The Veterinary Medicines Directorate (VMD) has published its Pharmacovigilance Annual Review 2015, which reviews 5674 reports of adverse events in animals, humans and the environment following the use of veterinary medicines over the course of the year.

5638 events were reported spontaneously, mainly by the marketing authorisation holder (61%), with the remainder largely reported by veterinary surgeons. 

Of these, 5512 were reports of adverse reactions in animals: 829 concerning suspected lack of efficacy, 4638 concerning safety. The majority of reports concerned dogs (2927), cats (1426) and cattle (386).

In dogs, medicines for the control of epilepsy were most often suspected of not having performed as expected (80 reports) whilst vaccines were most commonly reported as having failed to work (71).  However, the VMD points out that in many cases, vaccination failure was attributable to other causes (such as incomplete vaccination schedule).

In cats, flea spot-on products were most likely to be reported as not having worked (21). However, there are many reasons why owners may continue to see live fleas on their animal which are unrelated to product efficacy (such as reinfestation from the environment). 

Notably, the majority of efficacy reports in horses (12/19) related to euthanasia products, which the report says should serve as a reminder that alternative means of euthanasia should always be available in case the chosen method does not proceed as planned.

Of the safety reports, 59.6% involved dogs, 31% cats, 4.9% horses and 3.9% rabbits. The majority concerned vaccines (1360 reports, most commonly general signs or symptoms, such as lethargy or pyrexia), parasiticides (472 reports, most commonly lethargy, emesis, inflammation/pruritus, depending on method of administration) and inflammation control (412 cases, most commonly emesis, renal insufficiency and diarrhoea, depending on the drug type).

There were 124 reports of adverse events in humans. Of those involving veterinary professionals (about a quarter):

• There were two cases where owners were injured by a vet with a needle. In one case, despite the owner washing and disinfecting their hands immediately, the hand became too swollen to move and required anti-histamines and anti-inflammatories.
• A veterinary nurse developed a sore eye when vaccine was squirted into it as the needle came off the syringe. The symptoms resolved the following day.
• A veterinary surgeon reported brief periods of numbness around an injury sustained from a needle used for a rabies vaccination.
• A veterinary surgeon reported injection site pain after inadvertently injecting a small volume of a macrolide antimicrobial into his thumb. 
• A veterinary surgeon scratched his finger with a needle he had used to administer tilmicosin, and he thought a drop may have entered the wound. Nevertheless he did not seek medical attention until more than 3 hours later. Fortunately no treatment was required. 
• A veterinary surgeon pricked her finger with a needle on a syringe full of alfaxalone. No product was injected and she experienced no other symptoms than bleeding and pain from the puncture wound. 
• A veterinary surgeon was administering pentobarbital to a cat when the needle came off the syringe and between 1 and 20 ml of product squirted back into her eyes and mouth. She rinsed her eyes and mouth, drank some water and ate a banana. 45 minutes later she felt tired and ‘fuzzy’. She spoke to her GP by phone, but did not attend the surgery or receive treatment. She recovered within 3 hours. 
• A locum veterinary nurse developed swelling around an injury on her hand from a needle on a syringe of medetomidine. She had punctured a blood vessel, but thought only a small amount of product was injected. She felt light-headed and was monitored in hospital for a couple of hours, after which she returned to work with no lasting effects. 
• Two veterinary surgeons and a pet owner suffered needle stick injuries whilst an anti-emetic was administered to an animal that was being restrained by the owner. 

The VMD says that reports of needle stick injuries involving vaccines with a mineral oil adjuvant are of particular concern, because they often fail to show that the injured party has received prompt and correct treatment, either because they are themselves unaware of the necessity for swift intervention, or because they do not take the product package information leaflet with them when seeking medical treatment. 

Similarly, the VMD says that incidents involving injectable tilmicosin seem to be often dismissed as just a scratch, and that if you use these products, you should make sure you are fully aware of the warnings contained in the product leaflets.

To read the full report, visit: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/608968/PhV_Annual_Review_2015_v7.pdf 

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