CIMDA

Thanks Jo.  Having chatted over this, my husband is definitely of the opinion that it should be at the very least, reported to the head of the practice.  The crux of this matter is vaccinating a sick dog.... I'd be very interested in your opinion - would you be willing to look over the vet notes which I have a copy of? 

As Catherine also said, it seemed to be ingrained in vets that they must vaccinate at all costs but I think unless we start to challenge this and ask questions nothing will change.

Michelle

Hi

It is good to have such a debate on a forum like this. 

My personal opinion is: Owners should be aware, and be confident enough to say no vaccines, and preventative wormers, flea treatments  etc.....  We shouldn't be bullied by some arrogant vets.  Let's face it, a vet who vaccinates a sick dog is in the wrong.

A vet you can work with, and who will listen to your concerns and act on them, is one in a million.  Unfortunately, I am in contact with many people who have bad vets and some have even caused the death, and a lot of unnecessary suffering, of our pets and still they get away with it. My beardie girl fell victim to a specialist vet, so I speak from personal experience too.  Even if you make a complaint to the RCVS, if the complaint is about negligence the RCVS will throw it out saying that they do not deal with negligent cases and these have to be taken to the local courts.  Well, it was always like this in the past and unless they have changed their ruling it still is.

If these cases go unchecked the vet in question will continue to make the same mistakes.  I believe a complaint to the practice manager should be made because you never know if the head vet will welcome the complaint because it might be just what he needs to dismiss this employee.  Many years ago I complained to my vet about one of his junior vets and he asked me to put the complaint in writing.  Within three months the junior vet had left the practice.  He must have had other complaints about this woman.

Making a complaint to the RCVS is probably a waste of time,  but I think that the owners of the practice should have the opportunity to address the complaint and if nothing else make sure this does not happen again in his practice.

I hope you get the opinions of other CIMDA members.

Jo

Hi Amanda

I was totally wrong when I presumed the symptoms you are seeing is a result of the prednisolone.  Catherine is absolutely correct.  Bruno is not on nearly enough prednisolone and if he continues on such a low dose this will never resolve and he will get a lot worse, and the situation will become dangerous.

Bruno weighs just under 12kg so as Catherine says he should be on 12mg/kg twice a day. Have a word with your vet as soon as possible and if your vet won't treat Bruno as the protocol below then find another vet.   The immune system has to be suppressed for the destruction of the red cells to cease and 1mg/kg/12hrs is the lowest immunosuppressive dose a dog should receive for IMHA.  This is the reason why his PCV hasn't risen.

Good luck with your vet.

Jo

Great idea and it is worth it if it gives you peace of mind.

Jo

Hi  Annie

That is great news and worth while knowing that they don't have the MDR1 gene mutation.

Such bad luck to have both of them ill at the same time, but they have done very well. 

Take these last reductions very slowly.  It doesn't matter how slow you reduce it now and you may have the courage to withdraw it altogether in time.

Good to have a success story.

Jo

Hi

That makes sense because the destruction was likely to be going on in the spleen, hence regenerative anaemia.  Remove the spleen and you remove the problem.

Great result!

Jo

This is a public forum so I do have to be careful what I say - I do not want to criticize all vets but some do make mistakes. These are my thoughts, but I hope other members will jump in and add theirs so that you can get a more balanced view.

First of all, I do not think you will have any chance of compensation. It would only make matters worse and the vets would probably want you to find a new vet anyway if you do that.

Secondly, I completely understand and sympathize with you about not vaccinating a sick dog. Some years ago this happened to me. We had delayed her boosters because she was not well although we did not know what exactly was wrong. Anyway, to a certain extent she was well and my vet was worried that she would contact leptospirosis so she was vaccinated and I believe it led to her death a few weeks later. I think it is so ingrained in some vets that dogs need to be vaccinated against the diseases and do not weigh up what could happen if they vaccinate a sick dog. It probably happens every day and will continue to be their format. You could try contacting the veterinary body who deal with vaccine protocols (and even the vaccine companies themselves) to see if you can find out more or try to make a difference. As I said you could also tell your vet your concerns and ask why.

You should not vaccinate a dog that has an autoimmune disease anyway so you may have to be prepared for that "fight" against your vet when your dog's boosters are due again!

The best you can do now is to keep an eye on Milly, look out for unusual signs that she may be relapsing, have regular blood tests and ask for copies of those tests (and previous ones) so that you can be more confidently aware of your dog's health/illness. That way you will be able to "challenge" (nicely!) your vet if need be and feel a bit more in charge of your dog's treatment.

