Dogs on Phenobarbital: Understanding Side Effects and Critical Tips ππ
When your dog is diagnosed with epilepsy or seizures, Phenobarbital is often one of the first medications prescribed. While itβs highly effective in controlling seizures, it can come with side effects that every pet owner should be aware of.
Key Takeaways: Quick Answers About Dogs on Phenobarbital
- What are the common side effects? πΎ Increased thirst, urination, and appetite.
- Do side effects lessen over time? β³ Yes, many side effects subside after the first few weeks.
- Are there long-term risks? β οΈ Long-term use may lead to liver damage and sedation.
- What should I monitor while my dog is on Phenobarbital? π Regular blood tests and monitoring of behavior.
- Are there alternatives if side effects are severe? π‘ Yes, other anti-seizure medications may be an option.
πΎ What Are the Common Side Effects of Phenobarbital in Dogs?
Phenobarbital is effective at controlling seizures, but it can cause some noticeable side effects in dogs, especially during the initial stages of treatment. Some of the most common side effects include:
- Increased Thirst and Urination π§: Phenobarbital can cause polydipsia (increased thirst) and polyuria (increased urination), leading to your dog drinking and urinating more than usual.
- Increased Appetite π½οΈ: Many dogs experience polyphagia (increased appetite) while on this medication, leading to weight gain if food intake isnβt carefully monitored.
- Lethargy or Sedation π΄: Itβs common for dogs to appear more tired or sedated, especially during the first few weeks of treatment as their bodies adjust.
- Ataxia (Uncoordinated Movements) πΆββοΈ: Some dogs may appear clumsy or unsteady on their feet due to Phenobarbitalβs effects on the central nervous system.
Side Effect | Description | π‘ Tip |
---|---|---|
Increased Thirst/Urination π§ | Your dog will drink and urinate more | Ensure fresh water is always available πβπ¦Ί |
Increased Appetite π½οΈ | More hunger may lead to overeating | Use portion control and monitor weight π |
Sedation/Lethargy π΄ | May appear drowsy, especially early on | Encourage gentle activity to keep your dog engaged ποΈ |
Ataxia πΆββοΈ | Clumsy or wobbly movements | Keep stairs and sharp-edged furniture off-limits β οΈ |
β³ Do Side Effects Lessen Over Time?
In most cases, side effects tend to subside as your dogβs body adjusts to the medication. Increased thirst, appetite, and sedation are typically more intense during the first few weeks of treatment but often taper off. However, long-term side effects, such as liver damage, may take months or years to develop, so monitoring is essential.
Side Effect Timeline | Expected Changes Over Time | π‘ Tip |
---|---|---|
First 1-2 Weeks β³ | Increased thirst, appetite, and sedation | Monitor closely but expect gradual improvement πΏ |
1-2 Months π | Side effects often stabilize or lessen | Keep a log of behavior changes to track progress π |
Long-Term Use β οΈ | Watch for signs of liver issues (e.g., jaundice) | Regular blood work is key for early detection π©Ί |
β οΈ What Are the Long-Term Risks of Phenobarbital?
Long-term use of Phenobarbital comes with some potential risks, particularly to the liver. Over time, Phenobarbital can cause liver enzyme elevations and hepatic toxicity, which is why regular blood tests are critical to catch any issues early. Signs of liver damage might include:
- Jaundice π‘: Yellowing of the skin, gums, or eyes.
- Lethargy π€: Ongoing, excessive tiredness beyond the initial phase of treatment.
- Vomiting or Diarrhea π€’: Gastrointestinal issues may indicate liver distress.
- Increased Sedation π: A sudden increase in lethargy could signal liver complications.
Long-Term Risk | Impact on Health | π‘ Tip |
---|---|---|
Liver Damage π‘ | May cause jaundice, vomiting, lethargy | Schedule regular liver function tests with your vet π©Ί |
Increased Sedation π΄ | Can worsen if liver function declines | Monitor for changes in energy levels and report concernsπ |
Tolerance to Medication π§ͺ | May require dosage adjustments over time | Discuss alternatives or supplements with your vet π¬ |
π What Should I Monitor While My Dog Is on Phenobarbital?
Monitoring your dog while they are on Phenobarbital is critical for managing side effects and ensuring that the medication is effective. Hereβs what to keep an eye on:
- Behavioral Changes π: Note any changes in energy levels, coordination, or personality. If your dog seems excessively lethargic or begins stumbling more than usual, contact your vet.
