The art of prognoses: Is everything going to be all right?

Many diseases can be controlled or eliminated by various types of medications. With modern diagnostic techniques and proper application of therapy, clients can have confidence in your medical forecast that "Everything is going to be all right."

Here are some client-linked variables that influence prognoses:

In order for your short-term and long-term medical forecast to be on target, clients must be able to give:

1) the right medications to,

2) the right patient,

3) at the right time(s),

4) in the right amounts,

5) in the right dosage forms,

6) by the correct route of administration,

7) for the right duration of time,

8) with knowledge of the right responses, and

9) knowledge of the right action (if any) to take if adverse reactions occur. When appropriate, they must also:

10) return to the right hospital for re-evaluation on the right date by the right doctor.

In summary, provided your diagnosis was correct, and provided that effective, specific, supportive, and/or symptomatic forms of therapy are available, and provided your client is intelligently compliant with your recommendations, the prognosis that "everything is going to be all right" has the best chance of being accurate.

Providing a copy of the following list of "Do's and Don'ts" to your client will help achieve the right therapeutic outcome:

1) Do know the generic and brand name of the drug(s), and why it (they) is being given. Ask your veterinarian or pharmacist about the benefits and risks associated with generic substitutes.

2) Do understand the type and timing of the beneficial response(s) to therapy (e.g., desired effect) that is expected.

3) Do be sure you understand all instructions before starting to administer a drug(s), including how to give it, how much to give, when to give it and whether it should be given before, during or after meals. Also, know how long to give the medication(s), and what to do if problems occur.

4) Do become familiar with recommended techniques of giving medications. Do not leave the hospital until you are sure you (or someone with the same commitment to the well-being of your pet as you) can administer the medications.

5) Do ask your veterinarian what foods or liquids are compatible and/or incompatible with the medication you are giving — if you are planning to give oral medications disguised in food.

6) Do not (except when requested by your doctor) give medications in drinking water.

7) Do observe your pet to be sure that the medication was swallowed. Some pets do not swallow pills or tablets; they spit them out (often when you are unaware of it). In other situations the capsule or pill may stick to the wall of the esophagus. This may be minimized by having your pet swallow some water soon after you have given the medication.

8) Do ask your veterinarian or pharmacist about so-called "pill dispensers" or other items to help you follow directions.

9) Do keep a written record of the dates and times you give medications.

10) At meal times do not give the patient any form of therapy that may be associated with an adverse response, as this may be a factor that eventually contributes to food aversion.

11) Do know what to do if you forget, or are unable to give, medication(s) at the prescribed (daily, weekly, monthly, etc.) intervals.

12) Do understand important side-effectsthat may be associated with medications, the likely frequency of their occurrence and what to do if they occur. Do not leave the hospital until you obtain and understand a list of side-effects that should be reported to the doctor.

13) Do ask your doctor about drug interactions if multiple medications are being used. Do not rely on computer-generated instructions about interactions that often accompany medications purchased from pharmacies, because that information often is given in the context of human treatment. It may not apply to animals.

14) Do call your doctor if disease symptoms persist during therapy, especially if they become worse.

15) Do give liquid medications via the cup or other measuring device dispensed with that medication. Errors in dosing will occur if you use a different device because size and markings of different containers (including droppers, teaspoons, tablespoons) may not be standardized.

16) Do keep medications in their original containers.

17) Don't mix different pills in the same container.

18) Don't crush or break any capsules or tablets unless instructed by your doctor or pharmacist to do so. If you are instructed to split tablets, ask your doctor about the availability of precision pill-splitters (available from most pharmacies).

19) Do know where and how to store the medication (heat, humidity, and light can affect its potency and safety).

If medications are to be stored in the kitchen, store them away from the sink, stove or other heat sources.

20) Don't store medications in the bathroom.

21) Don't leave the cotton plug in a medication vial, because the cotton may draw moisture into the container.

22) Do keep pet medications separate from those for people.

23) Don't give more or less than the prescribed amount of the drug(s) without consulting with your doctor.

24) Do ask your veterinarian or pharmacist about the benefits and risks associated with generic substitutes for brand-name drugs.

Don't suddenly stop giving the drug(s) because the clinical symptoms have disappeared without checking with your doctor.

25) Don't wait until medications for long-term care are completely depleted before seeking refills.

26) Do be alert to changes in the appearance of refilled medications and alert your veterinarian or pharmacist if you notice changes.

27) Don't give the patient medications beyond the labeled expiration date.

28) Do inventory items in your medicine cabinet at least yearly, and discard all medications that have expired.

29) Don't give the patient old medications used for previous illnesses without checking with your doctor.

30) Don't give prescription or over-the-counter human medications to your pet unless your veterinarian advises that they are safe and effective.

Do you have items you would like to add to these recommendations?