Optio Rx, LLC and 26 affiliated debtors operated a specialty pharmacy business across four segments — retail dermatology (largest, ~59% of $166 million 2023 revenue), compounding including veterinary (most profitable), hospice, and fertility — with approximately 260 employees across 18 locations in seven states serving over 100,000 patients. The company filed for Chapter 11 protection on June 7, 2024 in the District of Delaware (Case No. 24-11188) before Judge Thomas M. Horan after EBITDA collapsed from $16.1 million (2021) to $6.2 million (2023) following a material payor contract dispute, a failed compounding strategy, and competition from former employees. At filing, total debt exceeded $235 million — including approximately $127.6 million in secured obligations (in default since September 2022 with $16 million annual cash interest), $73.8 million in subordinated note obligations, and $29.9 million in seller notes — with only $1.8 million cash on hand and revolver availability exhausted as maturity approached on June 28, 2024. A lender-supported restructuring via RSA implemented a partial debt-for-equity swap, converting secured debt into exit facility claims and equity in the reorganized Online Pharmacy Holdings LLC, with a distinctive GUC Trade Gift funded by secured creditors providing staged distributions to unsecured trade vendors. The plan was confirmed via cramdown on October 17, 2024 and became effective March 21, 2025. The reorganized entity operates as The Pet Apothecary, LLC. Final decrees closed most cases May 2, 2025, with the remaining case closed November 17, 2025.