How can a veterinarian minimize polypharmacy in a senior dog?

• A. Add more medications.
• B. Use only herbal supplements.
• C. Stop all medications.
• D. Comprehensive medication review, remove duplicates, assess interactions, use the lowest effective doses, and re-evaluate regularly.

Answer: (D)

Minimizing polypharmacy in a senior dog starts with a careful, systematic review of every medication and supplement the dog is taking. Older dogs often have altered drug metabolism and increased sensitivity to side effects, so each drug must have a clear, ongoing benefit. By conducting a comprehensive medication review, you can identify duplicates, overlapping indications, and potential drug-drug interactions that raise risk for adverse effects or reduced efficacy. The goal is to discontinue meds that are no longer needed, avoid unnecessary additions, and use the lowest effective doses for the remaining drugs while continuously re-evaluating as the dog’s condition changes. Involve the owner in monitoring for signs of adverse effects and consider regular lab work or veterinary check-ins to adjust therapy as needed. Relying on a single strategy like adding new meds, stopping all meds, or using unregulated herbal products does not address the complexity of aging pharmacology; a thoughtful, evidence-based approach to review and deprescribe is the safest way to minimize polypharmacy.