2083 Words; 10 minute read

In this article on keeping your small dog safe from veterinary malpractice, I look at the current state of vet care, the challenges many vets and their staff face, and the things we can (and should) do to be a supportive partner in our pups’ care. Surprisingly, it’s not that difficult to act as the final safety check in our small pups’ health care.

About fifteen years ago, I experienced firsthand how easily medical malpractice occurs.

Due to an error somewhere between the doctor giving me his handwritten prescription and the pharmacist handing me a bottle of pills, my medical team inadvertently prescribed me twice the appropriate amount of a drug designed only for short-term, low dosage use.

Within 24 hours of beginning the meds, I ended up in the emergency room.

Fortunately, my symptoms were limited to severe abdominal pain. IV fluids and anti-nausea drugs allowed me to leave the hospital less than five hours later, almost as good as new.

Although my body was ultimately fine, my attitude was not. In fact, I was pretty angry. At the time, I blamed everything on the physician’s illegibly scrawled prescription and the pharmacist who filled it. Looking back at my indignant response, I shake my head.

On what planet did I expect very human doctors and druggists to be perfect? After all, don’t they get to be human too?

And where was my responsibility in all of this? It wasn’t the dark ages, where information was locked away in priceless books few could read and even fewer could afford.

I could have saved myself days of severe pain and possible permanent liver damage had I just looked up my medication online and checked the dose. Why didn’t I do that? 

This experience changed my perspective not just in my interactions with human healthcare, but also in how I approach the care for our smaller, four-legged family members.

You can bet that now, I DO check every prescription med that enters my body.

And I certainly do the same for our pups.

Acting as a supportive partner in our pups’ medical care is crucial. Veterinarians and their staff, no matter how skilled or careful, are human and can be overworked, underpaid, and stressed.

They will make errors. And in the veterinary field, medication mistakes are the easiest ones for them to make.

My experience bears this out. This past summer, Phoebe, Scout, and I visited a new veterinary hospital to address some back pain Phoebe was experiencing. The vet was wonderful–a fairly new graduate from a top school who demonstrated both impressive expertise and genuine warmth. She took her time, she listened, and she began with a conservative approach to treatment, recommending rest and a common anti-inflammatory.

This vet hospital even had an onsite pharmacy, so we would be on our way home quickly. I paid the bill, grabbed the paper bag containing the meds, leashed the girls in their harnesses (they nearly always accompany one another to the vet–they’re one another’s emotional support dogs 😂), and rushed out the door, hoping to avoid the deluge threatening to let loose from the skies.

As I stood in the parking lot strapping the girls in their booster seats, someone called my name. I turned to see one of the vet techs rushing toward me, saying “we accidentally mislabeled the meds. We put Scout’s name instead of Phoebe’s.”

Of course, there was no harm done. They caught the mistake, and even if they hadn’t, I certainly wouldn’t have drugged up Scout when it was Phoebe who had the issue.

But, this error is a stark reminder of how easily mistakes occur in medical settings. Yet, just because it’s easy for mistakes to occur, does that mean they’re common? And if they’re common, how do we avoid veterinary malpractice?

Recent studies shed light on the prevalence of veterinary malpractice, emphasizing its impact on our pups. In “Veterinary healthcare needs to talk more about error: For the wellbeing of our patients and medical teams,” published in 2022 in the Journal of Veterinary Internal Medicine, adverse events were reported in 5 out of every 1000 patient visits, with 8% of these incidents resulting in permanent harm or death. 

At first glance, that might not seem like a lot–less than 0.5 percent.  

Yet, this figure represents a significant concern when considering the vast number of veterinary visits annually.

And, consider also that those are the statistics on REPORTED adverse events. Think of all the errors going unreported. Even in my encounter with medical malpractice landing me in an emergency room, I didn’t actually report it. Nor, I am sure, did my doctor.  

The disconnect between the statistics and actual adverse events underscores the importance of being vigilant when we visit any veterinary practice. 

(Warning: The following section discusses self-harm)

Veterinarians endure some of the highest mental health challenges of any occupation. In fact, their profession experiences death by suicide at a rate more than twice the general population.

Pet food company Royal Canin (not one of the foods we recommend) conducted a survey among Australian vets in 2022 and found:

• Over half have sought professional help relating to mental health
• Nearly 70% have lost a colleague or peer to suicide

In the US, Merck conducted a similar study in 2021, finding alarmingly poor mental health among vets. Key sources of stress include the shortage of qualified veterinarians and staff, long hours, high student debt, and low wages.

Indeed, a 2022 article entitled “Researchers Try to Understand High Suicide Rate Among Veterinarians,” reveals there’s no one answer.

While crushing debt is part of the issue, probably the profoundest contributing factor to veterinary stress is the nature of the job itself, where increasingly advanced and expensive treatments simply can’t extend the relatively short lives our pets live. Moreover, even when such treatments will work, many people can’t afford them.

In “Ruminating on rudeness: Exploring veterinarians’ experiences of client incivility,” a 2022 study looked at how client incivility impacts workplace conditions for veterinarians and their staff.

