Are you going through hell whenever you give medications to your pets? Perhaps a compounding pharmacy can finally put an end to this problem. Janet King and Dr. Alice Jeromin chat with Dr. Rae Hutchins, inaugural Chief Veterinary Officer of Wedgewood Pharmacy, who explains how customizing pet medications into palatable forms can make medicine time for your pets a breeze. She explains how such drugs are developed and produced, ensuring the safety and comfort of your beloved pets. Stop stressing over pill pockets and messy liquids by discovering how a responsible compounding pharmacy can change your and your pet’s life for the better.
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How A Compounding Pharmacy Can Heal Your Pets
Have you ever had problems giving your pet medication? Janet, I know you have with those cats of yours. You’ve come to the right place. We are lucky enough to have Dr. Rae Hutchins, who is the Inaugural Chief Veterinary Officer of Wedgewood Pharmacy. For those of you who don’t know what Wedgewood Pharmacy is, they specialize in individualizing medications for your pet.
You have a cat that can’t take an oral med? Chances are they can make it into either a liquid or, what we call, transdermal. Something that the medication is absorbed across the skin. There’s a lot of thought and work into doing these compounds, if you will. Wedgewood is world famous for their ability to get these meds into your pet. Darn it, we’ll do it. Not only dogs and cats, which we’ll talk to Dr. Hutchins about. I can’t wait to ask her about all the different species.
A little bit about Dr. Hutchins. She’s a Board-Certified Veterinary Internal Medicine Specialist on small animals. She is a DVM graduate of North Carolina State University with our friend Dr. Ed Breitschwert. Shout out to Dr. Breitschwerdt out there. We’ve had him on the podcast. Not only has she worked seeing patients, she’s also managed several veterinary hospitals in her career as well.
What I love is all of us vets somehow volunteer our time. She volunteers for Waggle, which is a non-profit that helps pet owners that are financially strapped try to get the means to treat their pets. Thank you, Dr. Hutchins, for that. Welcome. We can’t wait to find out all about Wedgewood Pharmacy and what they can do for our pets so we can get those meds in them.
Thank you for having me. I’m really excited to be here. Always happy to help. Anyone understands how to solve challenges in medicating their patients and making sure that our pets are getting the care that they need. I’m really happy to be here. Thank you for having me.
What Is Compounding Pharmacy And How It Works
Janet, I know you have questions because Janet wasn’t familiar. She even asked me before the show. “What does a compounding pharmacy do?” So, Janet?
What does a compounding pharmacy do?
That is a great place to jump in. I think there’s a lot of confusion around that. I think a lot of people think compounding is something that is not always done in the most scientific way. While that can be true, I’m here to tell you that there’s also a lot of science that goes into excellent compounding. A lot of people, most of the background that they may have on compounding is from the news or experiences that they may have in human medicine and in human pharmacy.
In veterinary medicine, a lot of that is similar. Meaning that the veterinary compounding pharmacies are highly regulated, just like they are in humans. The big difference in veterinary medicine is the reason why compounding is used. If you think about veterinary medicine, we are often treating all kinds of different animals, all kinds of different species.
As a veterinarian, I would go into one exam room and see a tiny chihuahua that I can hold in one hand. I would walk out of that exam room and walk into another one with a giant breed dog that is very different in stature. We’re faced with those challenges all the time. Additionally, we often are treating conditions in patients where the FDA approval process for the medication was not studied or not included. A lot of times, especially in sick patients, we are using medications extra label or off label anyways. Which means that there’s a lot of medical or clinical necessity and compounding for veterinarians.
It’s important to know that those high standards of regulations apply to veterinary medicine compounding. A lot of the time the motivations or the clinical reasons are different. One of the most important reasons that we compound or utilize compounded medications is because it’s so hard to give medications, especially to cats. Cat ownership is on the rise, which I love. I love cats. They are really sneaky and really challenging to medicate. Compounding is also a tool that veterinarians will often use to just make it easier to actually get those medications into their patients.
Is compounding, and this is really very layman, like a little bit of doxycycline, a little bit of this and a little bit of that put together?
