I'm so angry over my Yuri's recent vet experience....long rant

[Princess Turandot]

In March, I took Yuri to a prominent animal hospital because he had a UT blockage and it was 11PM. He needed surgery to have bladder stones removed. The entire time he was hospitalized he was lethargic and bloated, and never tried to urinate i.e. go to the litter box and posture. He was just leaking urine onto himself wherever he was laying. In fact, they were manually expressing him part of the time, i.e. pushing on the bladder to force the urine out. They discharged him 3 days after the surgery, with no UT related meds, just an antibiotic and pain medication. They tell me that his condition was probably due to anxiety abt being hospitalized.

I brought him back there 14 hours after he was discharged because nothing had changed, especially with the urination. They sent us back home, saying that he was okay. At 5AM the next morning, he was showing clear signs of respiratory distress so I rushed him back up there. He was re-admitted in heart failure. I had assumed that he had a heart problem that was unknown, but once they stabilized him and did heart scans, he only had a slightly enlarged heart. I asked the vet now caring for him what would have caused the heart failure, and he said it was probably fluid overload from a transfusion he had after surgery. I didn't know what to make of that.He also mentioned that he had an atonic bladder, which can happen when a dog or cat has stones: the bladder gets stretched and stops flexing. They are supposed to treat this by catherizing the animal for several days, so the bladder can re-coup. They didn't do this after his surgery.

At that point I figured that because they first discharged him before
he was urinating normally, that toxins built up in his blood and caused the heart failure. I wrote a complaint letter to the place asking that some of my charges be reversed, since they had discharged him before his original problem had been resolved. (The place is very expensive.) I eventually got a letter from their QA committee which was condescending & insulting, and took no responsibility for what happened.

After 12 days in the hospital, Yuri eventually recovered from the congestive heart failure, and started to urinate on his own again.
He's about 90% himself at this point.

I wrote a letter back to the CEO of the place & the director of surgery refuting the QA response. At the same time, I asked for a copy of his medical records. I got a package from them that only included tests results, no vet or nursing notes. (That's a violation of the vet regs in my state: I'm entitled to everything.) Oddly, there was only a single report in the package related to the first admission: a full blood chemistry work-up. There was nothing else related to the first stay. I've since requested all of the records, altho I haven't gotten them yet.

In the meanwhile, I start looking at what they did send to me. On both a cardiology and radiology report there was a box for his history from the prior admission. Both indicated that he had experienced a fluid overload during that admission, something that was never told to me. That in and of itself can kill the animal. Now, I understood why the resident had made that comment to me. Then I started looking at the bloodtest results. The 2 main factors that they check re: kidney problems are blood nitrogen (BUN) and creatinine levels in the blood. High levels indicate that the kidneys are not cleaning the blood. After Yuri was initially un-blocked, but before his surgery, his creatinine levels were normal, and his nitrogen level (referred to as 'BUN') was 70, where high normal is 34. However, when I brought him back to the facility in heart failure, his BUN had sky-rocketed to 213 and creatinine had jumped to 6.7, where high normal is 2.3. Additionally many of his blood count factors were in worse shape. These results were from just a day and a half after he was discharged to home and I was assured that he was okay. That further confirmed to me that he still must have been experiencing a urination problem, causing his kidneys to back up.

Yesterday, while I was obsessing about all of this, it occured to me that their Medical Records department had told me that they only sent out test results when I called to ask where the vet notes were. I had asked the clerk why I had only one report for the first admission, so she pulled out the record and told me that was all she could find. She put her supervisor on the phone who said that she would search for the other records. For some reason last night, I recalled having a detailed itemized bill for both stays, showing every charge and the date they were occured. I pulled out the bill for the first stay and discovered that based upon what was billed they never did another detailed blood test on him. This means they discharged a previously blocked cat without checking what his BUN & creatinine levels were.

This is what my poor boy looked like the day before he was discharged the first time. He looked the same way when he was discharged.





Four days after he was re-admitted, when they got the fluid out of his chest & lungs and had him catheterized, so the urine was flowing,
he looked like a totally different animal. His eyes were bright, he was alert and he was trying to run around the room during my visit with him.





This is one of those moments when I was glad NYC has stiff gun control laws. I can't believe that he had a life-threatening episode during his stay which I was not told about. And I really can't believe they never bothered to test his BUN & creatinine before they sent him home. This place is so fee oriented that I am confident that whatever is on the bill is everything they did.

(I'm in the process of being hooked up with an attorney with experience in the vet malpractice area.)

[Lorien]

1. I'm so sorry that you and Yuri were put through

this. I would be furious, too. It's heartbreaking looking at those photos-reminds me so much of when my kitty Peewee was going through his episodes with cardiomyopathy and hyperthyroid disease (he was shaved like that, with his leg wrapped the same way). The only problem with a lawsuit is that in most states, you only get reimbursed for the cost of the cat if you lose him to malpractice (since pets are considered nothing more than property). If you adopted the cat and paid nothing for him, then they will not allow for any damages-but then again, I don't know if this is true in every state. With the absurd amounts that are charged for vet care these days, it's appalling that this degree of ineptitude could have been allowed.

Good karma for you and Yuri both. :hug:

[SW FL Dem]

2. So sorry to hear this.

I have a rescue dog who has had to have bladder surgery twice for stones. The surgery is gruesome to say the least. I am lucky to have a vet who knows that I know my dog and I will fight for her. I insisted on bringing Libby home the night of her surgery (rather than leaving her unattended in the vet's office). The vet refused until I told her that I was uncomfortable leaving my dog unattended, and asked why she was better off in a cage than she would be at home with people who loved her and would take her to the emergency vet if she showed signs of distress. The bottom line is that you have to be an advocate for all your loved ones, furry or human.

