Paracetamol prescribing to small animals by veterinarians in Australia and New Zealand

OBJECTIVE: To describe the prescribing patterns of paracetamol by veterinarians in Australia and New Zealand. METHODS: An online survey was created and distributed to veterinarians in Australia and New Zealand over a 3-month period (July-October 2024). Survey questions addressed the respondent's veterinary education and qualifications, career history, paracetamol prescription characteristics and personal perceptions on paracetamol usage in small animals. RESULTS: A total of 1035 veterinarians completed the survey, with responses from 1025 participants included in the analysis. Most veterinarians (991/1022, 97.0%) reported having prescribed or recommended paracetamol for use in small animals, most commonly for dogs (980/985, 99.5%). This proportion did not differ significantly between veterinarians with postgraduate qualifications (384/395; 97.2%) and those without (607/627; 96.8%) (P = 0.86, chi-square test). Most respondents (80.9%) indicated they were more likely to prescribe paracetamol now compared to a decade ago. Most respondents reported prescribing paracetamol twice daily: 545/900 (55.1%) at 10 mg/kg, 350 (35.4%) at 15 mg/kg and 95 (9.6%) at 20 mg/kg. More veterinarians reported prescribing paracetamol as an analgesic 987/990 (99.7%) than as an antipyretic 314 (31.7%). Prescription of paracetamol for both acute and chronic pain was reported by most veterinarians 778/984 (79.1%). 96.5% of veterinarians reported not observing adverse effects when prescribing paracetamol. CONCLUSION: The majority of veterinarians responding to our survey prescribe paracetamol to dogs and generally perceived it as safe. Nonetheless, the widespread prescribing of paracetamol among veterinarians in Australia and New Zealand should not be interpreted as an endorsement of use or proof of efficacy for analgesia in dogs. Isolated reports of prescription to cats suggest areas where further education is warranted given the risk of life-threatening paracetamol toxicity in cats.