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  1. #1
    Join Date
    Jun. 14, 2006
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    VA
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    Default Unnecessary procedures, WWYD?

    For the record, I don't plan to do anything at this point, not enough information, but I am wondering what you all would do.

    So. Last year just before Xmas, my dog had a perforation of the small intestine that required a resection and anastamosis. Because he perforated, he also ended up being septic. It was a very very very expensive hospitalization.

    Fast forward to this year. In the last few weeks, he's been losing weight, kind of anorexic, and in the last 2 weeks, had loose stools.

    So I took him in to the university. They figured he had lymphoma and were going to ultrasound. But they also wanted to rule out parasites. He'd had a fecal done about 2 weeks prior at my reg vet but wanted to do another to rule out giardia and were also going to send a test in that was antigen based.

    Long and short, no cancer. They ended up doing another resection and anastamosis "preventitively" and a gastronomy as well. He had crap in his stomach (toilet paper). But they elected to remove the previous anastamosis side by side site and put in an end to end to avoid any kinks. Everything looked good once they were in there as far as healthy tissue, no blockage but they did these procedures preventatively.

    We're now 7 days post op with the exact same symptoms. And guess what? Doesn't look like the fecal was ever done as discussed. And now they want to do it because they think it might be giardia.

    If it IS giardia and it wasn't checked as was discussed AND written out and signed, and none of the other surgical stuff was necessary...would you ask them to credit you for the surgical procedures? I've heard from 3 different vets plus 2 students who were in the surgery that there was nothing remarkable about the previous site. They assumed that internal medicine did the tests they said they were going to.

    I'm not going to come unglued. I'm not. My dog is really special to me and I have a LOT of respect for the doctors at the university. But if it turns out that this is "just" giardia and we put my dog through MAJOR abdominal surgery and ended up with a 4k bill....I'm just not sure what to DO.

    Mistakes are made all the time. I get that. But the basic battery of tests should have been done IMHO. It's what I authorized. It's what I expected to happen. And it didn't.

    So IF I go back in today for a fecal and it IS giardia....what would you do? Would you ask them to credit you for the surgery?

    At this point, I don't know for sure what is going on, but I (and the surgeons) thought we had ruled out parasites before proceeding with surgery.

    Either way, I am happy to have my dog. BUt he's still sick. And I'm afraid I've put him through a majorly invasive procedure for naught.
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



  2. #2
    Join Date
    Sep. 7, 2009
    Location
    Lexington, KY
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    18,515

    Default

    Yes, I believe I would ask them to credit you for the surgery.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant


    2 members found this post helpful.

  3. #3
    Join Date
    Oct. 30, 2008
    Posts
    3,212

    Default

    150% yes. In fact, I'd ask in a fairly non-asking kinda way. Polite, respectful, but very firm on the "I expect to be credited for the unnecessary surgery..."
    Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

    You call it boxed wine. I call it carboardeaux.


    2 members found this post helpful.

  4. #4
    Join Date
    Jun. 14, 2006
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    VA
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    Default

    I am blessed with a 4th year who is very very helpful. The freaking clinician wants a diagnosis so wants me to drive in (45 min) and try to do a fecal, but he's got such runny stool and doesn't want to eat that there's no way that is going to happen. Plus, no offense to the vets out there because I totally understand wanting to do things the right way, I am out of money. My last day at work was Monday. I have no more income. I just spent 4k. Holy crap!

    And I NEED to get the heck out of MI and to VA before my horse ships.

    Deep breaths.
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



  5. #5
    Join Date
    Aug. 4, 2009
    Posts
    82

    Default

    Quote Originally Posted by BuddyRoo View Post
    I am blessed with a 4th year who is very very helpful. The freaking clinician wants a diagnosis so wants me to drive in (45 min) and try to do a fecal, but he's got such runny stool and doesn't want to eat that there's no way that is going to happen. Plus, no offense to the vets out there because I totally understand wanting to do things the right way, I am out of money. My last day at work was Monday. I have no more income. I just spent 4k. Holy crap!

    And I NEED to get the heck out of MI and to VA before my horse ships.

    Deep breaths.
    Can you collect the sample yourself? Consider asking your vet if you can mail it to the lab from home.



  6. #6
    Join Date
    Apr. 14, 2001
    Location
    Minnesota
    Posts
    16,854

    Default

    Oh, BuddyRoo. I'm so sorry you're going through this and your pup is still not right.

    Can you have a local vet run the fecal versus going back to the hospital?

    I would certainly have a conversation about a refund if the fecal is positive. Move it up the chain if you need to.



  7. #7
    Join Date
    Aug. 4, 2009
    Posts
    82

    Default

    Sorry for posting again, I just read your OP more carefully. I'm a veterinary lab tech and have a couple more questions.

    Has/does your dog have access to water that could be contaminated with Giardia?

