Veterinary Negligence/malpractice

[Freia]

Dear all,

I've just joined this forum and am making my first post now because I need some fellow dog owners' advice on a serious problem. I think that my current vet practice's negligence or malpractice (I'm not sure exactly what the right term is) has twice caused unneccessary suffering to my dogs, on one occasion almost costing one her life. Obviously I'm about to change vets, and I would value advice on that question, and I'd also value advice on what I should do about my current vet's performance.

My current issue concerns my 12-year old Tibetan Spaniel, Jack. Picture attached - I'm sure I don't need to add any detail about how much I love my old boy. He's been on medication for a while to keep a skin condition under control, and recently our vets changed him from Prednisolone to Atopica. A few days after the change he started showing signs of extreme pain, so we took him back to the vet. He'd seemed particularly sensitive to being touched around the mouth and jaw, so I suggested to the vet that he might have a toothache. The vet checked his mouth out thoroughly, concluded that he had no toothache, and hypothethised that Jack was reacting badly to the changed medication. He told us to stop the Atopica and see if he improved. Two days later he had not improved, so we took him back to the vet. This time the vet (a different one) checked him more thoroughly, and concluded that he had a recurrence of a previous spinal problem (a slipped disc, essentially) and prescribed painkillers. What this meant was that the first vet, through not trying carefully enough to establish the source of Jack's pain, needlessly left him in unmedicated pain for two further days. At any age, let alone 12, this is not something a dog should suffer. The second thing that concerns us about the current issue is that the second vet, while apparently being more careful and thorough in her diagnosis, made a simple clinical error in her prescription. In notes she copied to us she specified 6 drops of Metacam, while the label on the drug specified 12 drops. We were lucky enough to notice the disparity and check before administering the drug, but that sort of error could result in a dog being given a double dose of medication which could, with some drugs, have serious effects. Happily, with a better diagnosis and the right dose of medication, Jack is looking better tonight than he has for several days, but we're not happy at what we've had to go through to get to this point.

The previous issue, which concerns us more now that we've had a problem with Jack, concerns our younger Australian Terrier, Freia. She had a long history of illnesses, usually diagnosed and treated as urinary tract infections with a course of antibiotics. What she actually had, which was never detected by our vets, was a much more serious liver condition. (a hepatic shunt, for the experts) Because she and Jack were on a relatively bland diet (Z/D) because of Jack's skin condition, the full extent of her illness was never apparent. It only came to the surface when she spent some time at Hanrob while we were overseas, and was fed a normal dog food - we'd only specified the Z/D for Jack. This caused her liver condition to show its full effect. I vividly remember speaking to the vet (from London) and being told that she'd gone blind, she couldn't stand, was having problems breathing and 'might not make it through the night'. They thought she'd had a stroke, or had a brain tumour. We cancelled the rest of our holiday plans (including a dinner reservation at Noma) and caught the next flight home, not sure whether our dog would still be alive when we got back. We fully expected that we were returning only so that we could be there when she was euthenased, if she hadn't already died. Fortunately our vet had transferred he to SASH while we were in flight. At SASH they stabilised her, diagnosed her illness correctly, and then operated successfully. $10k of travel costs and $10k of SASH bills later we had our dog back, healthier than ever, with no question at all in our minds that every dollar was well spent in achieving that outcome. However, we wondered at the time whether our vets had ever thought carefully enough about what was actually making Freia ill so often, and our experience now with Jack heightens our concern about how Freia was treated.

So I have two questions on which I'd appreciate fellow dog owners advice.

First, is there a procedure I should follow about what I feel is inadequate professional care for my dogs? I just don't think that the vets' performance has been acceptable, and I don't think that just letting it go and changing to another vet is enough.

Second, I need some recommendations on a good vet. We live in the inner west (Darlington), but don't mind travelling a bit for a good vet.

In advance, thanks for your thoughts.

[Clyde]

What a gorgeous boy!!

I'm sorry you've had a rough trot with your vet.

I highly recommend Max Zuber at Gladesville Vet (they have a website). I used them for many years and can not fault him, he is terrific and seems to have a sixth sense about diagnoses. Even when I moved further away and was unhappy with a local vet diagnosis, I would go back to Max for a second opinion and he would get it right every time where other vets hadn't.

Good luck :)

[Guest lavendergirl]

Hi - so sorry to hear you have had such an upsetting time with both little dogs. Jack looks adorable and I can understand why you are upset after reading the background. I do not have any legal knowledge but suggest you start with having a look at the Australian Veterinary Association's website to see if they have a complaint process outlined there. It certainly sounds from your story that there was a lack of proper care in diagnosis in both cases. Unfortunately both in animals and humans there are many cases of medical negligence. The crux of the matter is how far you are willing to pursue the matter - both personally and financially - and what you expect from the outcome. It may be worth it to you to consult a lawyer who is experienced in animal cases to ascertain and clarify what can be achieved by any legal action i.e. is your priority monetary compensation and/or do you want to make sure that the vet(s) are appropriately dealt with through their own professional association.

