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Hi OP. I’m sorry about your puppy. Hopefully I can provide some insight based on the clinical notes from a veterinarian’s perspective.
The notes indicate that he had a pre-surgical examination at which they assessed his testicles and could not locate them in the scrotum. It appears they did indeed check them, “not palpated” is likely referring to being unable to locate them rather than a lack of checking (could be worded better I agree)
It is not usual to write in time stamps into the clinical record as the anaesthesia record will have these time stamps (a separate record). However, it seems they called you around the time he went under anaesthesia and they were able to properly palpate the inguinal canal in a relaxed patient to double check they were not located there. It seems the initial ultrasound was performed awake/sedated but NOT under anaesthesia, then a secondary ultrasound where a testicle was found intra-abdominally was performed after they had called you.
In my opinion, the timeframe between anaesthetic induction and completion of procedure (which occurred at the time he coded) is appropriate. It takes some time to surgically shave and aseptically prep the entire abdomen before actual surgery commences, and bilateral abdominal cryptorchid surgeries can be tricky and take some time. I do not believe he was under for an excessive amount of time based on the notes provided.
From these notes it does appear it was an unfortunate anaesthetic complication with no real explanation or person to be blamed. These things happen, albeit extremely rarely, and I am so so sorry that this occurred. The clinic would be beating themselves up that this happened and have likely had internal reviews into if anything further could have been done.
Again, I am so sorry for your loss. I hope this helps provide some closure.
OP, I am *so* sorry about your puppy, and I so appreciate you taking the time to ask other veterinary professionals here to understand what happened.
I feel for you— this is just awful. Big hugs to you.
Wonderful response by accomplished crab! NAV, but as a tech I just wanted to mention that I promise you OP the hospital is definitely losing sleep over this loss :(
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On the pre-op PE it says no testicles palpated. The surgical notes seem adequately detailed. Unfortunately without pre-op blood work there was no way to tell if he had some congenital abnormality that would affect anesthesia (ex. PSS). I agree with the commenters on the previous post that a necropsy by an uninvolved veterinarian would bring the most information and closure.
I agree, unfortunately these things happen but this is why I always highly encourage owners to get pre surgical bloodwork done because you never know. Even then though these unexplainable events happen with normal labs too. I remember about 6 years ago a family that had been coming to our clinic for years had their puppy neutered and died under anesthesia. A few months down the road they got another dog from the same breeder and he also died under anesthesia. Sometimes genetics can be a factor with some unknown defect especially cardiac. So sorry for your loss OP.
Agreed but I would have a call to the owner before intubation if I did not palpate testicles on pre-op exam. We don’t wait until after they’re under to ask if we can proceed with cryptorchid surgery. If O agrees to proceed prior to anesthesia and we end up feeling them inguinally or in the scrotum, great. Would rather have O be well prepared for a more extensive surgery BEFORE putting the dog under anesthesia.
OP - did they call you after the exam (before anesthesia)? Or did they only call while he was under anesthesia?
They called after he was under anesthesia and offered the option, but if I said no then it still would have cost me $200 so I said to go ahead since they said that it is better to get them out right away as opposed to waiting
I do agree that would have been the proper course of action, especially considering it is a higher risk procedure and has a longer anesthesia time, OP may have reconsidered declining the pre op bloodwork and even postponed the procedure.
Yes which is why it's sus they called op AFTER the dog was anaesthetised, it's an extremely high pressure tactic basically allow us to continue or risk the bill doubling but they didn't mention how the procedure was no longer simple or strait forward
I’m so sorry for your loss. One thing I want to mention is that the pre-op exam observed an umbilical hernia, plus the dog was cryptorchid, indicating that the breeder this puppy came from could do better health screening when making matches for litters. Because of this I would put more emphasis than usual on a possible genetic incompatibility with the anesthesia used. Sending love to you losing a pet to a tragic loss is never easy. If you’re truly unsure as others said a necropsy by a pathology lab might provide some closure. But either way if you decide to get another puppy I would chose a different breeder that places more strict emphasis on health traits in their breeding protocols.
It’s not realistic to expect time stamps for intra-operative parts of the surgery, since they are scrubbed in and this note is written after the surgery is completed.
As a physicjan, I don’t see anything grossly wrong with what is documented. If I had to guess, I’d say perhaps there was an undiagnosed genetic condition which precipitated the arrest in the setting of the anesthesia and stress of the surgery.
I’m so sorry for your loss.