It can be that. I like to think about it in several different ways. Compounding is any time you are taking a medication and changing the studied form that it was in. What that can include is actually anything from putting it into different packaging. Sometimes, the different approval processes or studies that were done are very specific to the types of packaging that a medication is in. Sometimes, compounding is related to combining medications like you just indicated. Sometimes, it’s changing the concentration which is really important in veterinary medicine.
Because concentration of medications, especially if they are what we call a narrow therapeutic area, meaning that they can be really toxic if you give too much. That’s important for really small patients. Sometimes, it just makes it a lot easier to give medications to a really large patient like a horse. Changing concentrations is another example of compounding. Really, truthfully, it’s any time you are changing the form of that medication from what was evaluated in a FDA-approved study.
Compounding pharmacy is about changing the form of medication from what was evaluated in an FDA-approved study. Share on XHow do I know if I need a compounding pharmacy for my pet?
I love that question.
Usually, I’m going to the pharmacy to get, usually, doxycycline because we’ve had a lot of Lyme around here. But, it’s just a basic human drug.
My answer to that is a compounded medication should only be prescribed by the veterinarian. Your veterinarian should be your partner in that conversation. Now, the important piece that I’ll say is that this is where a pet parent or a pet owner or anyone who loves an animal that they’re working with or cares for an animal. They can be an advocate for themselves and for their pet. The veterinarian should be the one to determine if it is appropriate to use a compounded medication. That’s super important but I believe that the pet owner should be really comfortable with being an advocate.
What that would look like to me in an exam room would be when a pet owner learns that their pet needs medication. They would share openly with their veterinarian or their veterinarian’s team and say, “I have concerns about giving medication because of these logistical challenges. They spit the medication all over the kitchen. My job impacts how frequently I’m home to give medication.” Anything that would cause a logistical challenge to adhering to the treatment plan should be raised. And then, the veterinarian could determine a compounded option, something that makes sense in the situation is clinically relevant and likely to help improve the outcome.
You add, I’m assuming, these incredible, tasty, delectable flavorings.
I was quizzing Janet before we came. I asked her, “What do you think the most common and accepted flavoring is for cats?” What was your guess?
I was laughing. I was saying Sour Patch Kids.
Oh, I thought you were kidding.
I was kidding. I’m going to guess liver because I got that liquid stuff that you told me to get to drink. It’s gross, but it’s liver tasting. I haven’t tasted it myself. Thank you very much.
Okay. Are you sitting down, Janet? Because wait until you hear the answer.
I’m sitting down.
The most popular feline flavor that we sell is marshmallow, which is hilarious to me. Because I think marshmallows are disgusting but my kids love it.
It’s sugar and they’re with sugar. Oh my God.
Here’s the really fascinating thing. Cats cannot actually physiologically taste sweet and our pharmacists know that. However, what it does is it masks the bitterness of the active ingredients of the medications that we’re trying to give. For any of those readers out there that have tried to medicate a cat and they do that terrible, just frothing, sad thing where there’s just drool coming down, all roping down.
They’re pushing against you. Yes.
The marshmallow flavor actually masks that bitterness so that they don’t even experience that reaction.
That’s the really fun thing about Wedgewood Pharmacy. We have pharmacists that have had specific veterinary training that are sitting there, dedicating their lives to thinking, “How do I block that really unpleasant experience that cats are having and that their families are experiencing?” It turns out it’s marshmallow.
I don’t want our readers to think they can just take a pill and shove it in a mini marshmallow and hand it to the cat.
No. Exactly. That’s exactly right.
Because I’m thinking, “Hey. I could.”
That’s exactly right. Cats actually, again, they don’t appreciate the sweetness of that marshmallow. The other thing that’s really important that goes into the compounding is we look very closely at what is the ratio of flavoring to the active ingredient. Does that flavoring actually destabilize the active ingredient? If there is a risk of that happening, we would not recommend that compound because you’re decreasing the likelihood of that medication having the effect that you intended.
What’s the most popular flavoring for dogs? My other question is that a horse pill must be huge.
