The gorilla had a serious gastrointestinal illness, but she refused to take the medicine she needed. Desperate, her trainer in Kansas called Rood & Riddle Equine Hospital’s Pharmacy. Could the compounding pharmacists there somehow make the gorilla’s medicine taste better?
Rood & Riddle’s pharmacist in charge, John Milam, asked what the gorilla liked to eat — bananas, strawberries? When the trainer said that the gorilla’s favorite treat was marshmallows, Milam reached for that exact flavoring agent. He combined it with the drug and sent the new version to the trainer.
The gorilla happily took all the medicine her relieved trainer would give her and recovered. Milam and the R&R pharmacy crew chalked up another success story.
Then there was the giraffe with a fungal infection on his nose.
“We worked with his vet to create a medicated solution,” said Sheena Baker, R&R Pharmacy’s purchasing and customer service manager.
The zookeepers dipped a mophead into the solution and hung it near the giraffe’s water bucket. Every time he took a drink, his nose was gently brushed with the medication he needed.
“It was an easy treatment and nobody had to climb any ladders,” said Baker.
The best part of Baker’s job is “when we help save somebody’s animal,” she said. “One guy came in whose dog was dying. His vet gave him a prescription, but warned it was a last ditch effort. That medicine saved the dog’s life.”
Milam mentioned “the interesting people and the different problems we get to handle every day.” He spoke, too, of helping animals, recalling a cat who couldn’t eat and was wasting away. After the right medicine was found that the cat could take, “he began to eat and the owner called me back, so happy,” Milam said.
Penguins (fish flavoring for their medicines), monkeys (generally fruit-flavored), harbor seals and moose, tigers, lizards and birds of prey are some of the animals, aside from the usual horses, dogs, and cats, that have gotten medicine customized to their tastes and needs at R&R Pharmacy.
One reason that R&R Pharmacy fills custom orders for so-called exotic animals is that “we have a partnership with Webster Veterinary nationwide. We do all the compounding for their clients,” Baker explained.
McKenzie Arnold, R&R Pharmacy’s director of business development, said that the pharmacy is one of only 150 compounding pharmacies in the entire United States.
“The amount of regulation in the compounding industry is huge, but Rood and Riddle is very focused on seeing that our program is top notch,” Arnold said.
The R&R Pharmacy holds PCAB (the national Pharmacy Compounding Accreditation Board) accreditation, a rigorous certification process.
“We had on-site inspection by a third party. They looked at our testing procedures, facilities — everything,” Arnold said.
Describing the extent of the procedures required for compounding drugs and the R&R Pharmacy’s sterile room with its separate work procedure, Milam said that the operation is “high tech.”
He added, “ I think people would be relieved to know we do a lot of testing and verification.”
“What sets us apart is our dedication to customer service,” Arnold said. “All of the 10 employees have background and experience in working with horses and small animals.”
The Jack Russells and Labradors that ride shotgun in the horse farm trucks know Baker, Ellen Melcher, Melissa Carpenter, and other employees will offer them treats when they accompany their owners. Most cat customers prefer home delivery, which is available free locally, for any order.
“Most people are surprised that we do small animals, but they make up maybe 35 percent of our business,” Baker said.
She noted that that amount is about equally divided between prescription medicines and OTC items. The biggest seller in both categories is flea-prevention medicine.
Serving the needs of horses, not surprisingly, accounts for the largest portion of the pharmacy’s business. Baker said that the three most common equine medicines sold are Banamine (for fever or colic), SNV (sulfa antibiotic) and Gastro Guard (stomach soother).
On the equine side, the pharmacy’s business is cyclical, just as the horse business is.
“During breeding season, it’s nothing to do 160 prescriptions a day,” Baker said. “In the slower seasons it’s 80 to 90 per day.”
Milam said that compounding medicines is “case by case. We have a few tricks to try when an animal can’t take a medicine.”
If a sick animal is throwing up, sometimes the medicine can be made into a transdermal patch or gel to be applied to the inner ear. There the skin is thin, so the medication is quickly absorbed.
Milam said that some drugs have a bitter taste, liquid or pill, so putting the medicine in a suspension and adding flavoring is a good option. For cats and dogs, “we use a lot of chicken, beef, or salmon flavors.”
Pharmaceutical manufacturers make far more drugs for people than for animals. Compounding is a way to give an animal a drug that isn’t available in the right dosage for its age or weight.
Milam said that the reverse situation occasionally happens, when a pharmaceutical company realizes that a drug is being prescribed by veterinarians through compound pharmacies. Then the company decides to manufacture it.
“Compounding gives vets more options,” he said. “It gives them a bigger arsenal of drugs for animals.”
Rood & Riddle Pharmacy is located at 1517 Bull Lea Road, Suite 150, in Lexington, and can be reached at (859) 246-0112, or online at www.rrvp.com.