Dosages May Vary

I was out on an errand today when a regular reader asked, “Why don’t you put names of medications and dosages on your Web site?”

The answer is a little complicated.

We do name certain medications used in certain conditions. Dosages, on the other hand, can vary from patient to patient and even day to day for the same patient. Publishing a specific dosage could be misleading, confusing and dangerous.

Specifically this reader was asking about treatment of mange. We have previously published pieces on the four kinds of mange in dogs (Otodectic Mange In Dogs), (Chyletiella-Walking Dandruff-In Dogs) (Sarcoptic Mange In Dogs) (Demodecosis In Dogs) and the three kinds of mange in cats (Demodicosis In Cats) (Sarcoptic Mange In Cats) (Otodectic Mange In Cats).

I intentionally did not even include a discussion of the medications used in treatment of Demodectic mange (or “red mange”) in dogs because of the wide variety of forms of treatments used by veterinarians for this disease. Why? Because some are approved for controlling this condition and some are used off-label.

What does off-label mean? Every medication approved by the FDA, Food and Drug Administration, for use in human and/or veterinary medicine is approved with a list of certain uses. Licensed practitioners, however, are not bound by that list of uses for approved medications. If there is an indication that a medication is the best choice for treating a certain condition for a certain patient and have good scientific basis for choosing that medication, we are authorized by our licenses to use our medical judgement in selecting from all legal medications available. Laws in some states may require consent from the patient or pet owner to use medications off-label.

Not long ago the news carried a fascinating statistic: Sixty-four percent of the medical information on the Internet is either outdated or outright wrong.

The reader mentioned above had read some information about treating Demodectic mange in dogs and had applied that information to his own pet. He was using a medication off-label, one that is commonly used by veterinarians. However, he was using an incorrect dose on an incorrect dosing schedule. That his pet was improving was evidence that she would likely have improved with no treatment at all.

See you tomorrow, Dr. Randolph.

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