Evaluating Pharmacists’ Role In Veterinary Medication Management and Education

The field of veterinary medicine focuses on the health and welfare of animals, as well as the prevention and control of zoonotic diseases. According to the American Veterinary Medical Association, there were more than 130,000 employed veterinarians in the US in 2024. More than 71% of employed veterinarians’ clinical practice revolved around companion animals, defined as the delivery of health care to animals owned for companionship, including exotic animals.¹

In terms of veterinary specialization, there were approximately 18,000 active board-certified diplomates in 2024. Despite this, only 64 veterinarians were board certified by the American College of Veterinary Clinical Pharmacology that year.² Furthermore, there are only 3 veterinary pharmacy–dedicated groups in the US: Society of Veterinary Hospital Pharmacists, American College of Veterinary Pharmacists, and American Academy of Veterinary Pharmacology and Therapeutics.

Given how few veterinarians specialize in pharmacology, continued expansion and increasing complexity highlight a need for professionals with advanced expertise in medication management, particularly pharmacists with specialized training in veterinary pharmacy.

Demographics of Veterinary Pharmacists

According to the Board of Pharmacy Specialties (BPS), there are 15 recognized specialties, including ambulatory care, cardiology, and compounded sterile preparations. The majority of these specialties revolve around human patient care. However, in February 2025, the directors of BPS issued a petition to evaluate veterinary pharmacy as a potential specialty certification. This action highlights veterinary pharmacy as an emerging and soon-to-be increasingly recognized area of practice.³

The Board of Pharmacy Technician Specialties (BPTS) formally recognized veterinary pharmacy in 2023 by offering a Veterinary Pharmacy Certificate. To be eligible for this certificate, the technician must be an active certified pharmacy technician and meet one of the eligibility requirements to sit for the examination. The eligibility requirements include completion of a BPTS Recognized Training Program for Veterinary Pharmacy or having a minimum of 1 year (1000 hours) of supervised pharmacy experience related to veterinary pharmacy. The certification examination assesses 4 domains: veterinary pharmacy concepts and terminology; veterinary pharmacy regulations and compliance; veterinary medications; and species-specific pharmaceutical care considerations.⁴

Despite growing interest and formal recognition at the pharmacy technician level, there is no clear, stepwise pathway for pharmacists to become board-certified. Currently, only a limited number of programs in the US offer 1 to 2 years of International Board of Veterinary Pharmacy–accredited residency for pharmacists.⁵ Before residency, pharmacy students are encouraged to pursue clinical rotations that are aligned with veterinary medicine. In contrast, veterinarians pursuing board certification in Veterinary Clinical Pharmacology must complete 1 of 13 AVCP Education Committee–approved residencies, publish at least 2 manuscripts, and pass 2 written examinations.^6-8

Despite increasing recognition of veterinary pharmacy as a specialized area, limited pharmacist involvement in routine veterinary care leaves significant gaps in medication management—directly impacting treatment outcomes and adherence issues.

Impact of Pet Ailments

As veterinary medicine evolves with expanding roles and specialties, the realities of medication management in companion animal care expose significant challenges impacting both clinical outcomes and client experience. Unlike human patients who manage their own treatment, pet owners are responsible for administering medications, making adherence and proper administration critical yet difficult.

In published research, rates of client adherence vary widely, with many pet owners underdosing, missing doses, or stopping medications prematurely—factors correlated with poor therapeutic outcomes, antimicrobial resistance, and prolonged disease states. Estimates suggest adherence rates in small animal practice range from as low as 22% up to about 80%, depending on how adherence is defined and measured, indicating substantial variability and gaps in effective treatment execution.⁹

Medication errors represent a major safety issue in veterinary practice. In a large review of 1031 incident reports at a veterinary teaching hospital, 66% of incidents were medication-related, and within these, 51% involved incorrect dosing, underscoring how common dosing errors are when pharmacists are not routinely integrated into care teams.¹⁰ The FDA has also documented that medication errors in animal care, ranging from prescribing miscommunication to misinterpretation of drug names and abbreviations, can directly lead to inappropriate medication use, potential patient harm, and in some cases, serious adverse events (AEs).¹¹

Owner administration challenges further compound these risks. For example, behavioral resistance from pets, difficulty with tablet administration, and owner injury during dosing attempts are commonly reported barriers that directly affect medication success rates.¹² Together, these data highlight how medication complexity and suboptimal adherence are integral problems in veterinary care that can undermine therapeutic efficacy and increase risk for pets and owners.

Rationale for Pharmacist Involvement

Given the documented challenges in veterinary medication management, there is a compelling rationale for expanding pharmacist involvement as part of the veterinary care team to improve safety, education, and patient outcomes. Pharmacists bring specialized expertise in drug therapy, pharmacokinetics, and error prevention that has demonstrable impact in human health settings. Emerging evidence suggests similar benefits in veterinary practice. For instance, when a veterinary teaching hospital introduced daily pharmacist chart reviews in small animal intensive care units, the proportion of reported medication incidents declined from 62% before implementation to 48% after, suggesting potential improvements in medication safety with pharmacist participation.¹³

