Making a complaint to a vet

[NewCoffee]

Little less than a month ago we had a vet out and it was a pretty bad experience. We just got the bill and I’d like to complain about the amount of sedatives he was given, and maybe about how it went as well (not sure if it would be better to just drop that part).

I’ve never written a complaint before and I’m kind of unsure about how to go about it. I’m Danish so some things will properly be a bit different here, but I’m still really curious to hear if any of you have experienced something similar and what you did.

I’m also really curious about if you know anything about sedatives being used in this way? I honestly haven’t seen many horses sedated and I’ve only been in charge of the whole thing a handful of times. It always seems to be an unpleasant experience, but I’m really curious about how normal this is and how “bad” sedating a horse should be.

We had the vet out to do some standard stuff (vaccinations and testing for worms) and to take a blood sample from my pony gelding. He is a really sweet pony and easy to handle, but he is cautious/scared of some people.

It’ll get too long if I go into details about what happened. But we started out with a pony who was cautious but curious and ended up with a pony who was panicking like I’ve never seen him panic before - and I’ve owned him for almost six years. I can’t blame the vet completely, but I believe that it was the vets incompetence when it comes to handling horses that made this situation spiral completely out of control. The vet didn’t exactly do anything wrong, it was just very clear that he didn’t know anything about handling horses.

The real issue, is that he needed to be sedated for the vet to be able to draw the blood and from my understanding he gave him way too much sedatives! When the vet left he said that he should be alright in 30 mins - an hour. Just after he left, he started having what looked like cramps all around his body. He also “forgot” which hindleg was which. It looked like he was trying to balance himself, but he couldn’t really figure out how to. He crossed them instead and moved them in the opposite direction than what he should have. One of his front legs also kept collapsing, so I had to kind of catch him and push it back up and support him when it seemed like he was falling over. He also had trouble peeing.

I don’t remember exactly how long it took, but I think it was about three hours before I could leave him. By that time he was still very sleepy, but seemed otherwise okay (and my mom and sister was there to keep an eye on him).

We just got the bill and they decided for some reason that everything should be put under my horse. So I had to check everything and figure out what belongs where. It says that I’m being charged for 1,5 ml Domidine. I wasn’t sure what that was, so I googled it and it’s a sedative: http://www.dechra-export.com/pd/10/en-gb/domidine-10-mg/ml/?Key=products - if you look at dosage it says that you should give 0,1-0,4 ml for each 100 kg (220.5 lbs) horse.

I’ve found a document from the Danish Health and Medicines Authority to back up those dosages as well.

My pony is 12/12.1 hh and I don’t think he even weighs 300 kg (661.4 lbs): http://hest2.webgallerier.dk/galleri/717/628/471/3580255-anden-saerlig-race-victor - taken just after he found something tasty between some Burdock Plants

Assuming his weight is 300 kg (which it’s not) he should only get a maximum of 1,2 ml. But for something minor like drawing blood, shouldn’t mild sedation be enough? I get that you want the horse properly sedated if you are going to float teeth or something like that, but for this he really only needed to be so sedated that he would stand reasonably still for a short while.

Unfortunately I have to leave to go on holliday in about 11 hours, so I will probably be without internet most of next week but I hope to be able to find some wifi spots somewhere. I really appreciate all answers as I’m kind of lost as to how bad this really is, how to write out the complaint and what to expect.

[Equibrit]

I’d be questioning my choice of vet.

[CrowneDragon]

Did he give the detomidine in the muscle? He must have, otherwise it wouldn’t make sense to give an IV injection to get the pony quiet enough to get blood from a vein. Anyway, the dosage for IM detomidine is higher than IV. That does still seem like a lot for a fairly small pony, but if the pony was over-the-top upset, perhaps the vet thought that was necessary. If the pony stayed on his feet I’d say you did OK. I’d pay the bill, not burn that bridge in case you are ever in a bind in the future, and find a new vet.

Good luck.

