- Joined
- May 14, 2014
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I was going to write this on Back's anniversary, but I have been putting it off because it's a bit painful to do. But here it is. In writing this I am going to skip details and fine points in order to keep it short. I could write 10+ pages but prefer not to do that. The complaint I filed with the board was 14 pages plus addenda and I don't want to go that route here.
Over a period of months, Back had lost weight and developed increasingly difficult hairballs. I mentioned the hairballs to his vet during Back's annual physical, but she didn't seem concerned. His second to last hairball was so painful for him that he was practically screaming in expelling it, but I didn't take him to the vet because -- as always -- he was completely normal after expelling it and wanted something to eat. He was terrified of the cat carrier (would pee all over himself in transit to the vet) so I decided not to take him, but if he had one more bad one then we were going, period.
Five days or a week later I knew he was going to have a hairball because I saw him licking around his mouth, which he always did preceding a hairball, and a short while later I heard the same vocalization as before, so I scooped him up and took him to the emergency vet because the regular vet was closed as it was a Sunday evening. This would cost more, but I didn't care, it was time to resolve this hairball problem. If I had only known the cost would be his life.
The vet diagnosed Back as being severely dehydrated, as much as 11%. That explained the weight loss and difficult hairballs. In fact, I recall his last hairball (a week before I took him in) as being just a hairball -- there was no vomit/fluid with it, no wonder he was in so much distress. EKG and ultrasound of his heart showed that he had normal sinus rhythm, severe microcardia due to dehydration, low heart rate of 120, but otherwise his heart was fine and he did not have any sort of cardiac disease. He was so vasoconstricted due to hypovolemia that the vet could not use a syringe to draw a blood sample from his jugular vein. So, in simple terms, the vet diagnosed severe dehydration with associated extreme low blood volume.
You don't need to be a vet to know how to treat this -- subcutaneous fluids. Simple. But the vet didn't provide any fluids at all. Her plan of action was to slice down the length of Back's jugular vein to force a blood sample. Obviously, this would have further reduced his blood volume and put him into hypovolemic shock, and even if it hadn't, how would she possibly close the vein to prevent him from bleeding out? A puncture from a syringe will self-seal and clot with pressure from a piece of gauze, but a lengthwise slice? So, rather than treat severe dehydration with hydration, her plan would have treated it with additional dehydration.
But she never got to that step.
Because Back's heart rate was 120, and she expected it to be 180 or more, she decided to intubate him while he was conscious and breathing on his own. Intubation is incredibly traumatic, as anyone who wakes up in the hospital and finds her/himself with a tube in his lungs will tell you, but at least in that situation they are usually on pain killers and never experienced the actual procedure when it was performed (usually under general anesthesia). Back was fully conscious and breathing when it was done to him, and I think that must have been the reason I heard him make a short, single howl as I was in the waiting room. So a ten pound cat, suffering from severe dehydration and resultant extreme microcardia is subjected to the trauma of having a tube shoved down his trachea into his lungs. One of the dangers of microcardia from dehydration is that the heart is in a weaker state and cannot handle stress well, and one of the rules of treating dehydration is not to stress the patient, to keep him calm while providing fluids. Unlike a person, Back wouldn't have had any concept of what was happening other than trauma, pain, and fear. A couple minutes later, while the vet was meeting with me in another room, he went into sudden cardiac arrest and died. The vet said she had no idea why that could have possibly happened. An x-ray of his body showed nothing abnormal, no internal bleeding, though there was something that looked like a hairball in his stomach.
I blamed myself for Back's death, but eventually I obtained the medical records. I was surprised with what I found. First, the records stated that Back had been vomiting that day, but I had told the vet he had been fine all day. Second, they stated that he was in agonal breathing, but when the vet met with me the first thing she said was that he was breathing fine, was severely dehydrated, and was intubated due to his low heart rate. In a subsequent phone call with the vet, in which I asked how he could be in agonal breathing when she had told me he was breathing, she indicated that she didn't actually witness agonal breathing but based that on my description of Back's behavior while in transit to the vet but not actually at the vet. Not only did I not say Back was in agonal breathing, it means the record is misleading, because it comes across as the vet actually seeing him in a state of agonal breathing, and that is a lie, as she saw him breathing normally and he was intubated before she ever spoke with me. Third, the records stated that Back was unresponsive, but the vet never said anything about that at the time we met, so I inquired during the later phone conversation. She said he was unresponsive because she scritched his chin and he didn't pull his head away. That is a very liberal use of the medical term "unresponsive", especially since most cats like having their chins scritched, Back was always docile and compliant when he was at the vet (the ride over was when he would whine and moan, but while there he was very docile), Back was probably lethargic at that time, and I am sure the howl I heard was his as it had his trademark unusual sound combining a donkey and a coyote.
