Prescribing non-CD pain relief/antibiotics (exceptional circumstance)

Scenario

Alex keeps a pack of hounds.

At feeding time, one of the dogs, Iceberg, had a fight with another of their dogs and has sustained a wound to the shoulder area.

Although Alex is registered with a veterinary practice, they have not yet attended the practice with the dogs.

Alex calls the practice and speaks to Pippa, a veterinary surgeon.

Alex explains that Iceberg is quite an aggressive dog and will not tolerate being examined by Pippa. Pippa explains that the dog will likely need antibiotics and possibly pain relief and so they should still attend with Iceberg and she will do what she can.

When Alex arrives, Iceberg is muzzled and clearly very distressed. Pippa assesses the situation and decides it is not safe to physically examine Iceberg for her or the team, however, she is able to look at the wounds from a safe distance and carry out a clinical assessment.

She is satisfied that, if left untreated, Iceberg’s welfare would likely suffer.

Pippa prescribes antibiotics and pain relief for Iceberg, and makes a note of the fact it would not have been safe to physically examine him.

Things to think about...

Pippa has taken responsibility for Iceberg and has taken him under her care.

She has carried out a clinical assessment, and when deciding whether to carry out a physical examination, has taken account of the fact that it would not be practical, or indeed safe, to do so.

Notwithstanding this, she is satisfied that she has enough information to diagnose and prescribe safely and effectively. The pain relief in question is not a controlled drug and, as such, she is able to prescribe it based on this assessment.

However, in respect of antibiotics, there are extra considerations to be taken into account before prescribing, namely, that they should not be prescribed unless a physical examination has been carried out unless there are exceptional circumstances.

In this case, risk to personal safety could amount to exceptional circumstances where antibiotics could be prescribed without a physical examination.

As such, it would be a matter for Pippa’s judgement as to whether it was appropriate to do so and her justification should be recorded clearly in the clinical notes.