- Appetite and Weight π: Increased appetite is common, but significant weight gain can lead to obesity and related health issues. Make sure youβre providing measured meals and tracking weight.
- Urination and Thirst π°: Track how often your dog drinks and urinates. Excessive urination can also be a sign of kidney issues in some cases.
- Blood Work π©Έ: Regular blood tests are essential for monitoring liver function and ensuring the medication isnβt causing organ damage. Your vet may recommend testing every 6 months or annually.
What to Monitor | Why Itβs Important | π‘ Tip |
---|---|---|
Behavioral Changes π | May indicate worsening side effects or liver problems | Track behavior daily and consult vet with concerns π |
Appetite/Weight π | Overeating can lead to obesity | Measure food portions and avoid high-calorie treats π |
Thirst/Urination π° | Helps track kidney and liver function | Keep water bowls filled but track excessive drinking π |
Blood Tests π©Έ | Essential for monitoring liver and kidney health | Schedule tests regularly and maintain a test log π |
π‘ Are There Alternatives If Phenobarbital Side Effects Are Severe?
If your dog is experiencing severe side effects or liver complications, there are alternative medications available for managing epilepsy and seizures:
- Potassium Bromide π§ͺ: This is another common medication used to manage seizures, particularly for dogs that cannot tolerate Phenobarbital. It has fewer risks of liver toxicity but may cause sedation and gastrointestinal issues.
- Zonisamide π: A newer option with fewer side effects than Phenobarbital, Zonisamide is often well-tolerated by dogs and may be a better choice for those who experience liver problems.
- Levetiracetam (Keppra) π₯: This anti-seizure drug is often used in combination with other medications or as a substitute when Phenobarbital isnβt tolerated. It has minimal side effects and is a safer option for dogs with liver concerns.
Alternative Medication | Benefits | π‘ Tip |
---|---|---|
Potassium Bromide π§ͺ | Lower risk of liver damage | May require a slow introduction to avoid GI issues π |
Zonisamide π | Fewer side effects compared to Phenobarbital | Works well for dogs with liver concerns but monitor sedation levels π |
Levetiracetam (Keppra) π₯ | Minimal impact on liver function | Good for combination therapy; consult vet for dosage advice π§ββοΈ |
βοΈ Final Verdict: Managing Phenobarbital Side Effects in Dogs
Phenobarbital is a highly effective treatment for controlling seizures in dogs, but itβs essential to understand and manage the side effects. While many of the initial side effects like increased thirst, urination, and appetite will lessen over time, itβs crucial to monitor long-term risks like liver damage. Regular blood work, careful observation of behavioral changes, and a willingness to explore alternative medications can help you maintain your dogβs quality of life throughout their treatment.
ποΈ Quick Recap: Managing Phenobarbital Side Effects
- Common early side effects: Thirst, urination, and appetite changes.
- Long-term monitoring: Focus on liver health with regular blood tests.
- Severe side effects: Alternatives like Potassium Bromide or Keppra may be suitable.
- Monitoring tips: Track behavior, manage diet, and keep close communication with your vet.
Your dogβs health and comfort are always the top priority, and by staying informed and proactive, you can help them thrive even while managing seizures. πΆπ
Comment 1: βHow can I tell if my dogβs Phenobarbital dose is too high?β
Signs of an excessively high Phenobarbital dose can become evident through changes in your dogβs behavior, coordination, and overall health. Monitoring these symptoms is critical, as an overly high dose can lead to toxicity:
- Extreme Sedation or Lethargy π€: While mild drowsiness is expected initially, if your dog seems unable to stay awake or lacks interest in activities they used to enjoy, it could indicate the dose is too high. Look for signs such as prolonged sleeping and difficulty rousing them for meals or walks.
- Severe Ataxia πΆββοΈ: Ataxia, or uncoordinated movement, is common when starting Phenobarbital, but it should improve with time. If your dog suddenly becomes extremely wobbly, has trouble walking in a straight line, or stumbles frequently, it could be a sign of overmedication.
- Excessive Thirst or Urination π°: Although increased thirst and urination are common side effects, sudden increases that go beyond what was initially observed can indicate that the medication concentration is too high. This could stress their kidneys and liver over time.