I hope things improve with both dogs and wish you luck in getting some resolution.

[Aussienot]

I sorry about the health problems your lovely dogs have had to go through. Veternarians can make mistakes but it's not necessarily malpractice or even bad practice. In all types of medicine, diagnsosis is part art and part science.

My advice would be to cherish and love your dogs, find a new vet you can trust, and let go of the past.

Edited May 16, 2012 by Aussienot

[Diva]

You can complain to the vet practioners board (I think that is what it is called) but I greatly doubt they'd find enough fault to take any action at all.

All you can do really is change vets and use word of mouth to let others local to you know you found them incompetent. I have had far worse experiences, and so have many others I know, but there is little recourse.

Some vets are brilliant, most are competent, some are sadly neither.

Good luck finding a vet you can have faith in, your dogs are lucky to have you looking out for them.

Edited May 15, 2012 by Diva

[stormie]

How much does your dog weigh? The dose of Metacam is 2 drops per kg as a maintenance dose but the starting dose is often double the maintenance dose, which can be done for several days. I suggest calling the Vet for guidance on the dosage before changing it yourself, as if you're not giving enough your dog may still be in pain.

As others have said, you can try to make a complaint but I'm not sure if you'd get anywhere. The first vet thought it may have been the Atopica, which can cause swollen gums so isn't completely out there as an idea and told you to return if there's no improvement for further investigation.

[dancinbcs]

Remember dogs cannot talk so diagnosis can be a bit of trial and error but some vets, like some doctors have better diagnostic skills than others. I know of lots of things that truly incompetant vets have done over the years but don't think your vets fit that category. Even the best vets can make an honest mistake too, they are only human.

The case with your first dog could be explained by drug reaction and they would need a couple of days to see what happened if the drug was withdrawn and I wouldn't expect any vet to have picked up the liver shunt without clear symptoms. Re-occuring urinary tract infections that seem to go on forever are quite common so most vets wouldn't be looking for anything much worse.

By all means look for a better vet but there is not really anything specific to complain about the old vets other than the fact that they are just ordinary vets. Really good vets are few and far between. I can highly recommend Dr Sandra Hodgins at Summer Hill Village Vet as being one of the better ones I have come across, having excellent diagnostic skills.

Edited May 15, 2012 by dancinbcs

[Guest lavendergirl]

I sympathise with the OP here. I too would have expected more from the treating vets. If the younger dog had several recurrent illnesses over the years I would expect blood tests - including liver function - to be done to rule out underlying disease at some stage. In the older dog I would expect a vet to recognise signs of bad reactions to a drug as opposed to a pain condition. If the dog had previously had spinal issues then that should have factored into a diagnosis - the OP had advised the vet that the dog was worried about the jaw area.

Did you raise your concerns with the vet and ask why the liver condition was not diagnosed?

[Missymoo]

Ok about the shunt..shunt (of any type) is really tricky to diagnose, and I think your vet was on the ball to transfer your dog and stabilise, otherwise you wouldn't have had a dog to come home too. Vets aren't magicians and they were going on what signs she was presenting with.

Being on the specialised diet had kept her ls hunt in check but going off that food her body basically couldn't process all the extra toxins and so she presented with all these aweful signs, also looking like stroke etc... There was no negligence here. You chose to come home, you chose to pay for the operation. You chose to incour those costs so I'm unsure of what you are complaining about with this case?

We test pups for shunt with our breed so I am quite aware of symptoms, testing etc..

Again both the tests for shunt are quite specialized (post pradial testing and in high result cases a Dye is ingested and scan taken). It's not a simple run of the mill test. What sort of illnesses did she present with? Aussie terriers are not known to usually have shunts so it may not have even occurred to the vet about this.

Edited May 15, 2012 by Missymoo

[stormie]

I sympathise with the OP here. I too would have expected more from the treating vets. If the younger dog had several recurrent illnesses over the years I would expect blood tests - including liver function - to be done to rule out underlying disease at some stage. In the older dog I would expect a vet to recognise signs of bad reactions to a drug as opposed to a pain condition. If the dog had previously had spinal issues then that should have factored into a diagnosis - the OP had advised the vet that the dog was worried about the jaw area.

Did you raise your concerns with the vet and ask why the liver condition was not diagnosed?

Except that liver shunts don't often show up on blood results - the liver enzymes can be normal in dogs with liver shunts so often they don't show up until they become more sick with other problems.

And it is possible that the dog wasn't showing as obvious signs of spinal pain at the time of the first visit when the OP thought it was the mouth.

[Missymoo]

I sympathise with the OP here. I too would have expected more from the treating vets. If the younger dog had several recurrent illnesses over the years I would expect blood tests - including liver function - to be done to rule out underlying disease at some stage. In the older dog I would expect a vet to recognise signs of bad reactions to a drug as opposed to a pain condition. If the dog had previously had spinal issues then that should have factored into a diagnosis - the OP had advised the vet that the dog was worried about the jaw area.

