In equine practice the use of medicines prescribed under the Cascade is essential to maintain equine health and welfare. BEVA’s health and medicines committee have recently reviewed the client information leaflets that are available here for distribution when unregistered medicines are dispensed.
When using the Cascade there is an expectation that key information relevant to the species being treated is given to the client, and the veterinary surgeon should provide the information that would be included in the package insert were it licensed for use in that species. Such documents also form the basis of informed client consent, a requirement of the RCVS code of professional conduct. The BEVA client information leaflets can be downloaded and provided to clients to satisfy these expectations.
BEVA have also provided sheets of downloadable QR code stickers that can be placed on bottles or bags that contain medicines prescribed under the Cascade and enable the client to access the information pertaining to their medicine direct from the BEVA website. The RCVS have confirmed that provision of the QR code satisfies the requirement in the RCVS code of conduct for client information to be provided. A hard copy however must be available for clients who do not have the ability to access online resources. BEVA would consider it good practice to provide a hard copy specific to the medicine and to highlight key points and potential risks of using each medicine prescribed under the Cascade in order to ensure there is informed consent. Informed consent is a professional obligation when using medicines under the prescribing Cascade. Although consent can be given verbally, the RCVS expect that consent is given in writing.
When the client is not available to give written consent, contemporaneous records of verbal consent should be recorded. The FEEVA / BEVA consent form ensures you get written consent while also recording the reasons for use of medicines under the prescribing Cascade.
In conclusion, when using medicines prescribed under the Cascade, it is good practice to:
- obtain signed consent using the BEVA/FEEVA consent form
- provide the client with an information sheet and/or QR code specific to the product that is being dispensed
- remember to label the products appropriately
Client information sheets are available for:
- “Specials” veterinary medicines in general
- Unregistered medicines in general
- Antibiotics in general
- Ocular antibiotics
- Ocular anti-inflammatories
- Corticosteroids
- Chloramphenicol
- Doramectin
- Doxycycline
- Enrofloxacin
- Macrolides and rifampicin
- Metronidazole
- Praziquantel
- Paracetamol
- Esomeprazole
- Misoprostol
- Long-acting injectable omeprazole
- Sucralfate
- Quinidine sulphate
- Levothyroxine
- Metformin
- Injectable altrenogest
- Deslorelin
- Pentoxyfylline