WWYD - Unhappy with vet service

Barklands

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I don't know if this is just due to the emotions of being due to lose horse to laminitis (as referred to in another recent post) but the more I think about our situation, the more frustrated I am with the vet service we have had.

We are registered with the "best" vets in the area and before Christmas last year my mare came down with severe laminitis. We had the vets out straightaway who advised bloods for EMS and Cushings, both of which came back negative. We had vets back out a week later and she was still in a lot of pain. We had full bloods run and a urine test (due to some other symptoms), all of which came back negative. She would improve then drop back when lowering her bute from 2 to 1 a day. We would regularly call the vets and ask for more bute but for over a month I was unable to actually speak to a vet myself to understand if her progress was normal or not. It turns out the vet tried to call me three weeks ago but I was in a meeting and they made no effort to call back, so was unaware that they had tried.

I became increasingly frustrated at lack of contact and over a week ago I was at the end of my tether and went in to speak to them. Finally I had a call back from the vet who explained she wasn't happy with progress and that there is an additional EMS test that they could run and a drug they could give to stop the insulin. Fast forward to yesterday, the vet attended, lifted up the foot and the mare has had catastrophic rotation and a very poor prognosis meaning we are at the end of the road and she is to be PTS this week. She is a young, otherwise fit horse and we followed the vet's instructions to the letter. I am not frustrated with the actual vet but feel that overall the practice completely dropped the ball. I had no idea there was an additional test that could have been done and drugs that she could have been given to lower the sugars in the body. Maybe the outcome would not have been different but she was not even given a chance. As an owner who has never had to deal with such severe laminitis, I had no idea of what timescales were normal and every time called felt like they were just trying to get me off the phone as quickly as possible.

To clarify, I was not given the opportunity to speak directly to a vet from end of December to three weeks ago when I missed their call. It was a further two weeks (plus me going in person to the practice) to actually speak to the vet. I am aware that they have difficult workloads and didn't want to be pushy but is this normal??

If you were in my position would you raise this? I am awaiting my final bill from the visit yesterday and paying it will really stick in my throat.
 
I'm glad I am not overreacting, it is hard to know when so many emotions are involved. At first it was treated as an emergency but it feels she completely slipped through the net and they took their eye off the ball. It is so difficult to know what is normal progress and what isn't. When we kept coming back for more bute surely that should have been a red flag but we only ever got to speak to the receptionists for weeks on end. What a waste.
 
That is horrendous, when one of my donkeys had a severe bout of laminitis before Christmas, I don't think a day went by without either my vet phoned me, I phoned him or he actually called in again until we were certain we had passed the dangerous critical stage.

That time scale was over a three week period that included Christmas day. He specifically gave me his home telephone number and private mobile to phone home at anytime if I thought things might be deteriorating over the Christmas period.

I am so sorry you have had such a difficult time and such a sad ending. Of course you are right it could well be that a more on the ball vet may not have made any difference to outcome, but on the other hand things may have been far better, you just can't know, but I would definitely put in a formal complaint to the practice.
 
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What a terrible experience for you and your poor horse. Laminitis is serious and if she had not rotated severely to start with (which I presume to be the case) she should never have been allowed to get to the point where she did. I have had two ponies with it, I regret to say, and I found the farrier more help than the vet. Mine were not so bad, and recovered with box rest, soaked hay, supportive bedding and special shoes. I think there is a drug they can give them now that helps. But living in the New Forest most local vets are quite experienced with laminitis. Unfortunately.
 
Awful for you and your poor horse. When one of mine went down with lami a few years ago, my vet was in daily contact, popped in to see him 3 orn4ntimes a week and did everything he could to push through blood results and get him through it.
I would be absolutely fuming with such neglect from the practice.
 
Thank you for all of your kind words. It has certainly been a learning curve and having the benefit of hindsight I certainly would have put a lot more pressure on them / transferred to another practice. I will be calling them in the morning to request a refund in full plus the cost of euthanasia, and most importantly a formal apology. If they agree to a refund, l will put it towards transport costs of hopefully sending her to the Royal Dick for research if they will take her, so that at least some good can come of this awful situation. However, unfortunately no refund or apology will bring back my horse. I fully expect they will try to wriggle out of any liability and shift the blame but I have to say, after reading your experiences I do not plan to back down on this one.
 
I have been through serious laminitis myself, did they pad the feet on the first visit? May I suggest that you get a second opinion, rotation does not always mean the worst outcome. It takes time and dedication but it can be ‘fixed’.
 