- Behavioral Changes π§ : Look out for irritability, confusion, or even aggression, as these can signal that the medication is affecting your dogβs nervous system. Such changes warrant an immediate discussion with your veterinarian.
Signs of Overdose | Behavioral Indicators | π‘ Tip |
---|---|---|
Extreme Lethargy π€ | Persistent sleepiness and lack of energy | Use a daily activity log to track energy levels π |
Severe Ataxia πΆββοΈ | Frequent stumbling, difficulty walking | Record videos to show your vet for a better assessment πΉ |
Increased Thirst/Urination π° | Drinking and urinating far more than usual | Measure water intake to provide accurate info π§ͺ |
Behavioral Changes π§ | Confusion, aggression, or unusual irritability | Seek immediate vet advice if sudden changes occur π |
Comment 2: βWhat should I do if my dog misses a dose of Phenobarbital?β
Missing a dose of Phenobarbital can be concerning, but there are steps you can take to minimize risks and maintain control over your dogβs condition:
- Administer as Soon as Remembered β°: If you realize a dose has been missed and itβs within a few hours of the scheduled time, itβs typically safe to give the missed dose immediately. This helps maintain a stable blood level of the medication. However, do not double up on doses to make up for a missed one.
- Timing Considerations π: If itβs closer to the next scheduled dose, itβs usually better to skip the missed dose and continue with the next one at the regular time. This avoids potential overdose risks due to overlapping medication effects.
- Watch for Signs of Withdrawal β οΈ: Missing a dose can sometimes lead to a lowered blood concentration, which may increase the risk of seizure activity. Monitor your dog closely for signs of restlessness, drooling, or muscle twitching. If a seizure occurs, contact your veterinarian immediately.
Action After Missed Dose | When to Apply | π‘ Tip |
---|---|---|
Give Dose Immediately β° | Within a few hours of scheduled time | Set reminders on your phone for dosing times π² |
Skip If Close to Next Dose π | If next dose is within 6-8 hours | Maintain a dosing calendar to track administration ποΈ |
Monitor for Withdrawal β οΈ | If dose is missed entirely | Keep an emergency contact number for your vet π |
Comment 3: βCan diet affect my dogβs response to Phenobarbital?β
Yes, diet can significantly influence how your dog responds to Phenobarbital, especially when it comes to absorption and metabolism:
- High-Fat Meals π: Phenobarbital is fat-soluble, which means that a diet higher in fat can enhance absorption of the medication. While this can make the drug more effective, it might also increase the risk of overmedication if the diet changes suddenly. Maintaining a consistent diet is key to ensuring stable blood levels.
- Protein Levels π₯©: Phenobarbital is metabolized by the liver, and diets high in protein can support liver function. However, for dogs with liver conditions, a moderate protein diet might be recommended to reduce strain on the liver while still maintaining essential amino acids that support healing and repair.
- Supplements and Herbs πΏ: Some supplements, such as milk thistle, are often used to support liver health in dogs taking Phenobarbital. While generally safe, they can interact with the medicationβs metabolism, so itβs crucial to consult your veterinarian before introducing any new supplements.
Diet Factor | Impact on Phenobarbital | π‘ Tip |
---|---|---|
High-Fat Meals π | Increases drug absorption | Keep diet consistent to avoid absorption spikes π² |
Protein Levels π₯© | Affects liver metabolism of medication | Adjust protein levels based on liver health advice π§ββοΈ |
Supplements πΏ | Can support or interfere with liver function | Always consult vet before adding new supplements πΏ |
Comment 4: βWhat is the process of weaning a dog off Phenobarbital?β
Weaning a dog off Phenobarbital is a gradual process that requires close collaboration with your veterinarian to ensure itβs done safely. Stopping the medication suddenly can lead to severe withdrawal symptoms and uncontrolled seizures:
- Step-Down Dosage Plan π: Your veterinarian will typically create a step-down plan, where the dosage is gradually reduced over several weeks. This allows the central nervous system to adjust slowly, reducing the risk of seizure recurrence.
- Introduction of Alternative Medications π: Often, weaning involves introducing a new anti-seizure medication alongside the reduced Phenobarbital. This creates a buffer to maintain seizure control while decreasing the dependency on Phenobarbital. Medications like Zonisamide or Levetiracetam are common choices.