In canine, actually the more popular flavors, they do also like marshmallow. Interestingly, they tend to respond really well to a lot of the more traditional meat flavors. Chicken, liver, those are really common. The important thing about all of the meat flavors that we utilize at the compounding pharmacy is that we’re also really careful to make sure that there’s no meat protein allergens in our flavors. That’s another important difference. If you have a dog with a meat allergy and you just take that capsule and shove it in a chunk of chicken, they would be exposed to those allergens. We make sure that that’s removed as a part of the process.
For horses, apple flavor, molasses, those are the big common ones. Cricket is one of our most popular flavors because we serve a lot of reptiles and avians. We’ve got some pretty disgusting flavors. We know they’re disgusting because at a very large veterinary conference, we just had a flavor shot bar. You got to come and decide if you knew what the flavor was. That was a highly entertaining experience.
Janet, that would have been a fun meeting to go to for us.
I had a friend that worked at Pepperidge Farm. He actually developed the cookie that’s open with nuts on top. She said they have a whole bank of flavors. Imagine all the goldfish come in twenty flavors. It used to be one. They test the human what is the most popular. I’m sure you do the same with pets. It’s the same concept.
We do. Although, you don’t want to hang out at our flavor bar. That flavor bar that you just described sounds amazing. I don’t think you want to hang out at ours.
The True Costs Of Compounding Medications
That’s right. The other point I want to make that I personally experienced is cost. For example, there was a drug that we used for an immune-mediated disease called Leukeran. I had to seeing eye dog in that needed that medication. The owner worked but she wasn’t a gazillionaire. The dog couldn’t take the one of the drugs that we normally use. I said, “Well, we better try them on Leukeran.” She came back for her recheck, $300 Leukeran, two milligram. When I checked with Wedgewood, they have it compounded at a much lower price.
Here’s the deal. If I need a dose that differs from that two milligram, I’m okay in ordering it from Wedgewood. That’s what the law says. He really did need a little bit of a higher dose. It turned out to be so inexpensive. Cost can always be helpful to the pet parent. When I was a pharmacist, Colchicine was so cheap. I just looked at Colchicine the other day. It’s so expensive now. It’s a medication used for gout. Cost savings with compounding pharmacies can be a real pleasure.
I would think of price and cost savings as, sometimes, an unintended benefit.
Exactly.
If we look at the regulations around the compounding space, choosing a compounded alternative strictly for price or cost savings is a no-no. We abide by that very carefully at Wedgewood. Honestly, any responsible compounding pharmacies should do that. Because a lot of times, if there is a copy being made just to reduce cost, chances are that cost is exactly where it is for a really important reason. There might be an inactive part of that drug that helps to improve bioavailability. It may be that sourcing the raw material or raw substance from the FDA-approved vendor is something that is costly for that manufacturer. There’s a lot of reasons that that cost goes into a medication.
That said, sometimes, especially in veterinary medicine, the dosing is different in the needs for pets. That does end up driving down the price. Sometimes, you will see that compounding is less. Or in animals specifically, sometimes, the raw material or the bulk substance doesn’t need to be manufactured in a way that causes that price to go up in the commercially available for the human realm. There’s a few reasons why we would see price be decreased.
The real value to me in compounding from a price sensitivity standpoint is that chronic care is really expensive. Chronic care goes up if the medications are not effective because they’re not able to be given effectively. If we’re unsure if the treatment is working, requiring additional diagnostics because you don’t know if the medication even got into the pet.
Chronic care goes up if the medications are not effective or the treatments are not given effectively. Share on XWhere I see the most value from compounding from a price and cost sensitivity standpoint is if it’s improving the adherence to the treatment plan, then that overall helps the cost of care go down. The other place that we’ll see it is because there are times where the concentration is different. The amount that you need for the patient is different. That in and of itself results in the cost going down as well. It’s a great point and it’s something that we shouldn’t shy away from as a part of the conversation. I just wouldn’t encourage any veterinarian or pet owner to seek that out as the only cause for going down a compounding path.
As a layman pet parent, I always ask the veterinarian, “No, it’s two CCs. Can you show me?” They give you that thing. First of all, I’m raised in the United States. I’m not used to the CCs, the milliliters. It’s just not my world. So, I will always ask and they give you that syringe thing. I’m like, “It’s this long.” I always verify it because I don’t want to screw up. I’ve learned from the sister, right?
