OS and her boyfriend got an Australian Shepherd puppy when the pandemic began. He is Hugo, and he is smart and awesome. He is now six months old.

Last week, OS noticed that Huge was not himself. He was very lethargic, was staggering, and wouldn't eat. When he tried to go up the stairs to the apartment, he struggled and then collapsed and slid down the lowest few stairs.

OS took him to the pet emergency room that night. She reported his symptoms, and the vet diagnosed a torn ACL. Vet prescribed anti-inflammatory meds and suggested they not give the meds to Hugo until he had a blood test to be sure the meds wouldn't hurt his kidneys or liver.

All of this sounded quite wrong to OS. She asked whether she could have her own vet do the blood work and how soon she should have it done. Vet said waiting the weekend would be fine; just do it before administering the ACL meds.

OS took Hugo home. When they got up in the morning, Hugo had peed and vomited on himself. OS scooped him up and they returned to the pet emergency room. They determined that Hugo had consumed rat poison; was in shock; he had aspirational peneumonia from inhaling vomit because he was in shock; and OS needed to "brace herself" because he might not make it. They were asked how much money they were willing to authorize for Hugo's care. The estimate was $3-7k; she authorized it.

The vets gave Hugo a couple of plasma transfusions; removed the blood from around his heart and infused him with it; gave an IV to raise his blood pressure; gave oxygen. This type of rat poison works by slowly depleting the body of Vitamin K so that blood will no longer coagulate, so he needed Vitamin K injections.

He spent one night in the ICU and somehow bounced back. By that afternoon, he went on a walk and was doing tricks. OS took him home and paid a bill of $4600.

My question is this: It seems to me that any vet who diagnoses an acl tear on a puppy, who does no imaging or blood work to confirm anything, and who misses the rat poison possibility (which is very common for city dogs) really botched this. The bill shows that the cost of the Vitamin K therapy was $180.

Everyone is delighted that Hugo pulled through, but this was quite a lot of trauma for OS (for all of us, really) and it really sounds like most of Hugo's care was attributable to an incorrect diagnosis.

How does that strike you? OS is trying to decide how aggressive to be with the emergency room, up to and including small claims.

How much of the cost was attributable, do you suppose, to the delay? Could very well be that the cost would have been the same (or close) if they had identified the problem on the first go round. You seem to be presuming that the vitamin K therapy would have been the only treatment needed.

I am rather surprised that they so quickly identified an ACL tear without any imaging. As a human with an ACL tear ... there are pretty standard physical manipulations that identify it. Not sure how different things are with a patient who can't talk to you, but it's hard to imagine that there aren't simple tests to nail down this diagnosis.

Yeah. Some costs were to treat the pneumonia. OS guesses $1400 from the bills.

But a vet would probably have to make sense of the bill.

I can’t imagine if you had a human baby who became listless and stopped eating and was so weak it couldn’t make it up a flight of stairs that any doc would conclude ACL injury without any tests.

There is a wide range of competency among veterinarians.
The idiot vet needs to be reviewed.

Not directly on point, but it seems like more and more people are buying animal health insurance. Do any of you guys do that?

I don’t know what to tell you, Cindy, wondering what the results of the initial physical exam were, were the dogs vitals off enough to warrant other tests the night before? Did he present like he was lame due to a physical issue, and crash (vomiting, etc) after the vet saw him? You don’t automatically take blood for something that seems to be a lameness, and lethargy (not wanting to move) could initially be attributed to pain. Definitely should ask these questions. Or maybe the vet was Inexperienced, and missed something. Hard to know without being there.

quote:

Originally posted by Nina:
Not directly on point, but it seems like more and more people are buying animal health insurance. Do any of you guys do that?

We have insurance on the younger dog, but I am not sure what it covers or what it costs.

quote:

Originally posted by jodi:
I don’t know what to tell you, Cindy, wondering what the results of the initial physical exam were, were the dogs vitals off enough to warrant other tests the night before? Did he present like he was lame due to a physical issue, and crash (vomiting, etc) after the vet saw him? You don’t automatically take blood for something that seems to be a lameness, and lethargy (not wanting to move) could initially be attributed to pain. Definitely should ask these questions. Or maybe the vet was Inexperienced, and missed something. Hard to know without being there.

I've now reviewed the records.

I cannot assess whether the vitals were off when they first brought him in. I'd have to do some googling to sort that out.

More to the point . . . I think the difficulty here is that they brought him in reporting lethargy as his main symptom. Among the things that caused them to be concerned about lethargy was, according to the records, his lying next to his water bowl, refusing to interact with them, and hesitating to go up the stairs; falling and sliding back down; having to be carried.

The vet examination says he examined like a dog with a torn ACL. The records report findings like "lameness." So the problem OS has is there's no way to prove that was wrong. And if it was not wrong, it is not negligence to focus on that as the cause of the problems.

My advice to OS will be to consider walking away. Without a vet reviewing the records and being willing to write down that the standard of care would be something different, she can't win even a small claims court case. It might be worth filing one anyone as a means to a settlement, but . . . my experience with litigation is that it is stressful. People tend to underestimate this when they are inexperienced in it. It can be months or even years of grinding your teeth about how you were done wrong.

If you were clearly done wrong, maybe it's worth it. Here, it is less clear, and they were lucky to walk away with a healthy dog. I mean, he had no discernible pulse when he came in the second time. Lots of people spend that kind of money and go home with nothing but heartbreak.

If she is really struggling to let this go, I might suggest she book an appointment with her own vet, go over everything, and let her vet talk her out of it for the cost of an office visit.