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LEARNING IN PRACTICE
Members of the veterinary profession have a responsibility to uphold standards to ensure the public has access to safe,
quality veterinary care. When those standards are compromised, the College responds. Every veterinarian can learn from
these situations and publishing the details of complaints received and resolved is intended to support that learning. The
example below is taken from an actual case and is offered as a self-reflection tool to improve practice across the province.
MEMBER TO OBTAIN FURTHER EDUCATION FOLLOWING RISKY SPAY
CASE SUMMARY
CASE CONSIDERATIONS
A one-year-old dog was taken to a clinic for
an elective spay surgery, performed by the
member. The length of anesthesia/surgery
was over one hour due to complications.
The Complaints Committee panel decided
the nature of the allegations made against the
member did not warrant a discipline hearing.
The member was presented with and signed
a Mutual Acknowledgement and Undertaking
to address the panel’s concerns regarding
his understanding of the canine female
reproductive physiology, his safe use of
heating pads, his treatment and management
of lesions following a burn injury and use of
off-label drugs.
The next day, the member examined the dog
for swelling in the perianal and vulvar region.
The client requested a copy of the medical
record to take to veterinarian B. Veterinarian B
examined the dog and concluded the tissue
swelling was due to hormonal influences from
spaying while in heat.
Nine days later, the medical records were
faxed to the second animal hospital at the
client’s request. Veterinarian B examined
the dog and concluded the dermatological
tissue reaction was probably a thermal burn
due to use of a heating pad during surgery.
After prescribing oral antibiotics, Veterinarian
B referred the client back to the member for
follow-up treatment.
Two days later, the member examined the
dog’s skin lesions. Antibiotics (cephalexin)
were dispensed for oral administration,
along with meloxicam, a non-steroidal antiinflammatory drug to be given once daily for
three days. There was discussion of a skin
biopsy. Alcohol was applied topically to the
affected skin, and a topical multi-purpose
medication which contained a steroid drug
(Surolan) was dispensed. A couple days later,
the dog was rechecked to assess the skin
lesions, which appeared to be healing well. A
topical cream (flumazine) was dispensed.
A week later, Veterinarian B examined the
dog’s skin lesions again. It was suggested
that topical treatment be altered to encourage
proper tissue repair. A therapeutic estimate
was provided for the client’s consideration.
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College Connection
The panel noted from the medical records
submitted that the dog first presented to the
member with a two-month history of vaginal
discharge. The member concluded the dog
was in heat as she was unspayed, but also
felt there may have been underlying uterine
disease as well as possibly a bleeding
disorder as other differentials.
The panel was concerned with the member’s
understanding of the canine reproductive
cycle. The panel noted there were other, safer
options including waiting until further on into
the cycle after hormonal influences have
waned. Also, diagnostics could have been
performed before delving into an invasive
surgical procedure which could have had
fatal consequences.
The panel also concluded that pain
management during the lengthy surgery, and
postoperatively, was inadequate especially in
consideration of the lesions.
The panel noted there was no dispute that
the dog was burned by a heating pad.
The panel agreed this should never have
occurred. The panel noted the member took
full responsibility for this occurrence and gave
the client a refund.
With regard to the management and
treatment of the thermal burn, the panel
noted concerns in the use of certain topical
medications to treat the damaged skin, and
that some drugs were given off-label. It
was the panel’s opinion that using isopropyl
alcohol 70% USP on a large area of damaged
skin due to burn injury may not have been
an appropriate treatment option, as this may
have caused further pain and skin irritation.
Also, the choice of Surolan as a “broad
spectrum” topical anti-bacterial, anti-fungal
and anti-inflammatory agent may not have
been appropriate for a large area of healing
tissue as there were other more acceptable
specific, topical therapies that could have
been used to encourage rapid tissue repair.
The panel was glad to hear the dog has
begun to heal from her surgery and the
thermal burn.
As part of the undertaking, the member
• received oral advice from the panel with
regard to their concerns.
• replaced any heating pad deemed to be
unsafe with safer options, such as water
blankets or bair huggers.
• undertook to obtain 4 to 6 hours of
continuing education in canine female
reproductive anatomy, physiology and
surgery.
• undertook to obtain 4 to 6 hours of
continuing education in anesthesia/
analgesic protocol.
• paid all costs associated with the
u ndertaking.