I added to this forum in January on - Compounding Pharmacies

Our post above was to share we have used Wedgewood pharmacy for years for Saxtons Cisparide, a motility drug to help Saxton's poop move with success. We used to get a 90 ml bottle of meds delivered, and as we neared the end of Saxton's meds, we would sometimes have issues where Saxton did not poop on schedule. (our hunch was the medicine is losing its effectiveness towards the bottom of the bottle.) So we told the vet and got a smaller quantity prescribed, and it has not been an issue since! 

We have been using Wedgwood for Purrkins phenobarbitol because his dose is so tiny and to cut a tiny human pill 15 mg pheno to 6.3 mg was not precise. With the pheno, we have bloodwork done to measure Purrkins serum levels to make sure his levels are good, not too high, too low, and proof of the medicine efficiency.🤬 Purrkins levels have been on a downward trend since June, checked again in July, August. His levels were trending lower but still in the ok range. We troubleshoot and can only figure the medicine is losing potency over time as Saxtons did? So we get a smaller quantity bottle prescribed. 

WELL, we went again in February for a recheck and blood draw now, our levels are way too low. Purrkins gets his meds like clockwork at 7 am and 7 pm! When the vet calls us we have to troubleshoot this and Mark looks closely at our meds; we have a fresh, almost full bottle of Pheno Mark see's crystals at the bottom! So I phoned the Vet & Wedgewood they confirmed the crystals should NOT be there that is the critical phenobarbitol crystalized, meaning Purrkins is not getting his dosage. The first pic you can't see the crystals well but can see it is not evenly distributed.

Flip the bottle over (this is after shaking)! A LOT OF CRYSTALS! That does not mix no matter how much you shake it!!!

To be honest and fair. (which is hard for me to do!)

Wedgewood pharmacist said they have never had this issue before with Pheno and this formula, we sent them images, and they took care of the problem asap, got us a new bottle free of charge, and shipped it out that day. If this ever happens again, we call again. We get a smaller quantity bottle hoping it would be more accurate, not lose potency and not crystalize.

A new bottle comes, and it looks good no crystals! (we do shake the poop out of the medicine before pulling the meds). 16 days into our fresh bottle of meds! Purrkins starts to have whisker twitches, and we see our new bottle of meds is now crystalizing AGAIN GRRR !!!!

I called Wedgwood again and got a different pharmacist, I sent her photos, and she said yes, they had seen this before! I do appreciate HONESTY, but yeah! She troubleshoots with us on where we store the meds a kitchen cupboard away from any heat or light source, Temp, we keep the house at 70 - 71 degrees, Did we rinse the syringe out after each use - No. She confirmed it's not our fault! This pharmacist thinks it's the cold weather & happening in shipping from Arizona to Michigan, but why does it come fine? 

We discuss in great detail our options and what other formulas would be accurate and stable. This pheno is a suspension mixed in water. The pharmacist says they do have oil-based, which would be more durable. Ok, great, we will do that. She called back and said she is sorry she misspoke pheno is not available thru them in oil-based. Options: We can do a chew, but if Purrkins does not like it for some reason, there is no way I can crush it and dissolve it in liquid form to give it to him. So not an option. We could do a capsule, but it would need to be specially ordered, and the dosage would have to be changed! The pharmacist wanted to send out another bottle of the same formula asap, so we had something as this medicine is CRITICAL! 

This time the customer service is not the same, and the meds DO NOT get prepared and shipped out asap. This was on a Friday morning, and as of Monday afternoon, the order was still processing; Purrkins has more whisker twitching, and I'm terrified he will have a seizure! (We are almost to one-year seizure-free) We tell them to cancel the order wtf? This is crazy!

THANK HEAVENS, WE ARE NOT ALONE. THRU THIS Dr. Rr is in the loop the entire time, and we discuss & try to figure out a solution over the WEEKEND! 

We went back to the pills, and Dr. R. found us a way to compound the medicine ourselves and get the precise dose. In the meantime, Dr. R has phoned Purrrkins neurologist and her vet colleagues and found a compounding pharmacy in Michigan that has had success with pheno in an oil base formula. She called in a script, and as scary as this is, we will try it and have the backup recipe to use if needed. Our new compounded meds (oil-based) arrived last night and will come back after a month of use. Have a blood draw and let you know if our serum levels are in line?! I'm hopeful & we will switch Saxton meds and tell a particular pharmacy all of my mind. You guys can well imagine!💨😡😤🤬😖😭

This long-winded post is a word of caution with compounding medicine and one of the worst-case scenarios when we put all our trust in a company with our animal's health. We cant always test the medication in the blood!

I'm not saying don't compound medication but be informed of the risks involved and wisely choose the company. I THOUGHT we did our vet routinely USED ( yea past tense now)Wedgewood. 

Is this a fluke and one in a million? I have no idea. It could be? It may be the weather difference and happening in shipping?!?(either way, it should never happen) But I wanted to revise my original post to say that we have NOT always had success in compounding & and hope to spare another furmily. Purrkins has suffered. We have suffered. I'm not done with Wedgewood yet...

I'll update when we know more, and if you want to send some tripawd power Purrkins way, we would appreciate it.🙏🏻🙏🏻🙏🏻 We can keep checking off no seizure days as we get these levels back up!

Hoppy Triday all! 

Holly & Purrkins (not happy to say the least)

🫂🫂🫂🙏🏻🙏🏻🙏🏻💝💝💝