Did you raise your concerns with the vet and ask why the liver condition was not diagnosed?

Except that liver shunts don't often show up on blood results - the liver enzymes can be normal in dogs with liver shunts so often they don't show up until they become more sick with other problems.

And it is possible that the dog wasn't showing as obvious signs of spinal pain at the time of the first visit when the OP thought it was the mouth.

Snap Stormie!

[megan_]

I sorry about the health problems your lovely dogs have had to go through. Veternarians can make mistakes but it's not necessarily malpractice or even bad practice. In all types of medicine, diagnsosis is part art and part science.

My advise would be to cherish and love your dogs, find a new vet you can trust, and let go of the past.

And sometimes they're not even mistakes - just trial and error. It is pretty common to recommend ceasing a medication if the symptoms only start once the midication is taken.

[SchnauzerMax]

I sympathise with the OP here. I too would have expected more from the treating vets. If the younger dog had several recurrent illnesses over the years I would expect blood tests - including liver function - to be done to rule out underlying disease at some stage. In the older dog I would expect a vet to recognise signs of bad reactions to a drug as opposed to a pain condition. If the dog had previously had spinal issues then that should have factored into a diagnosis - the OP had advised the vet that the dog was worried about the jaw area.

Did you raise your concerns with the vet and ask why the liver condition was not diagnosed?

Except that liver shunts don't often show up on blood results - the liver enzymes can be normal in dogs with liver shunts so often they don't show up until they become more sick with other problems.

And it is possible that the dog wasn't showing as obvious signs of spinal pain at the time of the first visit when the OP thought it was the mouth.

I was told by a vet that one symptom of a liver shunt can be a dog smaller in size than its litter mates but the diagnosis is tricky (and costs $$) unless the dog is showing active signs of liver problems.

[BigDaz]

Vets make an educated guess, GP's make an educated guess, and the difference is we can accurately define the symptoms, but in the end they both guess (understandable). I think what it boils down to is, were all avenues explored when it comes to diagnosis. My biggest gripe is not being referred to a specialist early enough, Vets tend to "try this" then come back in a week, if that doesn’t work "try the next thing".

My girl had ED which was not diagnosed for months until I was referred to a specialist (I didn’t know how this all worked previously), because of the months of mis-diagnosis she now has severe arthritis for which I have been trying various costly treatments.

She had to go to the Vet tonight because she cant jump (unrelated to the ED, seems to be in issue with back legs), I was told to try Rimadyl for her current issue and see how it goes, if that doesnt work bring her back. My reply was, if Rimadyl doesnt work please give me a referral to the specialist.

[persephone]

Hi - I've re read your post a few times now ...and IMO the problem seems to be .......just humans... With Freia .. AFAIK urinary tract infections aren't a common symptom of a liver shunt , so there was no real reason for a vet to be looking for that ...and as explained it isn't something easily /commonly tested for.

With jack ...perhaps the vet was just going on your supposition of toothache ? Owners are often the ones who know their pet better than anyone, and can spot a problem , esp a recurring one .

perhaps the vet did concentrate his examination a bit much on the area you thought was causing pain...but looking at it from a different angle ..at least the vet DID spend time checking out your hypothesis ! Some vets will just give a very cursory check

A new vet will obviously make you happy ... just ensure they get all the histories , and I hope your next vet visits are happy ones! :)

[JulesP]

UTIs are actually common with liver shunts :) Most of the dogs on my liver group have crystals of some sort. But I wouldn't expect a vet to immediately jump to liver shunt if the dog has a UTI. The symptoms of liver disease can be fairly vague. It took over a year for Amber to be diagnosed and then it was really by accident as the vet was xraying her heart and noticed the liver wasn't normal.

I don't think there is a malpractice/negligence issue here.

[persephone]

UTIs are actually common with liver shunts :)

Thanks :)

[Meea]

While I agree with all the comments that you just have normal vets and bad luck -

I live in the same suburb as you and can confirm that one of the closest vets does have a reputation for lightweight work and I travel a bit further to someone I can trust. Unfortunately the same vet owns all three of the surgeries surrounding us so you need to travel to get a choice.

Pm if you want to confirm.

Meea

[tdierikx]

I recommend Annandale Vet Clinic - 62 Moore Street, Leichhardt - awesome vets there! Well worth travelling a bit further for.

T.

[Danois]

While I agree with all the comments that you just have normal vets and bad luck -

I live in the same suburb as you and can confirm that one of the closest vets does have a reputation for lightweight work and I travel a bit further to someone I can trust. Unfortunately the same vet owns all three of the surgeries surrounding us so you need to travel to get a choice.

Pm if you want to confirm.

Meea

LOL I think I know who you mean too and now avoid them. I travel to Pennant Hills from the Inner West for my vet. 35 mins in light traffic - about 1 hour 10 in heavy. If needs be I'd use the Uni in an amergency.