| Complaint: | Complaint 19-95 |
|---|---|
| Respondent: | Christina Grant |
| Premises: | VetMed |
| Related: | 19-94 |
This portion of the complaint follows from 19-94 when the dog was brought to VetMed. Grant was the attending veterinarian. The complainant tells us that Grant specifically told her the dog needed a lot more sildenafil and that she specifically told Grant no. She states that Grant told her the dog would need a lot more testing then and she again said no; she relates that she lost two close family members to problems with medications and doesn't want it to happen again. The complainant tells us that she was able to visit her dog for about five minutes. She called for an update and was told that the dog was doing well and to call back in 30 minutes. About half an hour later she received a call telling her that her dog had died; she was told the dog's heart stopped and fluids came out her nose. After going to make final arrangements for her dog she was charged for euthanization; she asked how that could be if the dog died naturally and she was told that the dog was actually euthanized because it was the only humane thing to do. She also states that she found charges for sildenafil on her invoice.
Grant's response tells us that the dog had abdominal distension, difficulty breathing, and a variety of other problems. She also tells us that she diagnosed severe pulmonary hypertension and potential renal disease (or maybe dehydration, gastroenteritis, or internal bleeding). She also says that she told the complainant that sudden death of her dog could occur at any time. She states that she handed off care to another veterinarian (White?) and went home, and that she was unaware that the complainant later tried to contact her to talk about the case.
The Investigative Committee's response is basically a copy of the discussion from 19-94, stating that the sildenafil treatment was appropriate and claiming that it has no side effects. The writeup on 19-95 mentions Wells from 19-94 but no mention of Grant that I can see. They don't seem to tackle whether or not the complainant actually approved the use of sildenafil. They also seem to completely ignore the scary possibility that VetMed killed her dog without her permission because they felt it was the right thing to do. The complainant says that she was told her dog died, went to the hospital, and was told the dog was euthanized. The findings of fact say that the complainant authorized euthanasia. Even the Investigative Committee's own Findings of Fact state that the euthanasia procedure was not documented in the medical record. No discussion at all and no suggestion that an investigation should be opened regarding that veterinarian.
Let's also talk about the top veterinarians (Rai, Butkiewicz, and Sidaway) who apparently think that sildenafil has no side effects. I'd suggest we start by looking at what better veterinarians have to say about that. One place to start reading might be the "ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs." There we see things like "Some PHâspecific treatments (e.g., pulmonary artery vasodilators such as PDE5i) might lead to acute pulmonary edema in some dogs with PH." Some cautions pertain specifically to left-sided heart disease (this dog apparently had a left-sided murmur but right-sided heart disease), but much of it is rather general in scope, including mentions of particular subcategories of pulmonary hypertension. That came out in 2020 so at least some of these concerns must have been known in the 2019 time frame of this complaint. Of course, that doesn't mean that sildenafil killed the dog, but it does mean a more appropriate question would be to ask whether or not the veterinarians managed risk appropriately through testing and monitoring during treatment.
| Source: | September 9, 2019 PM Investigative Committee Meeting |
|---|---|
| People: | |
| Christina Grant | Respondent |
| Roll Call: | |
| Adam Almaraz | Aye |
| Amrit Rai | Aye |
| Brian Sidaway | Aye |
| Christine Butkiewicz | Aye |
| William Hamilton | Aye |
| Result: | Passed |
| Source: | October 10, 2019 Board Meeting |
|---|---|
| Proposed By: | Robyn Jaynes |
| Seconded By: | Jessica Creager |
| Roll Call: | |
| Christina Bertch-Mumaw | Absent |
| Darren Wright | Aye |
| J Greg Byrne | Absent |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Sarah Heinrich | Recused |
| Result: | Passed |
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.