That’s another really one that can play into costs, right? If you have an actual applicator device that’s giving the exact amount that you want, the result is that often you see less waste of medication. Which is to say, it puts money back in your pocket over time. Also, it improves with the accuracy of treatment, which is a huge reason why people come to Wedgewood Pharmacy. We have applicator pins that are meant to be easy to provide accurate dosing. That’s what I’m referencing when I talk about packaging.
Another thing I’m really proud of is our team just released a new formulation of an eye medication called tacrolimus. It’s for immune-mediated conditions of the eye. One of the biggest pieces of feedback that we got is that it’s really hard to squeeze the bottle. When you squeeze the bottle, what comes out causes frothiness. The animals don’t like the bubbles in their eyes so they’re getting away from you. And then, drops are going everywhere. We reformulated it to make sure that the viscosity of the medication was less irritating to the eye and easier to come out of the dropper.
We’ve gotten very positive feedback. That process took us six months to do because in order to change that viscosity, we had to make sure that the drug remained active. That it was in the appropriate concentration and that the appropriate amount was coming out of the dropper. All of these things are things that go into compounding. Again, if you’re finding the right compounding pharmacy, they should be looking into all of these things for any medication that they’re releasing. The package has a huge piece of it.
How Compounded Medicines Are Produced And Distributed
I have a question. When you compound a drug for whatever treatment, is it FDA approved then? How does that work?
No. They finished good.
Because you’re changing the original, right?
Right. What is required by regulations and the governing body? The State Boards of Pharmacy are who regulate compounding pharmacies. The FDA regulates compounding pharmacies if they have what’s called a 503B facility, which Wedgewood does. We were the first veterinary compounding pharmacy to have a 503B facility. We have two of them. The FDA regulates what’s in the 503B.
We produce and distribute medications from that facility. We follow the same good manufacturing policies and procedures that are required for human compounding in that facility, which is really great. The FDA comes in regularly and audits us. We welcome them. It’s something we’re really proud of. Again, any compounding pharmacy should do that.
If it’s a 503A pharmacy, meaning that they’re making personalized medications for a patient, that is not regulated by the FDA. It’s regulated by the State Boards of Pharmacy. If we were to get a prescription in and ship it out to any state, any state where that medication is going has a right to come in and audit us. Make sure that we are following their requirements.
Compounding requirements, we have to use FDA-registered bulk substances. The bulk substance that we get, the raw materials essentially, come from FDA-registered providers and that comes from FDA-approved processes. But, putting it into this different form doesn’t go through the FDA process. That’s the key difference between the two.
Janet, that is a key difference. I want to give you two examples. Ketoconazole, an anti-yeast drug. I would have owners bring in their bottle, amber bottle. That’s one point for the compounding pharmacy. It wasn’t Wedgewood. It was just someone up the street that compounded it. The powder of the drug was at the bottom. The liquid that it was supposed to be suspended in was at the top. There was no “Shake well” on the bottom. If this owner is pouring this liquid and giving it to the dog, they’re not going to get any drug at the top. They’re going to get an overdose of the drug at the bottom because all of it’s at the bottom.
My point is, it really is an art to compounding. You have to know what drug is soluble in what liquid. I think Wedgewood does a great job of that. My other example was a dog that saw me as a dermatologist for skin. It was on five different cardiac meds. I said, “Oh my goodness, you must be medicating all day?” “No, the pharmacy put them all together in one bottle.” Rae and Janet, I’m going to tell you. The chance of all five drugs being compatible and stable is nil. Of course, I had to sit down when I heard that one. I said, “We need to have a talk.”
I’m sure that still goes on. That was in the bad old days before the professional art of compounding places like Wedgewood became known to all of us veterinarians. Back in the day, my cat wouldn’t take this. The neighborhood drug store, I’m not criticizing because I worked at a neighborhood drug store. But, they wouldn’t do any research to find out what liquid is this drug compatible with and for how long it is stable. It may not be effective after a week.
That’s exactly right.
I commend Rae’s people there because they do a lot of background research and publications as to what drug mixes with what and what it doesn’t mix with.
That’s exactly right.