The results weren’t pretty.

In fact, researchers reported “the results indicate that veterinarians are exposed to a range of rude behaviours from clients, with suggested causal attributions spanning financial concerns, stress and worry. Adverse consequences associated with uncivil interactions included increased stress, mental health impacts and withdrawal from clients.”

In other words, vets repeatedly face clients accusing them of putting profit over animal care. Unfortunately, they bear daily witness to pet owners’ extreme grief that may spill over to expecting a vet to act as therapist. Sometimes, they’re simply the figurative punching bag for angry clients blaming them either for the state of the profession itself or for the cost of the treatment their pup needs.

All of this–the debt stress, the long hours, the ethical dilemmas and the sometimes abusive pet owners–adds up to a level of mental exhaustion that makes malpractice errors much more likely.

Understanding these pressures can help us, as pet owners, contribute to a more supportive environment that reduces the risk of errors.

But what specifically can we, as pet parents, do about it?

We can be kind.

We can be informed.

We can be a partner in our pup’s medical team.

Clearly, these steps are vital. The veterinary profession deserves respect and care from those of us who rely on it. Moreover, particularly when it comes to our small dogs whose slight size magnifies the gravity of even seemingly minor mistakes, there’s simply no disadvantage to stepping up our role. We can play a pivotal part in safeguarding our pups from avoidable harm. Engaging actively in our small dogs’ health care decisions can significantly reduce the risk of errors and improve outcomes

As a small dog owner, your role in preventing vet malpractice requires advocating for your pet. This means being present, respectfully asking questions, and understanding your pup’s treatments.

How to Help Your Vet Help Your Small Dog:

Be Informed: Understand common health issues in small dogs. Read up on the latest advances published in veterinary publications.

Many peer-reviewed journals are freely available online. Of course, don’t trust Dr. Google more than you trust the professional in front of you, but do ask questions:

• “I read an article in the Journal of X about Y. Could we talk about this as an option?”
• “Are there other options you’ve seen that might work?”
• “I like to use holistic approaches too. What can you recommend that might help here?”

Monitor Treatments: Monitoring your dog’s response to treatments is crucial for their health and helps ensure any potential errors are caught early:

• Be vigilant about the medications and dosages prescribed. Look up the drug, check the dosage again, and follow your vet’s instructions completely. More on that, below.
• Keep an eye on any changes in your pup’s eating habits and bathroom routines. Report any issues to your vet.

Follow-Up: Sometimes, life gets busy and we think we’re best at determining whether our pup is fully healed or back on track. But if your vet has asked for an additional visit, be sure you make and keep the appointment.

For example, Phoebe seemed fine after an issue with a ruptured anal gland, but only an internal exam revealed continued inflammation requiring a further round of anti-inflammatories. Thus, if we’d just assumed she was okay, rather than having her re-checked, we’d have cost her days or weeks of discomfort at the very least. At worst, we would have wound up with another rupture.

Thus, one of the most important ways we can help is to be aware of the potential for medication errors, which can be especially concerning for small dogs. The FDA’s report on Veterinary Medication Errors highlights common reasons for these errors. It’s crucial for small dog owners to understand these reasons to better safeguard their pups:

• Drug Names That Look Alike or Sound Alike: Confusion can arise from medications with similar names, leading to the wrong drug being prescribed or administered.
• Drug Labels: Issues with drug labels such as lack of background color contrast, overcrowded information, inconsistent presentation of drug strength, and the use of certain font styles and sizes can lead to misunderstandings.
• Drug Dosage Devices: Difficulties can arise from the use of drug dosage devices, like oral syringes, that are poorly designed or have inadequate directions for use.
• Illegible Handwriting: Illegible handwriting on written prescriptions can result in the dispensing of the wrong medication or dosage.
• Miscommunication in Verbal Orders: Miscommunication while verbally prescribing orders can also lead to errors.
• Product Defects: Some product defects, such as faulty parts or packaging, incorrect or missing label information, can result in accidental exposures and potential harm.
• Improper Storage or Disposal: Incorrect storage or disposal of drug products can lead to accidental exposures or overdoses.

Veterinary Medication Errors, 2023. For those interested, the FDA website offers further insights and guidelines on preventing medication errors in veterinary care.

As guardians of small dogs, we must be as vigilant with our pet’s medication as we are with our own. Always ask for clarification on medications, their dosages, and proper administration to ensure the safety of your small dog. And, always look up the medication online, cross-referencing the size, shape, and color of the pill with the one in your hand. Confirm the dosage. Then, call your vet if something doesn’t seem right. In doing so, you can be the final safety check in your pup’s medical team.

As responsible pet parents, our commitment to our small dogs’ health doesn’t stop at preventing veterinary malpractice; it extends to being prepared for any emergency. In fact, when you have time, read my article on emergency first aid kits for small dogs. It’s packed with essential information and practical tips to ensure you’re ready to provide the best care in any situation. Together, let’s take proactive steps towards safeguarding our beloved pups’ health and well-being.