1. Shastay, Ann MSN, RN, AOCN

Article Content

When a patient recently visited a hospital clinic, a practitioner was reconciling external medication information from Surescripts. Based on Surescripts information, the patient was taking oral enalapril 5 mg daily. When asked about this medication, the patient reported the enalapril was for her dog. The practitioner called the patient's community pharmacy, which confirmed that the enalapril was for the patient's dog.


It is uncertain how Surescripts captured the prescription for enalapril as the owner's medication. However, the community pharmacist noted that it is company policy to use both the pet owner's last name and date of birth when creating a pharmacy profile for a pet. For Surescripts to capture a prescription, it has to be adjudicated via the owner's insurance, implying the pet's profile may have been linked to the owner's profile, or the owner's profile could have been erroneously selected at some point when entering the enalapril prescription which was never corrected.


Fortunately, the patient confirmed that the medication was for her dog. However, if the patient had been admitted to a facility and was not able to help with the reconciliation process, the risk of an error would be high. The pet's medication could have been added to the patient's list of "home medications" and prescribed during hospitalization, and even upon discharge. This is particularly a concern with medications such as insulin, anticonvulsants, antidepressants, anxiolytics, and analgesics, which are commonly prescribed for pets and often filled in community pharmacies.


Several other community pharmacies indicated that no formal policy exists on this subject, and that practices often vary. Creating a profile for a pet under the pet owner's last name, address, and telephone number is common, making the profiles very similar. Some pharmacies have a separate field for the pet owner's name in the pet profile. One pharmacy reported a checkbox in the profile to indicate that the patient was a pet. Another pharmacy said staff often add "canine" or "feline" to the name field. However, all the pharmacies we contacted noted they do not use the owner's date of birth for the pet. Instead, they use the pet's actual birthdate or a fictitious birthdate if the pet's actual birthdate is unknown. When pet owners pick up medications for their pets, verification of identity is usually by name and address, although some pharmacies require entry of the (fictitious) birthdate as a standard check.


Community pharmacies should create a standardized policy and procedure describing exactly how to create a unique pet profile in the pharmacy computer system. It should look as different as possible from the owner's profile (e.g., different color background, different fields, paws, pet pictogram). A standard process to determine a fictitious birthdate if the pet's birthdate is unknown should be used. All pharmacy staff should be educated about the policy and procedure (and never enter a pet's prescription into the owner's profile). The pet and owner profiles should not be linked together in any way.


Top 10 Tips for Keeping Pets Safe Around Human Medications

Most people are aware of the need to keep medications out of children's reach, but they don't necessarily realize that similar rules apply to pet safety. Pets can also get into medications that are not intended for them, which could cause harm. The following is one example.


After an outing at the park with his two dogs, a man picked up his monthly prescription refills from the pharmacy and placed the bag on the passenger's seat in the car. Before returning home, he headed to the grocery store. While he was in the store, one or both of the dogs got into the pharmacy bag containing his medications. The dog(s) took a prescription bottle containing 90 tablets of lisinopril 5 mg into the back seat and chewed the bottom of the bottle open. The man returned to his car and drove home. When he brought the pharmacy bag into the house, he did not notice the lisinopril was missing. Several hours later, he went out to his car and noticed that the lisinopril tablets were strewn all over the back seat and floor. He was only able to find 70 of the 90 tablets.


Both dogs were taken to an emergency veterinarian, who examined the dogs and called the Animal Poison Control Center run by the American Society for the Prevention of Cruelty to Animals (ASPCA). Fortunately, the toxic dose of lisinopril for either 50-lb dog was well above the missing amount of lisinopril (100 mg), and the dogs suffered no adverse effects. Had the dogs ingested a different medication, the outcome could have been tragic.


To keep your four-legged family member safe, follow the recommendations in our Top 10 Tips:


1. Store all medications out of your pet's reach. Most dogs can quickly chew a bottle open to get to the medications inside.


2. Don't leave medications on tables or nightstands where your pet can reach them.


3. If you drop any medications on the floor, immediately pick them up. Pets are likely to mistake dropped medications as dropped food scraps and eat them.


4. Keep human medications and pet medications separate. Although pets may often be treated with the same medications as people, the doses are usually vastly different, and confusing the doses can be fatal. Keep medications intended for different species of pets separate because mix-ups can have undesirable effects when used for a different species. For example, some flea medications intended for dogs are highly toxic to cats.


5. Don't let pets come in contact with or eat medication patches (e.g., nicotine patches, fentaNYL patches) prescribed for you. If pets are prescribed a medication patch, be sure they do not lay next to heat sources that could enhance the medication's absorption and lead to an overdose.


6. Don't let pets come into contact with or lick your skin where medical creams (e.g., sports creams, topical nonsteroidal anti-inflammatory creams, fluorouracil topical cream) have been applied.


7. If a pet sitter or someone unfamiliar with your pet's medicines will be giving medications to your pet, leave clear written instructions to prevent confusion and dosing mistakes.


8. Never give pets human medications (including over-the-counter medications and weight-loss products) without consulting your veterinarian. Some medications, such as ibuprofen, can be fatal for pets.


9. Properly dispose of expired medications in pet-safe containers.


10. Always contact your veterinarian or the Animal Poison Control Center (888-426-4435) if your pet has ingested any medications that were not prescribed for them. A $65 consultation fee may apply when you call the Animal Poison Control Center.



We hope errors never happen, but if they do, report veterinary-related medication errors to the US Food and Drug Administration (FDA; You can also report errors to ISMP ( and we will forward them to the FDA Center for Veterinary Medicine.