| Complaint: | Complaint 22-44 |
|---|---|
| Respondent: | Sage Hubert |
| Premises: | VetMed |
| Related: | 22-43, 22-45 |
This complaint follows from 22-43 and pertains to Hubert's involvement.
Hubert states that he first saw the dog during the July recheck. At that time the complainant reported no episodes of collapse but had an increase in coughing; no lethargy was reported. A cardiology workup found the dog to be at an elevated risk of congestive heart failure and x-rays showed a severely enlarged heart but no signs of pulmonary edema. The arrhythmias were also noted. Hubert states that in consultation with Matthews they decided to put the dog on spironolactone to reduce the risk of congestive heart failure.
He also spoke with the complainant and told her about the pending risk of heart failure; she indicated the dog was on a far higher dose of pimobendan than was written in VetMed's records at the time. His response states that they were not going to change the pimobendan dose but would "not" start the dog on spironolactone; I assume this is a typo, as he states that the complainant agreed to follow the recommendation. He also discussed a pacemaker and offered to speak with Miller for his opinion. Following that, it appears that the complainant was told it would only help with quality of life, and as the complainant reported the dog had a good quality of life, the pacemaker was not pursued.
He also notes the complainant found an error in the dog's physical exam report. The report actually said the dog presented "with obvious lameness" but he corrected it to "no obvious lameness, and the patient was ambulatory x4." (That's one hell of a typo! Makes you wonder.)
Most of the remainder of Hubert's response pertains to the last weeks of the dog's life, commencing with the stomach upset and episodes of collapse that ensued after that visit. He notes the complainant was told to discontinue the CBD treats she had been giving the dog; Hubert later recommended discontinuing the spironolactone. An exam at VetMed found the dog to be on the edge of congestive heart failure; Hubert specifically emphasizes that Matthews told the complainant she could discontinue the spironolactone if she wanted. She again turned down the option for a pacemaker and was sent home with discharge instructions noting the dog could drop dead at any time.
The complainant called VetMed for advice over the next two weeks, asking questions about symptoms of congestive heart failure; it appears that the episodes of collapse may have tapered off after discontinuing the spironolactone and CBD treats. A follow-up with Miller at another clinic then recommended restarting the spironolactone, and he also notes that the complainant had unfounded concerns about the dosing (he explains that the complainant thought the maximum dosage was 2 mg, rather than understanding it was 2 mg per kg). He concludes by noting that the complainant had concerns about the cardiology care provided at VetMed and spoke to hospital manager Stephanie Foote; grief counseling was recommended.
The Investigative Committee discussion is copied verbatim from 22-43.
| Source: | March 3, 2022 PM Investigative Committee Meeting |
|---|---|
| People: | |
| Sage Hubert | Respondent |
| David Stoll | Respondent Attorney |
| Roll Call: | |
| Adam Almaraz | Aye |
| Amrit Rai | Aye |
| Gregg Maura | Aye |
| Justin McCormick | Aye |
| Steven Dow | Aye |
| Result: | Passed |
| Source: | April 4, 2022 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Craig Nausley |
| Seconded By: | Melissa Thompson |
| Roll Call: | |
| Craig Nausley | Aye |
| Darren Wright | Aye |
| J Greg Byrne | Aye |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Melissa Thompson | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | 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.