In the case of animals for which the veterinarian is responsible and in order to prevent unacceptable suffering of these animals in the event of a condition for which no veterinary medicines have been marketed in the Netherlands, a veterinarian has the option of treating these animals with a veterinary medicine for which the marketing authorisation states that it is intended for use in other animal species, or intended for the treatment of a different condition in the same animal species.

If the above-mentioned veterinary medicine is not available or cannot be used, a medicinal product that has been authorised in the Netherlands may be used, or an available veterinary medicine with a marketing authorisation in another EEA member state for use in the same animal species or a different animal species with the same condition.

If the above-mentioned (veterinary) medicinal products are also not available, the veterinarian has the option to prepare the veterinary medicine himself or have it prepared by a pharmacist (extemporaneous preparation).

A veterinarian can obtain such medicinal products that have been authorised in the Netherlands or a veterinary medicine authorised in another EEA member state via a licensed wholesale distributor in veterinary medicines in the Netherlands or in another EEA member state.

The veterinarian is responsible for the correct labelling for the user.

A wholesale distributor or veterinarian may not advertise veterinary medicines pursuant to the cascade.

Requirements for the veterinarian regarding the records are stated in articles 5.1-5.4 of the Veterinary Medicinal Products Regulation.