Monday, October 24, 2011

706. Practise defensive medicine? New puppy with blood in the stools


When a new puppy has blood in the stools or vomiting/diarrhoea, the following will be the procedures at Toa Payoh Vets to provide the highest standard of care and to defend the vet in the event of litigation or complaint when the puppy dies later.

1. HISTORY. Record all vaccinations done and dates and by whom. Do not forget to do so. Record your epidemiological study to determine whether parvovirus is a likely cause.

2. GENERAL EXAMINATION. Demeanour. Weight, rectal temperature, pulse and respiratory rate. Abdominal pain, gas in the GIT and other observations.

3. DETAILED EXAMINATION. Parvoviral test, blood test (haematology or complete blood test), stool test. It will be a case for veterinary negligence if the parvoviral test is not done.

4. TREATMENT. According to symptoms. IV, SC or oral fluid therapy depending on situation. Antispasmodic, antibiotics, multivitamins, protein drip, Vit K1 when necessary. Times and amounts given will be recorded.

The vet in charge of the case is responsible for details of time, amount and other information will be recorded in the hospitalisation sheet.

5. COMMUNICATIONS WITH THE OWNER IN WRITING. A veterinary report explaining the significance of the tests and case must be given to the owner on discharge/death of the puppy. It is best to keep the owner informed daily of the health of the puppy. Such phone calls must be recorded in the medical case files.

Record under AMD (Against Medical Advice) the owner's rejection of advices of the test in your medical record. Failure to do so implies that the vet has not advised at all in cases of litigation/complaint. As Singapore is becoming a litigious society, I advise that the highest standard of care to be given at all times. An example of a case done by me is down shown in the images.

Updates and more pictures are at: TOA PAYOH VETS WEBPAGE:

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