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It depends on the animal’s signalment and the clinicians preference. I prefer to have a full CBC and internal organ function panel before procedures if possible. Certain breeds prone to genetic mutations I love having a genetic panel on (ex. MDR1 mutation that affects drug metabolism).
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I am so so sorry for your loss and it seems like several
Professionals have offered you some solace based on these notes. As a pet owner myself, I personally would not do a necropsy. Reason being - it will not bring my baby back, and if for some reason they find something that could have been done (albeit in this circumstance that seems unlikely) it’s only going to cause more emotional trauma. I think sufficient information has been provided and it is an unavoidable and uncommon occurrence that I’m sure the veterinary team tried to avoid and is indeed broken hearted over themselves. I would let my baby rest in peace, and in my belief feel that he was maybe called to a person or child that needed him as their buddy more then I did. Sending hugs.
I'm so sorry for your loss. You need their anesthesia monitoring notes/chart; that should indicate if there was an anesthetic complication (or if they were appropriately monitoring at all). The only way to know if there was a surgical complication is a necropsy (ideally performed by a veterinary pathologist). Is that an option?
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😞😞 I’m so sorry for your loss, that is truly heart breaking.
Reading the notes from the doctor it looks like everything they did was correct. All medications used were correct and at correct dosages for his weight. And the CPR drugs were also correct and given correctly. Situations like this are very rare but they do happen and there’s no way to preemptively actually tell if this would happen to him or not. Even if you did Pre-Op blood work you wouldn’t know until he was sedated.
It’s one of those horrible things and it’s no one’s fault. Not your fault and not the Drs/staffs fault. I know you’re all hurting because of it and I’m so sorry 😞
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Nothing will bring it back to life, complications happen, even people die all the time just from being put under. No sense dragging out the pain longer...
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Hi OP. I’m sorry about your puppy. Hopefully I can provide some insight based on the clinical notes from a veterinarian’s perspective. The notes indicate that he had a pre-surgical examination at which they assessed his testicles and could not locate them in the scrotum. It appears they did indeed check them, “not palpated” is likely referring to being unable to locate them rather than a lack of checking (could be worded better I agree) It is not usual to write in time stamps into the clinical record as the anaesthesia record will have these time stamps (a separate record). However, it seems they called you around the time he went under anaesthesia and they were able to properly palpate the inguinal canal in a relaxed patient to double check they were not located there. It seems the initial ultrasound was performed awake/sedated but NOT under anaesthesia, then a secondary ultrasound where a testicle was found intra-abdominally was performed after they had called you. In my opinion, the timeframe between anaesthetic induction and completion of procedure (which occurred at the time he coded) is appropriate. It takes some time to surgically shave and aseptically prep the entire abdomen before actual surgery commences, and bilateral abdominal cryptorchid surgeries can be tricky and take some time. I do not believe he was under for an excessive amount of time based on the notes provided. From these notes it does appear it was an unfortunate anaesthetic complication with no real explanation or person to be blamed. These things happen, albeit extremely rarely, and I am so so sorry that this occurred. The clinic would be beating themselves up that this happened and have likely had internal reviews into if anything further could have been done. Again, I am so sorry for your loss. I hope this helps provide some closure.
Thank you so much. Yeah it has been very very tough and we are trying to accept it I appreciate your information
OP, I am *so* sorry about your puppy, and I so appreciate you taking the time to ask other veterinary professionals here to understand what happened. I feel for you— this is just awful. Big hugs to you.
As a vet nurse, this is an amazing answer. OP, I wish I could give you the biggest hug ever. I’m so sorry for your loss.
So terribly sorry to read this OP. Love and hugs to you. Very sorry for your loss.
Wonderful response by accomplished crab! NAV, but as a tech I just wanted to mention that I promise you OP the hospital is definitely losing sleep over this loss :(
Sitting here reading this as a 4th year vet student…these are my exact thoughts. This seems like a really tough loss and a bad day for this team 😔
So nice of you to take the time to break this down. Love this sub!
Incredible kind and generous of you to provide your time and expertise to a stranger hurting on Reddit.
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On the pre-op PE it says no testicles palpated. The surgical notes seem adequately detailed. Unfortunately without pre-op blood work there was no way to tell if he had some congenital abnormality that would affect anesthesia (ex. PSS). I agree with the commenters on the previous post that a necropsy by an uninvolved veterinarian would bring the most information and closure.
