CONSIDER

Music is: "Amazing Grace"...

Consider…

“Definitive diagnosis of urethral calculi is based on clinical signs, inability to pass a catheter, and evidence of calculi on survey or contrast radiographs.”

--- Howard B. Seim III, DVM, Dipl. ACVS, Fort Collins, CO --- from “Management of Cystic and Urethral Calculi in Male Dogs”

OUR COMMENT: ***Dr. Thomas FAILED to take radiographs on several occasions. This is INEXCUSABLE!! SEE VIOLATIONS PAGE***

“...urethral calculi are removed via urethrotomy”

--- Howard B. Seim III, DVM, Dipl. ACVS, Fort Collins, CO --- from “Management of Cystic and Urethral Calculi in Male Dogs”

OUR COMMENT: ***Dr. Thomas removed urethral calculi. She DID NOT perform a Perineal Urethrostomy as she states in Stempy’s records. She actually performed an extremely poor attempt of a Urethrotomy…BUTCHERING OUR BELOVED DOG, STEMPY, in the process! Stempy had an incision at least 9 cm in length! AGAIN….SHE DID NOT PERFORM A PERINEAL URETHROSTOMY!!

“The urethral calculus to be removed is located by evaluation of radiographs, palpation of the os penis and its relationship to the calculus, and/or passing a catheter in the urethra until it contacts the stone, removing the catheter and using it as a measure to locate the calculus. A 2-3 cm skin incision is made directly over the calculus."

--- Howard B. Seim III, DVM, Dipl. ACVS, Fort Collins, CO –-- from “Management of Cystic and Urethral Calculi in Male Dogs”

OUR COMMENT: ***Saturday, 9/24/05, Dr. Thomas continued JAMMING & JAMMING the catheter in trying to FORCE the catheter past the stone. She NEVER measured to locate the calculus. She NEVER took a radiograph to locate the calculus, yet she continued JAMMING & JAMMING the catheter. Stempy was sent home WEARING a catheter. Again, Stempy’s incision was at least 9 cm in length! She told us after the surgery on 9/27/05, that evidently she had lodged the catheter to the stone on 9/24/05. She stated to us that she was unable to remove the catheter. Stempy was placed back in a cage, where he, himself removed the catheter. In Stempy’s records, Dr. Thomas completely changes her story and claims she removed the catheter during surgery. That is NOT what she told us.***

“A Urethrostomy provides a permanent opening caudal to the os penis that is large enough to accommodate passage of most urethral calculi.”

--- Howard B. Seim III, DVM, Dipl. ACVS, Fort Collins, CO --- from “Management of Cystic and Urethral Calculi in Male Dogs”

OUR COMMENT: ***AGAIN, Dr. Thomas DID NOT PERFORM A PERINEAL URETHROSTOMY!! There was no new opening made!***

“Long term prognosis is dependent on evaluation of calculus composition, dietary management, management of urinary tract infection, and attention to urine pH.”

--- Howard B. Seim III, DVM, Dipl. ACVS, Fort Collins, CO --- from “Management of Cystic and Urethral Calculi in Male Dogs”

OUR COMMENT: ***Dr. Thomas FAILED to provide correct dietary management. Dr. Thomas FAILED to perform or recommend quarterly urinalyses.***

“Patients that have an elective urethrostomy have a favorable prognosis if attention is paid to proper surgical technique...”

--- Howard B. Seim III, DVM, Dipl. ACVS, Fort Collins, CO --- from “Management of Cystic and Urethral Calculi in Male Dogs”

OUR COMMENT: ***The key word above is ELECTIVE. We NEVER authorized anything more than a Cystotomy. Period.***

“Anesthesia should be induced and maintained with caution. The animal should be well hydrated and cardiac and output and blood pressure maintained to ensure adequate renal perfusion. Urine output should be measured intraoperatively where possible to monitor renal function. Agents such as methoxyflurane, phenothiazine tranquilizers, droperidol, barbiturates, and tiletamine/zolazepam should be avoided. Agents providing cardiovascular stability, including narcotics such as oxymorphone or etomidate, and inhalants such as isoflurane are recommended.”

