Redefine the Fairness to Pet Owners Act so that it is inclusive of misdiagnosed animals
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Creating an accurate diagnosis is the foundation of effective health care. INCLUDING THE VERBAGE MISDIAGNOSIS IN "THE FAIRNESS TO PET OWNERS ACT" IS NECESSARY TO SAFEGUARD PETS AND THEIR OWNERS. While prescribing medication is equally as important, it is secondary.
This Petition Discusses:
- The questionable culture of Veterinary Centers of America, over 600 facilities across the United States and Canada
- The "Fairness to Pet Owners Act" and laws pertaining to writing prescriptions
- The pet diabetes epidemic/ instituting a standard practice to protect animals and their owners
- Violation of FDA regulations (Off Label Use of human medications) in this case human insulin
- Misinforming the public about insulin administration and diabetic care : limitations of urine testing vs using a glucometer, how to prepare insulin for administration, creating an accurate diagnosis, recommendations vs standard practice
- The American Veterinarian Medical Association Principles
- Misdiagnosis leads to misdiagnosis and how it can lead to further decline: the solution becomes the problem and the pet owner and their animal suffers
- Confidentiality and poor record keeping, failing to provide clinical records for assessment, contradictions in clinical notes
Released by Banfield 2016 " Diabetes—In 2011, we reported a 32 percent increase in canine diabetes and a 16 percent increase in feline diabetes since 2006. Unfortunately, diabetes continues to grow in prevalence among dogs. Canine diabetes has increased by 79.7 percent since 2006, while, in felines, the prevalence of diabetes has increased 18.1 percent over the same time frame."
If you have the unfortunate experience of becoming involved with an unethical doctor you may be subjected to a lot of heartache and unnecessary doctors bills. Your animal can quickly lose their quality of life; lose their vision, strength, ability to walk long distances, and breathe normally to name a few things. You will face the uncertainty of their life being in danger every time you walk out the door.
Prescribing the MOST efficient tools to pet owners (ex. glucose meter) to help them determine (DIAGNOSIS) what amount of medication to administer (FDA approved INSULIN whenever possible, not human insulin that may not require a prescription) should be a part of the "Fairness to Pet Owners Act".
I paid for a urinalysis and while the results were pending the VCA doctor placed my animal on antibiotics. The results were negative. This is a misdiagnosis. A prescription was written, filled and administered in error. THIS WAS NOT AN ACUTE SITUATION.
"THE FAIRNESS TO PET OWNERS ACT" DOES NOT ADDRESS THIS SCENARIO.
This clinician jumped to conclusions without creating an accurate clinical picture THEN PLACED HIM ON HUMAN INUSLIN (which is against the FDA regulations) which contributed to my animal going BLIND, rapidly losing weight, losing his ability to WALK PROPERLY, and have shortness of breath(his nervous system was affected)ETC.. This behavior was then translated into her instructions for his home care. HE LOST HIS SELF CONFIDENCE AND CONFIDENCE IN ME etc. . ITS NOT OKAY! Jake was a healthy animal for the majority of his life. As he got older he developed some love handles and was slowing down. The vet even recognized that he wasn't a "typical" large breed 11 year old dog. He was very healthy and fit for the most part. She expected him " to live another 5 years with a great quality of life.".
SHE RUINED HIS LIFE AS FAR AS IM CONCERNED.
I did eventually learn how to regulate him WITH A METER and on paper he was an extremely well regulated dog who was in therapeutic range and his overall blood work was basically normal. Why then was he crippled? He was now forced to use a medication that regulated his body but was like poison to him.
I was instructed to use urine testing without being fully informed of its limitations and I was not provided with a glucometer from the onset of treatment. No animal or human being should begin insulin shots without utilizing a blood glucose meter. Urine testing does not safeguard an animal in a crisis situation nor does it allow for accurate record keeping.
She also quickly removed blood pressure medication that she prescribed claiming that I said he was allergic to it which is false and failed to dispense medication that was stated in her case notes. She didn't even bother to try and correct the conditions that could cause insulin resistance which may prevent the animal from utilizing their own natural insulin efficiently before throwing a bunch of medication at him. She ruined my beautiful animals sense of wellbeing. After having a significant allergic reaction/adverse effects to the medication (blood pressure medication, insulin and antibiotics were given together)the clinician didn't even mention the increased likelihood of him becoming thyroid sick which would impact his ability to manage his glucose regulation and effect his constitution.
