The complainant's dog had been sluggish, not eating, and appeared to have a distended
abdomen. The complainant says the dog had always been a picky eater but when the dog
did not improve she followed through with an appointment with Knoblich. Knoblich did
an examination including an EKG and diagnosed atrial fibrillation. The complainant,
a registered nurse, asked if dog and human EKGs were similar. Knoblich allegedly said
yes. The complainant then asked to see the EKG and noted that it didn't look like
atrial fibrillation to her. She says Knoblich appeared to take offense. Knoblich sent
the dog home with six new medications and said the dog would die without them, but did
not suggest any urgency in transferring the dog to care at a referral facility. Knoblich
also allegedly said that the dog would get worse before he got better but that the dog
would have a marked improvement in the next 24 hours. The dog got worse at home and was
dead within twelve hours of the first doses of medication. The complainant attempted to
discuss the situation with Knoblich but the conversation did not go well. Knoblich
allegedly said that she was a doctor whereas the complainant was just a nurse. Knoblich
also allegedly said that she never diagnosed atrial fibrillation, that she wasn't God,
and that they dog was already very sick. There were also problems obtaining a full set
of records for the dog after he died.
Knoblich's response goes into detail regarding her examination of the dog. She also tells
us that the signs she read on the EKG strip were highly concerning and suggested that the
complainant take the dog elsewhere. She says that as the prognosis was poor without a
transfer she offered to attempt to treat the dog presumptively with medications, and she
reminded both the complainant (and indirectly the Board) that medications have side effects.
She also disputes the factual content of the complainant's recollection regarding their
later conversation.
The Investigative Committee had a mixed verdict on this one. They said they were concerned
that it took so long to get the dog's records after he died. They also thought that it may
have been bad for the dog to have been treated for atrial fibrillation if he didn't have
atrial fibrillation, but they didn't think that would have killed him. They also blame the
complainant for not taking the dog somewhere else because the complainant had a medical
background, apparently ignoring the complainant's assertion that Knoblich told her that the
dog would worsen before he improved. The investigators also discussed that "based on the fact
that the dog died that evening, something was going on with the dog." They found a violation
that Knoblich didn't provide the dog's records within 10 days as required, but no violations
regarding the care of the dog. The Board added an additional violation stating that Knoblich
didn't provide adequate information regarding emergency care and follow-up. Knoblich was
required to take six hours of continuing education and pay a $750 civil penalty.
You may remember Knoblich from 18-41 where the vet board felt she
was acting outside the bounds of her abilities in incorrectly providing follow-up care for
a dog's leg injuries.
ARS 32-2232 (12) as it relates to AAC R3-11-502 (8) failure to provide records or copies of records, including copies of radiographs, to Complainant within 10 days from the date of request or sooner if the animal's medical condition requires.
A.R.S. § 32-2232 (12) as it relates to A.A.C. R3-11-501 (1) for failure to provide professionally acceptable procedures for not stressing the need for emergency care, nor documenting on the discharge instructions what signs and symptoms to watch for and where to obtain emergency care.
A.R.S. § 32-2232 (12) as it relates to A.A.C. R3-11-501 (8) failure to provide records or copies of records, including copies of radiographs, to Complainant within 10 days from the date of request or sooner if the animal’s medical condition requires.
Penalties:
Probation (1 year)
Continuing education (3 hours in emergency medicine)
Continuing education (3 hours in communication)
Civil penalty ($750)
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.