[ReSomething]

Oooooh boy. I agree with Crowne Dragon.

When we had the old guy sedated to do his teeth for the first time the vet didn’t even tell me what he gave him and he was just about that bad. The old guy was really agitated, dragging the vet and the tech around the stall, head up to the roof and I don’t know what the vet thought.
Bad as in legs splayed out, head down, REALLY out of it. I wasn’t happy but made use of his condition to de burr his head and mane and get the witches knots out, since they were easy to reach. I did not use that vet for further dental work or anything needing sedation but still purchase some supplies and have had him do shots.

I now use a different vet practice for dental and other work, I make sure to weigh by tape before he gets there, and we have had excellent results with no struggling during any part of the procedure, rapid recovery and ability to eat comfortably afterwards.

[2DogsFarm]

Before you crucify the vet have a conversation about the sedation.
You can ask about the dosage & express your concern over recovery time.

My TB had to be sedated for getting his teeth done (in stocks!) - he had a great circulatory system & generally needed an initial dose, then a booster when he started showing signs of coming out.
Generally Dormosedan initially then a Turbogesic cocktail to follow.

Recovery time thus took longer than if a single dose had been sufficient.
I’d stay with him, at the clinic, until he was safe to load on my trailer.
Vet stayed with me & the recovery usually took anywhere from 20-40min.
He looked like he was drunk, head low, wobbly & he’d take a bite of grass, then forget to chew.

As alarming as your pony looked, I’m assuming he was back to 100% when the sedation wore off.

[Wonders12]

It sounds like this vet may not be the best choice for your pony because of the way he works with horses. However, I don’t know that your vet necessarily did anything wrong.

As a BM, I can say sedation tend to be very traumatic and scary for a lot of horse owners. I’ve had boarders crying because their horse looked so “terrible” during a normal sedation.

Some horses come out of it quickly, some take longer. Some cross their legs, some drool, some have “bed eyes” all day. I’ve had to prop 2 against a stall wall because they try to use their head for balance. If the horse stays standing, and they are normal once they come out of it (which can be an extended period of time for some), I usually consider it a fine sedation.

Horses, like people, all handle sedation differently. Some ponies need what would knock out a WB. Some WBs will get tired on what is just in the needle. The dosages are guidelines, not rules. I’ve also seen more than one very capable vet say “oops, she probably didn’t need quite that much, next time we will use less.” There are other factors that go into play too. IM takes more than IV. If a horse is already “up” (as yours was) it can take quite a bit more to bring him down.

I would ask your vet exactly how much was given, and then tell that history to each vet you work with. I would also pay the bill, not make a stink, and find a different primary vet. But when you’re having an emergency in the middle of the night, you want to be on good terms with every vet in the area.

[NewCoffee]

Equibrit: He’s from a clinic with several horse-vets so you pretty much just get a random one out. Unfortunately they are the ones who are closest to us (“only” 60 km) and the only ones who are willing to drive out to where we live. We will definitely be requesting a different vet in the future and if that isn’t possible then I will find a way to get him trailered to a good vet. If I could, I would trailer him myself because I know of a vet who is really good, but I don’t have a license or a car yet.

CrowneDragon: Yes they did! I’m glad to hear that a higher dosage is needed when it is injected into muscle. Do you know how much they usually use when they inject into muscle?

I doubt that a sober complaint will burn any bridges, both from my previous experience with this clinic (they seem very professional and nice) and from other peoples experience with them. Plus, they have many different vets so I’d be weird if they all decided that they won’t treat our horses from a simple complaint.

ReSomething: He didn’t really tell me either. I mean, he told me that he was going to sedate him, but I didn’t really get to say anything and then it was just done. They have given him too much in the past as well, so I always make sure to tell the vet before he sedates. I don’t know if he just looks heavier than he is or if he is sensitive.

I did take the opportunity to apply some sunscreen around his nose, he wasn’t really a fan of that.