How To Determine If A Drug Has Expired
That was one of my questions. How do I know when the drug has expired?
Compounding is also really interesting. There’s a group called USP. It’s a really important organization because they have dedicated their organization to the safety and increasing the odds that a compounded medication will have the intended effect. Really important. Notice I’m not saying that it will be efficacious because that’s an FDA approval process. But that will have the intended effect that the caregiver has when they’re prescribing.
USP has put together really clear guidelines that help compounding pharmacies put procedures in place that will make it exceedingly likely that things like sterility, stability, etc. are going to occur in their compounded medications. Around 2023, the FDA started something called Guidelines for Industry or GFI 256. It is something that a lot of compounding pharmacies talk about. GFI 256 helps compounding pharmacies stay compliant with these regulations and recommendations that come through from USP.
If you’re a pet parent out there, you’re like, “How do I know if my veterinarian is partnering with a really good compounding pharmacy?” These are really important things to ask or look for. There’s something called PCAB accreditation following USP guidelines, being GFI 256 compliant. These are all important phrases that you could ask about and look into. If your compounding pharmacy has those things, that accreditation, those specific guidelines and regulations that they’re following. If they’re audited by the FDA and their State Board of Pharmacy, and if they’re veterinary-specific compounders, odds are they’re going to do a really good job for your pet, which is super important.
To answer your original question, “How do I know about expiry or expiration?” In compounding, we have what’s called a Beyond Use Date or BUD. BUD is set by USP regulation for different vehicles. For oils, it’s different than it is for aqueous suspension, than it is for sterile. USP gives us those as a compounding pharmacy and says, “Unless you invest in your own stability studies, these are the requirements you have to have.” We post those on our label.
A fun fact about Wedgewood is that we invested into our own analytical lab so that we can check the concentrations. We can verify that the bulk raw substance we have is actually what it should be. We can check potency. We can also do our own stability studies. If we have a really popular product that’s helpful to veterinarians or pet owners to have it on hand for a year before it expires, we’ll actually conduct those stability studies. That requires a hefty investment from the pharmacy. It literally requires that that medication is sitting in that dosage form. Every day, they’re looking at it. They’re testing it to make sure that it is stable. Remain sterile if that’s appropriate for that medication, etc. for the period of time that we put on the label.
Wedgewood Pharmacy’s Online Purchasing Platform
I have another question. I go to my veterinarian and say, “You need this drug for Libby. It’s going to be prepared at a compounding pharmacy. I’m sending you to Wedgewood.” Then what happens?
We have an online purchasing platform. We actually partnered with a company called Blue Rabbit, which is essentially an online pharmacy platform that has a great technology solution to allow you to purchase compounded medications. We merged with them which was really exciting and brought us an expanded offering or ability to get these medications to the homes of our clients and patients. This can now be shipped directly to you, which is awesome.
Our medications are available on other platforms as well. If certain medications that you purchase that are compounded on Chewy, for example, they come from Wedgewood Pharmacy. Veterinarians work really closely with online pharmacies like Vetsource, Vetcove. We distribute our medications through those as well. We do our best to be wherever a veterinarian is ordering for one of their clients. We do our best to be there. It’s really easy to get those medications. We do that because it’s the right thing to do for our business. Also because we believe our compounded medications are the best. We want to be where people need us.
How quickly can I get that drug?
It depends. If you are getting something that we make a lot of and we pre-package it because we know we’re constantly getting orders of that. For example, our transdermal methimazole, which is a really common medication for cats with hyperthyroidism, the most common endocrine conditions in older cats. We have a great transdermal for the group that’s very popular. That’s something that we call “Pick, Pack and Ship.” The moment the order comes in, we pull it off the shelf. We put it in the right packaging. We send it out. We do that on average in about 1.2 days from the moment the order comes in to the moment we get it out and shipping.
Our average time to customer is four days. We’re working really hard to try to get that down to two. If you are ordering something that is very customized, meaning that it’s a flavor that we don’t often do. It’s maybe a dosage form that’s a little uncommon, or it’s a combination and we need to look to see if that makes sense from a pharmacist standpoint. You could be looking at more like seven to ten days.
That’s fast. I wish J.Crew were that fast. I want it now.