THIS IS NEGLIGENCE WHICH HAD GRAVE CONSEQUENCES. THIS IS ANIMAL CRUELTY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Please consider including the following:
1. Unless it is a life threatening emergency (an event that merits immediate resolution) it is a federal offense to prescribe pet owners medication prior to diagnostic results being verified and evaluated in the context of a complete clinical picture once a pet owner has agreed to said testing and the animal has completed such tests as an exam, blood draw, x-rays etc. (results are in pending status).
2. Please enforce the FDA Regulations in relation to off label use of human medications in animals( especially human insulin which may not require a prescription). It is a federal offense to fail to inform an animals owner of alternative medications and leave an animal on medication that is harming him/her when there are FDA approved alternatives that require a prescription which have not been implemented and or other options available to remedy the decline and prevent further deficits from occurring which my cause medical expenses.
3. Ideally, please go on to support a "Best Practice" standard to establish and treat a diagnosis of Diabetes Mellitus in animals which is presently loosely managed.
For example: Diabetic animals require a glucometer to have their blood tested regularly so that their medication can be administered effectively. Using glucometers is not standard practice apparently(Merk to supplier of Vetsulin states, " A handheld glucometer is one way to measure glucose levels. Handheld glucometers are not crucial, but are easy to use and may be worth the investment. Ask your veterinarian which model best suits you and your dog's needs.". I was instructed to use urine testing and its LIMITATIONS WERE NOT explained to me. Urine testing does not safe guard emergency situations and some possible conditions. Humans use blood testing in conjunction with urine testing right from the start of treatment why wouldn't animals?
For example: It is important to conduct tests prior to medication administration in order to obtain an accurate clinical picture. A Fructosamine test allows for a snap shot of the animals glucose regulation over a few weeks and can hopefully accurately supply a good idea of what has been taking place. It does have some limitations however which should be taken into consideration. Human beings typically utilize a similar test called an A1C test or an even more sensitive test called an oral glucose test perhaps animals could utilize them as well.
For example: Insulin resistant causing conditions should be reduced or eliminated whenever possible especially because there have been issues with insulin being produced and taken by animals in recent years. Some conditions are obesity, hypothyroidism, and pancreatitis (my dog showed signs of all three of these but he was not afforded the chance to resolve them before he was placed on insulin). In addition, there is a discrepancy related to a tic disease that went unresolved for an extended period of time although I questioned his test results over and over.
I was also not given a choice of insulin at all (human or animal): INFORMED CONSENT WAS NOT ESTABLISHED. Animal insulin is most like an animals composition which reduces the risk of complications and this is why FDA APPROVED animal insulin exists. My dog was placed on human insulin and had a complete break down which his VCA doctor did not even attempt to correct. I was told I could "SLING HIM AROUND" when he couldn't walk. Had she followed the AAHA guide lines and ATTEMPTED to correct the insulin resistant conditions that were present: obesity, pancreatitis and low thyroid reading along with a tic disease perhaps he would've avoided insulin and maintained his quality of life!!!!!!!!!!!!!!!!!
DON'T LET THIS HAPPEN TO YOUR ANIMAL WHILE YOUR SEEKING HELP FOR YOUR VERY HEALTHY SENIOR DOG WHO IS HAVING AN ALLERGIC REACTION/SIDE EFFECTS TO A MEDICATION THAT IS NOT FDA APPROVED FOR DOGS. I didn't let them talk me into this surgery. They cut his nails while he was there after I told them not to. Why would they cut a dogs nails who needs to be sedated when he was there for a possible condition that could kill him in its worst state? He was referred for possible laryngeal paralysis because he struggled on one walk and the clinician who saw him said he didn't have the typical signs but didn't rule it out. He was referred by a doctor who aggressively treated him for a tic disease that he doesn't have a titer for. It turns out his son was a staff member at VCA. This doctor did not return my calls after my dogs decline and his office staff were rude to me. He was never formally diagnosed with Laryngeal Paralysis and he didn't ever have surgery. His elevated sugar level was discovered inadvertently because he wasn't symptomatic. The VCA doctor insisted he was diabetic and scared me into treating him.
In addition, if the American Veterinary Medical Associations ethics called "The Principles" were being utilized my animals quality of life may have been maintained instead of seriously impaired. My dogs primary physician should have been able to educate me and evaluate my animal( RECOMMEND A GERIATRIC BLOOD PANEL); I did not need to see a specialist. Had proper intervention been established early on his quality of life may have been protected. He was very high functioning until he was given insulin. Once he entered into a crisis we were not treated with respect. In fact I had to ask the Ct. Dept. of Health to assist me in obtaining my animals records.
