Pet Owners Want Informed Consent of Drug Risks
Every once in a while you run into a unique voice that speaks out for animals in a way that touches, inspires, and energizes. I’ve certainly run across a few in the last 10 years, as you can see from the web sites and articles I feature here on my site -- most of which came about as a result of a personal tragedy connected to veterinary care for their pets.
One strong, outstanding voice in the area of consumer education is journalist Kelly Kaczala, News Editor at The Press (Ohio). She has written frequently on the subject of pets as family, animal welfare, status of pets as property, and the risks of extra-label drugs being used by vets on pets.
One of her most touching articles is A Fond Farewell to an Old Friend featured on the excellent site DOGS Adverse Reactions telling of her sweet dog Mattie and her poignant memories of her.
I was curious as to what happened to Mattie and did some research. Mattie’s heartbreaking account of her death is found in the article below, which was part of presspublications.com’s Pets as Family Special Report. Kelly served as Project Manager and contributed heavily to the section, along with writers Melissa Burden, Larry Limpf, J. Patrick Eaken, and editor Tammy Wilhelm.
Kelly's sad experience with Sylvania Veterinary Hospital, Dr. Bob Esplin DVM and Dr. Ross Mahowald, DVM, is a cautionary tale to anyone blindly trusting their vets, especially when it comes to drugs that are administered.
Here is an excerpt from her article, Pet Owners Want Informed Consent of Drug Risks:
|I got a copy of [Mattie's] medical records. I definitely had concerns. Her surgeon, Dr. Ross Mahowald, injected Mattie with Acepromazine, a tranquilizer I believe should have been avoided because it had caused a seizure under another veterinarian’s care. In addition, the vet on call that evening gave Mattie, who had a history of liver disease, Domitor [medetomidine], a potent sedative, after surgery, though the drug is not supposed to be given to dogs with liver disease. Both conditions were noted throughout Mattie’s medical history, which Mahowald and Robert Esplin, senior veterinarian at the Sylvania Veterinary Hospital, claimed to have reviewed prior to surgery.|
She goes on to say:
Had veterinarians at Sylvania Veterinary Hospital informed me Mattie would be given Acepromazine and Domitor, I would have declined. I don’t think she was a suitable candidate for either drug. Acepromazine, because of her seizure history, and Domitor, because it should not be used in dogs with liver disease. The Sylvania Veterinary Hospital that night had already given Mattie pain medication, one that can enhance Domitor’s side effects of slow heart rate and low blood pressure.
Would it have changed the outcome? Perhaps. Maybe not. But I would like to have known about the drugs the Sylvania Veterinary Hospital planned on giving Mattie that day.
-Kelly Kaczala, Pets as Family Special Report, The Press, presspublications.com
As readers of this site know, informed consent is one of my pet causes and one that I preach to people everywhere I go who talk to me about their vet experiences. Because of what happened to Suki, I take a very dim view of veterinarians who somehow manage to bypass the owner when it comes to specific procedures such as anesthesia, surgery, and the potential dangers of drugs.
Crazy, you say? It happens. Vets just doing whatever they think is “best” to someone else’s animal (someone else’s property, if you want to get legal about it) without even bothering to pick up the phone or make contact with the owner in any way to let them know what is happening is inexcusable and unforgivable. Informed consent is legitimately obtained ONLY by explaining to the owner the risks and benefits of the procedures to be performed BEFORE the acts are done. Vets cannot come up with their own ludicrous definitions of informed consent such as, "she dropped off her pet," "she didn't have an appointment," "she told my receptionist we could do what we felt was necessary," and other such arrogant, self-serving drivel.
Even the vets who do keep the owner in the loop often don’t disclose everything they should, as evidenced by vets who don't bother to provide the CIS (consumer information sheet) supplied by the drug companies themselves. Is it ignorance? Arrogance? Apathy? The hope that clients are clueless and trusting enough to not ask too many questions?