- Frequent Monitoring π©Ί: During the weaning process, your dog may require more frequent veterinary visits to monitor blood levels and adjust the plan as needed. Watch for any signs of increased seizure activity, such as twitching, head tilting, or drooling, and report them immediately.
Weaning Step | Purpose of Step | π‘ Tip |
---|---|---|
Step-Down Dosage π | Gradually reduces Phenobarbital levels | Follow your vetβs schedule strictly; donβt skip steps π |
Add New Medication π | Maintains seizure control during transition | Ask about potential side effects of new medications π¬ |
Frequent Monitoring π©Ί | Ensures safe adjustment and controls side effects | Keep a detailed seizure diary to share with your vet π |
Comment 5: βHow long does it take for Phenobarbital side effects to become evident?β
Side effects from Phenobarbital can appear quickly, often within the first week of administration. However, their intensity and persistence can vary based on dosage, dog size, and individual health conditions:
- Immediate Side Effects β±οΈ: Within the first 24 to 48 hours, you might notice symptoms like lethargy, increased thirst, and appetite changes. These initial effects are the bodyβs response to the introduction of the medication.
- Gradual Onset Effects π : Over the first 2 to 4 weeks, more persistent side effects like coordination issues (ataxia) and behavioral changes may become more noticeable. At this stage, the body is adjusting to the steady-state level of Phenobarbital in the blood.
- Long-Term Effects π§ββοΈ: Side effects such as liver enzyme elevations or signs of hepatic stress usually take months to years to manifest. These require regular blood tests to detect before they become severe.
Onset Timeframe | Expected Side Effects | π‘ Tip |
---|---|---|
24-48 Hours β±οΈ | Lethargy, increased appetite/thirst | Allow for extra rest during the adjustment phase π |
2-4 Weeks π | Ataxia, behavioral changes | Report changes to vet to adjust dosage if needed π |
Months-Years π§ββοΈ | Liver stress, elevated liver enzymes | Stick to regular blood work schedule for early detection π©Ί |
Comment 6: βCan Phenobarbital cause behavioral changes in dogs?β
Yes, behavioral changes can occur in dogs taking Phenobarbital due to its impact on the central nervous system. These changes can range from increased irritability to general disorientation:
- Irritability or Aggression π‘: Some dogs may become more irritable or reactive than usual, especially if they feel drowsy or disoriented. This can be stressful for both the dog and its owner, particularly in multi-pet households.
- Restlessness or Hyperactivity πββοΈ: While Phenobarbital is a sedative, it can paradoxically cause some dogs to become restless or display uncharacteristic pacing. This may be a sign of underlying discomfort or anxiety due to the medication.
- Disorientation or Confusion π€: Dogs on Phenobarbital might seem confused or easily startled. They may have trouble recognizing familiar places or people, and some might even bark at seemingly nothing. This is usually a result of the medicationβs effect on brain function.
Behavioral Change | Reason for Change | π‘ Tip |
---|---|---|
Increased Irritability π‘ | Changes in nervous system function | Give your dog a quiet space to retreat when needed π‘ |
Restlessness πββοΈ | Possible discomfort or anxiety | Provide a calm environment and regular routines πΏ |
Disorientation π€ | Medication affecting cognitive function | Use gentle cues and maintain familiar surroundings π |
Comment 7: βHow can I support my dog’s liver while they are on Phenobarbital?β
Supporting your dogβs liver health while theyβre on Phenobarbital is crucial, as long-term use of the medication can put extra strain on this vital organ. Here are some effective strategies:
- Regular Liver Function Tests π©Ί: Consistent blood work, including liver enzyme panels, is essential for monitoring your dogβs liver health. Tests like ALT (Alanine Aminotransferase) and ALP (Alkaline Phosphatase) levels help detect early signs of liver stress, enabling timely adjustments in treatment. Your veterinarian might recommend testing every 3 to 6 months, depending on your dogβs condition.
- Milk Thistle Supplementation πΏ: Milk thistle is a popular supplement used to support liver function in dogs. Its active ingredient, silymarin, has antioxidant properties that can help protect liver cells from damage. Itβs crucial, however, to consult your vet before starting any supplement to ensure it doesnβt interfere with your dogβs current medication regimen.