PLEASE INCLUDE ENFORCING THE AVMA ETHICS IN THE FAIRNESS TO PET OWNERS ACT
In my animals circumstances because he immediately declined and presented with an allergic reaction/side effects having a glucometer on hand would have been ideal in addition to being on the insulin that is designed for his species (not humans) may have prevented the reaction. Supplementing him with thyroid medication which was prescribed by another doctor significantly helped him. He was able to walk again for short distances.
He had swelling around his eyes, had a drunken gait, had extreme hind end weakness, didn't like receiving the shot, rapidly lost weight, went blind, couldn't walk on his own and suffered further complications. Without further diagnosis and additional medication being prescribed my animal could have died. VCA left him a crisis without acknowledging what they had done. My primary veterinarian wouldn't take us back and claimed that he was now a "complicated case". VCA redirected me back to them. This was taking place while my animal was in a crisis and they wouldn't give me his records.
The initial prescribing specialist said I could, " sling him around " and failed to give me a prescription she had noted in her case notes. The prescribers name at the pharmacy was a doctor I had never even met. I was given 10 pages of other animals records and they wouldn't release his diagnostic records to me. The Connecticut Dept. of Health did not verify that I received them in a timely manner which I did not; years passed and I still didn't get them in form that could be reviewed for clinical assessment.
It is also important for medication to be distributed responsibly when diagnosis has not yet been determined. Treating the symptoms incorrectly may in fact exasperate the underlying cause. Before sending me to a specialist, my animals primary physician prescribed prednisone which should not be given to a diabetic dog. He also treated him aggressively with antibiotics for a tic disease that he does not have a titer for. I later was forced to see another specialist when my new primary physician would not give my animal Vetsulin. This doctor once again withheld a test which is exclusive to his organization which may have helped to resolve the tic disease discrepancy. Instead he told me to go back and ask the previous physician what the error was. One of the physicians happens to be under investigation for animal cruelty as of May 2019. My dog was so uncomfortable he was urinating and defecating in his office( he has never done this before). These doctors stressed us out!!!!!!!!!!!!!!! and drained my pocket book.
PLEASE REVISE THE FAIRNESS TO PET OWNERS ACT
Fairness to Pet Owners Act (H.R. 3174/S. 1200)
"Introduced in House (07/23/2015) Fairness to Pet Owners Act of 2015 Directs the Federal Trade Commission to require prescribers of animal drugs to verify prescriptions and provide copies of prescriptions to pet owners, pet owner designees, and pharmacies, without the prescriber demanding payment or establishing other conditions. Applies these requirements to medication for a domesticated household animal that consumers are not allowed to purchase without a prescription.
Treats a violation of this Act as an unfair or deceptive act or practice under the Federal Trade Commission Act."
ITS NOT SIMPLY THAT YOU HAVE A CHOICE OF WHERE TO GET THE MEDICATION …… In all "FAIRNESS" ……. ITS THAT THE CORRECT MEDICATION HAS BEEN PRESCRIBED AT THE CORRECT TIME AFTER THE CORRECT TESTS HAVE BEEN COMPLETED AND AN ACCURATE CLINICAL PICTURE HAS PRESENTED ITSELF. MOST IMPORTANTLY THE PET OWNER HAS THE BEST TOOLS TO ASSESS THEIR ANIMAL FROM THE VERY FIRST INJECTION.
"Dogs and cats in the early stages of nonclinical DM appear healthy, have a stable weight, and are usually identified as a result of routine laboratory evaluation. They do not have clinical signs of DM. Stress hyperglycemia needs to be ruled out, as well as correction of any insulin-resistant disorders and discontinuation of drugs associated with impaired insulin release or sensitivity. Reassessing BG or monitoring urine glucose (UG) levels once the patient is no longer stressed at home or measuring serum fructosamine concentrations may help differentiate between stress hyperglycemia and DM, and determine if further action should be taken.
The initial evaluation of the diabetic dog and cat should:
• Assess the overall health of the pet (history including diet and concurrent medications, and a complete physical exam).
• Identify any complications that may be associated with the disease (e.g., cataracts in dogs, peripheral neuropathy in cats).
• Identify any concurrent problems often associated with the disease (e.g., urinary tract infections, pancreatitis).