During this phone call I asked other questions, but the vet stopped answering them -- she wouldn't say yes or no or I don't know, she wouldn't say anything. I even pointed out that she wasn't responding to any of my questions and got no response, so I let the uncomfortable silence build -- and eventually she assured me that Back wasn't in pain when he died because he fell unconscious prior to his heart stopping. If you read the records without any other information, what you see is a cat that had been vomiting before being taken to the vet and, as presented to the vet, is essentially dead. In all likelihood, this cat had been poisoned or had some sort of internal trauma. But this image you would have in your mind from reading the report is a flat-out lie.
I filed a complaint with the board, alleging the vet killed Back due to the trauma from intubating him while he was conscious and breathing on his own, and that she had falsified the records to cover up killing him. By law I am not allowed to see the investigator's findings, and the decision ended up being what I expected it would be -- nothing. I'm guessing it was a he said/she said situation, with the vet responding to the investigator's questions with "I don't recall, I'd have to look at the medical record".
My focus in the complaint was on the intubation, but I should have focused on the vet not properly treating dehydration, being incompetent and not fit to practice veterinary medicine. You see, I also had a phone call with the chief of staff of that emergency hospital, and during our conversation it became apparent to me that he assumed the vet gave Back fluids. I had to point out to him that despite her own diagnosis of severe dehydration, the vet didn't give him fluids, and at first he politely argued with me, even telling me that she was excellent and highly regarded. When I told him to check the records (which he apparently had neglected to take seriously) he realized there was no information whatsoever about fluids being provided -- there would have been some entry about subcutaneous fluids being given if they had in fact been given. He sounded very surprised while looking over the records and indicated he would have to discuss with the vet, but I of course never heard back about this.
What I think happened is the board may have assumed, just like the chief of staff had assumed, that fluids were provided, because OF COURSE they would have been provided -- any licensed veterinarian knows you treat dehydration with hydration, especially if the dehydration is so severe that you cannot find the cat's jugular vein and you can see via the ultrasound that you just performed that he has extreme microcardia!!! But this vet was so incompetent that, despite her own diagnosis of severe dehydration, she never gave Back fluids to resolve it. Instead, she traumatized him by shoving a tube down his trachea and pressing sharp objects against his neck.
So, Back basically died of fright.
Every once in a while there is a post on this board asking if you can come to accept the death of your cat. While I miss another cat I had who was euthanized due to advanced HCM (after 16 months of medication), I accept what happened. It has been over four years and I don't accept what happened to Back, it just shouldn't have ever happened, but I know I cannot undo it. So, I dwell on it, I think about him every single day, I tell him I am sorry for what that incompetent vet did to him, and I hope she doesn't kill anyone else's pet.
Over a period of months, Back had lost weight and developed increasingly difficult hairballs. I mentioned the hairballs to his vet during Back's annual physical, but she didn't seem concerned. His second to last hairball was so painful for him that he was practically screaming in expelling it, but I didn't take him to the vet because -- as always -- he was completely normal after expelling it and wanted something to eat. He was terrified of the cat carrier (would pee all over himself in transit to the vet) so I decided not to take him, but if he had one more bad one then we were going, period.
Five days or a week later I knew he was going to have a hairball because I saw him licking around his mouth, which he always did preceding a hairball, and a short while later I heard the same vocalization as before, so I scooped him up and took him to the emergency vet because the regular vet was closed as it was a Sunday evening. This would cost more, but I didn't care, it was time to resolve this hairball problem. If I had only known the cost would be his life.
The vet diagnosed Back as being severely dehydrated, as much as 11%. That explained the weight loss and difficult hairballs. In fact, I recall his last hairball (a week before I took him in) as being just a hairball -- there was no vomit/fluid with it, no wonder he was in so much distress. EKG and ultrasound of his heart showed that he had normal sinus rhythm, severe microcardia due to dehydration, low heart rate of 120, but otherwise his heart was fine and he did not have any sort of cardiac disease. He was so vasoconstricted due to hypovolemia that the vet could not use a syringe to draw a blood sample from his jugular vein. So, in simple terms, the vet diagnosed severe dehydration with associated extreme low blood volume.
You don't need to be a vet to know how to treat this -- subcutaneous fluids. Simple. But the vet didn't provide any fluids at all. Her plan of action was to slice down the length of Back's jugular vein to force a blood sample. Obviously, this would have further reduced his blood volume and put him into hypovolemic shock, and even if it hadn't, how would she possibly close the vein to prevent him from bleeding out? A puncture from a syringe will self-seal and clot with pressure from a piece of gauze, but a lengthwise slice? So, rather than treat severe dehydration with hydration, her plan would have treated it with additional dehydration.
But she never got to that step.
