I have managed to get my vet to agree to trial Paige on thyroxine (still within range so he was reluctant but her T4 has dropped and she has symptoms).

The (small rant, sorry) arsey vet nurse/receptionist has just rung to let me know he's dispensing some Leventa solution for her.  I asked if he'd given a reason, to be told 'well I'm not going to argue with the vet about it...'  in a really sharp tone.  I didn't ask you to dear, you stroppy b*tch!  She said she could ask him if I wanted (also in arsey tone) so I said yes, and she's just rung back to tell me that apparently, he has to now prescribe Leventa in the first instance for a newly diagnosed patient as it's just been licenced.

I know about the Cascade system (having to use a licenced, suitable product for a given disease if there is one before going to other species' drugs then to human drugs if required) but I'm not making sense of this when Soloxine has been licenced and suitable for years.  It's also my personally preferred drug as it's a twice daily dose which is the optimal regime for treating hypothyroidism, whereas Leventa is once a day - and also a liquid, which is going to be a PITA to give to her 2-3 hours before feeding!

Can anyone shed light on this?

Have a look a this
http://endocrinevet.blogspot.co.uk/2012/03/alternative-dosage-forms-of-l-thyroxine.html
some medical links at the bottom
I would maybe send a email to jean dodds & get her verdict on it

Nikita

I had a similar scenario with a bitch several years ago.  She was put on epiphen, low dose, and liquid.  (For seizures.) When her next blood test showed she needed a higher dose, I didn't think to ask why it was phenobarbitone tablets.  I was just pleased that tablets were far less fiddly, and thought no more about it.

Her next blood test showed another change.  The results came through while I was on holiday.  My vet called me on my mobile with the results, as he knew that I had the dog with me.  And he asked if I had enough tablets with me to increase her dose.  I said yes, so her dosage was upped while I was away.

On my return, I called in to the hpspital and asked one of the girls to order me some more phenobarb, but wanted the next size tablet up, to save me messing about giving one and a half tablets.  My repeat orders were done by phone with no problems.  Until I had an appointment with another dog, and saw my vet to talk to.  I was gobsmacked when he told me that I could get him struck off!!! 

When we got to the bottom of it, it was a misunderstanding.  When I asked for a larger tablet, the girl I spoke to ordered the same drug (naturally), but it appeared that this next size tablet came in "epiphen" which you prescribe for dogs, only using the human equivalent (phenobarb) if the same dosage is not available.  Neither the receptionist or I were aware!

Now something like that I could understand - but grumpybint was very clear that he'd said it was licencing, that because the leventa has now been licenced for dogs he had to use that first for a new case (i.e. Paige), rather than the usual soloxine which has been licenced for years.

It's certainly not a dosing issue - he wants her on 0.5ml once a day which is 0.5mg, where for a dog her size the soloxine dose would be 0.4mg twice a day.  So she'll be getting a fair bit less than the bodyweight dose, to begin with at least.

One of my girls was on Soloxine and, was doing fine on it,  like you about, 3 years ago, when I went for more pills was given Levanta. I have to say that Katya coped very well with the change and seemed a bit brighter than before.

Well she's on it, thankfully she'll take it in some sausage so that worry is sorted, phew :-)

I've asked elsewhere about my original question though, re. the licensing - apparently it's complete bull :-(  Leventa has been licensed for years and there is no reason he couldn't have put soiloxine out for her, and certainly nothing saying he HAS to use Leventa now for new cases.

I'm a lot more bothered that I've been flat-out lied to about this than what he's given her - I have heard good reports of Leventa elsewhere since asking so I'm happy to continue with it but I am very put out that the vet I consider to be the best in the practice has behaved this way.

That is assuming, of course, that dintsybint receptionist didn't get it wrong - I have to take Paige in for a restest in a few weeks and I'll be asking him directly then why he prescribed it to find out the truth.

Some wild guesses: money/preferred supplier; he has got muddled and rather than admit it has tried to b/s his way out?