LolasMummy
Mama Doe
Sorry this is really really long! Any advice re the letter?
Covering Letter to vets re Desmonds Treatment
Dear .............
I am writing to you regarding the concerns I have regarding the care Desmond (our rabbit) has received whilst being under the care of your surgeries.
I have enclosed an outline of the current treatment he has received from your surgery and is receiving within a specialist centre at the moment.
In summary Desmond was misdiagnosed with solely a dental problem when in fact he has Encephalitozoon Cuniculi (EC). Desmond was also discharged to us on Saturday 5th December 2009 in renal failure, GI stasis and with severe dehydration.
As I am sure you are aware EC is one of the most common rabbit diseases and I believe should have been diagnosed by your vets given the symptoms he was presenting with.
I have concerns regarding the treatment Desmond received and would like to discuss these concerns with you.
I look forward to hearing from you shortly with a date and time that we can meet.
letter attached re his condition
Tuesday 1st December 2009
We had an appointment with ..........regarding Desmond limping on his front right foot. At this time he was mis-diagnosed with a severe sprained foot. We were advised to keep him calm and limit the hopping around and he was not to go up or down the stairs.
At this time there were no other symptoms apart from generally appearing under the weather and us reporting that we were not happy with his eating and passing faeces.
Thursday 3rd December 2009 –
We came home from work and found Desmond lying in his cage listless and unwell. We had an emergency appointment with .......... in the evening where we reported thick sludgy orange urine, not eaten or drunk since last night, no evidence of faeces since the night before, unable to bend to clean himself as unsteady, very listless and limping.
.......... took Desmond’s temperature which he stated registered at 40˚C we were advised this was within normal limits (I am now aware that normal rabbit temperature should be 38.3oC - 39.4oC).
......... gave Desmond a Baytril injection in case he had an infection and advised we attend the surgery for a review in the morning.
We questioned ..... regarding the lack of food and water and asked if we should syringe feed Desmond. ......... said that this may help.
.........mis-diagnosed Desmond with an upset stomach due to a reaction to the Metacam (he had been taking this since the appointment on Tuesday 1st December) and advised we stopped giving him this medication. No other medication was suggested.
We syringe fed Desmond every 1.5 hours with water and mushed up pellets.
Friday 4th December 2009 –
We had an appointment with ..........in the morning. Desmond was still presenting with thick sludgy orange urine, no evidence of eating or drinking since Wednesday evening, no evidence of faeces since Wednesday evening, unable to bend to clean himself as unsteady, very listless and still limping. All these symptoms were reported to .............
............ checked his paw again (we reported that we felt his paw had very slightly improved) and checked his stomach and reported that his bladder was empty. ............then examined his teeth and found a spur on his lower right tooth which had cut into his cheek and tongue and attributed all his symptoms to this. ..... stated that he needed a dental done under general anaesthetic to correct the spur on his tooth.
Desmond had a dental completed on Friday morning........... called me to say that Desmond had woken up from the anaesthetic and he was fine but they will review him in half an hour and give him syringed food if needed. I asked ........ if she had given him any pain relief or gut stimulant which she assured me she had.
At approximately 5pm, I called ... surgery for an update on Desmond’s condition. The person I spoke to knew nothing about Desmond (and even queried that they had a rabbit in the hospital) however after putting me on hold she came back and told me that Desmond was fine. I asked if he was eating and drinking to which she stated she didn’t know, I explained that it was very urgent if he wasn’t eating or drinking as this had been going on too long and we were concerned regarding GI stasis. At this point she stated that as far as she knew he was eating and drinking.
I requested that he was monitored for eating, drinking, urinating and passing faeces.
Desmond was kept in over night at ................
Saturday 5th December 2009:
We picked up Desmond at 9.30am where we were seen by a veterinary nurse, who assured us that Desmond was a ‘lovely friendly rabbit’ and had fully recovered following the general anaesthetic. We were assured Desmond had eaten, but the veterinary nurse was unable to determine if he'd passed faeces. We were advised to keep Desmond warm and calm for the next few days.
After requesting that Desmond was provided with adequate pain relief we were told that he had received no Metacam since the operation and we were told that we could therefore give him some if needed.
We arrived home with Desmond and let him into his cage at which point he lay down in obvious distress with very sunken eyes. We therefore medicated Desmond and returned half an hour later to review his symptoms. At this time Desmond had made no effort to move, eat, drink, urinate or pass any faeces and his eyes appeared very sunken.
We found an exotic specialist centre which classed Desmond as an emergency and agreed to take him without a vet referral. Whilst driving Desmond to the specialist he became severely lethargic and was responding less and less on the journey.