Because Back's heart rate was 120, and she expected it to be 180 or more, she decided to intubate him while he was conscious and breathing on his own. Intubation is incredibly traumatic, as anyone who wakes up in the hospital and finds her/himself with a tube in his lungs will tell you, but at least in that situation they are usually on pain killers and never experienced the actual procedure when it was performed (usually under general anesthesia). Back was fully conscious and breathing when it was done to him, and I think that must have been the reason I heard him make a short, single howl as I was in the waiting room. So a ten pound cat, suffering from severe dehydration and resultant extreme microcardia is subjected to the trauma of having a tube shoved down his trachea into his lungs. One of the dangers of microcardia from dehydration is that the heart is in a weaker state and cannot handle stress well, and one of the rules of treating dehydration is not to stress the patient, to keep him calm while providing fluids. Unlike a person, Back wouldn't have had any concept of what was happening other than trauma, pain, and fear. A couple minutes later, while the vet was meeting with me in another room, he went into sudden cardiac arrest and died. The vet said she had no idea why that could have possibly happened. An x-ray of his body showed nothing abnormal, no internal bleeding, though there was something that looked like a hairball in his stomach.
I blamed myself for Back's death, but eventually I obtained the medical records. I was surprised with what I found. First, the records stated that Back had been vomiting that day, but I had told the vet he had been fine all day. Second, they stated that he was in agonal breathing, but when the vet met with me the first thing she said was that he was breathing fine, was severely dehydrated, and was intubated due to his low heart rate. In a subsequent phone call with the vet, in which I asked how he could be in agonal breathing when she had told me he was breathing, she indicated that she didn't actually witness agonal breathing but based that on my description of Back's behavior while in transit to the vet but not actually at the vet. Not only did I not say Back was in agonal breathing, it means the record is misleading, because it comes across as the vet actually seeing him in a state of agonal breathing, and that is a lie, as she saw him breathing normally and he was intubated before she ever spoke with me. Third, the records stated that Back was unresponsive, but the vet never said anything about that at the time we met, so I inquired during the later phone conversation. She said he was unresponsive because she scritched his chin and he didn't pull his head away. That is a very liberal use of the medical term "unresponsive", especially since most cats like having their chins scritched, Back was always docile and compliant when he was at the vet (the ride over was when he would whine and moan, but while there he was very docile), Back was probably lethargic at that time, and I am sure the howl I heard was his as it had his trademark unusual sound combining a donkey and a coyote.
During this phone call I asked other questions, but the vet stopped answering them -- she wouldn't say yes or no or I don't know, she wouldn't say anything. I even pointed out that she wasn't responding to any of my questions and got no response, so I let the uncomfortable silence build -- and eventually she assured me that Back wasn't in pain when he died because he fell unconscious prior to his heart stopping. If you read the records without any other information, what you see is a cat that had been vomiting before being taken to the vet and, as presented to the vet, is essentially dead. In all likelihood, this cat had been poisoned or had some sort of internal trauma. But this image you would have in your mind from reading the report is a flat-out lie.
I filed a complaint with the board, alleging the vet killed Back due to the trauma from intubating him while he was conscious and breathing on his own, and that she had falsified the records to cover up killing him. By law I am not allowed to see the investigator's findings, and the decision ended up being what I expected it would be -- nothing. I'm guessing it was a he said/she said situation, with the vet responding to the investigator's questions with "I don't recall, I'd have to look at the medical record".
My focus in the complaint was on the intubation, but I should have focused on the vet not properly treating dehydration, being incompetent and not fit to practice veterinary medicine. You see, I also had a phone call with the chief of staff of that emergency hospital, and during our conversation it became apparent to me that he assumed the vet gave Back fluids. I had to point out to him that despite her own diagnosis of severe dehydration, the vet didn't give him fluids, and at first he politely argued with me, even telling me that she was excellent and highly regarded. When I told him to check the records (which he apparently had neglected to take seriously) he realized there was no information whatsoever about fluids being provided -- there would have been some entry about subcutaneous fluids being given if they had in fact been given. He sounded very surprised while looking over the records and indicated he would have to discuss with the vet, but I of course never heard back about this.
What I think happened is the board may have assumed, just like the chief of staff had assumed, that fluids were provided, because OF COURSE they would have been provided -- any licensed veterinarian knows you treat dehydration with hydration, especially if the dehydration is so severe that you cannot find the cat's jugular vein and you can see via the ultrasound that you just performed that he has extreme microcardia!!! But this vet was so incompetent that, despite her own diagnosis of severe dehydration, she never gave Back fluids to resolve it. Instead, she traumatized him by shoving a tube down his trachea and pressing sharp objects against his neck.
So, Back basically died of fright.
Every once in a while there is a post on this board asking if you can come to accept the death of your cat. While I miss another cat I had who was euthanized due to advanced HCM (after 16 months of medication), I accept what happened. It has been over four years and I don't accept what happened to Back, it just shouldn't have ever happened, but I know I cannot undo it. So, I dwell on it, I think about him every single day, I tell him I am sorry for what that incompetent vet did to him, and I hope she doesn't kill anyone else's pet.
Condolences on the tragic loss of Back. What a horrible, terrible experience for both of you - very traumatic for you. And it is further insult that the vet board has denied you justice. You did the good fight and Powers greater than any vet board know this. I fervently pray that other pets are spared the incompetent performance of that lousy vet. 
