Case report: treatment of canine colitis in a dachshund with a compounded oral tri-mix (green lizard).

Feline herpetic keratitis (infectious keratoconjunctivitis), an infection of the conjunctiva and cornea that is common in cats, involves a three-pronged treatment approach: (1) antiviral therapy, (2) immunomodulatory therapy, and (3) antibacterial therapy. Since very few agents have been approved for the treatment of feline herpetic keratitis, and many of the drugs that were approved at one time for this indication can no longer be purchased, compounding pharmacists can play a vital role in the prevention and treatment of this infection. Investigators at the Colorado State University College of Veterinary Medicine and Biomedical Sciences evaluated the effect of a new antiviral agent, cidofovir, for ophthalmic use in treating feline herpetic keratitis. Researchers concluded that application of cidofovir significantly decreased the clinical signs of acute ocular infection in cats with feline herpesvirus type 1, one of the primary causes of feline herpetic keratitis. Working with veterinary ophthalmologists, compounding pharmacists can develop other treatment options in patientspecific dosages and dosage forms to ensure that treated cats have an excellent response to therapy. continued on next page Case Report: Transdermal Fluoxetine as Therapy for Feline Anxiety RxTriad-A publication of the International Journal of Pharmaceutical Compounding. © 2007 IJPC. All rights reserved. Oxytetracycline hydrochloride 150 mg Polymixin B sulfate 15 mg Lacrilube 15 g Dispense 15 g Sig: Apply 1/4 inch strip in each affected eye of the cat 4 times daily until the conjunctivitis resolves. Hyoscyamine sulfate 2 mg Lidocaine viscous 2% 33 mL Maalox 33 mL Sterile water 33 mL Dispense 100 mL Sig: Give 1-2 mL by mouth twice a day routinely and may give an additional 1-2 mL as needed up to twice a day for intestinal cramps. Idoxuridine 15 mg Thimerosal 0.3 mg Sterile water for injection 15 mL Dispense 15 mL Sig: Place 1 drop in each affected eye of the cat every 4-6 hours until conjunctivitis symptoms resolve. Fluoxetine 200 mg Pluronic lecithin organogel 10 mL Dispense 10 mL Sig: Apply 0.2 mL (4 mg) to the cats ear daily, rub in thoroughly. Wear finger cot or gloves when applying. CASE REPORT CONTINUED (1) an elixir containing hyoscyamine, an anticholinergic belladonna alkaloid, and phenobarbital, (2) lidocaine viscous, and (3) an antacid/antigas suspension containing magnesium hydroxide, aluminum hydroxide, and simethicone in the proportions 200-200-20 mg/5 mL. The veterinarian named his formula “green lizard,” a preparation prescribed for both human and veterinary patients. The tri-mixture was formulated by Winston’s owner, a pharmacist. Dosing is 1 to 2 mL orally twice a day or as needed to give the dog symptomatic relief. Pancreatic enzymes have been added to his daily therapy, and his nutrition has been adjusted. The owner and the veterinarian felt that an alcoholand phenobarbital-free preparation would be advantageous for this animal, therefore a modified formula leaving out the anticholinergic belladonna alkaloid and phenobarbital was prescribed. The “modified green lizard” formula continues to provide symptomatic relief for Winston until a more definitive treatment plan can be determined.