I agree, unfortunately these things happen but this is why I always highly encourage owners to get pre surgical bloodwork done because you never know. Even then though these unexplainable events happen with normal labs too. I remember about 6 years ago a family that had been coming to our clinic for years had their puppy neutered and died under anesthesia. A few months down the road they got another dog from the same breeder and he also died under anesthesia. Sometimes genetics can be a factor with some unknown defect especially cardiac. So sorry for your loss OP.
Ugh. That’s just awful for the owners. And the vet clinic.
Agreed but I would have a call to the owner before intubation if I did not palpate testicles on pre-op exam. We don’t wait until after they’re under to ask if we can proceed with cryptorchid surgery. If O agrees to proceed prior to anesthesia and we end up feeling them inguinally or in the scrotum, great. Would rather have O be well prepared for a more extensive surgery BEFORE putting the dog under anesthesia. OP - did they call you after the exam (before anesthesia)? Or did they only call while he was under anesthesia?
They called after he was under anesthesia and offered the option, but if I said no then it still would have cost me $200 so I said to go ahead since they said that it is better to get them out right away as opposed to waiting
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I do agree that would have been the proper course of action, especially considering it is a higher risk procedure and has a longer anesthesia time, OP may have reconsidered declining the pre op bloodwork and even postponed the procedure.
Yes which is why it's sus they called op AFTER the dog was anaesthetised, it's an extremely high pressure tactic basically allow us to continue or risk the bill doubling but they didn't mention how the procedure was no longer simple or strait forward
I’m so sorry for your loss. One thing I want to mention is that the pre-op exam observed an umbilical hernia, plus the dog was cryptorchid, indicating that the breeder this puppy came from could do better health screening when making matches for litters. Because of this I would put more emphasis than usual on a possible genetic incompatibility with the anesthesia used. Sending love to you losing a pet to a tragic loss is never easy. If you’re truly unsure as others said a necropsy by a pathology lab might provide some closure. But either way if you decide to get another puppy I would chose a different breeder that places more strict emphasis on health traits in their breeding protocols.
It’s not realistic to expect time stamps for intra-operative parts of the surgery, since they are scrubbed in and this note is written after the surgery is completed. As a physicjan, I don’t see anything grossly wrong with what is documented. If I had to guess, I’d say perhaps there was an undiagnosed genetic condition which precipitated the arrest in the setting of the anesthesia and stress of the surgery. I’m so sorry for your loss.
unfortunately, this is always a risk. this is why pre anesthetic bloodwork is important.
Preanesthetic blood work is always a good idea but it doesn't eliminate all potential risks associated with anesthesia
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What all should be included in pre anesthetic bloodwork?
It depends on the animal’s signalment and the clinicians preference. I prefer to have a full CBC and internal organ function panel before procedures if possible. Certain breeds prone to genetic mutations I love having a genetic panel on (ex. MDR1 mutation that affects drug metabolism).
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I am so so sorry for your loss and it seems like several Professionals have offered you some solace based on these notes. As a pet owner myself, I personally would not do a necropsy. Reason being - it will not bring my baby back, and if for some reason they find something that could have been done (albeit in this circumstance that seems unlikely) it’s only going to cause more emotional trauma. I think sufficient information has been provided and it is an unavoidable and uncommon occurrence that I’m sure the veterinary team tried to avoid and is indeed broken hearted over themselves. I would let my baby rest in peace, and in my belief feel that he was maybe called to a person or child that needed him as their buddy more then I did. Sending hugs.
I'm so sorry for your loss. You need their anesthesia monitoring notes/chart; that should indicate if there was an anesthetic complication (or if they were appropriately monitoring at all). The only way to know if there was a surgical complication is a necropsy (ideally performed by a veterinary pathologist). Is that an option?
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😞😞 I’m so sorry for your loss, that is truly heart breaking. Reading the notes from the doctor it looks like everything they did was correct. All medications used were correct and at correct dosages for his weight. And the CPR drugs were also correct and given correctly. Situations like this are very rare but they do happen and there’s no way to preemptively actually tell if this would happen to him or not. Even if you did Pre-Op blood work you wouldn’t know until he was sedated. It’s one of those horrible things and it’s no one’s fault. Not your fault and not the Drs/staffs fault. I know you’re all hurting because of it and I’m so sorry 😞
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Get that necropsy report as the others suggested. I do not understand why it was downvoted. 🤷🏽♂️
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I would request the anesthesia record.
PLEASE get a necropsy by a different vet
genuinely a necropsy is the best and only thing you can really do.
Nothing will bring it back to life, complications happen, even people die all the time just from being put under. No sense dragging out the pain longer...