Thanks for your reply Catherine.  This is in the UK.  And to make matters worse, I worked there for 4 months last year!!  Unfortunately she became sick 2 months after I left.  I could go to another vet although they are further away and of course they would want to know why I have left... I am in contact with a few people who still work there.  I really don't want to make trouble as it's awkward, it's a small community.... At the same time, I think questions should be asked and perhaps this might make them review their procedures.  They don't have much competition in the area and a lot of people moan about them.  My husband feels we have every right to complain/ask questions as we have spent nearly £20,000 since October (mostly with the referral vets and lots of complications!! but they have also received about £5000 from this illness...).  My husband is after some compensation from them but I'm not sure we'll ever get any answers and they will become defensive.  One minute I agree with you, just leave it, and move on.  Other times, I think this must be a clear breach of vaccine procedure?  will other dogs be made sick because they are lax about their procedures?  I do feel strongly that this is bad practice... I think we most likely will end up having a conversation with them and as you say, keep it light and amicable but at the very least, it might make them tighten up a bit. The same vet also treated my cat,,, said absolutely nothing wrong with him (= over anxious pet owner...) and then he keeled over dead a few months later at the age of 5!!!  so we won't be seeing that particular vet any more!!!  I guess I am just keen to know how bad is it that she went ahead and vaccinated a dog with suspected IMHA....  Vaccine labels clearly state only for healthy dogs and that's the bit I feel very strongly about.  Luckily Milly is now doing very well, but it has taken a huge amount of work/money/stress to get her back. x

Are we talking about UK vets? Is it possible for you to find another vet? If so I would just sign on with them and not say anything to them or even your old vet. Otherwise there is every chance they will know each other and they will stick together and you will be labelled a trouble maker.

If you have to stay with your current vet you can say nothing; try another vet in the practice, or write a letter to the vet concerned saying how worried you are that your dog that was ill was vaccinated and could he explain his reasoning on that. Try to keep it light.

It has been my experience that I had been using the same vet for years and I was very pleased with him. When I had reason to complain about something serious,  I wrote him a letter and he came to see me, apologized and took on board everything and we carried on going to that vet. But he was one in a million! Previous to that I had been to a different practice for a few years and when something serious happened he did not want to know (so we left).

You have to judge for yourself and one should be able to complain, but I think you will find that many vets will stick together and also the vet governing body and you do really need to have vets on your side.

So....my advice would be to grit your teeth (even though you have a reasonable complaint) and just learn lots about dog health/illnesses etc. so that if anything like that arises again you can be confident of challenging the decision (and even refuse to have the vaccine for instance) although do it in a pleasant way!

Just my thoughts.......

He needs to be on about 12mg of Prednisolone TWICE a day, a total of 24mg a day.
1.5mg twice a day is only 3mg and way too low.
I hope his PCV is okay today but I am guessing that if he has been on such a low dose of Preds. the panting is due to a drop in PCV. I hope I am wrong but I would take him straight to the vets or at least phone them and discuss increasing the Preds. to an immunosuppresive  dose immediately.

Here is the medication protocol:  (You might also want to read this: http://cimda.co.uk/smf/index.php/topic,11.0.html  )

Immunosuppressive Protocols for Oral Prednisolone in the Dog.
Ref: Clinical Immunology of the Dog & Cat by Michael J Day  – Professor of Veterinary Pathology, University of Bristol, UK and WSAVA - Chairman of Scientific Advisory Committee.

This example is base on a dog receiving an induction dose of 1.0mg/kg/q12hrs

Dose                Duration (based on clinical effect)

1.0mg/kg/q12h             10-28 days
0.75mg/kg/q12h            10-28 days
0.5mg/kg/q12h             10-28 days
0.25mg/kg/q12h                         10-28 days
0.25mg/kg/q24h                         10-28 days
0.25-0.5mg/kg/ Every other day      at least 21 days
0.25-0.5 mg/kg/ Every third day       at least 21 days

Azathioprine (a cytotoxic drug) can be used in combination with prednisolone at 2mg/kg/24 or 48 hrs and dose gradually reduced, when remission is achieved, over a period of months.
Clinical response to Azathioprine may take up to 6 weeks. (Plumb’s Veterinary Drug Handbook)

Don't forget the gastroprotectant!