2DogsFarm: I honestly am mad at that vet and I don’t want to use him again. If it were just the sedatives, then that could be an error but he seemed very incompetent overall.

We’ve had him out a couple of times and I’ve never been a fan of him. I’d ask questions and he wouldn’t really answer and he indirectly said that my pony’s health isn’t as important as a riding horse’s is.

This is not to say that I want revenge or anything. I just feel like you should complain when an error like this is made. It might not make a difference, but if you don’t complain then how will they now to do it different? I don’t really feel like dealing with him again, but maybe I should try to get a hold of him to discuss it directly.

Luckily he seems 100% okay

[NewCoffee]

Wonders12: It was really scary to watch, I thought that he was going to fall over and break a leg.

I think it’s scary even when he is given the right amount, but then he’s usually only out for an hour and then he’s fine. He is a bit wobbly, but he doesn’t seem like he is going to fall over. He only crosses his hindlegs when he has been given too much.

But I’m happy to know that this isn’t that unusual. Do you know what the guidelines are when it’s injected into the muscles?

As far as I know they write pretty much the exact dosage on the bills, so that should be covered already. We have an old bill from them that we refer to for how much he needs and when we tell them that before then he’s fine. Everything was just so rushed this time, so I didn’t get to tell him before it was already done.

And I’m definitely paying the bill.

[AKB]

I would not burn any bridges by complaining. Request a different vet next time, or use a different vet practice.

Why did the vet use sedation at all? Most horses have been trained to hold still when the get injections or blood draws. If the pony is always bad about injections, you should train him or have a trainer work with him, so he behaves for the vet. It isn’t fair to ask a vet to put himself at risk because you have not trained the pony.

What did you want the vet to do? It sounds like there was no way to get the pony to cooperate except by giving a huge dose of sedatives in the muscle. After a big IM dose, it is not surprising he was dopey for a while.

[Eventer13]

The signs you described sound typical for sedation: ataxia, dropping the penis, sometimes knuckling over. I would not be particularly concerned about that personally, but I’ve seen enough “drunk” horses that it doesn’t really phase me. To be fair, they rarely fall over even if they are staggering. The risk of them breaking a leg is pretty slim even after serious sedation. Actually, detomidine usually causes them to plant the feet.

Detomidine has a ceiling effect. This means that beyond a certain point, adding more drug will only prolong sedation rather than increase the effect, which probably explains why it took him so long to wake up. So its actually a relatively safe drug to use in horses even though it is considered strong, and usually doesn’t drop a horse. I agree that 1.5cc is a lot, especially for a pony. Did he have to re-dose? I would be more annoyed by the fact that I had to pay for that much detomidine than the fact that the pony was very drunk. Perhaps it was because he was giving it IM and was trying to get an effect ASAP?

If I were going to file a complaint, I think I’d be more upset with how the pony was handled. It sounds like the vet was rushed, so I might ask next time to have more time scheduled for the appointment. That doesn’t excuse him for rushing, but I think its a good thing to do to advocate for your horse. In the future, I may also ask for some sedative to give to the pony myself ahead of time (such as Dorm gel) to help prevent the escalation. Ideally, the vet would take the time to work with the pony, but if you have limited options in vets you may just have to take it into your own hands and have the pony out of it when the vet comes. Or see if you can request that he not come out any more.

And I do agree that working with the pony yourself to handle restraint from different people would also be a good idea. You can’t necessarily blame the vet for going for sedation if they felt like the pony was getting dangerous, especially if he doesn’t know the pony. His first priority is to keep everyone safe.

[NewCoffee]

AKB: He stands for most people. He stood fine when vet arrived, but vet then got him worked so much up that he wouldn’t be near him. He still stood fine, as long as vet kept his distance. This is not an issue of him being trained badly and I frankly don’t think it’s fair that you jump directly to that conclusion.

My complaint isn’t that he had to be sedated, but the dosage. After reading what people here have to say, then that might not even be a valid complaint at all. If it truly was an appropriate dosage then there won’t be any complaint at all.