I have been through serious laminitis myself, did they pad the feet on the first visit? May I suggest that you get a second opinion, rotation does not always mean the worst outcome. It takes time and dedication but it can be ‘fixed’.
I was advised against padding the feet and that her small flake shavings would ball in her feet. The false sole has completely come away from her off fore and she has a terrible abscess and as such the vet believes she will not likely not recover, she was not x-rayed on Monday but vet suspects pedal bone is about to penetrate. She is not insured either as she was a project that ended up staying, frustratingly I was planning to arrange insurance for her and as such I am not sure I would have the budget to put her through very intense treatment that she would now require given the significance of her rotation. In addition, she is in a lot of pain and her heart rate is high, suggesting she isn't really coping. The thought of her being cooped up for several more months with no guarantees is an uncomfortable one with me. I think even with a second opinion to PTS is the kindest thing at this stage.
 
I was advised against padding the feet and that her small flake shavings would ball in her feet. The false sole has completely come away from her off fore and she has a terrible abscess and as such the vet believes she will not likely not recover, she was not x-rayed on Monday but vet suspects pedal bone is about to penetrate. She is not insured either as she was a project that ended up staying, frustratingly I was planning to arrange insurance for her and as such I am not sure I would have the budget to put her through very intense treatment that she would now require given the significance of her rotation. In addition, she is in a lot of pain and her heart rate is high, suggesting she isn't really coping. The thought of her being cooped up for several more months with no guarantees is an uncomfortable one with me. I think even with a second opinion to PTS is the kindest thing at this stage.
I’m so sorry you are at that stage. Any vet worth their salt would have padded the hooves to support them at the initial visit. The abscess is likely from where her pedal bone is pressing down on a build up of dead tissue due to the rotation. I completely understand why you are feeling that pts is the kindest thing and you are not wrong. I was just over £3k for my horse’s lamintis but he was insured. I can understand you wanting to take things further.
 
I’m so sorry you are at that stage. Any vet worth their salt would have padded the hooves to support them at the initial visit. The abscess is likely from where her pedal bone is pressing down on a build up of dead tissue due to the rotation. I completely understand why you are feeling that pts is the kindest thing and you are not wrong. I was just over £3k for my horse’s lamintis but he was insured. I can understand you wanting to take things further.
Yes it appears that padding is the standard treatment from what I have looked at online since - just feel they have totally failed her. Not looking forward to having to argue with the vets about this at such a difficult time but if anything I feel responsible that they take away some lessons from this as I would hate anyone else to be in this position.
 
I am so very sorry to read your post. Appalling lack of proper care and treatment from your vet and I would definitely complain loud and clear to the practice manager if you get nowhere with the vet/s concerned. Make sure you have all attempts at contact etc in chronological order, and the outcomes. I am so very sad for you but a second opinion could also well be worthwhile as Barklands has suggested. Sending positivity and strength to you at this very difficult time.
 
I was advised against padding the feet and that her small flake shavings would ball in her feet. The false sole has completely come away from her off fore and she has a terrible abscess and as such the vet believes she will not likely not recover, she was not x-rayed on Monday but vet suspects pedal bone is about to penetrate. She is not insured either as she was a project that ended up staying, frustratingly I was planning to arrange insurance for her and as such I am not sure I would have the budget to put her through very intense treatment that she would now require given the significance of her rotation. In addition, she is in a lot of pain and her heart rate is high, suggesting she isn't really coping. The thought of her being cooped up for several more months with no guarantees is an uncomfortable one with me. I think even with a second opinion to PTS is the kindest thing at this stage.
So sorry for your poor mare’s agony, please, if she has extensive rotation and penetration, the kindest act is destruction asap - don’t wait to ‘arrange’ this.
Yes, some can ‘recover’ from founder in all four feet, but the physical and psychological stress on both that animal and also its carer will be extreme. Don’t, even if you have unlimited funds.
Sounds like your practice were not helpful and I would be bitterly unhappy, but unfortunately clinical autonomy and wide variation around laminitis treatment persists. It is also depressingly true that some animals given the best intervention will just sink inside their hoof capsules like stones, whilst neglected others improbably and against all odds, come round.
A terrible disease and a vicious learning curve.
 
So sorry for your poor mare’s agony, please, if she has extensive rotation and penetration, the kindest act is destruction asap - don’t wait to ‘arrange’ this.
Yes, some can ‘recover’ from founder in all four feet, but the physical and psychological stress on both that animal and also its carer will be extreme. Don’t, even if you have unlimited funds.
Sounds like your practice were not helpful and I would be bitterly unhappy, but unfortunately clinical autonomy and wide variation around laminitis treatment persists. It is also depressingly true that some animals given the best intervention will just sink inside their hoof capsules like stones, whilst neglected others improbably and against all odds, come round.
A terrible disease and a vicious learning curve.

