| Complaint: | Complaint 20-91 |
|---|---|
| Respondent: | Melvin Paquin |
| Premises: | Animal Medical Center of Surprise |
The complainant says that his dog was suffering from myelopathy and that her quality of life had declined to the point euthanasia was necessary. He booked an appointment at Animal Medical Center of Surprise and was told the process was compassionate and peaceful. The dog was taken out of the room for a catheter insertion and an injection of sedative. They brought the dog back and the dog immediately collapsed, hit her head on the floor, urinated, and seized and convulsed. He banged on the door until Paquin came through to give her the heart-stopping final dose. He says it was horrible to see his dog die so badly. He subsequently brought a new puppy to see Paquin and asked him what happened during the euthanasia. He says Paquin didn't know and suggested it was some underlying problem or a neurological issue, ruling out the sedative. The complainant says that he researched the sedative, acepromazine, and found a variety of warnings about using the drug in Boxers (which his dog was). He confronted Paquin about this and says that Paquin became very defensive, citing his education and years of experience. Paquin pulled the Merck Vet Manual on him to show there were no concerns.
Paquin's response gives us some background. He then moves on to the discussion with the complainant. He corrects the complainant and says he actually pulled out Saunders Handbook of Veterinary Drugs, 4th Edition and not the Merck Manual, then told him to read the relevant sections while he attended to another patient. He then said that the complainant agreed with him, couldn't find any evidence in the book or online, and left feeling embarrassed. (There was also a note in Saunders that "a risk of seizures in animals from administration of acepromazine may not be as great as was once thought," which Paquin somehow thinks actually helps his argument here. It doesn't.) He then says that he told the complainant the dog may not even have had degenerative myelopathy (which seems like a weird thing to mention at this time?). Paquin also says that he reached out to some other specialists in the area once he knew the board was going to investigate him. One was Matt Miller, a cardiologist at VetMed, who said that the drug wouldn't cause a dog to seize and pointed to a study of sixteen seizure-prone dogs. He also contacted Scott Plummer at Veterinary Neurological Center (and a former vet board chair) who also said that the drug doesn't make dogs seize; people just used to think that. Paquin also says he was a chief of staff at Banfield for seven years and they never worried about this stuff either; he literally argues that Banfield wouldn't use it if it weren't safe. He also tells us that he told the complainant to leave and never come back because he needed to have 100% confidence in his veterinarian.
The Investigative Committee ruled that acepromazine is not contraindicated in Boxers and that they had no concerns with Paquin giving the drug.
The author has attempted to look up what evidence changed the veterinary community's mind regarding acepromazine aside from the paper that Miller cited ("A Retrospective Study on the Use of Acepromazine Maleate in Dogs With Seizures"); It seems unlikely that most would agree a single retrospective study discussing 16 out of 36 dogs is statistically significant enough to prove much of anything. The Veterinary Anesthesia & Analgesia Support Group's writeup on acepromazine still states "there are still references to acepromazine lowering the seizure threshold for epileptic patients (increased seizure risk)" but that "many anesthetists feel this is not a significant risk at the doses currently recommended" and curiously that "many feel that Boxers require lower doses than other dogs of similar size and disposition."
| Source: | August 8, 2020 PM Investigative Committee Meeting |
|---|---|
| People: | |
| Melvin Paquin | Respondent |
| Roll Call: | |
| Adam Almaraz | Aye |
| Amrit Rai | Aye |
| Brian Sidaway | Aye |
| Cameron Dow | Aye |
| Result: | Passed |
| Source: | September 9, 2020 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Jane Soloman |
| Seconded By: | Jessica Creager |
| Roll Call: | |
| Darren Wright | Aye |
| J Greg Byrne | Aye |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Sarah Heinrich | Absent |
| 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.