I hope that Yuri has a full recovery and that you two have a long and happy life together.

[Princess Turandot]

3. This was at a multi-service animal hospital which employs..

around 100 vets, residents and interns, and several hundred other people and a supposed wonderful rep. I only brought him there because of the time the blockage occurred. So, I had no reason to believe he would not be 'safe'. I left out many details..he was evaluated as slightly anemic before surgery (hematocrit of 26% vs normal of 29%) but became very anemic after the surgery, so bringing him home in this case would not have been very good. They called me at 12:30AM the morning after the surgery to ask permission to give him a blood transfusion because of a decline in his red blood cells. (They explained the risk of transfusion rejection to me, but not transfusion overload, which apparently did happen after-wards and is also life-threatening.)

The surgery itself seemed to go okay. Maybe it is easier in a cat?
He never even fussed at the incision, which I could barely see a week later. The problem, or one of them, was that after-wards he still could not pee normally and they seemed to have missed that.

Thanks for your good wishes. He just started playing in his usual manner this week. It's been abt 6 weeks since he was discharged the second time.

[Merope215]

4. Poor guy. I would be livid

if I'd had an experience like that. I'm awfully sorry the two of you had to deal with that kind of crazed incompetence (or indifference, which I suppose is even worse). I'm glad he's feeling a little better now.

And I hope you're able to sue that place; like Lorien said, it can be hard to get damages higher than the "value" of the animal, as though if you paid $10 to adopt a cat, that would compensate you for its death or serious injury. It's ridiculous - like having your kid be worth whatever you paid the hospital for childbirth costs. Good luck with that fight, and I hope you and Yuri are both well. :hug:

[Princess Turandot]

5. I'm so angry (still) thar my internist just increased my blood pressure..

medication, since my 'resting' pressure has been hanging around between 85 and 95.

Today, I had another hassle with them. Their medical records department had not sent me any vet notes, which they are required to do. They just sent me test results. Today they gave me some crap about how I needed to request those from the individual vets, even though these are employee vets and thus agents of the hospital. They had sent me cardiologist & radiologist reports, so I asked the clerk why I did not need to directly request their reports from them. Of course they could not answer that question, and the manager refused to get on the phone with me twice. So I faxed off a third demand for the records, listed all the doctors and the state regs which entitle me to all of his records. I also sent the Chief of Staff (also a blowhard) a copy. I mailed copies as well.

[sleepyhead]

7. You are absolutely entitled to a copy of the record.

And that means the entire history, not just a test list or an invoice. Are you in NYC by any chance? I know that one of our local specialty places is notorious for lots of red tape in getting records sent out (even when a referring veterinarian requests them). See if you can get the direct number of the medical records department, and try talking to someone there. They are *obligated* to get you a copy of the record within a "reasonable" time.

[Princess Turandot]

8. I am in NYC..

if you are referring to a LARGE specialty/er place than you know whom I'm referring to. I am about to leave to get the full set of records because after 15 minutes of run around yesterday, and 30 minutes of frustration the day before, I finally called OPD in NYC, who get really outraged by the records stuff. I got the email address for the unit supervisor (that's because the guy who I spoke to was very upset over what I had been told, even after I told the place that I knew what the law required.) Before complaining, I finally called the secretary to the CEO of the place, and not long afterwards someone I had already spoken to was scurrying around to find the record and get a copy made. I'm abt to leave to go pick it up.

They actually had the balls to tell me that they did not send out certain doctors notes because they were' filled with symbols and terminology that people didn't understand, who would then call and bother them with questions'. Oh my, someone wants to ask a question after paying beaucoup bucks for their pets care..what nerve.

Oh, and they don't usually include notes vets make of what they say they've told clients. Gee, I wonder why.

[sleepyhead]

9. Wow.

I know exactly what hospital you are talking about. I can't believe that they would tell you that you're not entitled to see the entire history. The history is supposed to be written up in such a manner that anyone can pick it up and follow the story in chronological order. (That doesn't necessarily mean that you as a non-medical person would understand every word, but the history must be complete and coherent enough so that it makes a logical story.) They are also supposed to document every conversation that occurs between doctor and client. Not that it makes your situation any better, but they have not always been cooperative with referring veterinarians either. (In fairness, I don't know if that is a function of hospital policy, or the fault of individual doctors who may not be the best communicators.) In their defense, they have made some progress in correcting this situation over the past 10 years or so, but the sheer size of the place often makes communication difficult.

And what if you were to take the redacted history to another doctor? He or she wouldn't have the whole story and thus might not be able to make appropriate medical decisions for your pet. This is one of my major peeves about some of the hospitals I deal with. Just today I had someone come in for a second opinion and the history I got was not only totally illegible, it left out a substantial amount of the test results and the reasoning behind the treatments that were given. This made the visit last at least 3 times as long as it otherwise would have, as I had to try to piece together the history from the chicken scratches on the paper and the client's recollections of what was said. A hassle for all concerned.

Good luck with your efforts - feel free to PM me if you need any help with any of this.

[China_cat]

6. Report them to your state Veterinary licensing board.

It's the least you can do.

[Eurobabe]

10. Poor baby, I went through a similar thing

when my cat was blocked in 1994, but we took him to an emergency vet, and they did all the right things. My cat was projectile vomiting at the point that we got him there, he was really sick. I remember his eyes being so slitty too, from all the pain, the prodding and meds. What an ordeal. I sure hope your fur kid continues on the path to wellness.

Try putting your cat on filtered water, if you haven't already, that has stopped the crystals with my older cat, who is now almost 14. They never get just straight tap water, vet said it could have been the ph of H2O encouraging crystal growth.

And yes, I wouldn't hesitate to pull out the stops and report this vet to a state licensing board, and whatever else you could.