    Has your dog been on antibiotics in the recent past?



  8. #8
    Join Date
    Jan. 4, 2007
    Location
    TX
    Posts
    41,548

    Default

    Another question, test results or not, why didn't they start him on medication for Giardia anyway right off, before surgery, in a case like his?



  9. #9
    Join Date
    Jun. 14, 2006
    Location
    VA
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    Default

    Alright...so here's what I know to answer questions...

    RD: no, not that I know of. limited to our yard. but we are in the country so a raccoon or coyote could bring it in. And no, no abx. Not since last Dec. He's not even on abx now. Well, metronidazole in the last 2 days. But otherwise no.

    Bluey, don't know. don't freaking know. I thought it was a base we were going to cover.



    When I first had him admitted, I signed a consent to do fecal AND a giardia snap test. Neither were done.

    We were admitted in one dept then transferred to another.

    The surgical dept was under the impression (as was I ) that the fecal had been done.

    It wasn't.

    Today, the 4th year suggested I get the meds. He's been on metronidazole now for 4 doses which is also good for giardia.

    On my way to the clinic, I called my old boss (vet) and explained the situation. He said I may be screwed because even if I test now, after being on the metronidazole, it may be negative. He suggested doing a snap test and said it just took a few ounces of fresh stool to do.

    I asked I could buy a test at my vet clinic but they send out to MSU and MSU had told me I needed a big sample hence just treating him.

    I am not a litigious person, please don't get me wrong. BUt if I just put my dog through this because the basic basic basic shit we AGREED TO DO didn't get done?

    Oy.

    And FWIW, the 4th year started treading water when she called back after speaking to the business office. She was pissed when she first told me the test wasn't done. Then she called and said "oh, he would've needed this surgery."

    I call bullpoop.

    Maybe. Maybe not. But if dosing with what equates to a power pack does the trick, I'm probably going to raise a little noise. I am a good customer. I am not a cheap skate. But this may be more than I can handle if all he needed was a power pack, not major abdominal surgery.

    I did this to him. He's a good sport but God, I Should've asked more questions.
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



  10. #10
    Join Date
    Jun. 14, 2006
    Location
    VA
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    Default

    He eats the hamburger/rice well, just nothing else. And his feces are liquid. Just as a side note.

    He has lost 20+ lbs now so Im just desperate to get him to EAT.
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



  11. #11
    Join Date
    Jan. 30, 2007
    Posts
    3,155

    Default

    BR, recently I had a stomach bug run through some of my house cats with the associated runs, and someone suggested cooked pumpkin (not pie filling, but pumpkin- I know Aldis carries it canned, so most supermarkets ought to too). Also was wondering about probiotics and yogurt. I know it's only treating the symptoms, but dang, your poor pup must feel bad.
    Hang in there, girl!
    D.
    Founder of the I LOFF my worrywart TB clique!
    Official member of the "I Sing Silly Songs to My Animals!" Clique
    http://wilddiamondintherough.blogspot.ca/



  12. #12
    Join Date
    Aug. 4, 2009
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    82

    Default

    Yikes. I do see a lot of liquid, stinky, gassy (sorry for the graphics) dog poop. And when it's that nasty and it turns up negative for parasites and Giardia antigen, it's sometimes due to opportunistic gut bacteria flourishing after a round of antibiotics or pathogenic infection that requires a culture for identification. If the power pack does work, keep in mind that there's a possibility it could have cleared out a gut infection that wouldn't have shown up on a fecal or Giardia test.

    Are his routine fecals typically performed in-house or sent to a lab? If the one from 2 weeks ago at the regular vet had been sent out, the lab tech would likely have recognized Giardia cysts if they had been there. They can take quite a bit of practice to find though, and are easily missed by clinics.

    Please don't take it out on yourself! Everything is a tricky judgment call in a case like this. Let's say they did a fecal/Giardia and they were negative. Should they have ordered a fecal culture or gone ahead with surgery in response? It's easy to see how someone looking at his chart and history would have been worried about his intestines and ordered the surgery. And you may very well have ended up where you are now with the exact same knowledge.

    At least you and they now know that his previous surgery hadn't caused complications - that's excellent. And if he has more GI problems in the future, they'll be able to rule out anastamosis complications with more certainty due to the preventative work they did last week. That might prevent unnecessary surgeries in the long run.

    I second the canned pumpkin and probiotics. I hope your baby feels better soon!



  13. #13
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    Jun. 14, 2006
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    VA
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    Default

    He just vomited...all over my bed. Oh well, the sheets just got cleaned since I vomited all over them LAST night. It's one of the other, eh?

    I will try probiotics and pumkin but the thing is, we are exactly where we were before when I took him in. So that might help, but it's not a solution per se, KWIM?

    Sigh.