--- David Holt, BVSc, Diplomate ACVS, University of Pennsylvania School of Veterinary Medicine --- from “Surgical Management of Urogenital Emergencies”

OUR COMMENT: ***Acepromazine is a phenothiazine tranquilizer. As stated above, it should be avoided in urogenital emergencies. Dr. Thomas used acepromazine in 11/03, 3/05, and 9/05 DESPITE the FACT that we informed her on 11/1/03 of Stempy having had previous seizures and DESPITE the FACT that it should be avoided in urogenital emergencies and DESPITE the FACT that it should be avoided in brachycephalic breeds.***

“...difficult urethral catheterization should also increase the index of suspicion for urethral injury. Obtaining urine from a urethral catheter does not exclude the possibility of urethral trauma. The catheter could pass directly through the urethral rupture into the peritoneal cavity where urine is collecting. Urine leaking into the peritoneal cavity will initiate a chemical peritonitis.”

--- David Holt, BVSc, Diplomate ACVS, University of Pennsylvania School of Veterinary Medicine --- from “Surgical Management of Urogenital Emergencies”

OUR COMMENT: ***Dr. Thomas FORCED the catheter to pass on 9/24/05. She FAILED to do a radiograph on 9/24/05. We DEMAND to see the radiograph Dr. Thomas claims she did on 9/27/05. We suspect she may have caused a urethral rupture that went unnoticed until 9/27/05. We believe that she did not notify us or refer us to a specialist because of this and that she must have been trying to repair her MAJOR MISTAKE made on 9/24/05. It is the ONLY thing that could possibly explain a 9 cm incision. As stated above, urine leaking into the peritoneal cavity will initiate a CHEMICAL PERITONITIS!!!***

“The urethra (the narrow tube connecting the urinary bladder to the outside world) is a difficult place to perform surgery so it is preferrable to move the stone back into the bladder for removal rather than attempting removal from the urethra.”

--- Mar Vista Animal Medical Center, 3850 Grand View Blvd., Los Angeles, CA 90066 --- from “OXALATE BLADDER STONES IN THE DOG”

OUR COMMENT: ***Dr. Thomas only made one attempt to flush the stone back to the bladder on 9/24/05. She FAILED to do a radiograph to determine if she was successful. She then FORCED the catheter, possibly causing a urethral rupture.***

“...therapeutic plan has been devised to minimize the chance of recurrence ..... a urinalysis should be performed every 2 months or so for the rest of the dog’s life (University of Minnesota’s current recommendation). Radiographs are taken every 3-6 months so that any new stones will still be small enough to be retrieved from the bladder by flushing...With radiography monitoring, it is hoped that new stones can be detected while they are still small... If one skips this monitoring, one may find stones present have developed to a large size and surgery is again needed to remove them...”

--- Mar Vista Animal Medical Center, 3850 Grand View Blvd., Los Angeles, CA 90066 --- from “OXALATE BLADDER STONES IN THE DOG”

OUR COMMENT: ***Dr. Thomas never implemented ANY type of therapeutic plan. Dr. Thomas FAILED to recommend or perform ANY monitoring such as urinalyses or radiographs!! SEE TIMELINE AND VIOLATIONS.***

“...it is important to have radiographs taken to check for the presence of more stones..... Radiographs are taken monthly to monitor progress.”

--- Mar Vista Animal Medical Center, 3850 Grand View Blvd., Los Angeles, CA 90066 --- from “STRUVITE BLADDER STONES IN THE DOG”

OUR COMMENT: ***Dr. Thomas FAILED to take radiographs…on MULTIPLE occasions. SEE TIMELINE AND VIOLATIONS.***

“Acepromazine maleate is a phenothiazine derivative.....a tranquilizer for dogs, cats and horses. It provides no analgesia....Acepromazine should not be used in animals with a history of epilepsy, those prone to seizures, or those receiving a myelogram because it may lower the seizure threshold. Brachycephalic breeds....are particularly prone to cardiovascular side effects (drop in blood pressure and slow heart rate). Acepromazine should be avoided...in these breeds.”