- Liver-Friendly Diet π: A diet rich in high-quality proteins and low in processed fats can ease the burden on the liver. Look for dog foods labeled βliver supportβ or consider home-cooked meals that focus on lean meats like chicken or turkey, with plenty of fresh vegetables. Avoid feeding high-fat treats or table scraps, which can add stress to the liver.
- SAM-e (S-Adenosylmethionine) π: SAM-e is another supplement that supports liver function by promoting cell regeneration and reducing oxidative stress. Itβs often used alongside Milk Thistle to provide a dual-action approach to liver support. Your vet can recommend an appropriate dosage based on your dogβs weight and health needs.
Liver Support Strategy | Benefit to Dog | π‘ Tip |
---|---|---|
Regular Liver Function Tests π©Ί | Early detection of liver stress | Schedule tests during routine vet visits π |
Milk Thistle πΏ | Antioxidant protection for liver cells | Use vet-approved formulations for safety π₯ |
Liver-Friendly Diet π | Reduces dietary stress on liver | Look for dog foods labeled βliver supportβ πΆ |
SAM-e Supplement π | Promotes liver cell regeneration | Combine with Milk Thistle for enhanced protection πΏ |
Comment 8: βCan Phenobarbital interact with other medications my dog is taking?β
Yes, Phenobarbital can interact with various other medications, potentially altering their effectiveness or leading to adverse effects. Itβs crucial to understand how these interactions might impact your dogβs health:
- Effect on Other Anti-Seizure Medications π§ : Phenobarbital is sometimes used in combination with other antiepileptic drugs like Levetiracetam or Zonisamide. It can speed up the metabolism of these medications, potentially requiring higher dosages of the other drugs to maintain their effectiveness. This is why careful dose adjustments are necessary when using combination therapies.
- Impact on Pain Medications π: Non-steroidal anti-inflammatory drugs (NSAIDs), like Carprofen or Meloxicam, may be prescribed for pain management in dogs. Phenobarbital can increase the liverβs metabolic activity, which might reduce the effectiveness of these drugs or place additional strain on the liver. Monitoring liver enzymes is especially important if your dog is on both types of medication.
- Antibiotics and Antifungals π¦ : Certain antibiotics and antifungal medications, such as metronidazole or ketoconazole, can interfere with Phenobarbitalβs metabolism, leading to increased blood levels of Phenobarbital. This can heighten the risk of toxicity and side effects. Adjusting the Phenobarbital dose or the accompanying medication might be necessary to balance their effects.
- Sedatives and Anesthesia π΄: Dogs on Phenobarbital may have an altered response to sedatives or anesthesia due to the medicationβs sedative properties. If your dog requires surgery or any procedure involving anesthesia, inform your vet about their Phenobarbital use, as adjustments in dosages might be required to ensure safety.
Medication Interaction | Effect on Phenobarbital or Other Drug | π‘ Tip |
---|---|---|
Anti-Seizure Drugs π§ | May require increased dosages of other drugs | Discuss all dosage changes with your vet π |
Pain Medications (NSAIDs) π | Can increase liver strain | Monitor liver enzyme levels during treatment π©Ί |
Antibiotics/Antifungals π¦ | Risk of increased Phenobarbital blood levels | Adjust dosages based on vetβs recommendations π¬ |
Sedatives/Anesthesia π΄ | May need dosage adjustments for procedures | Inform vets about Phenobarbital before any procedure π₯ |
Comment 9: βWhat should I do if my dog has a seizure while on Phenobarbital?β
Experiencing a seizure in a dog thatβs already on Phenobarbital can be alarming, but there are specific steps you can take to ensure their safety:
- Stay Calm and Ensure Safety π§ββοΈ: During a seizure, itβs important to remain calm and ensure your dogβs immediate surroundings are safe. Move furniture or any sharp objects out of the way, and place a soft towel under their head if possible. Avoid placing your hands near their mouth, as they may bite unintentionally.
- Time the Seizure β±οΈ: Use a stopwatch or phone timer to measure the length of the seizure. Most seizures last 1-2 minutes, but if it continues for more than 5 minutes, this is considered a medical emergency, known as status epilepticus, and requires immediate veterinary intervention.
- Note the Details π: Keep a seizure log with details like duration, time of day, and any triggers you may have observed. This information is crucial for your vet to adjust the Phenobarbital dosage or consider other medications.