This is a very sensible post.
Unfortunately vets aren’t there to provide a telephone advisory service- I'd be very cross if they had refused a visit, but beyond that, I don’t think there is grounds for complaint.
 
Send an unemotional, factual letter with the time line to partners/head of practice.Do not in that letter mention you want money, what you need to see is their response, give them 7 days to respond. When you have their response you can push for financial compensation. You may find on line recommendation for a diagnostic, treatment schedule you can refer to. If you used an insurance company their lawyers may have a view and input. This sounds appalling service and I’m really sorry you are in this position.
 
OP, I am very sorry about your horse. However, I do have a different point of view and I do think that you should have taken more responsibility both in researching the condition yourself, and in getting the vet back out very, very much sooner. Calling to speak to the vet isn't how it works. Vets don't (OK, they do, but they are not supposed to) give free consultations via the phone. Calling owners with results is generally done free of charge, but taking up a busy vets time for free phone consults is frowned upon, otherwise everyone would do it and they'd lose tons of money. It is the owner's responsibility to keep an eye and call the vet back in if things are going downhill or not progressing. It was your prerogative to ask for a different vet at any point. Reading your second paragraph the horse wasn't seen for over a month - you say you were unable to speak to a vet. Did you try to book a follow up visit?? Your horse was in pain. Vets are busy, and pulled in all directions. Many vets go above and beyond to follow up, often FOC, but they are not obliged to, and I don't think that in this case it is solely the vets at fault. Yes, they could have been more proactive (not obliged to be) but so could you.
I hope that your horse is pain free soon.
 
This is a very sensible post.
Unfortunately vets aren’t there to provide a telephone advisory service- I'd be very cross if they had refused a visit, but beyond that, I don’t think there is grounds for complaint.
Please read my post again, in case it is not clear, I was describing how she was getting on to the receptionists and asking whether she needed to be seen, they claimed to be speaking to the vet, the practice was simply dispensing more bute without consulting regarding her progress. I asked several times whether she needed to be seen again, further I was not given any details regarding the additional EMS test or drugs she could have had until two weeks ago. I don't know if you have had personal experience of severe laminitis but every horse is different, whilst she was making some progress it is evidently clear now that she was not making enough progress and IMO that is for the vet to ascertain not me, given I have no veterinary training.
 
OP, I am very sorry about your horse. However, I do have a different point of view and I do think that you should have taken more responsibility both in researching the condition yourself, and in getting the vet back out very, very much sooner. Calling to speak to the vet isn't how it works. Vets don't (OK, they do, but they are not supposed to) give free consultations via the phone. Calling owners with results is generally done free of charge, but taking up a busy vets time for free phone consults is frowned upon, otherwise everyone would do it and they'd lose tons of money. It is the owner's responsibility to keep an eye and call the vet back in if things are going downhill or not progressing. It was your prerogative to ask for a different vet at any point. Reading your second paragraph the horse wasn't seen for over a month - you say you were unable to speak to a vet. Did you try to book a follow up visit?? Your horse was in pain. Vets are busy, and pulled in all directions. Many vets go above and beyond to follow up, often FOC, but they are not obliged to, and I don't think that in this case it is solely the vets at fault. Yes, they could have been more proactive (not obliged to be) but so could you.
I hope that your horse is pain free soon.
Where did it come across that I was expecting free phone consults? I asked several times if they felt she needed to be seen again. I was so frustrated with the service I went in person to the veterinary practice - they were simply dispensing bute which made me think her slow progress must have been normal. If vets are prescribing medication they have a responsibility to ensure that it is providing suitable treatment, given they seemed rather unconcerned I didn't realise the extent of her prognosis until Monday. Given you say taking up a busy vets time for free phone consults is frowned upon, do you feel that it is the receptionists that should be deciding whether a horse needs to be seen or not? As I have made clear, there were several occasions when I asked if she needed to be seen, they simply dispensed more bute.
 
Where did it come across that I was expecting free phone consults? I asked several times if they felt she needed to be seen again. I was so frustrated with the service I went in person to the veterinary practice - they were simply dispensing bute which made me think her slow progress must have been normal. If vets are prescribing medication they have a responsibility to ensure that it is providing suitable treatment, given they seemed rather unconcerned I didn't realise the extent of her prognosis until Monday. Given you say taking up a busy vets time for free phone consults is frowned upon, do you feel that it is the receptionists that should be deciding whether a horse needs to be seen or not? As I have made clear, there were several occasions when I asked if she needed to be seen, they simply dispensed more bute.
Look, don’t be defensive, you need to be strong and decisive right now - you will never use this practice again, and neither would I.
Just sort out the poor mare asap, please do not prolong such hopeless distress with second opinions and bill-disputes, call your hunt or fallen stock service if (understandably) can’t bear to see those vets again.
It is very difficult for a layman to query professional medics in any field, it is even more difficult to prove clinical incompetence /malpractice, including where there is clearer evidence of this than obvious from your case history.
As before, a bitter learning curve, and so very sorry your horse is suffering.
 
