A dog's misdiagnosed pyometra leads to diabetes and a near-death experience: Part I

Complaint: Complaint 22-25
Respondent: John McWhirter
Premises: Casa Grande Animal Hospital
Related: 22-26

The complainant states that her mother took her dog to see McWhirter for a variety of issues including increased thirst, loss of appetite, lethargy, vomiting, an eye problem, and hip weakness. He apparently thought allergies were the likely cause and prescribed Depo-Medrol, a steroid, and ordered some lab results. The results came back and Maher, another veterinarian, called with news of an elevated white blood cell count; she thought it was either a serious infection or cancer, but likely cancer, and started the dog on a course of antibiotics.

The family set about finding a veterinary oncologist but learned that Case Grande would have to make an official diagnosis of cancer before they would see the dog. McWhirter called them and said that Maher had recommended an ultrasound, something the complainants say they weren't aware of. They were told that it would be several days before an ultrasound could be done, but after protesting, an ultrasound was scheduled the following day. A third veterinarian, Fallini, called them to tell them the dog had pyometra and would need emergency surgery. They agreed on surgery but Fallini was unavailable to give updates; Fallini informed them that the surgery went well but the dog wasn't doing so well in recovery, also having high blood sugars and suffering from likely sepsis. The dog would need to be transfered to AVECCC in Gilbert for overnight monitoring, so the family picked up the dog and drove her there (that's a transfer in veterinary medicine). The complainant also blames the dog's diabetes on the incident.

McWhirter's response heavily leverages the medical record as he walks through the sequence of events. He did state that he believed something "metabolic or physical" was going on, also noting that a possible stifle injury with the dog was not the cause of the problem. He stated that he told her some disease process was beginning that couldn't be found on physical exam and recommended testing; he states the complainant turned down testing so he offered the Depo-Medrol as a trial. He also relates that this was the only time he had an interaction with the dog, with the remainder handled by Fallini and Maher. He also stated that he called the complainant regarding a request for subcutaneous fluids and learned the dog was being admitted for an ultrasound. (This is odd as the complainant's account seems to suggest McWhirter left a message stating Maher had recommended an ultrasound.)

The Investigative Committee stated that the dog should have been brought back for additional testing as soon as the preliminary blood work was received. They also suggested the Depo-Medrol could have exacerbated the dog's subsequent diabetes, as well as wondering whether McWhirter jumped the gun on the injection. Concerns were also noted about handling of the eye issue. However, most concerns focused around the lack of a veterinarian in charge of the patient's care, passing of the case, lack of follow-up and clarity on the part of Maher in particular regarding possible diagnoses other than pyometra, and more. They also claim to have concerns with the premises itself and note that neither complaint was filed against the responsible veterinarian for the premises. The Investigative Committee voted to find a violation for failure to communicate with the pet owner, McCormick opposed; the Board sentenced McWhirter to 12 hours of continuing education and a $1500 fine, a rather steep penalty for them.

The concerns regarding the entire premises may not be a new thing, but it doesn't appear that anyone ever bothered to really look into it. Casa Grande Animal Hospital had multiple complaints (18-03, 19-65, and 20-50) prior to this one but it appears nobody thought much of them; all were dismissed.

Motions

Investigative Motion: Find violation

Source: February 2, 2022 PM Investigative Committee Meeting
People:
John McWhirter Respondent
Roll Call:
Adam Almaraz Aye
Amrit Rai Aye
Gregg Maura Aye
Justin McCormick Nay
Steven Dow Aye
Violations:
ARS § 32-2232 (12) as it relates to AAC R3-11-501 (1) for failure to communicate to the pet owner on September 7, 2021 the seriousness of the dog's blood results and not recommending the dog be brought back in for re-evaluation.
Result: Passed

Board Motion: Schedule informal interview

Source: March 3, 2022 Board Meeting
Proposed By: Craig Nausley
Seconded By: J Greg Byrne
Roll Call:
Craig Nausley Aye
Darren Wright Aye
J Greg Byrne Aye
Jane Soloman Aye
Jessica Creager Absent
Jim Loughead Aye
Melissa Thompson Aye
Nikki Frost Aye
Robyn Jaynes Aye
Result: Passed

Board Motion: Find violation

Source: May 5, 2022 Board Meeting
People:
John McWhirter Respondent
Proposed By: Craig Nausley
Seconded By: J Greg Byrne
Roll Call:
Craig Nausley Aye
Darren Wright Absent
J Greg Byrne Aye
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Nay
Melissa Thompson Aye
Nikki Frost Aye
Robyn Jaynes Aye
Violations:
A.R.S. § 32-2232 (12) as it relates to A.A.C. R3-11-501 (1) for failure to communicate to the pet owner on September 7, 2021 the seriousness of the dog’s blood results and not recommending the dog be brought back in for re-evaluation
Result: Passed

Board Motion: Find violation

Source: May 5, 2022 Board Meeting
People:
John McWhirter Respondent
Proposed By: Craig Nausley
Seconded By: J Greg Byrne
Roll Call:
Craig Nausley Aye
Darren Wright Absent
J Greg Byrne Aye
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Aye
Melissa Thompson Aye
Nikki Frost Aye
Robyn Jaynes Nay
Violations:
A.R.S. § 32-2232 (11) Gross negligence; for administering a long-acting steroid to a dog exhibiting symptoms of illness without a diagnosis or presumptive diagnosis causing unnecessary suffering
Result: Passed

Board Motion: Issue board order

Source: June 6, 2022 Board Meeting
Proposed By: Craig Nausley
Seconded By: Jessica Creager
Roll Call:
Craig Nausley Aye
Darren Wright Aye
J Greg Byrne Absent
Jane Soloman Aye
Jessica Creager Aye
Jim Loughead Absent
Melissa Thompson Aye
Nikki Frost Absent
Robyn Jaynes Aye
Result: Passed

Board Order: Order 22025 JOHN MCWHIRTER, DVM

Source: Order 22025 (June 6, 2022)
Violations:
A.R.S. § 32-2232 (11) Gross negligence; for administering a long-acting steroid to a Patient exhibiting symptoms of illness without a diagnosis or tentative diagnosis which caused unnecessary suffering.
Penalties:
Probation (1 year)
Continuing education (6 hours in reproductive diseases)
Continuing education (3 hours in pharmacology)
Continuing education (3 hours in client communication)
Civil penalty ($1500)

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.