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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.
NECROPSY MUST BE OFFERED FOLLOWING UNEXPECTED DEATH
BRIEF SUMMARY
The client took her newly adopted dog to a
clinic for updated vaccinations and a physical
examination prior to scheduling a spay. The
examination was unremarkable and the spay
surgery was booked. Preoperative blood
testing was not performed on the dog.
The dog appeared healthy just before spay
surgery began with normal vital signs.
Anesthesia consisted of sedation, induction
and maintenance on isoflurane.
The medical records did not indicate that
any complications occurred during surgery.
The member told the client that it had been
a difficult surgery. The written submissions
indicated there was possibly a medical
condition of the uterus present at the time of
surgery.
Later that same day, the dog was discharged
from the hospital but was returned that
evening due to bleeding at the incision site.
The dog was admitted and exploratory
surgery was performed to determine the
possible cause of hemorrhage.
Although the member remained in the clinic
with the patient overnight for monitoring, the
dog died early the next morning.
Following the dog’s unexpected death, a
necropsy was not offered to the client, nor
was one performed.
REASONING
The panel advised the member of concerns
due to his failure to offer an independent
necropsy following the sudden death of a
patient. As well, more consideration should
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have been given to postoperative care
including extended hospitalization following a
difficult surgery.
The client alleged the member should have
contacted her when the surgery began and
the member realized something was wrong
with the dog’s uterus.
The submissions reviewed by the panel
indicate staff attempted to contact the client
during the surgery. The panel agreed that it
would not have been in the best interests of
the dog to stop the surgery for the member
to personally phone and discuss the
complications, but to continue quickly and
cautiously to complete the operation.
Although the member advised the client
that it had been a difficult surgery, the dog
was discharged that day. The panel agreed
the member should have recommended to
extend the dog’s hospitalization stay or refer
her to another veterinary hospital with 24 hour
monitoring of patients.
Following the dog’s unexpected death, a
necropsy was not offered to the client, nor
was one performed to definitely determine the
cause of death.
Although, the written submissions indicated
that there was possibly a medical condition
of the uterus present at the time of surgery
such as a pyometra or mucometra, this was
not confirmed through gross postmortem
examination, which may have included
histopathology, had it been performed.
The College’s regulations state a client should
be informed of the availability of a necropsy
following an unexpected death.
Key Considerations
Ontario Regulations 1093
• Professional Misconduct •
www.cvo.org/consent
Interested members are encouraged
to review Ontario Regulations 1093.
Practice Standards can be found in
Part II of the Regulations and defines
the various elements which constitute
professional misconduct under the
Veterinarians Act.
One of the requirements of the
legislation is that the client is offered
a necropsy from an independent
veterinarian in situations where the
animal dies unexpectedly or from an
anesthetic.
The full text of the regulations is
provided below:
The College’s legislation, Ontario
Regulation 1093, Section 17 (1) 23,
states that professional misconduct
includes the following:
“If an animal has died unexpectedly
or from an anesthetic, failing to
promptly inform the client about the
availability of a necropsy through
a veterinarian independent of the
attending veterinarian but, having
provided the information, the
attending veterinarian or associate,
upon the client’s request, may
perform the necropsy”.