• Identify any conditions that may interfere with the patient’s response to treatment (e.g., hyperthyroidism, renal disease, hyperadrenocorticism).
• Evaluate for risk factors such as obesity, pancreatitis, insulin-resistant disease, diabetogenic medications, and diestrus in female dogs."
(urine testing does not protect against this because of its limitations and it appears to me that it would be one of the biggest conditions to guard against when starting insulin treatment how vets could not stress the importance of home blood glucose testing is really ridiculous)
Occasionally, what appears to be an ineffective insulin dose is really due to receiving too large a dose of insulin. This is called rebound hyperglycemia (somogyi Overswing effect) . When it occurs, the dog’s blood sugar level drops drastically and rapidly after receiving too large a dose of insulin. But the dog’s body quickly releases its own cortisone and adrenalin that cause its blood sugar to soon rise to abnormally high levels again. Careful examination of your pet’s blood glucose curve will detect this phenomenon. The treatment is smaller and possibly more frequent insulin doses.
LIMITATIONS OF URINE TESTING
"If monitoring your diabetes control by testing your urine glucose, it’s important to understand the limitations of this method.
* A urine glucose test does not reflect your blood glucose level at the time of testing; instead, it gives an indication of your blood glucose level over the past several hours. For example, some of the urine present in your bladder may be 2 hours old, and may show glucose even though your blood glucose may have normalised since then. Compare this to a blood glucose test which gives you a reading of your current blood glucose level.
* A urine glucose test does not give you any information about low blood glucose levels, as glucose is only found in the urine when the blood glucose level is above 10 mmol/L. That is, a negative urine glucose test may be the result of a normal blood glucose level or a dangerously low blood glucose level, with the urine glucose test unable to differentiate between the 2 situations.
* The results of a urine glucose test are influenced by the volume and concentration of urine that you pass, which will vary with the amount of fluid you consume and your fluid loss due to such things as heavy sweating or vomiting.
* Urine glucose tests designed for home use rely on interpreting a colour change to define the result. Subtle colour differences may be difficult to interpret.
* If a urine glucose test is not read at the specified time after applying the urine to the test strip, then the result is prone to error.
* Some medications may interfere with the results of urine glucose testing.
Advantages of urine glucose monitoring
* Urine glucose testing is easy to do: just dip the test strip in the urine and read the result at the allocated time.
* It is less painful than blood glucose monitoring — no finger pricks to collect blood!
* Urine test strips are less costly than buying a blood glucose monitor and its test strips."
If you don't have the good fortune of having a veterinarian that assess your animal properly by ruling out diagnosis, listening carefully and establishing the proper criteria for a condition your animal could be placed in GREAT DANGER in a short period of time IF YOU ARE NOT AN EDUCATED PET OWNER. Pancreatitis can disrupt blood sugar levels temporarily along with other conditions.
There is the potential for a "complicated case" to evolve which may include the other elements of the endocrine system as they are all interelated (the major endocrine glands include: the adrenals, pancreas, pineal, pituitary, reproductive and thyroid glands). They may go blind!
All veterinarians are expected to adhere to a progressive code of ethical conduct known as the"Principles" . This is a great concept if it is utilized and enforced.
* Did you know that animals are considered property(similar to a car)and historically there have been few legal ramifications for malpractice. How does this translate into how owners and animals are treated?
**** ALWAYS BE SURE TO (obtain a copy)OF THE REFERRAL FORM FROM THE PRIMARY DOCTOR TO THE SPECIALTY PHYSICIAN TO MAKE SURE THAT IT IS ACCURATE before they start examining your animal!!!!!!!!!!!!!!!!!!!!!!!! THE BENEFIT MUST OUTWEIGH THE RISK!!
In addition to the treatment we endured, I now find it concerning that my personal experience included an entity that predominantly influences the market and claims to be setting a standard of care(they have over 700 small animal veterinary hospitals across the United States and Canada, a nationwide clinical laboratory and diagnostic imaging company). According to one source, VCA has "1 of the 10 most over paid CEO's". In fact the CEO is also the chairman and the president of Veterinary Centers of America Antech Inc. . I was unable to obtain my records from VCA and had to request the Dept. of Health to assist me. I was given 10 pages of others animals records along with some of my dogs records and a link to my dogs diagnostics records that expired after a time period instead of a hard copy. There was a physicians name on the prescribing log that I had never even met and the radiologists opinion was not on my dogs discharge sheet. There was a recommended emergency prescription in my dogs case notes but it was never dispensed to me nor was it called in to the pharmacy. I called three times during the week to make sure my dogs records were there when I arrived and they weren't.