And in no way was a heavy sedation necessary. The vet had left even before the sedatives really kicked in. I’d say he was about as sedated when he drew the blood as he was three hours later when I left him.

This might be a cultural thing, but I feel like some of you are assuming that complaining will be way more severe than I think it will be. It’s really not anything that would make anyone mad or burn any bridges. In fact it is considered the right thing to do when it comes to health stuff. The reasoning being that it could help people (or animals) that they are being made aware of anything going wrong.

It’s not like I’m going to storm into the building and demand that I won’t have to pay or anything. I’m simply planning on writing them an email about this issue, but I don’t know much about medicine or sedating horses so I felt like I should get some more information first so I know how bad this really was. Of course I will pay the bill. Anything I could imagine getting out of paying is part of the Domidine which is peanuts.

And if it really was really bad, I would like to get them to admit and apologize for the error as well.

After reading what people here have to say, I might not even complain at all. Maybe there aren’t even anything to complain about. I would still like to know what the normal dosage is when it is injected into muscle before I decide though. And I definitely won’t be using this vet again anyway, because this is just the tip of the iceberg.

[Simkie]

Wow, that’s a lot of dorm for a pony. NewCoffee, I used to have a big drafty mare who needed a cocktail to trim her feet. The vet always hooked me up with 1/2cc dorm and 1/2 cc ace, to be administered IM. Worked great for her. She was 1400 lbs. (Granted, she was quiet and not all ramped up when it was given, all horses respond differently, etc etc etc)

I’d much rather slap a twitch on a horse for something as brief as a blooddraw.

Good luck with your note. I don’t think you’re out of line at all with what you’ve stated in this recent post. I’d never have that particular vet out again!

[DaniW]

sounds like normal sedation to me . You might be careful of being too particular or you will go d yoursf short of a vet. If I were the vet, I’d fire you for complaining if in their judgment the pony needed sedation. It’s not their job to train your pony, it’s yours

[NewCoffee]

Eventer13: I didn’t know about the ceiling effect, but that is really nice to hear! I’m glad to know that it seemed more serious than it was. The more you know the less you worry.

I’m not so worried about the money, it really isn’t much compared to the total bill, but I’d still like to make a complaint if they gave him too much, or what would objectively be too much for a pony of his size. Do you know how much they usually give when they inject it into the muscles?

I honestly don’t know what this vets problem is, it almost seems like he dislikes horses or are scared of them or something. But he did suggest the gel for next time as he was leaving and I think it sounds like a great idea, at least the next couple of times.

I don’t blame him for wanting to sedate him at all. I have been making an effort to get him to meet more people, especially right after this thing started and as far as I remember the last time he got scared of a random person was 3+ years ago. He is great with all kinds of different people now, but he gets a bit cautious around some. Be nice to him and he will usually be fine after a short while and even when he’s cautious of you he is really well behaved. He just kind of stands there with wide eyes and wants to sniff you.

I think it’s the smell that vets and farriers have or something because they are always a bit scary. He is the same way for our farrier but he is great with horses and its never even an issue. Those few extra minutes he spends on greeting him and doing things gently are very valuable. Vets are a different story, sadly the ones we have had out haven’t been great with horses and he doesn’t get to have the same nice experience with them as he does with our farrier. I really miss our old one now, but he retired.

[AKB]

I think Eventer13 has some good suggestions. Giving the detomidine/Dormosedan gel before the vet arrives may sedate the pony enough to make him cooperate. It is a lot easier to sedate a pony who isn’t worried than to try to sedate an agitated pony.

Years ago, I worked with children who were sedated with an IM medication before having procedures done. The children were always agitated before the sedation because they had a fracture or a bad facial laceration. The IM meds never seemed to make any difference during the procedures. They would fight and scream unless you gave them huge doses. Then, afterwards they would fall into such a deep sleep that they seemed they would stop breathing. These days, the IM meds are not used in those situations because it is hard to give enough to get sedation, but not so much that there is not a risk of side effects or complications. At least you can hold down a child to get an IV line in. With horses, it isn’t so easy.

