August 5, 2010
From Parkway Administration

Dear Mr. Lemieux,

We want to express our condolences for your loss of Bb, we know the bond you shared with your dog was strong and your loss is heartbreaking. We have taken time to review your visit to our practice on June 5, 2010 and shared the medical record with our Medical Director as well. Medically, we absolutely confident that Parkway Veterinary Hospital did the best for your dog under the circumstance and that a transfer to Dove Lewis Emergency Animal Hospital was warranted to confirm the concerns we had after running diagnostic tests. Dove Lewis was able to confirm a diagnosis that made euthanasia a humane choice for Bb. We don’t take this decision lightly as we acknowledge the grief losing our pets bring but your recent E-Mail account of what took place leading up to Bb’s passing is simply not accurate.

We’ve attached a copy of the medical notes so that you can review them as well. We’ve also summarized our findings and treatments below. We realize this information is a lot to take in under such emotional circumstances and hope this summary helps.

Bb presented (arrived) on her feet and panting.
Owner indicated dog has had these “episodes” before and referred to them as “shock”. He stated that IV fluids had fixed her in the past.

Upon examination, Dr. Melanie noted Bb was panting, weighed 41.6lbs, normal temperature, weak to walk and more comfortable lying down, was dehydrated and had pale and tacky gums. Heart rate was elevated (tachycardic) at 175 beats per minute and her respiratory rate was listed again as panting.

Dr. Melanie made the following R/O (rule outs), which are medical ideas based on symptoms and history that need to be confirmed with diagnostic tests. Anemia, Chronic Renal Failure, Internal Bleeding, Neoplasia of liver or spleen, Melena.

Dr. Melanie recommended Bloodwork and Urinalysis.
Bloodwork showed elevated ALT (a liver enzyme).
She then recommended radiographs of the abdomen.
Radiographs showed Microcardia (small heart),
Possible ascites (fluid in the abdomen),
hepatomegally (abnormal liver) and
possible radiopaque urolith (bladder stone) or calcified skin growth (dense spot noted).

These findings were shared with you in an exam room and Dr. Melanie showed you the suspicious areas on the radiographs as well. Dr. Melanie recommended an Ultrasound of the abdomen to confirm suspicions of liver disease and ascites. You granted us permission to start hydrating her with fluids and so we bolused her with 300mls of Normosol and sent her with you to Dove Lewis for Ultrasound and continued supportive care.

The abdominal ultrasound performed at Dove Lewis confirmed fluid in the abdomen, and also multiple small masses within the abdomen. An abdominocentesis (collecting fluid from the abdominal cavity) was performed and the fluid was determined to be non-clotting blood. Exploratory surgery was offered as an option to find and remove the source of the bleeding, but you declined that option and Bb was humanely euthanized.

Carl, we are deeply saddened for your loss. We would like to pass on information for The Pet Loss Support Group as many of our clients have shared with us how much this helps them accept their pet’s death and focus on joyous memories of the life they shared with their beloved pet. Our hearts go out to you.

You have stated your concerns to Dr. Melanie and I at length more than once on the phone and you have restated them via E-Mail. We are sorry that your recollection of what took place differs from what the records show but at this point we do not see any benefit to be gained by discussing the matter with you further. However, if you would like we would certainly be willing to send our medical records to the Oregon Veterinary Medical Examining Board for review. That is the State agency which governs veterinary medicine in this State and that review would be completed at no cost to you. Just send me an E-Mail letting us know that you would like us to do so.

Warm Regards,

Dr. Melanie Mielke
Wendy Thompson