Another reason is cost savings for all stakeholders. For veterinary, carrying costs for compounded or rarely-dispensed medication may be significant, and writing prescriptions for them is more cost-effective operationally. For pet owners, state legislatures permit owners to request prescriptions instead of obtaining medications from the veterinarian, which allows owners to price-shop for the lowest cost, especially when coupled with discount cards and supplemental insurance.¹⁴

Medication errors in veterinary prescriptions are also often rooted in confusion over species-specific dosing and unfamiliar abbreviations (issues pharmacists are trained to recognize and prevent). A study evaluating veterinary prescription dispensing at community pharmacies found that weight was omitted from nearly 98% of prescriptions, a critical oversight considering weight-based dosing is foundational to accurate drug therapy in animals.¹⁵ Similarly, the FDA’s Center for Veterinary Medicine notes that misinterpretation of common veterinary abbreviations like “SID” (once daily) as “BID” (twice daily) has led to dangerous overdoses, illustrating how standardized pharmacy review could intercept harmful errors before they reach the patient.¹⁶

Beyond preventing errors, pharmacists can enhance client education by clarifying drug indications/techniques and adverse effect profiles (services that improve adherence in human populations and have the potential to do the same in veterinary contexts). Research suggests that improved communication and repeated education significantly enhance owner adherence, directly contributing to better clinical outcomes and reduced antimicrobial resistance.⁹

Additionally, veterinarians have identified community pharmacists as valuable partners for compounding species-appropriate formulations when commercial products are unavailable—addressing a practical gap in veterinary therapeutics.¹⁷ Compounding for animals requires extensive specialized knowledge and skills.

For instance, because cats cannot metabolize certain compounds and ingestion of them can be fatal even at low doses, compounded products cannot contain alcohols, benzoic acid derivatives, or azo dyes. Administration of medications to cats can be challenging, as cats will typically not swallow pills or ingest food with flavors they find unpalatable. Compounding medications with safe flavoring agents may help, or use a more convenient route of administration, such as transdermal gels utilizing pluronic lecithin organogel, or subcutaneous administration.¹⁸

Taken together, these findings support a model in which pharmacists are integrated into veterinary practice, not only to reduce preventable medication errors but also to strengthen clients' understanding and animals’ chances of successful treatment.

Rationale and Long-Term Impact

Building on the documented prevalence of medication errors, adherence challenges, and gaps within species-specific pharmacotherapy as outlined earlier, the long-term impact of the integration of pharmacists into veterinary care extends beyond error prevention to sustainable improvements in safety/efficacy and access to care. Given that veterinary pharmacotherapy often relies on extrapolation from human data, the translational value of pharmacist expertise is particularly strong in this setting.

Currently, all FDA-approved drugs for animals are documented in the Green Book, which includes medications originally approved for human use and those approved specifically for animals.¹⁸ Many active ingredients commonly used in veterinary medicine originate from human pharmaceuticals.

For example, nonsteroidal anti-inflammatory drugs (NSAIDs) approved for human use can be toxic to animals, necessitating the development of species-specific agents such as carprofen, which is used to manage pain associated with conditions like canine osteoarthritis.^19,20 Furthermore, NSAIDs that are FDA approved in cats are cyclooxygenase 2 selective, and they include robenacoxib (Onsior; Elanco Animal Health) and meloxicam (Mobic; Boehringer Ingelheim Pharmaceuticals, Inc).¹⁹

However, because relatively few medications are developed exclusively for animals, veterinarians frequently rely on human drugs prescribed for “extra-label use” under the Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA), including gabapentin for seizure prevention.^21,22

A contributing factor to the limited number of animal-specific drug approvals is the greater availability and lower cost of human medications. Medicare coverage of human drugs, such as meloxicam, further widens this disparity. For example, a 7.5-mg tablet of meloxicam for humans may cost approximately $0.18, whereas a 25-mg caplet of carprofen for dogs may cost over $0.30.^23-25 Given this reliance on human medications, pharmacist involvement becomes essential to ensure appropriate drug selection and monitoring across species. Pharmacists are uniquely trained to account for interspecies differences in pharmacokinetics, toxicity, and metabolism, and to identify contraindications that may otherwise be overlooked.

Beyond safety considerations, pharmacists contribute to long-term improvements in therapeutic outcomes by compounding species-appropriate formulations when commercial options are unavailable and by providing targeted client education. Counseling pet owners on administration techniques, AEs, and adherence strategies directly addresses the owner-driven barriers to treatment success identified earlier in this article. Collectively, these roles support a multidisciplinary care model that improves medication safety, optimizes efficacy, and strengthens continuity of care in veterinary practice.

Conclusion

Despite the wide range of specialties within veterinary medicine, relatively few veterinarians receive formal training in pharmacology, and access to pharmacists with specialized veterinary expertise remains limited. Veterinary medication management is inherently complex due to species variability, limited animal-specific drug approvals, and dependence on pet owners for medication administration. These challenges contribute to high rates of medication errors and suboptimal therapeutic outcomes.

Expanding pharmacist involvement in veterinary medicine directly addresses these gaps by introducing expertise in medication safety and adherence issues. By integrating pharmacists into veterinary care teams, practices can reduce preventable medication errors, improve adherence, and enhance overall treatment outcomes. Ultimately, increased pharmacist participation represents a practical, scalable solution to the persistent medication management challenges in veterinary medicine, aligning with the broader goals of improving animal health outcomes and client experience.

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