IT WAS VERY DISHEARTENING TO DISCOVER THAT VCA MAY BE UNDERMING THEIR OWN STOCK HOLDERS, VETERINARIANS, AND THE PUBLIC THAT THEY SERVE.
I SHOULD HAVE RESEARCHED VCA BEFORE I TOOK MY ANIMAL THERE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
"The Nation’s 10 Most Overpaid CEOs" CLICK ON LINK ABOVE
"VCA Inc.: Gentle giant or takeover threat? " CLICK ON LINK ABOVE
"When VCA Antech, Inc. bought MediMedia Animal Health and its Vetstreet.com business in July for $146 million, Vetstreet's data from nearly 5,000 practices moved under the same corporate umbrella as the nation's largest chain of stand-alone veterinary hospitals." CLICK ON LINK ABOVE
"One of the largest providers of veterinary diagnostic laboratory services in the United States is winning suits against clinics and clinic owners who sought to cancel extended service contracts with the company before their terms were up." CLICK ON LINK ABOVE
"VCA: Why This Pet-Care Provider Is Seeing New Highs In Market "
CLICK ON LINK ABOVE
IT IS CONCERNING WHEN A COMPANIES EMPLOYEES FILE AN ONGOING LAW SUITE AGAINST THEM BECAUSE THEY FEEL VIOLATED. I wonder how this effects their work performance? CLICK ON LINK ABOVE
The AVMA DOES NOT support this bill, they think it is an administrative burden.
CLICK ON LINK ABOVE
"Yes, Soaphie is on vetsulin/caninsulin. We attempted to switch her over to NPH and she basically "collapsed" and wouldn't move for ANYTHING - super lethargic and just - again - she wouldn't move. We quickly changed her back to Vetsulin/Caninsulin. Who knows how long that will last as there are huge difficulties getting it." posted 2008 * they have had success with stocking since then
(I joined the K9Diabetes Forum and discovered another persons dog did terrible with human insulin as well / Soaphie & Sydney's Mom/click on the link above)
Animal based insulin's have been used safely and effectively for over 70 years although some animals and people may have better results with other kinds. Vetsulin (porcine insulin zinc suspension) is the only FDA approved insulin for dogs. In Feb. 2019 another FDA approved insulin was introduced for diabetic dogs called ProZinc, it is not recommended for animals that have experienced adverse reactions to human insulin.
"The FDA says that because compounded drugs vary in quality and potency, it strongly encourages the use of FDA-approved veterinary insulin for newly diagnosed diabetic dogs or when transitioning patients from one product to another."
"ProZinc is contraindicated in dogs and cats that are sensitive to protamine zinc recombinant human insulin or any other ingredients in ProZinc, according to the FDA. The drug should not be given during episodes of hypoglycemia. The most common adverse effects in the canine clinical trial were lethargy, anorexia, hypoglycemia, vomiting, seizures, shaking, diarrhea and ataxia."
MY DOG COMPLETELY SHUT DOWN AND HIS VCA DOCTOR DID NOT HAVE A CONSCIENCE AND HELP HIM.
ABOUT LARYNGEAL PARALYSIS AND THYROID HORMONES
Allowing my animals thyroid hormones to tank placed him in great danger. Several conditions could have arisen that would be very costly to correct. Even when he couldn't walk on his own and she took a thyroid test that was low she didn't supplement him.
The physicians failed to assess my dogs thyroid level prior to insulin administration which complicated matters; perhaps this is why he wasn't supplemented and was allowed to cascade into a crisis. Had I not taken action when they told me I could "sling him around".he may have died or required emergency laryngeal paralysis surgery known as a tie back surgery (they sow the folds in the throat back so the animal can breathe).
He was very high functioning before he clearly had an allergic reaction/ADVERSE EFFECTS RELATED to the HUMAN INSULIN which may have impacted his thyroid functioning. He was treated with Benadryl which reduced the swelling around his eyes but did not remedy the other aspects of the decline.
In 2016, Connecticut was lauded for becoming the first state to pass legislation allowing for an animal advocate to be appointed in animal cruelty cases. see article above
** Please note that I am not a doctor and a licensed professional with a good work history should be consulted for their professional opinion. You may want to research scholarly articles before making any serious decisions as well as get a second opinion.
** This petition may change over time as more information becomes available. I did my best to utilize credible sources please verify what is being read for accuracy.
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