    I can't do much more. I'm out of money. THey double charged me for a few procedures and meds, but even with that coming my way, I'm pretty much done financially.

    This sucks.
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



  14. #14
    Join Date
    Mar. 8, 2004
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    Baltimore, MD
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    Default

    Mega jingles for you both


    1 members found this post helpful.

  15. #15
    Join Date
    Jan. 26, 2001
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    NC
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    Default

    I would get TWO places to test him and if he has it, tel them you will not be paying for the surgery and ask how they intent to compensate you and your dog for the unnecessary procedure.
    Poor guy. I hope he feels better fast and you both get some rest tonight.


    1 members found this post helpful.

  16. #16
    Join Date
    Nov. 2, 2006
    Location
    Maine
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    Did they get an intestinal biopsy in surgery? I work for one smart lady, we ultrasound most of our exploratory candidates pre surgery and in many dogs inclined to eat things they shouldn't we see signs of IBD. DH's dog ate a corn cob in August, the biopsy I took during surgery confirmed IBD. Took him off all poultry and after years of being underweight despite copious food, he looks good.

    While not a fan of prescription foods in general, a trial of HA or z/d might be helpful



  17. #17
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    Jun. 14, 2006
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    VA
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    Default

    Marsh, they did biopsy the intestine and we're all clear.

    He's been on I/D low fat, regular I/D, baby food, variations on the theme of canned GI low residue foods, regular canned foods, etc etc etc. I can try isolating him to z/d or some such, but not til I get to VA. I did locate a veterinary practice that is willing to take us on. Explained the situation to the veterinarian, etc.

    He has only vomited the one time--wasn't vomiting prior to surgery and hasn't since except for last night. Still defecating, though runny. Ate well this a.m. and at noon with hamburger/rice mixed in.

    He had a fecal at the regular vet 3 weeks ago done in house. They said they couldn't do the snap w/o more of a sample last night. So I've got the fenbendazole in him, treating as if.

    I'm going to hit the road today. I just don't see the point in waiting here if there's not much more to do. The last message I got from the vet student at MSU was to follow up on the fecal with my regular vet.

    He's fine otherwise...bright, energetic, drinking, playing. But he looks like a danged skeleton.

    I'm going to have hubby pick up some pumpkin so I can add that in tonight when I get to VA. I'm not going to feed him again til we're out of the car. I don't want to deal with loose stools in the rental vehicle.

    Just finishing packing up and should hit the road soonish I hope!
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



  18. #18
    Join Date
    Jun. 24, 2005
    Location
    Alabama
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    8,775

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    BuddyRoo-that's a good idea not to feed him on the road. A little break won't hurt him, and you don't want him getting carsick too.
    You can't fix stupid-Ron White



  19. #19
    Join Date
    Sep. 20, 2005
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    Default

    I'm going to be the voice of dissent here, with a caveat...

    Unless the procedures were done without your knowledge and consent, I think you're pretty much SOL. Presumably, you knew there wasn't a definitive diagnosis before consenting to the surgery. Presumably, you gave them the go ahead anyway.

    Now, if I'm wrong and the vets actually LIED to you about something, you might have a case. But in the end, you were in the driver's seat - you consented to the procedures. I don't know any vets that make guarantees with regard to outcomes, so I doubt they'll credit you for the procedures. And I really don't see why they should.

    Unless, like I said, the procedures were done without prior consent.
    "Are you yawning? You don't ride well enough to yawn. I can yawn, because I ride better than you. Meredith Michael Beerbaum can yawn. But you? Not so much..."
    -George Morris



  20. #20
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    Jun. 14, 2006
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    VA
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    Default

    SNL, I'm not concerned about the procedures that were done with consent but the one(s) that WEREN'T done that we agreed to do to start down the path of ruling thing out.

    Because now I have a post op dog that even the surgeons are thinking might just be an intestinal parasite. There's not much other explanation for the issues he's having. And that fecal was supposed to be done first.

    I could *almost* make the argument that once they did the ultrasound and saw that he had a side by side and a stomach full of crap, that they decided not to do the other diags.

    But he had his ultrasound first. They still did a U/A, blood work, and the other diags on the list. A dog who presents as anorexic and having loose stool? I think a fecal is warranted. And we discussed that quite a bit actually as he'd just had one two weeks prior. In fact, the vet said something to the effect of, "I know he just had one, but I would feel more comfortable if we did one here and did the snap as well because sometimes things get missed."

    So, the fecal was kind of a major piece of this.

    The communication isn't so great at times because you talk to a different person each time and the left hand doesn't always know what the right hand is doing/has done. But still.....4k vs 26 dollars.

    Will be hard to prove anything at this point, I understand that. But I am pretty disappointed that they didn't do the fecal. They even took a sample while I was in the ROOM!

    Oh well, not much I can do right now, just need my dog to feel better. If I can get THAT, I will be okay.
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



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