Is it legal to compound controlled substances?
It is. We also get audited by the DEA. We have a very specific licensure for DEA. Our most common controlled substance medication that we prepare is gabapentin. We have a nice combination of gabapentin with trazodone, which really makes getting your cats to the vet much easier.
Yes, right.
It’s a really common one. We have a delicious chew with a little catnip flavor that makes those visits much less stressful. And then, buprenorphine. We actually have a buprenorphine version that lasts longer in the blood of animals because of the dosage form that we’ve put it in. It’s also really great for cats, especially post-dentist or something like that for it helps to reduce pain from a procedure for longer. Those are two most common controlled substance medications that we have.
Addressing The Biggest Fails In Veterinary Compounding
Are there any epic fails? Do you see that? Everything sounds so great and fabulous. There has to be some that you learn from, right?
A couple of things that I would say epic fails. Generally speaking, in the compounding world, this is coming from me as a veterinarian who wants to help my colleagues. There’s a lot of fear around “What if I choose compounding and I’m not allowed to legally?” That to me is a fail. If veterinarians aren’t comfortable and they’re not choosing the best option, that’s affecting adherence or outcomes of patient care. That to me is a failure.
If veterinarians are not choosing the best option for patient care, they are failing at their job. Share on XThat’s a big part of what I have a lot of passion around at Wedgewood. How do I help veterinarians feel really comfortable around “This is the time”? Because if a commercially available option is there and it suits the needs of your patient, absolutely, 100%. You should prescribe that. But if you’re starting to go extra-label, meaning you’re not prescribing in exactly the way that it was intended to be used or studied to be used. That’s the moment you should and can start thinking about compounding and weighing the risks and benefits of modifying that commercially available versus a compounded medication. To me, that’s a big fail. How do we educate the profession and pet owners who are struggling to give them medications on, “Hey, this is an option. Here’s when it’s really reasonable to think about it.”
I think it’s stressful for some pet owners. Janet, when Dr. Hutchins was talking about methimazole for hyperthyroid cats. That, normally as a pill, has to be given twice a day. You might get the morning one in, but “Geez, I’ve got to get that second one. I’m already in bed.” People I’ve talked to that have hyperthyroid cats had no idea that methimazole could be made into a transdermal form, which they just put on the ear. It’s easy peasy.
That’s why I wanted to have Dr. Hutchins on because pet parents, there’s an easier way out there. You just need to ask questions of your veterinarian. Don’t ever condemn yourself that, “Just can’t get this medication in.” It’s not your fault. There’s various reasons. You might have arthritis in your hands. You can’t open. That pill is so tiny, you can’t give it to the cat. That’s when Wedgewood and Dr. Hutchins come in handy because we can make that happen for you.
We can. Veterinarians, we swore an oath to protect our patients. First, do no harm. Protect our patients. Protect that human-animal bond. Sometimes, there’s a tension when we diagnose a disease because we know that we need to treat that disease. Sometimes treating that disease results in a rift between the patient and their family. Compounding can often be a way to close that gap. It can actually make treatment a pleasurable experience if it tastes like a treat.
Especially if it’s flavored.
Exactly. They’re like, “Give me that marshmallow-flavored treat. I’m here for it.”
We had a diabetic cat. I’ll never forget when they said, “You’re going to be giving insulin twice a day.” I was like, “Oh my God, I don’t even know how to handle a syringe.” The twelve-year-old assistant goes, “I got you.” I’m like, “Really?” The next thing I know, I’m shooting up the cat. I had the whole family trained because I didn’t want to be the only one that had to be around in the morning and the afternoon. She was cool with it, but I’ll tell you the two cats we have, I don’t think that works so well. The ear swab thing sounds great.
There’s new things out for diabetes and cats. You’re lucky Janet. Hopefully they won’t need that.
Listen, the future is feline, as I like to say. There’s a lot going on for cats which warms my heart.
Dr. Hutchins’ own Beagles And Chickens!
I want to ask Dr. Hutchins about these two beagles that I’ve seen pictures of.
You have beagles?
He’s a beagle mom.
They are howlers.
