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Veterinarians Cleared for Wider Use of Telemedicine During Pandemic

FDA eases drug rules to foster social distancing due to coronavirus outbreak

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For older adults and those with underlying health conditions facing the difficult choice between risking a trip to the vet or foregoing treatment for a sick pet, there's good news. The Food and Drug Administration has temporarily suspended the enforcement of rules that prohibited veterinarians from prescribing certain medications after a televisit alone. A 2019 poll sponsored by AARP found that 55 percent of adults ages 50 to 80 own at least one pet.

Here's how it works: An owner might send the vet a video or photo of the pet, for example, and have a video chat about the symptoms. The same goes for the owners of livestock. After making a remote diagnosis, the vet can then write an order for certain prescription drugs, something that wasn't allowed in the past without examining the animal in person.

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The steps announced March 24 by the FDA were triggered by the pandemic. The changes should let vets make greater use of telemedicine to maintain the health of household and farm animals, while heeding the call for social distancing — including staying six feet apart from others — to slow the human-to-human spread of COVID-19, the illness caused by the new coronavirus.

Fine print of the FDA decision

At the heart of the change is the ability for a vet to prescribe what's known as an “extralabel” prescription drug without an in-person exam of an animal. Extralabel use could apply to, say, an antibiotic such as Cephalexin that's FDA-approved only for human use. Extralabel use also means prescribing a drug for a condition or disease for which the FDA has not authorized its use.

The Veterinarian-Client-Patient Relationship explained:

  • “V"= vet
  • “C"= client, meaning animal owner or caretaker
  • “P”= patient, meaning the animal
  • “R” = these three parties’ relationship

The FDA says it specifically plans to temporarily suspend enforcement of some federal rules in the context of what's called the veterinarian-client-patient relationship, or VCPR. 

Until now, rules on prescribing extralabel drugs required vets to first physically examine the animal and/or make medically appropriate and timely visits to the location where the animal is kept. That precluded prescribing such drugs via only a televisit.

To help vets use telemedicine to address animal health during the pandemic, the FDA says that, generally speaking, it does not intend to enforce the animal examination and premises visit portion of its rules on extralabel drug use in animals and veterinary feed directive (VFD) drugs. The change will limit human-to-human interaction and the potential spread of COVID-19, the agency says.

One caveat: If state regulations on extralabel drug use are stricter than the federal rules, the state rules remain in force.

A big deal for pet, livestock telehealth

"This is a big deal,” says Lori Teller at Texas A&M University College of Veterinary Medicine & Biomedical Services, where she is a clinical associate professor of telehealth. “My in-box has been exploding for the past 10 days,” she says, as vets reach out with questions about telemedicine.

"There's been a huge surge in demand to learn how to better incorporate telemedicine in the workflow,” Teller adds, “and to use third-party platforms to capture (case) notes, especially while social distancing."

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Before the pandemic, many vets had been informally practicing telemedicine by taking after-hours calls and receiving emails, texts and communication via Facebook Messenger, she says. She prefers taking a more systematic approach using a formal telehealth platform. That way medical records are kept in one place to promote continuity of care of an animal. A late-night call to your vet might not necessarily be entered into the pet's medical record the next day, or at even all, she says.

Pets and the coronavirus

Teller and her physician-husband have two yellow Labs, Gracie, almost 4 years old, and Tucker, almost 8. The matriarch of the fur family is Maggie, a domestic shorthair cat, who turns 19 years old on April 1.

As to whether people can contract coronavirus by petting their dog or another's dog, she says: “With everything that we know about coronavirus, the risk of transmission between pets and people is extremely low.” Still, after petting any animal a person should practice good hygiene and wash their hands, Teller notes.

"If you're healthy and the pet is healthy, snuggle away,” she advises. “If you are ill, the CDC recommends that someone else in the household care for your pet."

The CDC, which stands for the Centers for Disease Control and Prevention, says there is no evidence at this time that pets can spread COVID-19.

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