Kelly's coverage of the important topic of informed consent – in this case focusing on drug risks -- is a great public service to help others avoid the tragedy that befell her precious Mattie at Sylvania Veterinary Hospital in Ohio. Although a necropsy did not show a cause of death, Kelly’s message – and I agree with it wholeheartedly – is that she was not given the chance to accept or decline drugs that she would have not permitted to be administrated to Mattie because of her history. The bottom line is that she will never know if she had been given the chance to decline the use of these drugs -- would Mattie have lived?
I urge you to read her articles. They are chock full of good information on everything from anesthesia in older animals, to the shortcomings of the Better Business Bureau, to over-vaccination, to the dangers of pain-killers, and much more.
The best pet owners are the best informed – and from there, they can make the best choices of vets who respect their rights and wishes as the guardians of and decision-makers for their beloved companions. As we have seen so many, many times -- with tragic outcomes -- blindly trusting your vet is not a very good idea when it comes to the safety of your pet.
Catalano, Founder, vetabusenetwork.com
Read more about it
Here is an excerpt from Extra-Label Use of Drugs Tricky for Vets, by Melissa Burden, The Press, on the use of Domitor (one of the drugs given to Mattie)"We do not have evidence of the safety and effectiveness of the drug for the unapproved indication,” [Linda Grassie, communications director at the FDA] said. Extra-label promotion, “may mislead a medical or veterinary practitioner to use a product inappropriately” for an extra-label use.
Domitor, according to its label, is contraindicated in dogs with underlying health conditions, including liver, heart and kidney disease, respiratory disorders, fatigue, dogs that are in shock, or are severely debilitated. Special care is recommended when treating very young animals, debilitated older animals, coughing dogs, or dogs in poor general condition, says the label.
Clinical trials of Domitor,
approved by the FDA in 1996, concluded that it is mostly safe and
effective so long as it's used "according to the label."
Sylvania Veterinary Hospital, according to [Dr. Ross] Mahowald, routinely uses Domitor on dogs after surgery to keep them sedated and quiet, an extra-label use.
-Melissa Burden, Extra-Label Use of Drugs Tricky for Vets
And an excerpt from Do You Know About the Drugs Your Pet Will Get?, also by Melissa Burden:Veterinarians at the Sylvania Veterinary Hospital, on Holland-Sylvania Road, say they learned about the unapproved uses of Domitor (medetomidine), a potent sedative for dogs, at CME seminars sponsored by Pfizer, which manufactures the drug.
The hospital routinely uses Domitor on dogs after surgery, a use unapproved by the FDA.
Domitor, according to its label, can be used in dogs undergoing short procedures, such as teeth cleaning and minor surgeries not requiring muscle relaxation.
Robert Esplin and Ross Mahowald, veterinarians at Sylvania Veterinary Hospital, said using Domitor on dogs after surgery was discussed at seminars funded by the drug giant as part of Pfizer’s DALE (Domitor Antisedan Local Expert) program.
“We had very limited material on Domitor before I went to the seminar,” Mahowald said. "We discussed how Domitor was used, different methods, and how it is used in different species.”
Mahowald was among 400 veterinarians invited by Pfizer to go on two all-expense paid trips to Chicago to attend the seminars, said Esplin, who occasionally appears on Channel 13's "Ask the Expert," segment and "Ask Dr. Bob" on radio station Star 105 FM. Pfizer chooses vets already using the drug at a "high rate" to participate in the DALE program, according to Pfizer. Following the seminars, Mahowald signed a contract with Pfizer to hold seminars for area veterinarians to discuss the “new uses” of Domitor. Pfizer pays Mahowald and other “DALEs” for each seminar they hold.
-Melissa Burden, Do You Know About the Drugs Your Pet Will Get?
For more information:
Special Report: Pets as Family, at presspublications.com
CIS? What is THAT?
Hint: It's a Client Information Sheet that accompanies certain veterinary drug products that pose serious health risks to companion animals. Do you have a vet who supplies pet owners with a copy when warranted? Or is he/she ignoring the risks and depriving you of your right to know when a drug is potentially dangerous to your pet?
Romi's Rimadyl Site
D.O.G.S. Adverse Reactions
Animals in Print: Emerging Issues Regarding Informed Consent