Saturday 5th December 2009 (in the specialist centre) -
On arrival at the specialist centre Desmond was assessed and deemed very urgent.
Desmond was diagnosed immediately with GI stasis and severe dehydration. It was deemed necessary to admit Desmond to the hospital for full supportive care and further tests.
Less than an hour later Desmond went into crisis and required significant treatment on an emergency basis to keep him alive.
Later that afternoon Desmond was diagnosed with probable Encephalitozoon Cuniculi (EC) after displaying listlessness, renal failure and Neurological problems (he was having trouble maintaining his gait).
Desmond was also diagnosed with severe dehydration and an unspecified infection.
Desmond was provided with was full supportive care, which included IV fluids, force feeding, pain relief, anti-inflammatories and treatment for EC.
Due to the severity and infectious nature of EC it was also deemed necessary to treat Lola.
Sunday 6th December 2009
The specialist contacted us to report that Desmond’s condition was still critical.
His gait had become ‘spectacular’ meaning that he was no longer able to maintain a standing position and therefore unable to eat or drink.
The specialist stated that Desmond required full supportive care (IV fluids, force feeding, pain relief, anti-inflammatories and treatment for EC).
It was deemed necessary to perform some tests to confirm the diagnosis (which was still thought to be EC on the basis of his significant symptoms). Some of these tests are deemed ‘highly risky’.
The specialist stated that Desmond was in severe renal failure.
Monday 7th December 2009
On Monday morning the specialist contacted us to state that Desmond had improved very slightly over night but was still classed as critical.
On Monday evening the specialist phoned to state that the bloods performed on Desmond showed that his urea had slightly lowered but his creatinine was still very high. The specialist stated that the renal failure is of greatest concern.
At the current time Desmond is unable to have any anti-inflammatories that are required to treat the inflammation due to the added pressure this medication would put on his already failing kidneys.
Overview
Since Desmond was admitted to the specialist centre he has been classed as critical.
Desmond has been diagnosed with EC based on his presenting symptoms.
At the current time Desmond is still requiring full supportive care (IV fluids, force feeding, pain relief, anti-inflammatories and treatment for EC)
If Desmond’s renal values do not improve considerably in the short term there is a very poor prognosis.
I want a meeting with our vets to see what they say and to state that we are not paying their bills and expect significant help with the current costs of his treatment in the specialist centre (current cost at about £500)
Covering Letter to vets re Desmonds Treatment
Dear .............
I am writing to you regarding the concerns I have regarding the care Desmond (our rabbit) has received whilst being under the care of your surgeries.
I have enclosed an outline of the current treatment he has received from your surgery and is receiving within a specialist centre at the moment.
In summary Desmond was misdiagnosed with solely a dental problem when in fact he has Encephalitozoon Cuniculi (EC). Desmond was also discharged to us on Saturday 5th December 2009 in renal failure, GI stasis and with severe dehydration.
As I am sure you are aware EC is one of the most common rabbit diseases and I believe should have been diagnosed by your vets given the symptoms he was presenting with.
I have concerns regarding the treatment Desmond received and would like to discuss these concerns with you.
I look forward to hearing from you shortly with a date and time that we can meet.
letter attached re his condition
Tuesday 1st December 2009
We had an appointment with ..........regarding Desmond limping on his front right foot. At this time he was mis-diagnosed with a severe sprained foot. We were advised to keep him calm and limit the hopping around and he was not to go up or down the stairs.
At this time there were no other symptoms apart from generally appearing under the weather and us reporting that we were not happy with his eating and passing faeces.
Thursday 3rd December 2009 –
We came home from work and found Desmond lying in his cage listless and unwell. We had an emergency appointment with .......... in the evening where we reported thick sludgy orange urine, not eaten or drunk since last night, no evidence of faeces since the night before, unable to bend to clean himself as unsteady, very listless and limping.
.......... took Desmond’s temperature which he stated registered at 40˚C we were advised this was within normal limits (I am now aware that normal rabbit temperature should be 38.3oC - 39.4oC).
......... gave Desmond a Baytril injection in case he had an infection and advised we attend the surgery for a review in the morning.
We questioned ..... regarding the lack of food and water and asked if we should syringe feed Desmond. ......... said that this may help.
.........mis-diagnosed Desmond with an upset stomach due to a reaction to the Metacam (he had been taking this since the appointment on Tuesday 1st December) and advised we stopped giving him this medication. No other medication was suggested.
We syringe fed Desmond every 1.5 hours with water and mushed up pellets.
