In response to 2 comments:
http://www.toapayohvets.com/surgery/20080815Maltese_
Uroliths_Male_ToaPayohVets.htm
has the details of the surgery to remove the bladder stones.
As at Aug 9, 2008, the Maltese is living a normal life now.
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2 comments:
THANK YOU for performing the surgery to remove the bladder stones. I am unable to get your link to the story to work, so I do not know the details.
You are exactly correct. Bladder stones tend to be a recurring problem.
Would it be possible for Dr. Sing to read my comments? I would like his opinion on the care our beloved Stempy received and if he has an opinion as to what might have happened. We are in the USA, so he should feel comfortable in commenting. See below:
www.stempy.net
Stempy had a problem with bladder stones. This is a condition that needs to be monitored and managed. There is much more to managing this condition than just a diet change.
Stempy was already on a prescription diet from his previous vet due to a previous problem with stones that was dealt with by his prior vet nonsurgically. We changed vets in the Fall of 2003 because we never saw the same vet twice at our old clinic. We wanted a vet who would get to know our dogs. It was then that we made the worst decision of our lives in our choice of a new vet.
The vet we chose was a solo practitioner close to home. We had started buying Stempy’s prescription diet from this vet in September 2003. Since this vet had never seen Stempy, she required us to provide his records from his previous veterinarian in order to dispense his prescription diet. (*-Note that in Stempy’s records from this vet, she claims that his previous records contained no mention of his bladder stone history. If that is the case, then what in the world was she doing dispensing a prescription diet to Stempy without ever seeing him? Isn't that a failure to establish a vet/patient relationship?) This vet sold us Stempy’s prescription diet several times before doctor and patient ever met.
Stempy met this vet for the first time under adverse circumstances. In November of 2003, Stempy had a urethral obstruction caused by a bladder stone blocking his urethra. This is a medical emergency. Of course, all we knew at the time is that Stempy couldn’t go pee and he was very uncomfortable. The vet was able to wash the obstruction back to his bladder. As she should, she took radiographs to see the stone, and she did a urinalysis. Based on the urinalysis, she changed his diet. She sent Stempy home wearing a catheter to wait a few days for a cystotomy to be performed. We informed this vet of a few seizure-like episodes Stempy had experienced in his past because we were worried it would cause problems with his anesthesia. This vet responded to this information by saying, “Oh really.” (The vet denies this conversation ever occurred – we remember it vividly) Stempy had his cystotomy and recovered well from surgery. Based on lab results, this vet again changed Stempy’s diet. Stempy had one additional urinalysis at one post surgical follow up appointment that contradicted the lab results and her again changing his diet. She paid no attention and should have changed his diet again, but did not...she left him on one not even formulated for bladder stones and had him on this wrong diet for the remainder of his life.
From our extensive research after Stempy’s death, we learned that this vet did not follow proper protocol starting with this very first surgery. She failed to take post surgical radiographs after the cystotomy to verify removal of all stones. She failed to recommend quarterly urinalyses to monitor his urine. This is a MUST for bladder stone patients as many patients form new stones in the future. She failed to recommend twice yearly radiographs. This is a MUST with the goal being to catch new stones forming while they are small enough to be removed non-surgically.
There were several opportunities to recommend a urinalysis or radiograph to us to monitor Stempy’s condition. She never recommended anything.
In March of 2005, Stempy again had a urethral obstruction. We were not sure that is what it was at the time. This vet failed to take radiographs to ensure her diagnosis. She again washed the stone back to the bladder to relieve the obstruction. A cystotomy was scheduled for the following week and Stempy was sent home wearing a catheter again. When we went to pick up Stempy post surgery, somehow the stone had magically disappeared, so no cystotomy was performed. We were never shown radiographs to back up her claim. No future monitoring was recommended or performed.
In September 2005, Stempy again had a urethral obstruction that unblocked itself just prior to going to see this vet. Despite his prior history, she failed to take radiographs and failed to diagnose bladder stones, even though she was told he was obstructed and had been for a day until just prior to coming in. She said he just had elevated sperm in his urine and sent him home.
ONLY TWO WEEKS LATER, Stempy again experienced a urethral obstruction from most likely the SAME STONE. She AGAIN failed to take radiographs to confirm diagnosis, location, and amount. She FAILED to properly wash the stone back to the bladder and tried jamming the catheter in to push the stone back to the bladder. She stated in his records that she was unable to collect a urine specimen. She sent Stempy home wearing a catheter and scheduled a cystotomy for the coming week. How would she pass a catheter and NOT be able to obtain a urine specimen?
This vet ONLY had permission to perform a cystotomy - nothing else. She did NOT perform a cystotomy. She had lodged the catheter to the stone with the forceful catheterization she had performed. She was unable to remove the catheter. She told us that Stempy, himself, removed the catheter, although this is not what she wrote in his records. She performed an unauthorized procedure which she said was a perineal urethrostomy. This is not the procedure she performed. Her own vet tech stated she had NEVER performed that type of surgery before. She cut our little boy from his anus to his scrotum - a NINE cm incision - and NO NEW permanent or temporary opening was made - as would be expected with a urethrotomy or a urethrostomy. This vet had failed to wash the stone back to the bladder and had instead lodged the catheter to the stone. She would have known this if she would have taken a radiograph three days earlier when he was brought in. Instead, Stempy was either still obstructed for those three days or she had damaged his urethra and/or bladder when she attempted the forceful catheterization. Instead of referring us to a specialist, this vet tried to fix her own negligence.
Stempy was in extreme pain post surgery. We took him back to her EVERY DAY post surgery. She never properly examined him. Stempy was not eating and was only dribbling urine. She just kept changing his pain medicine. Then she gave us a tranquilizer (Acepromazine) with no pain killing abilities and led us to believe it was yet another pain killer. This tranquilizer lowers the seizure threshold and is not recommended for brachycephalic breeds.
Two days post surgery, this vet's clinic denied Stempy care when his condition was deteriorating.
Three days post surgery….Stempy passed away. He was found unconscious and lifeless on his pillow. We rushed him to this vet to no avail.
It is our contention that Stempy passed away because of that unauthorized “surgery” that this vet had NEVER performed before that would have NEVER have been needed had she taken radiographs as needed and properly diagnosed and treated his condition. Her attitude and failure to properly care for him those 3 days after his unauthorized surgery - to the point that the clinic DENIED Stempy care the night before he died - is deeply disturbing. Did she WANT Stempy to die?
(**NOTE: This vet never recommended or performed any blood tests prior to ANY of the surgical procedures she performed.)
The State Vet Board dismissed our complaint just like they do over 90% of all malpractice complaints. In the USA, it's protect the bad vet, not our pets. We were never even interviewed. We believe the vet is 100% responsible for Stempy's death.
Thank you for reading.
We hope the Maltese has a smooth recovery and finds a great new home.
I applaud his caretakers for getting him the surgery he needed. I hope he does well. Good ending to the story if he does.
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