--- Dr. Barbara Forney, VMD, Chester County, Pennsylvania --- from “Acepromazine Maleate For Veterinary Use”

OUR COMMENT: ***Dr. Thomas prescribed this tranquilizer for Stempy on 9/29/05. We were led to believe it was a pain killer. We told Dr. Thomas that Stempy was in EXTREME pain. She prescribed this DESPITE the fact that it provides NO analgesia. Dr. Thomas was informed on 11/1/03 that Stempy had experienced two seizures in his past. Dr. Thomas used and prescribed Acepromazine DESPITE the FACT that it is known to lower the seizure threshold. Dr. Thomas used Acepromazine DESPITE the FACT that it should be avoided in brachycephalic breeds.***

“Postoperative management of dogs with Calcium OxalateUrolithiasis begins by obtaining radiographs immediately after surgery. This helps to differentiate surgical failure to remove all of the calculi from recurrence of calculi, if calculi are discovered at a later date...”

--- Dana Dolinsek, DVM, “Calcium oxalate urolithiasis in the canine: Surgical management and preventative strategies”

OUR COMMENT: ***Dr. Thomas NEVER took a post-operative radiograph.***

“Detection of crystalluria is not synonymous with the presence of uroliths. Crystalluria often is present in absence of uroliths. Conversely, uroliths can be present without concomitant crystalluria.”

--- Carl A. Osborne, DVM, PhD Dipl. ACVIM, DVM Newsmagazine --- from “Improving management of urolithiasis: diagnostic caveats”

OUR COMMENT: ***Dr. Thomas performed urinalyses in 3/05 and 9/05 that showed no crystals in Stempy’s urine. As stated above, uroliths CAN be present without concomitant crystalluria. Dr. Thomas FAILED to take a radiograph.***

“The primary objectives of radiographic evaluation of patients suspected of having uroliths is to determine their site(s), number, density and shape(s). Although properly performed ultrasonography is comparable to survey radiography in detection of uroliths, ultrasonography does not provide information about the relative radiodensity or shape of uroliths. Because the radiodensity, shape and size of uroliths often provides valuable clues as to their mineral composition, we prefer to use survey radiography as the initial imaging procedure when evaluating most patients for uroliths. Once urolithiasis has been confirmed, radiographic and/or ultrasonographic evaluation are important to detect predisposing or complicating abnormalities. Radiographic evaluation of changes in urolith size is also an important index of therapeutic response.”

--- Carl A. Osborne, DVM, PhD Dipl. ACVIM, DVM Newsmagazine --- from “Improving management of urolithiasis: diagnostic caveats”

OUR COMMENT: ***Dr. Thomas FAILED to take radiographs…on MULTIPLE occasions. SEE TIMELINE AND VIOLATIONS.***

“Most veterinarians will perform a cystotomy, however, many prefer to refer animals in need of a urethrotomy, urethrostomy, or nephrotomy to a surgical specialist.”

--- American College of Veterinary Surgeons (ACVS) --- from “UROLITHIASIS (URINARY STONES)”

OUR COMMENT: ***Dr. Thomas did NOT have authorization to perform any of the procedures stated above. She had a DUTY to refer us to a specialist. She FAILED in that duty as she did NOT refer, nor did she seek our authorization. This was an UNAUTHORIZED procedure!!***

…protect the public…it’s your duty!!

Greg and Cindy Munson

(Note to website visitors: In our opinion, it is obvious that the Board here in Texas could care less about protecting the public, much less our animals. Ignoring all evidence, the Board dismissed our complaint twice! In our opinion, it's now very clear who the Board here is interested in protecting.....the vet and NOT the pet! Shame on you, TSBVME!!)

If you love your pet, NEVER blindly trust your vet!