- Post-Seizure Care π€: After the seizure, your dog may experience a postictal phase, which can involve confusion, disorientation, and temporary blindness. Allow them to rest in a quiet space with minimal stimulation. Offer water once theyβre fully alert, as seizures can be dehydrating.
Action During a Seizure | Why Itβs Important | π‘ Tip |
---|---|---|
Ensure Safety π§ββοΈ | Prevents injury during seizure | Use pillows or blankets to protect your dog ποΈ |
Time the Seizure β±οΈ | Determines if emergency care is needed | Call your vet if seizure lasts over 5 minutes π |
Log Details π | Helps in adjusting medication dosage | Include time, duration, and any potential triggers π |
Post-Seizure Care π€ | Aids in recovery after a seizure | Keep water accessible and stay close for comfort 𧑠|
Comment 10: βWhat are the signs that Phenobarbital is working for my dog?β
Evaluating the effectiveness of Phenobarbital in your dog involves observing changes in seizure frequency and overall behavior:
- Reduced Frequency and Intensity of Seizures π: The primary indicator that Phenobarbital is effective is a noticeable reduction in the number and severity of seizures. While it may not completely eliminate them, successful treatment usually results in less frequent episodes and milder seizure activity compared to before the medication started.
- Stabilized Behavior π§ : Beyond seizure control, effective Phenobarbital treatment may lead to a more stable, predictable mood. Dogs that were previously anxious or aggressive due to seizures may become calmer and more relaxed, indicating better control over their neurological symptoms.
- Normal Appetite and Energy Levels πβπ¦Ί: After the initial adjustment phase, a dog responding well to Phenobarbital will typically return to a more balanced routine. They should regain a healthy appetite without excessive weight gain and engage in regular activities like walks or playtime without significant lethargy.
- Blood Work Confirmation π©Ί: Regular blood tests can provide quantitative confirmation that Phenobarbital levels are within the therapeutic range, meaning the medication is effectively controlling seizures without causing undue side effects. This is especially important for adjusting dosages to keep levels in the optimal range.
Sign of Effective Treatment | What It Indicates | π‘ Tip |
---|---|---|
Fewer and Milder Seizures π | Shows medication is controlling episodes | Maintain a detailed seizure log for comparison π |
Stabilized Behavior π§ | Indicates reduced neurological symptoms | Note improvements in social interactions πΎ |
Normal Appetite/Energy πβπ¦Ί | Reflects adjustment to medication | Monitor weight to ensure a healthy balance π |
Therapeutic Blood Levels π©Ί | Confirms effective dosage without toxicity | Follow vetβs testing schedule to ensure stability π§ββοΈ |
Comment 11: βHow can I reduce the cost of Phenobarbital for my dog?β
Reducing the cost of Phenobarbital treatment involves exploring different options for obtaining the medication and managing veterinary expenses:
- Generic Alternatives π: Ask your veterinarian if there are generic versions of Phenobarbital available, which can be significantly cheaper than brand-name formulations. Generics contain the same active ingredient and are often just as effective.
- Online Pharmacies π»: Many online pet pharmacies offer lower prices for Phenobarbital. Look for pharmacies that are veterinarian-approved and require a valid prescription. This ensures the medicationβs quality and compliance with safety standards. Compare prices across several trusted sites to find the best deal.
- Discount Programs and Coupons π·οΈ: Some veterinary practices offer discount programs for long-term medications. Additionally, websites like GoodRx may have coupons that apply to pet medications, including Phenobarbital. Itβs always worth asking your vet or pharmacy if there are any available discounts.
- Ask for Larger Prescriptions π¦: If your dog is on a stable dose, ask your vet to write a prescription for a 90-day supply rather than a 30-day supply. Many pharmacies offer price breaks on larger quantities, making this a cost-effective option for long-term use.
Cost-Saving Strategy | How It Helps | π‘ Tip |
---|---|---|
Generic Alternatives π | Lower cost with same effectiveness | Ask your vet to specify βgeneric allowedβ on prescriptions π |
Online Pharmacies π» | Often offer lower prices than local stores | Verify pharmacy accreditation before purchase π§ββοΈ |
Discount Programs π·οΈ | Reduces monthly medication expenses | Check for coupons on pet-specific discount websites π° |
Larger Prescriptions π¦ | Bulk purchasing reduces per-dose costs | Request a 90-day script if your vet agrees π |