They are. My husband and I both grew up loving beagles. We adopted two beagles. They were our heart dogs, Sally and Isaac. Sally came from a pharmaceutical research facility.
God bless you.
She just had the best disposition. Isaac was rescued from a hunting colony in North Carolina where we’re from. They filled our home with a lot of terrible yeasty smells and a lot of sounds.
I can see you’re mixing up the ear medications.
But just so much joy. So much of the time when I was prescribing treatments or putting myself in the shoes of family, Sally and Isaac taught me all the lessons of what is hard, what is joyful, and how I think about that when I’m talking with families. They were the best. They were the absolute best.
I hear you and your husband. “Do you take these beagles to be your married pets?”
She was the ring bearer in our wedding, so yes. A very important role.
I love that.
And she listened.
Practicing in Ohio, I really think that the beagle is the most “found” dog. I had two clients that lived in Central Ohio. She had four beagles. I said, “Where did you get them?” They just showed up at the house because the old thing is “this dog won’t hunt” and they just leave them out in the country somewhere. I had literally two clients that had four beagles each. One of them had horrible bladder cancer. They just took such great care of her. God bless them. I always say “There’s nothing like a beagle. Got to love a beagle.”
They’re the best breed. They get a lot of really strange conditions, it turns out. Which when you’re an internal medicine specialist, it’s great to learn from those experiences.
What about the chickens?
Do you have a chicken?
We have a farm. The chickens are, they rule the house. We have fourteen.
They’re very bossy.
Really?
Yeah. We have fourteen. We have six that are very young little chicks and then the rest are older. They’ve been ruling our home for over three years now. We are a full-fledged chicken family. We took family photos in 2025. We had chickens in our family photos. Ruby is our favorite and she knows it. Everything that she does makes it clear that she knows that she is the favorite of the flock.
That’s a lot of eggs.
Janet, think about this. Does every veterinarian that lives in North Carolina have a farm? Because Dr. Breitschwert had a farm too. Is that a pre-req?
I learned a lot from them.
You live out in the country.
We grow a lot of produce. Those girls, they’re out there fertilizing the chickens and giving us a lot of eggs.
Do they have a cute hen house? I love cute hen houses.
They have a hen house. We let them range except for when there’s risk of predators. We have a lot of protection around them. I show them love with food. They’re way too fat but that’s okay. I love them so much.
Food is love. Do the beagles get along with the chickens or do they go after them?
No, they’re separate. They stay. They’re fine.
They stay separate.
Can you imagine my cats?
Janet’s cats are ready at any given moment to jump on anything.
It’s been so cold. It was like zero degrees Celsius, one degree Celsius here. We couldn’t let them out. Honest to God, the whole house shook with meows because they wanted to go out. We couldn’t. We were terrified to let them out.
Frustrated cats.
It’s 38 degrees Celsius, so we’ve been letting them in and out a little bit.
How old are they? Have they always been together?
They’re siblings. A brother and sister, Atticus Caticus, and Isabelle. They are going on six. We got them during COVID because I let them outside. They’re like our resident Orkin people, the cats.
She has a chipmunk problem.
I found out we have flying squirrels because there were these tails. I didn’t know what it was. It’s like a feather. I didn’t know what it was. I literally did Google Lens. I’m like, “Oh my God. We have flying squirrels.” They’re wonderful cats.
That’s wonderful.
They just do their work. That’s their job.
I was chuckling. Janet asked about horses. I just pictured Dr. Hutchins and myself when we were doing equine medicine and you had to give the sulfa antibiotic to the horse. There’s a big mortar and pestle in the horse barn with a big jug of molasses. We’re all grinding these. Sulfa meds taste so horrible. I remember my cat was on a sulfa med. As I always tell people, “You’ll get the first dose in.” I would walk in the room with the prescription vial, the cat would run out like a shot!
Never again.
That’s right. For Wedgewood to be able to mask that taste. When I was in pharmacy school, we made peppermint schnapps in pharmacy lab and fun stuff.
For humans, people. We want to make it clear.
Yeah, we had to taste that. Let me tell you this. We could never mask the taste of potassium chloride. No matter what we did, it was a horrible flavor. I picture sulfa drugs like that too.
