Question about vet treatment

dave_s

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First, can I emphasise that I am not attempting to apportion blame. I realise that after the death of a much loved pet there is a grieving process and anger is part of that. But I am just trying to understand a delay in noticing a major injury that Jinxy suffered.

Jinxy was taken to an emergency vet at 10pm on wednesday where she was treated for hypothermia.

She was x-rayed the following morning and shown to have damage to her pelvis.

It was only when I visited her on the Friday and was concerned at the way she was vomiting that a further x-ray was done which showed a huge hernia that had pushed through her stomach wall and went up into her chest restricting her breathing. Thats 42hrs after being admitted.

When the vet called me to tell me this, she said that she was the only one in and had consultations that afternoon and that she would not be able to operate until the evening.

Jinxy died shortly after being woken from the operation.

I appreciate none of us are veterinary professionals and nobody has access to the case notes but my question is, would it be reasonable to assume that an injury of this magnitude should have been noticed in the first x-ray. And on noticing it would it have not been obvious that she would be suffering major internal bleeding which should have been treated immediately, rather than waiting another 4 hours.

I have not spoken with the vet involved about my concerns as I want to be sure I am not talking twaddle. I will speak with my regular vet tomorrow but I do not know if he would see it as unprofessional to make an opinion when he does not have all the notes.

Any thoughts would be really appreciated.

Many thanks
Dave
 

yosemite

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I'm sorry you lost your beloved kitty. Not being a vet nor having any medical knowledge I honestly cannot say whether a hernia could become that enlarged in 42 hours. I guess I'd have to see the before and after x-rays to know for sure.

I hope you get some answers.
 

cobbybear

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Hi, So sorry about your poor cat. Personally I think that the extent of her injuries should probably have been noticed in the first x-ray, once noticed I would have thought that it would be treated with much more urgency, probably as an emergency situation. You should mention it to your vet but not sure if he would speak out against his colleague even if he agrees with you. Maybe you should make a formal complaint, cause to me the level of care towards your cat was just not acceptable. Just make sure you ask questions and hopefully you'll get all the answers you need to find your peace, you don't want nagging doubts, better to get it all clear in your head if you can.
 

cloud_shade

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Originally Posted by Dave_s

I have not spoken with the vet involved about my concerns as I want to be sure I am not talking twaddle. I will speak with my regular vet tomorrow but I do not know if he would see it as unprofessional to make an opinion when he does not have all the notes.

Any thoughts would be really appreciated.

Many thanks
Dave
I would ask for copies of the notes/chart and the x-ray--you paid for them, so they should not have a problem giving them to you. That way, you can review what happened with your regular vet. I'm so sorry for your loss.
 

misskiwi67

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A cat that presents with a pelvic fracture should be assumed to have been hit by a car. An animal that was hit by a car should receive abdominal and chest radiographs... at least in my opinion. If you refused these diagnostics, then the missed hernia was probably not the vets fault.

Treating the hypothermia was a MUCH bigger concern as this is life threatening... and further diagnostics may not have been done for that reason. The hernia was probably there the whole time, and if bleeding was an issue, it would have killed your kitty much sooner. The hernia may not have even caused your kitties death (many animals will have them found incidentally years later with no known history of trauma), it just looks like a major problem, and the fact that your vet missed it is obviously unfortunate.

Four hours is seldom life-changing, and in fact, if your kitties condition was not stable, four hours of fluids can be a major life saver. The ONLY surgeries that are emergencies (cancel everything) are conditions of sepsis such as pyometra, something like a gastric torsion that compromises the circulatory system, or a condition resulting in a punctured/collapsed lung... and even those often wait 2-3 hours while the patient is stabilized.

Hindsight is 20/20 however... your best bet is to get a necropsy performed, and talk to both the ER vet and your regular vet. Also make sure that your vet and the ER vet speak to each other, as this will help your vet get both sides of the story to better communicate to you. Its FAR too easy to make assumptions when you weren't there.

Lastly, there may have been a lot going on that your vet was not aware of during the surgery. Its difficult to know exactly what caused the death of your kitty without a full necropsy complete with histopathology to determine the extent of the damage to the internal organs. Even then, you may never know if it was the surgery, the delay in surgery, or something completely unrelated that resulted in death.
 

shorty14788

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I would certainly ask for a copy of your records and your Xrays. Legally you are entitled to them.

As for the Xrays, Some vets like them collimated down. (Very focused in on the specific part they want to look at) Depending on where the herniation was and how big it was, it may not have even been in the original xrays.

Thats why I suggest you get a copy of the xrays. It is important to know if the herniation was visible in the originals. You could bring them to another vet to confirm the findings.

I know it doesn't help things, but I'm very sorry to hear of your loss. Best wishes for you...
 
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dave_s

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Thank you for your objective opinions, it is very much appreciated.

I acknowledge that it is possible that the hernia could have been missed due to something other than negligence. But, and I am speaking completely out of ignorance here, should a hernia which had caused a 10cm split in her stomach not have been very evident? And if so, would treatment 24hrs earlier have given her a better chance of survival?

Nothing is going to bring Jinx back but if things have not been done that should have been, then I want to know. Vets are like GP's, we trust them implicitly and tend to not question their opinion and/or treatment. But, if things have not been done that should have been, is it not right to bring the fact to light.
 

misskiwi67

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Originally Posted by Dave_s

. But, and I am speaking completely out of ignorance here, should a hernia which had caused a 10cm split in her stomach not have been very evident? And if so, would treatment 24hrs earlier have given her a better chance of survival?
You would have to ask another ER surgeon that question, and without all the other details, its still hard to determine. It sounds like your kitty was on the downhill slide before the hernia was discovered.

In my opinion, the trauma that CAUSED the 10cm split in her (diaphragm) was probably much more likely to have caused her death. I think you're very lucky to have found her when you did, and lucky to have had the chance to do everything you could to save her. I'm so sorry for your loss, and even more sorry that you have to struggle with these questions while you grieve.
 

urbantigers

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I'm sorry to hear about your cat
I would just go and discuss your concerns with the vet. Not in an accusatory manner, just say you want to have a chat about what happened and ask about the hernia. The vet may be able to explain to your satisfaction why it wasn't discovered sooner (and exactly what the cause of death was). After you've had that chat is the time to think about whether you feel they were negligent and whether you want to pursue it. Right now you just need to find out what was done or not done and why.
 
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