In our pediatric clinic, no one wanted to take care of the families who had complained for what we thought was no reason. I worried that sometimes, their kids did not get the best care because experienced staff knew them and avoided them. Therefore, I am always reluctant to complain unless I am sure it is justified.

Find a vet who you like and trust. Then, this won’t be an issue.

[vandenbrink]

Unless you have a lot of other vets to choose from…don’t complain. Most vets I have come across do not handle that well. My guess is that if you complained over something like that, they likely will be too busy to come out next time…unless they really need the business. Choosing the right amount and cocktail to sedate a horse to a perfect level of control is not easy. It’s even more difficult when they are amped up. The adrenaline counteracts the effect so most vets will give more…or a combo of things. It seems a bit on the high side for that drug for a “normal” sedation but still within reasonable ranges…as were the after effects.

If this particular vet is again at your farm to sedate a horse I would ask him/her to lower the dose a bit compared to last time, since your horse must be overly sensitive to that drug.

[2DogsFarm]

I’m glad to hear your pony recovered from the sedation.
Maybe next time ask if the sedation can be a 2-step process as I described?

Please don’t email your vet, it is such an impersonal approach & despite wording carefully, the tone of your email might not come across to the vet as if you were speaking directly.
IIWM, I’d call the clinic, ask to speak with that vet & if he was not available, ask if someone else can answer a question about sedation.

Sadly, not all vets - large or small animal - have developed a decent “bedside manner”.
They may be completely competent, but just don’t seem to care for the animals they are treating.
If you can’t trailer to the vet of your choice, you may have to make do with what you have.

[LauraKY]

Our ancient pony was a cheap drunk and never needed more than 1/2 a dose. Now that you know how he reacts, make sure you tell your vet.

I don’t know why you’re so upset about sedated horses though, sometimes it is absolutely necessary. You just have to be very careful around sedated horses.

[BeeHoney]

I feel like I still don’t understand exactly what the vet did wrong other than have a poor “bedside manner” and speak rudely to you. What exactly did the vet do to get your pony worked up? Was he rough with him? Did he strike him or shank him?

As far as the sedation, what others have said is true. None of what you describe with regard to the sedation or drug dose is evidence of poor or incompetent veterinary care. The dose was on the high side, but sedation doses are very individual and the sedation was also given IM. IME ponies can require relatively (sometimes unusually so) large amounts of sedation to achieve the same effect as a larger horse.

If I owned a pony that had to be sedated to draw blood from, I’d be more embarrassed about the pony’s behavior AND way more worried about the safety of my vet than worried that the vet wasn’t “nice enough” to it. Obviously I don’t know you or your pony, but it sounds to me like you have a very difficult, possibly spoiled pony. Whatever the source of your pony’s issues, I think you need to recognize that it isn’t fair for you to expect your vet (whoever it is) to risk their personal safety to take care of your pony. Veterinarians have a very dangerous job and have every right to sedate a difficult horse/pony to the point where it can be safely cared for.

I don’t mean to seem harsh. This vet may indeed have been incompetent, you just haven’t given us any facts that support that. It seems to me that the greater problems are your pony’s bad behavior and the risks to people and veterinarians handling him–and the lesser problems your pony’s personal dislike for this vet or your pony being sedated for a longer period than normal after his vet visit.

[rememberthenight]

Vets get hurt all the time and can be gun shy when large animals start to act up. A good vet of mine was out for nearly 6 months from a well placed kick that broke his back and leg. It was not a good day. He is noticeably more sensitive of a nervous horse now.

My Arabs, and donkey takes a SIGNIFICANT amount more than my draft cross and QH. nearly double- though I would have to got back through tons of invoiced, and almost always takes a second IV dose wen the first dose isn’t enough.