Send an unemotional, factual letter with the time line to partners/head of practice.Do not in that letter mention you want money, what you need to see is their response, give them 7 days to respond. When you have their response you can push for financial compensation. You may find on line recommendation for a diagnostic, treatment schedule you can refer to. If you used an insurance company their lawyers may have a view and input. This sounds appalling service and I’m really sorry you are in this position.

I would also send a letter or an email, something in writing that you can edit, and then you also have proof of what was 'said', and how.
 
Let's not be too hard on the poster. She is probably very emotional, losing her horse and possibly feeling guilty of "should I have booked another call-out sooner", should I have been firmer on the phone, is it my fault?
Yes the vets should have called if they had said they would, and keep prescribing Bute should have raised concerns.
However, the horse needs to be PTS asap, it is in agony and I am surprised the vet didn't do it when they saw the x-rays.
It is an awful situation to be in but I think it is a combination of factors, which can be learnt from by both parties, that have caused it. Definitely write a structured factual email to the vets including when you phoned, asked for more Bute etc. asking for a full investigation.
 
Let's not be too hard on the poster. She is probably very emotional, losing her horse and possibly feeling guilty of "should I have booked another call-out sooner", should I have been firmer on the phone, is it my fault?
Yes the vets should have called if they had said they would, and keep prescribing Bute should have raised concerns.
However, the horse needs to be PTS asap, it is in agony and I am surprised the vet didn't do it when they saw the x-rays.
It is an awful situation to be in but I think it is a combination of factors, which can be learnt from by both parties, that have caused it. Definitely write a structured factual email to the vets including when you phoned, asked for more Bute etc. asking for a full investigation.
Yes, hindsight is a wonderful thing which seems to be forgotten by some. Had I known the extent and that her slow progress was very much abnormal, I would have approached the situation very differently however, vets are a regulated professional service and I believe they absolutely do have a responsibility to follow up. I work in another regulated industry and if I approached my work in a similar manner there would be no doubt that it would be seen as negligent.

X-rays were not taken on Monday but I was advised that whilst there are things they could possibly do the treatment would be very intense, there would be no guarantees and her current prognosis is very poor. The reason I have not yet PTS is that they took further bloods to ascertain if she could have had the EMS medication, we agreed I would await the results and that would solidify my decision (although having had a day to think, my decision is solidified regardless of the outcome of the test). She is now on a higher dose of pain relief so is more comfortable but will be arranging the PTS when I speak to them this morning.

You are absolutely correct, I feel very guilty about the situation about what I could have done differently. I put my trust in the vets and followed their direction, I find the likes of social media or the forum when dealing with severe veterinary issues unhelpful as there can be so much conflicting advice and it all gets a bit overwhelming. So I put my trust in the professionals and I can’t help but feel that trust was misplaced.
 
@Barklands your post has upset me greatly and I can feel your anguish as I went through something similar.

Can I suggest you write a formal letter of complaint to the practice manager and copy in the governing body. There is a significant compliance and process failure here that is reportable.

Please reach out and I will help you write it.

In the meantime, if you are able to - get to another practice. The outcome may be the same for your horse but you have tried every avenue.

My situation turned out well for horse as practice #2 saved her and rehabbed her but only just.

Practice #1 had other systematic failures I was unaware of, and by reporting the incident they were forced to make significant changes to their business model, staff ways of working and client relations.
 
Look, don’t be defensive, you need to be strong and decisive right now - you will never use this practice again, and neither would I.
Just sort out the poor mare asap, please do not prolong such hopeless distress with second opinions and bill-disputes, call your hunt or fallen stock service if (understandably) can’t bear to see those vets again.
It is very difficult for a layman to query professional medics in any field, it is even more difficult to prove clinical incompetence /malpractice, including where there is clearer evidence of this than obvious from your case history.
As before, a bitter learning curve, and so very sorry your horse is suffering.
Where did I say I am prolonging with second opinions or bill disputes? Another poster suggested getting a second opinion, I explained I wouldn’t be doing so as it will not change the outcome and the decision to PTS has been made. I feel they should cover the cost after the event but prolonging to cover a bill is certainly not how I am approaching the situation. Unfortunately for the vets, I am not a layman.
 
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