Friday 4th December 2009 –
We had an appointment with ..........in the morning. Desmond was still presenting with thick sludgy orange urine, no evidence of eating or drinking since Wednesday evening, no evidence of faeces since Wednesday evening, unable to bend to clean himself as unsteady, very listless and still limping. All these symptoms were reported to .............
............ checked his paw again (we reported that we felt his paw had very slightly improved) and checked his stomach and reported that his bladder was empty. ............then examined his teeth and found a spur on his lower right tooth which had cut into his cheek and tongue and attributed all his symptoms to this. ..... stated that he needed a dental done under general anaesthetic to correct the spur on his tooth.
Desmond had a dental completed on Friday morning........... called me to say that Desmond had woken up from the anaesthetic and he was fine but they will review him in half an hour and give him syringed food if needed. I asked ........ if she had given him any pain relief or gut stimulant which she assured me she had.
At approximately 5pm, I called ... surgery for an update on Desmond’s condition. The person I spoke to knew nothing about Desmond (and even queried that they had a rabbit in the hospital) however after putting me on hold she came back and told me that Desmond was fine. I asked if he was eating and drinking to which she stated she didn’t know, I explained that it was very urgent if he wasn’t eating or drinking as this had been going on too long and we were concerned regarding GI stasis. At this point she stated that as far as she knew he was eating and drinking.
I requested that he was monitored for eating, drinking, urinating and passing faeces.
Desmond was kept in over night at ................
Saturday 5th December 2009:
We picked up Desmond at 9.30am where we were seen by a veterinary nurse, who assured us that Desmond was a ‘lovely friendly rabbit’ and had fully recovered following the general anaesthetic. We were assured Desmond had eaten, but the veterinary nurse was unable to determine if he'd passed faeces. We were advised to keep Desmond warm and calm for the next few days.
After requesting that Desmond was provided with adequate pain relief we were told that he had received no Metacam since the operation and we were told that we could therefore give him some if needed.
We arrived home with Desmond and let him into his cage at which point he lay down in obvious distress with very sunken eyes. We therefore medicated Desmond and returned half an hour later to review his symptoms. At this time Desmond had made no effort to move, eat, drink, urinate or pass any faeces and his eyes appeared very sunken.
We found an exotic specialist centre which classed Desmond as an emergency and agreed to take him without a vet referral. Whilst driving Desmond to the specialist he became severely lethargic and was responding less and less on the journey.
Saturday 5th December 2009 (in the specialist centre) -
On arrival at the specialist centre Desmond was assessed and deemed very urgent.
Desmond was diagnosed immediately with GI stasis and severe dehydration. It was deemed necessary to admit Desmond to the hospital for full supportive care and further tests.
Less than an hour later Desmond went into crisis and required significant treatment on an emergency basis to keep him alive.
Later that afternoon Desmond was diagnosed with probable Encephalitozoon Cuniculi (EC) after displaying listlessness, renal failure and Neurological problems (he was having trouble maintaining his gait).
Desmond was also diagnosed with severe dehydration and an unspecified infection.
Desmond was provided with was full supportive care, which included IV fluids, force feeding, pain relief, anti-inflammatories and treatment for EC.
Due to the severity and infectious nature of EC it was also deemed necessary to treat Lola.
Sunday 6th December 2009
The specialist contacted us to report that Desmond’s condition was still critical.
His gait had become ‘spectacular’ meaning that he was no longer able to maintain a standing position and therefore unable to eat or drink.
The specialist stated that Desmond required full supportive care (IV fluids, force feeding, pain relief, anti-inflammatories and treatment for EC).
It was deemed necessary to perform some tests to confirm the diagnosis (which was still thought to be EC on the basis of his significant symptoms). Some of these tests are deemed ‘highly risky’.
The specialist stated that Desmond was in severe renal failure.
Monday 7th December 2009
On Monday morning the specialist contacted us to state that Desmond had improved very slightly over night but was still classed as critical.
On Monday evening the specialist phoned to state that the bloods performed on Desmond showed that his urea had slightly lowered but his creatinine was still very high. The specialist stated that the renal failure is of greatest concern.
At the current time Desmond is unable to have any anti-inflammatories that are required to treat the inflammation due to the added pressure this medication would put on his already failing kidneys.
Overview
Since Desmond was admitted to the specialist centre he has been classed as critical.
Desmond has been diagnosed with EC based on his presenting symptoms.
At the current time Desmond is still requiring full supportive care (IV fluids, force feeding, pain relief, anti-inflammatories and treatment for EC)
If Desmond’s renal values do not improve considerably in the short term there is a very poor prognosis.
I want a meeting with our vets to see what they say and to state that we are not paying their bills and expect significant help with the current costs of his treatment in the specialist centre (current cost at about £500)
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