Compounding, extralabel drug use, and other pharmaceutical quagmires in avian and exotics practice

The lack of Federal Drug Administration-approved drug products in the United States for avian and exotic animals creates daily challenges for the practitioner. The day-to-day practice of avian and exotic animal medicine requires us to meet these challenges in many ways, including by: extralabel use of domestic human and animal products; simple compounding or other manipulations in the clinical setting; using a pharmacy compounding service; using medicated feeds; and using imported pharmaceutical products. These may present legal and ethical issues to the practitioner that he or she may not be aware of. This paper will discuss some of practical and legal implications of these methods (based on U.S. laws), with an emphasis on compounding and extralabel use.