Shame on you Walmart!

Note: Since many of my viewers/listeners cross over between my three different shows, I make a big effort to not cover the same material on more than one show in any given week. However, since a good many of my viewers do not cross over between shows, remaining attached to one or another particular one for whatever reason, I found the Walmart topic too important to be left out of any of my shows this week. Each show still has its own fresh supporting material or flavor this week nonetheless, I do apologize to my cross over audience that had to her about "Shame on Walmart" covered on more than one show.

In this episode:

Pet joke of the week: Mommy's Night Out
Personal comment: Shame on you Walmart!

Transcript of personal comment from this episode of The WebDVM:

My personal comment tonight stems from a work related experience I had last week, when a canine patient came in with sore hips. Her owner informed me that she had been giving the dog "doggy" aspirin that she got from Walmart for the past week, but that it did not seem to help. In response to that, I asked, "are you sure it was aspirin and not a joint nutritional supplement?"

"No," she said, "it is aspirin, here is the bottle." Then she proceeded to pull out a bottle of Pro-Pet aspirin, labeled for use in dogs for joint and arthritis pain. The best part?? the label read, "Veterinarian Approved."

Folks, I cannot tell you how infuriated this makes me, not at the owner - she was only trying to help her dog - but at Walmart for selling this stuff over the counter to pet owners that have no idea how harmful this can be to their dogs. Most of us are quite aware that regular taking of even enteric coated aspirin has the potential to irritate our stomachs, often leading to ulcers of the gastrointestinal system. In dogs, this potential for GI ulceration is far greater than it is in humans, owing to the exceptionally high incidence of vomiting and stomach ulcers developing, often after only a few days of aspirin administration.

I have seen it all too often. Dog comes in vomiting blood. I ask the owner if he has been on any medications and they inform me that the dog has been on nothing but the daily dose of aspirin they decided to give him for his arthritis. Some of these dogs I can treat as outpatients with antibiotics and GI protecting medications, while others are not so lucky. Some end up with ulcers so bad that they have to be hospitalized, some need surgery to repair a perforating ulcer, and others die despite our best efforts to save them.

You see, aspirin is in a class of drugs called non-steroidal anti-inflammatory drugs, called NSAIDs for short. Other examples of human drugs in this class, no less toxic for dogs and perhaps even more harmful, are ibuprofen, acetaminophen, and naproxen, commonly known under the labels Advil, Tylenol, and Aleve, respectively. They work by inhibiting an inflammatory enzyme in the body known as a COX enzyme, responsible for reactions that lead to pain and inflammation. This helps to reduce pain, swelling and fever, making these medications very helpful. But unfortunately, not all COX enzymes are bad. In fact some are important in helping to protect the stomach, liver and kidneys. This is where these drugs are potentially harmful, because while inhibiting the bad COX enzymes helping the patient on one hand, they also inhibit the good ones, leaving the body at risk for GI, liver and kidney disease. Therefore, the best NSAIDS available, are ones that selectively in inhibit only the bad COX enzymes, while preserving the good ones. For people, Advil, and Naproxen are more selective COX inhibitors than aspirin, owing to the movement generally away from aspirin use in favor of these other drugs in people, with aspirin now being used only under very specific circumstances.

In dogs, as I have already explained, aspirin is terribly toxic to the canine GI, but other human NSAIDs, even the more selective COX inhibitors, are liver and kidney toxic. For this reason, there are veterinary labeled NSAID medications that we can prescribe, such as Previcox, Deramax, an Rimadyl. Even with these canine labeled NSAIDs, there is potential for adverse effects, which is why we have to be very careful with their use and these medications can only be purchased by pet owners by prescription only while a patient is under the care of a veterinarian.

So you can see that Walmart's decision to sell a dangerous NSAID like aspirin over the counter, labeled for use in dogs and touted to be "Veterinarian Recommended," is not only appalling, but also unethical and most likely illegal. I do not know one vet that would recommend that aspirin be sold and labeled this way, when there are much more effective and safer prescription options for dogs in pain. I will go so far as to say that any veterinarian that does recommend this, should have his or her license to practice taken away. There are only a few circumstances in veterinary medicine where treatment with aspirin is indicated, and only under the close supervision of an attending veterinarian, certainly not as an over the counter product for the general pet owning population to decide how and when to treat.

Back to the dog I saw that alerted me of this situation, luckily, she had not yet had her stomach cooked by the aspirin she was receiving. But as it turned out, she did not have any hip problems as the owner thought, she had a slipped disc in her back, which was not only causing pain, but also some neuromuscular dysfunction in her rear limbs. What she needed what not an NSAID at all, but a steroid. Unfortunately, I could not give her a steroid right away like she needed, because of the aspirin that was in her system. The combination of the two would have virtually assured her a gastric ulcer that to date she had luckily escaped. Instead, I had to put her on a narcotic pain reliever to control her pain and have her strictly confined, while we waited 3 days to begin the steroid she so desperately needed to alleviate the root of her problems - the pressure of a disc compressing her spinal cord. So this patient may have escaped injury from the aspirin she was being given, but because of that aspirin I was forced to delay necessary treatment, prolonging her recovery. Nice job, Walmart, hope the 5 bucks you made off the bottle of pills was worth it!

On my end, I have begun to draft a letter to the Florida State Veterinary Board, on which I am compiling signatures of as many veterinarians in my area that I can get to sign it. You too can help to force Walmart's hand to stop their practice by writing the veterinary board of your state, as well as alerting your veterinarians of what they are doing so that they may act as well.

That is our show for this May 8, 2010. Happy Mothers day to all mommies out there.

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Dr. Roger Welton is the President and chief veterinarian at Maybeck Animal Hospital in West Melbourne Florida, as well as CEO of the veterinary advice and health management website Web-DVM.net.