Veterinary Client Rights, medical records, etc

Medical Records

 Q: I wrote my old vet and asked that all my dogs medical records be sent to me.  I  only received his exam card, no blood test results.  What's the protocol on receiving your pets medical records ?  Am I entitled to have his blood work results?
 

A:  The most direct approach to this problem is to request a conference with your vet if he is a solo practitioner You are entitled to copies of the medical records and if you do not get them, you should contact the Board of Veterinary Medicine in your state and report that you are having difficulty obtaining medical records from your vet.

Mike Richards, DVM
1/29/2001
 

Pet Insurance

Q: Dr. Richards,   Does YOUR practice accept forms of "Pet Insurance" as payment    for covered procedures?
 

A: We accept pet insurance (we have a provider number with the largest insurer) but we have not had anyone try to use pet insurance at our practice for a couple of years. We are awakening to the reality that it is going to be necessary for pet owners to have insurance for their pets over the next few yearsand have set a goal for next year of trying harder to discuss this with clients, though.

Mike Richards, DVM
12/12/2000
 
 

Emergency Medical Treatment While Boarded

Q:Dear Dr, I am very upset an concerned regarding my 1 1/2 year old Visla, we boarded him and our other dog at a kennel. We dropped them both off on Wednesday is was approx. 98 degrees outside. The staff assured me that the kennels were air conditioned and the animals could go in and out through the day. I cautioned them to watch the animals for heat stroke, they said they would. By Thursday the Visla had a seizure. A caretaker noticed the dog was on the ground and he was kicking his hind leg, once they approached they noticed he was frothing at the mouth. (I do not know if he had loss of bladder/bowel) Somehow they lost our emergency number and when I arrived on Saturday at 2 pm, I was informed he had a seizure disorder, and placed on Phenobarbital 1 grain q 12 hr. I requested to talk with the vet that treated him to find out why he was diagnosed as a seizure disorder and not a heat stoke related seizure. This dog has been very healthy and has never shown signs of seizure. I contacted his breeder and he stated that he has never had any reports or personal hx with his Visla's having seizures. Since I brought the dog home and could note he has lost significant weight, I fed him 1/4 can of dog food, and started him on small amounts of water. After 2 hrs the dog started to urinate a moderate amt, his face continued to have small spasms but this diminished as the night went on. I gave him a 1/2 of pill at 10 pm instead of the whole, and at 3:30 am the dog had a bowel movement and urinated a large amount. I fed him a full can of dog food and he drank two bowls (approx 300cc's) of water. His face spasms had stopped completely. It is now 11am, Farley has been up with and spasm free since approx 9 pm last night. He has continued to eat, drink, and urinate. I have just given him the other 1/2 of pill, since I worry about causing a seizure through withdrawl. His personality is slowly returning. I really believe this was caused by heat but fear his health, I requested the vet draw blood but this will not be available until Monday night. They drew no blood and I have no record of his I/O only that he was given Valium and a IV. Please advise.

A very worried mom in Oklahoma, Barbara

A: Barbara-You probably know a great deal more about what is going on now. It would be possible for a seizure disorder to occur at this age even if this was not a previous problem. It is also possible for heat stroke to produce seizures. I am curious about several things in the history and I think it would be best for you to speak directly with the veterinarian who treated your dog and to obtain a written copy of the records. I believe that it is your right in all states to have a copy of the records. In most states the vet is allowed to charge you a reasonable fee for the photocopying but that should be a small expense if it is charged.

You are entitled to know what your dog's temperature was on arrival at the veterinary hospital. While a seizuring dog outside on a hot day will certainly have an above normal temperature it may be possible to discern whether this was heat related or not. A temperature above 106 degrees fahrenheit would be strong indication that heat was part of the problem or the cause of the problem. You should find out why phenobarbital was used on the first incidence of seizure activity and you should have access to any lab work that was done. In general, seizures have to be pretty severe for most vets to use phenobarbital on the first incidence of seizures. Some vets are more apt to use phenobarbital than others and there is some justification for their use quickly but it is not the standard. If these seizures were severe enough to induce a veterinarian who does not normally go immediately to phenobarbital use to do so, that would be important to know.

You were right to insist on having lab work done as it may indicate the cause of the seizures. If it does not, at least you know that there is not a contributing problem and that the seizures will need to be controlled through medication when that seems appropriate to you and your vet. It may be that everyone will concur that immediate control is best or you may want to adopt a wait and see attitude.

Phenobarbital is addictive and it is best to withdraw it slowly if you decide to do that. Please ask for your vet's help with this. It is best to be careful when attempting to withdraw a dog from barbiturate medications.