Then there’s the issue of antibiotic resistance to deal with when antibiotics are started...found under the sofa...started again...spit out...repeat...

Given this setup, is it any wonder compounding pharmacies are finding veterinary medicine a lucrative place to invest their time and money?

But the take-home message here is not about building new businesses with our pet-dedicated dollars, it’s more about meeting the needs of our pets with the willingness to make medications work through any means necessary.

Trouble is, clients don’t always inform us when the meds aren’t going down the gullet. Not every pet owner is educated enough about drug choices to know they can ask us for alternatives. And, truth be told, we don’t always pointedly ask whether an unhappy outcome might be the result of poor drug compliance. (It just seems kind of rude to ask, you know?)

Now that you’ve read this, however, you know what you need to do. When your dog hides a tidy stack of tablets under the bed and your cat drools for hours after her pill, consider asking for another method. No one need suffer when so many other options are available.