A cat's seizures get out of control and a veterinarian only gets a letter of concern

Complaint: Complaint 18-52
Respondent: Alison Ariano
Premises: Chaparral Veterinary Medical Center

The complainant believes that Ariano mismanaged seizures in her cat leading to his euthanasia. The complainant brought her cat for generally not feeling well and being dehydrated. Ariano did a workup and recommended reducing phenobarbital and added Baytril for anemia, Mirtazapine for appetite, and prednisolone for a potential lung issue. The cat went from having occasional breakthrough seizures to multiple grand mal seizures, and the complainant found resources online suggesting the mirtazapine dose could be to blame; overdoses can lead to Serotonin Syndrome. She also found suggestions that Baytril is also contraindicated in cats with nervous system problems. The complainant states that Ariano said the mirtazapine dose was incorrect but seemed ambivalent about the cat's health. The cat ended up being taken to BluePearl's emergency service where a veterinarian named Mayer recommended euthanasia. The cat had gone from having an occasional breakthrough seizure (and none in the past six months) to having ten in the time the cat was being helped by Ariano.

Ariano's response has additional medical detail and notes that she even responded to the complainant's emails on her days off; she also says it's sad the cat was euthanized but he was a very sick cat.

The Investigative Committee basically said that anything could cause breakthrough seizures but that the dosages of Baytril and mirtazapine were both incorrectly recorded and too high, thus finding violations. The veterinary board only kept the violation for recordkeeping and issued a letter of concern for the dosage; Ariano had to pay $500 and take six hours of continuing education.

Motions

Investigative Motion: Find violation

Source: April 4, 2018 AM Investigative Committee Meeting
People:
Alison Ariano Respondent
Roll Call:
Christina Tran Aye
Mary Williams Aye
Robert Kritsberg Aye
Ryan Ainsworth Aye
Violations:
ARS 32-2232 (21) as it relates to AAC R3-11-502 (L) (8) for failure to document in the medical record the frequency of the medications, Baytril, mirtazapine and prednisolone, were to be given to the cat
ARS 32-2232 (12) as it relates to AAC R3-11-501 (1) for failure to provide professionally acceptable procedures by prescribing Baytril and mirtazapine at too high of a dose.
Result: Passed

Board Motion: Offer consent agreement with modified conclusions of law

Source: May 5, 2018 Board Meeting
Proposed By: Sarah Heinrich
Seconded By: Christina Bertch-Mumaw
Roll Call:
Christina Bertch-Mumaw Aye
Darren Wright Aye
J Greg Byrne Aye
Jessica Creager Aye
Jim Loughead Aye
Julie Young Aye
Nikki Frost Aye
Robyn Jaynes Nay
Sarah Heinrich Aye
Result: Passed

Board Motion: Offer consent agreement

Source: May 5, 2018 Board Meeting
Proposed By: Sarah Heinrich
Seconded By: Christina Bertch-Mumaw
Roll Call:
Christina Bertch-Mumaw Aye
Darren Wright Aye
J Greg Byrne Aye
Jessica Creager Aye
Jim Loughead Aye
Julie Young Aye
Nikki Frost Aye
Robyn Jaynes Aye
Sarah Heinrich Aye
Result: Passed

Board Motion: Issue letter of concern

Source: May 5, 2018 Board Meeting
Proposed By: Sarah Heinrich
Seconded By: Christina Bertch-Mumaw
Roll Call:
Christina Bertch-Mumaw Aye
Darren Wright Aye
J Greg Byrne Aye
Jessica Creager Aye
Jim Loughead Aye
Julie Young Aye
Nikki Frost Aye
Robyn Jaynes Aye
Sarah Heinrich Aye
Result: Passed

Board Order: Order 18052 ALISON ARIANO, DVM

Source: Order 18052 (June 6, 2018)
Violations:
A.R.S. ยง 32-2232 (21) as it relates to AAC R3-11-502 (L) (8) for failure to document in the medical record the frequency of the medications, Baytril, mirtazapine and prednisolone, which were to be given to the cat.
Penalties:
Probation (1 year)
Continuing education (6 hours in medical record keeping)
Civil penalty ($500)

The primary source for the above summary was obtained as a public record from the Arizona State Veterinary Medical Examining Board. You are welcome to review the original records and board meeting minutes by clicking the relevant links. While we endeavor to provide an accurate summary of the complaint, response, investigative reports and board actions, we encourage you to review the primary sources and come to your own conclusions. In some cases we have also been able to reach out to individuals with knowledge of specific complaints, and where possible that information will be included here.