call for help

[Chris Douglas]

Hi everyone,

after hearing here about valium gel/suppositories I asked the vet for a "call back" about getting some and was told by their receptionist they don't do the gel or suppositories I was finally able to talk to the vet herself today and looks like the reason they don't "do" it is cause they don't have it "but" if I was to get "all' the info. on it then they would consider "trying to script" it to the local drug store ... and this only after I asked her if she couldn't just write a prescription for it ...

so here's where all of you come in ... can y'all post exactly what the prescription label says to I can in turn give that info to the vet and she can try to script it to my local drug store?

it was only after I voiced my concerns about how the valium tablet given rectally doesn't work quick enough to keep my Molly from having cluster's and the Keppra can't be given to her orally if she doesn't wake up while having these clusters that she agreed to try and "script" the gel out to the local drug store ...


thanks in advance,
Chris and Molly

[Chris Douglas]

so here's what I have found so far about dosing:

http://canine-epilepsy.com/diazepamprotocol.html

"In dogs not taking phenobarbital, the dose is usually 0.5 to 1 mg per kg." ... and if I did this right then my 27 pound Molly is roughly 12 kg's ... soooo then it's (12 times 0.5 mg's of valium which is) 6mg's valium ... to ... (12 times 1mg's valium which is) 12 mg of valium

so my question is does this sound about right to all of you? ...

[Dozer]

Chris

I have found this forum to not be very active

I would contact another vet in your area, I found another vet and he had way more information than my original vet

[Chris Douglas]

hi Dozer,

thanks for the "come-back" ... I've noticed the same thing about this forum ... perhaps you could post links to more active forums ...

I would contact other vets. if we had any ... unfortunately the vet we do have is only here 2 days a week as is

... then there's the concern that if we did go outta area which costs just doing that ... and the costs of all the tests having to be "redone" (since what I have found in my experience is that even though "patient record's" can be and have been faxed one vet to another in my past) that the 2nd vet always wants to do their own tests ... as if somehow the new tests will show anything different ... ... when it's the exact same tests ...

Chris and Molly

[Chris Douglas]

just learned from the pharmacy that the valium gel is available in a twin syringe pack of a combined 2.5 mg per pack for roughly $250.00 to $280.00 ... so much for that "cost prohibited" route ... ... and so far he can't find where valium suppositories are available at all ... this from someone who's not only a pharmacist but own's in another town a "compounding pharmacy" ... he did say he would check into the possibility/cost of "compounding a valium suppository" for us ...

not holding out much hope for that happening for a multitude of reason's ... availability of supplies needed and cost of doing it if it could be done ...

looks like we're stuck with the valium tablets used rectally during 1st seizure and hope the cluster's aren't really really bad ...

[SpencerBhumi]

Hi Chris,

That cost is astoundingly ridiculous. Was that misread and be just 25-28 dollars?

I mentioned elsewhere that I use intravenous valium solution – which comes with its storage and handling issues. This IV solution absorbs (oral/nasal/rectal) and works the same as tablets – but quicker.

An ampoule of intravenous valium for human use 10mg/1ml costs about $5.00 (plus whatever mark-up by the pharmacy).

My vet uses a different strength & volume (animal market suppliers) and their mark-ups cost me about $30.00 per dose calculated for Spencer.

This liquid valium must be stored in DARK GLASS – light will degrade the active constituents and plastic will absorb the active constituents. If I need to use it I need to draw up the volume into a syringe and insert the dose rectally (that minute or two of light & plastic is insignificant to degradation of the valium).

My next thought for you will be to 1) ask your vet if they can dispense one dose of IV valium solution in a dark glass bottle + a plastic syringe for administration, 2) visit your own doctor to see if you can get an ‘alternative script’, 3) for interest & info sake, visit your local hospital and see what preparations they have available. Children’s hospitals/wards often have different preparations for easy use. If you can see that these preparations are available, take this info back to your pharmacist and see if they can source it – or if there is a hospital pharmacy, if they will supply it, and finally 4) crush your tablets add water and make your own.

Good luck.

Trevor & Spencer
Grateful for the good days, weeks (months).

[Chris Douglas]

Hi Trevor,

that was "no" misread or Typo" ... $250.00 to $280.00 for a "twin-pack" of "pre-loaded" syringe's ... 1.25 mg per syringe/2.5 mg total per pack ... at the local drug store/ pharmacist resourcing supplier's of human med's ... no suppositories from their source available ... only liquid(storage issues for me so didn't get a price) and gel as above ...

the only thing the vet carries are the tablets ... will script. out the suppositories if I get the "dosage protocol's for her" ... but now I got the dosage info. for her (haven't told her yet) I can't fill script at drug store ...

so I asked pharmacist about pill crusher and mix with water, suck it up in syringe, and insert rectally(without needle) 1" .... same "delivery system" as gel ... basically

he said it would depend on the "fillers/binders used by the manufacturer's ... if they are "water soluble" ... and that was something only the manufacturer would know ...

so I came home ... "test drove" the pill crusher on valium pill ... it crushes "finely" ... the placed in small container(Glad 4 oz mini round) with a "dribble" of water ... it dissolved on it's own without stirring ... was suspended "nicely" ... let sit for over an hour without it "gelling or clumping" ... so I think I"m on to something ...

then went to an animal supply place and was able to purchase plunger's for .49 cents ...