It’s very possible. Gabapentin is one of the most bitter active ingredients. Really very bitter. It’s interesting because different flavor profiles will mask it. Peppermint is also a very common flavor in the equine space. These are the types of things that we play with, honestly, to see. It doesn’t surprise me that you are playing with some of those things.
A long time ago. I had to do something for fun in pharmacy lab.
Dr. Hutchins’ Biggest Pet Peeves
We got to ask Dr. Hutchins our questions. What is your pet or human peeve?
It could be something little.
It could be about your husband or the chickens.
The chickens. Or like, people don’t put their blinkers on.
It better not be about the beagles though!
Okay. Since you said that my husband’s in fair territory here.
Hope you’re listening, honey.
Hi, honey.
He’s kept me around for over twenty years. This will probably be okay.
No, you kept him around.
I like to call it man-looking where we’ll say, “Hey, you need to go grab so and so. It’s in the pantry.” Then I hear, “It’s not there.” I’m like, “Well, did you man-look or did you look-look?”
Don’t make me get up. Janet lives with three men. It’s horrible.
Yeah. Let me tell you.
I have two boys.
“Where’s the ketchup?” I know it’s in the front door on the bottom shelf. That’s my favorite question.
Before they even open the door.
Right.
You have two sons, Dr. Hutchins.
I have two sons.
Janet, same household as you.
“Where’s the ketchup?” It makes me nuts.
Or the other, “Where’s the remote?” And then, they get pissed when I’ll be watching. We have the Apple TV thing. They’ll be like searching. I’ll go like this on the side of it, “Find the afternoon.”
When I’m trying to get to sleep, I hear “Click, click, click.” I’m like, “Okay, two more. Click, click. Stop it.”
I hear the laptop next to me. I’m like, “Get out of here.” “Oh, can you hear that?”
Discussion Wrap-up And Closing Words
Anyway, I just can’t thank you enough for being on. I just want everyone to know compounding pharmacy is such a fabulous service. It really takes up the reason for “I can’t give this to my pet.” Yes, you can, because we can make that happen!
As a pet owner here, when they give me a drug, I’m like, “How is it going in?”
That’s, to me, the question that every pet owner should ask. “How can we make this easier?” Because the fact of the matter is that again, you have to find the right compounding pharmacy. That’s really important. If your veterinarian is partnered with the right compounding pharmacy that is following all the guidelines and regulations, then they can help you find solutions. It doesn’t have to be hard.
If your veterinarian is partnered with the right compounding pharmacy, they can help pet owners find solutions. Share on XOr expensive. In many cases, it’s less expensive.
Thank you so much. This has been a pleasure. I sure learned a lot as a pet owner.
We can’t thank Dr. Hutchins enough. I just love hearing about compounding because anything that gets the medication into the pet, I’m all for. What about you, Janet?
And, eases the angst of the pet owner. Thank you for the great work you do. We appreciate you. Thanks for joining us.
Thanks for adopting beagles.
Thanks for having me. It’s been a true pleasure. I hope it was a helpful conversation.
Important Links
About Rae Hutchins
Dr. Hutchins is Wedgewood Pharmacy’s inaugural Chief Veterinary Officer, where she focuses on advancing patient care and helping veterinarians deliver safe, effective, and individualized treatment for pets. A board-certified specialist in small animal internal medicine, Dr. Hutchins brings deep clinical expertise and a passion for translating complex medical topics into practical, real-world guidance.
Before joining Wedgewood, Dr. Hutchins led and supported care teams across multiple veterinary hospitals while also practicing as a board-certified small animal internist. She brings firsthand experience caring for complex medical patients and partnering with pet owners and veterinary teams to guide treatment decisions.
Dr. Hutchins earned her Doctor of Veterinary Medicine from North Carolina State University and remains deeply committed to expanding access to veterinary care. She serves on the Board of Directors for Waggle, a nonprofit that helps families overcome financial barriers to life-saving treatment for their pets.
In her role as Chief Veterinary Officer, Dr. Hutchins collaborates with veterinarians nationwide to develop pharmacy solutions that enhance patient comfort, safety, and treatment success. She is dedicated to education, innovation, and helping pet owners better understand the care their animals receive.