Most of us animal lovers have been following the tragedy surrounding the death of 21 polo horses in Florida with great interest. The details just get worse the more we know, don’t they?
According to the latest report, the Venezuelan polo team was used to using Biodyl, a supplement that is available elsewhere, but not approved for use in the United States. So, they had a compounding pharmacy mix up a similar concoction- with this result.
Veterinarians use compounding pharmacies a lot- I’ve used the actual pharmacy in question. We use many, many medications in an “off-label” fashion, because most drugs simply are not approved for use in animals the way they are in people. When you have an unhappy cat who needs to take tapazole on a daily basis, having it compounded into a fish flavored syrup can be a lifesaver, literally. I have a patient, a 150 pound mastiff with Addison’s disease, who would be dead without compounding pharmacies- the owner cannot afford a $300 injection once a month, but can afford an oral medication that achieves the same goal, which is specially compounded for $70 a month.
There are a handful of compounding pharmacies, including the one in this case, who specifically cater to veterinarians. They are very familiar with the medications we use a lot. Most of the time when we use compounding pharmacies, it is in a straightforward capacity, taking already available drugs and making them in a different flavor, or a special dosage. Asking a compounding pharmacy to make up a medication that is not available in the States, however, is treading murkier water. It’s done, obviously. And when you ask a pharmacy to construct a medication from scratch that is not one they normally do, you, as the prescribing vet, are assuming the risk if it doesn’t work the way you wanted. The laws on this type of prescribing are somewhat murky, though with this incident I imagine it is going to be much more closely examined in the veterinary community.
No one has said yet if the compounding pharmacy made the medication incorrectly, or if the prescribing veterinarian gave them the wrong dosages to begin with.
Either way, not good.
From http://www.guardian.co.uk/sport/2009/apr/24/polo-horses-cause-death-florida:
”According to La Nación, the national Argentinian newspaper, the ingredient in question was sodium selenite, a salt made from selenium. The paper, citing anonymous sources, said that the prescription had requested 0.5 mg of sodium selenite per millilitre of horse supplement, but the chemist had mistakenly included 5 mg, or ten times that amount. Selenium is regarded as harmless at low doses, but as potentially poisonous at higher concentrations.”
Wow. Thanks Jeb.
More speculation here: http://scienceblogs.com/terrasig/2009/04/biodyl_francks_pharmacy_and_fl.php
What I want to know is, if Biodyl is a proprietary blend by Merial (I’m assuming it probably is) how did the vet come up with the recipe?
And what kind of checks does a compounding pharmacy have in place to catch an error of magnitude like that? If it’s not something they normally make, they would be less likely to realize it.
It was a selenium overdose: http://scienceblogs.com/terrasig/2009/04/selenium_the_cause_of_lechuza.php
No word yet on whether it was the pharmacy’s or the prescribing vet’s error.
Did you ever happen to hear the out come of this situation? I could not find anything. Thanks,