I found a small dark brown glass bottle with a plastic/rubber tit screw-on lid that has a glass eye dropper attached to the lid to put a "pre-crushed" pill in ... cleaned it good with rubbing alcohol and place glass bottle part in microwave just long enough to get good and hot for drying and sterilizing ... since the crushed pill doesn't come in contact with the lid and the eye-dropper tube is glass I hope having a plastic screw-on lid won't hurt the valium ...

well ... that's where we're at at this point ...

[Gentle Jacob's mom]

The price they gave you for rectal valium is insane! I heard of ridiculous prices before but this is the highest I've ever heard. Can you check out mail order compounding pharmacies? I have to get going or I'd look for you. If you can, find one that dispenses in a dark bottle (usually brown or blue). Getting it in syringes is not a good idea. It looses it potency that way. I don't know about doing it yourself. I wouldn't do it, but I'm a wimp when it comes to these things. When our holistic vet was teaching me how to mix the tincture he came up with for Jake so that we could save $$, I was a mess. Now I do it with my eyes closed.

Lynne

[Chris Douglas]

the pharmacist I was talking to was "filling" in for the owner and he has a "compounding pharmacy in another town as well ... he going to check into things for me ... took my e-mail address and phone number ...

and what I found interesting is the fact he couldn't find where valium suppositories was available thru the drug store's supplier's ... at all ... an on the net I have learned woman use them for a myriad of issues from floor dysfunction to pelvic pain ... and the woman use them "vaginally" as well ...

my only concern at this point is that using water as a dilutant (when during a seizure I mix it with the pre-crushed valium tablet) may be too thin and watery to stay in ...

all that being said ... I feel better knowing that at least during the 1st seizure, if I can get the "re-crushed" valium mixed with water and sucked up in a .49 cent syringe and inserted rectally ... then not only is it going to be absorbed quicker, cost less, and I've done all I can considering my limited ability financially and storage wise ...


as for the "pre-loaded syringe's and plastic ... it has an additive that I can't remember the "techie name" (Propylene glycol?) of that make's it ok to be in the plastic ...

[Chris Douglas]

just a update: ... just talked to the twice weekly vet here and after telling her about the expense of gel valium ... and what I have done concerning the valium table/pre-crushed/ stored in a sterilized brown glass bottle ... ready to be mixed with water and syringed during the 1st seizure ... she was quite pleased ...

and she mentioned that since our last discussion last week she had given some thought to "pre-crushing" some pills for me for just that very application ... and giving me the syringe's I would need ... dang, iffin' I'd of know that I could of saved myself .49 cents ..

so I then asked her if I could "pre-mix" the water with the "pre-crushed" valium and store it in the same glass brown bottle for use during that 1st seizure thereby eliminating 1 step in the process during the 1st seizure ... when I'm "stressed-out" ... ... anywayzzzz ...
and she said she couldn't see any reason why that would hurt anything and make it even quicker to be administered ...

edited for p.s. ... back when she wanted me to find out for her the "dosing protocol" ... I took in what I found out thru the internet ... which is 0.5 to 1.0 mg's per kg's of dog body weight ... after reading this ... I had copied it down on a pocket ... she said, "yup, that should be about right" ... Thanks Lynne for the link!!!!! ...

canine-epilepsy.com/diazepamprotocol.html

http://www.canine-epilepsy.com/diazepamprotocol.html

[cesullivan]

A friend was given ky, surgical tubing, a syringe and liquid valium for rectal delivery...I believe this site will give you and your vet some more information.

http://www.canine-epilepsy-guardian-ang ... e_protocol

[Chris Douglas]

hi Chris,

thank for help ... this is the site that I posted links to that was given to me by Lynne ... it's a great resource of info ...

[Chris Douglas]

now my next thought is to "precrush" 1 keppra and make sure it crushes finely ... then add a drop or two of water to make sure the binders/filler's used don't make it clump or gel ... maybe if everything goes ok it could be added to the valium in the glass brown bottle for use during the 1st seizure ... thereby making it possible to get both drugs into Molly almost immediately and having them "absorbed" quickly ...

I warned both the pharmacist and the vet that "my lil' train may be goin' around the bend" with all this over-thinking it to death with 'what can I do that's both cost effective and helpful for Molly ... .... but so far they are in agreement that what I'm doing is ok and safe ... or as one of them said, "I'm ahead of the curve" ... in reference to the pill crushing, sterilization and use of brown glass bottle ... the hard part is not knowing what binders/filler the manufacturer used in the pills, that's something only they know ...

[cesullivan]

Yeah, it can get expensive. Since Cali tends to have between 4-10 grand mals anywhere between a minute and 12 hours apart, I try everything to break them as I am worried about status and the effect of her not recovering in between the seizures. The neurologist sold me some Keppra Intra-muscular bottles. I want to say I got 4 bottles for $250 or maybe $350. Each bottle is one 5ml shot. So she gets a shot and a pill right after the first seizure. So 750mg tablet and 500mg shot. I can give up to 3 shots, but I stopped at 2 shots and took her to the ER last time.

[Dozer]

Looks like you are getting help, I am not aware of any other forums on this subject but I am sure they are out there.

I started with a 2nd vet with no records transferred, yes he did his own blood tests and started from there.

Good luck with your pooch