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-   -   Looking for Medical Expert (https://www.yorkietalk.com/forums/general-yorkshire-terrier-discussion/262360-looking-medical-expert.html)

messica 05-06-2013 07:49 PM
Looking for Medical Expert
 
Hello. I am new to this site. One of my two very beloved yorkies recently and very tragically passed away, right after an ameroid costrictor placement surgery to correct an extrahepatic portosystemic shunt. I won't go into too much detail, but the cause of death does not involve the normal complications associated with this type of surgery.
I am wondering whether anyone knows of a veterinary/medical expert able to read through the records (including the necropsy) to help sort out the actual cause of death because it still remains a mistery.
Thank you very much.
Jessica

Wylie's Mom 05-07-2013 04:59 AM
I'm so very sorry for your loss :(. I don't know who you might get in touch with, but I know many members here are very familiar with shunts and may know who to refer you to. Best of luck.

MomtoJasper 05-07-2013 05:11 AM
I am so sorry for the loss of your baby. My thoughts and prayers are with you. I have no experience with shunts. I'm sure those who do will be along shortly to help you. I hope you find the answer you need. Take care.

lynzy420 05-07-2013 05:11 AM
Quote:
Originally Posted by messica (Post 4206243)
Hello. I am new to this site. One of my two very beloved yorkies recently and very tragically passed away, right after an ameroid costrictor placement surgery to correct an extrahepatic portosystemic shunt. I won't go into too much detail, but the cause of death does not involve the normal complications associated with this type of surgery.
I am wondering whether anyone knows of a veterinary/medical expert able to read through the records (including the necropsy) to help sort out the actual cause of death because it still remains a mistery.
Thank you very much.
Jessica
Obviously you are not at peace and need answers. I assume you have your pups health record and all the notes from the vet. You have 2 options that I can see. Contact a specialist at a Vet School and make an appointment for a consult. I don't see why they wouldn't accomodate you. Or you can get retain an attorney who will be able to investigate your request.

I endured an absolutely crazy situation with a vet many years ago and retained an attorney. This vet was eventually censured but little else happened.

messica 05-07-2013 05:53 AM
Thank you!
 
Thanks for the kind words and suggestions. Toby (my little guy) was the most loving sweet charming little being, and he filled our lives with joy. I am not comfortable with what's happened, especially as it is not clear. I have medical records (most, though I have had to hound the hospital for them, still waiting for more) and the autopsy report. I'd like to have an unbiased opinion from an expert, and I am of course considering what next steps to take. I appreciate any recommendations. Thanks again!!

pstinard 05-07-2013 07:15 AM
Quote:
Originally Posted by messica (Post 4206439)
Thanks for the kind words and suggestions. Toby (my little guy) was the most loving sweet charming little being, and he filled our lives with joy. I am not comfortable with what's happened, especially as it is not clear. I have medical records (most, though I have had to hound the hospital for them, still waiting for more) and the autopsy report. I'd like to have an unbiased opinion from an expert, and I am of course considering what next steps to take. I appreciate any recommendations. Thanks again!!
If you're in New York City, New York University in Manhattan has an Office of Veterinary Resources, and they might be able to put you in contact with someone who could independently look over your records to figure out what went wrong. See the link below:

Office of Veterinary Resources

juliegibeault 05-07-2013 07:28 AM
So sorry for your loss. You are Toby's voice and I am glad that you are trying to figure things out. Its what I would do as well.

I have no idea who you would contact, but I hope others can give you advice.

yorkietalkjilly 05-07-2013 07:31 AM
Can you redact them for privacy and post the records on Facebook and ask for unbiased veterinary opinions from all who have great experience in this? There are so many very knowledgeable people in this area on YT that may not see this thread and respond or not and I imagine the same types are on Facebook as well. Also, you can look up each and every term in the veterinary medical dictionaries online and read the reports so repeatedly, look up meanings online and look up illustrations online, and repeat it so much you can finally figure a great deal of it out.

Yorkiemom1 05-07-2013 07:31 AM
Dr Tobias from the University of Tenn. is the benchmark person for liver shunt surgery, with years and years of research and training other surgeons how to do the procedure .....she is so very helpful with babies and this condition and how it is treated....you could contact them and tell them your issue and possibly they would look over records and offer some assistance. It is very difficult, as you know, to get doctors to speak against another docs practice.....I am not sure how vets feel about doing this....it may be best to retain an attorney, and let THEM contact Dr.Tobias, like an expert witness status.......

pstinard 05-07-2013 07:43 AM
Quote:
Originally Posted by Yorkiemom1 (Post 4206540)
Dr Tobias from the University of Tenn. is the benchmark person for liver shunt surgery, with years and years of research and training other surgeons how to do the procedure .....she is so very helpful with babies and this condition and how it is treated....you could contact them and tell them your issue and possibly they would look over records and offer some assistance. It is very difficult, as you know, to get doctors to speak against another docs practice.....I am not sure how vets feel about doing this....it may be best to retain an attorney, and let THEM contact Dr.Tobias, like an expert witness status.......
Contact info for Dr. Tobias at the University of Tennessee:

PLEASE NOTE: Dr. Tobias only replies to emails from veterinarians

The University of Tennessee College of Veterinary Medicine - Liver Shunt Research

Faculty

messica 05-07-2013 07:45 AM
Thank you ALL! It is heartwarming to get your responses. I did contact U. of Tenn. before deciding to have the surgery in NY with a prominent expert here. They all know each other, but I will try. I will also try NYU. Toby 'developed' a pneumothorax in surgery for unknown reasons, and the most viable hypothesis I got so far is that his lung(s) were 'nicked' in surgery. How I regret....
Thanks again to you all.

pstinard 05-07-2013 07:45 AM
More info on liver shunts from the University of Tennessee:

http://www.vet.utk.edu/clinical/sacs...NAL-201304.pdf

yorkietalkjilly 05-07-2013 08:17 AM
The only time I ever saw a human patient with a pneumo in a practice was when a doctor accidentally stuck the upper lobe of the lung doing a cervical trigger-point injection lower down in the upper back. It was pretty bad to see. I know it can happen spontaneously but when it happens during liver-shunt surgery, it is likely from a nick. I hope you get some expert help.

Did the surgeon tell you what caused the death and/or the pneumo himself? Did he/she own it?

pstinard 05-07-2013 08:29 AM
Quote:
Originally Posted by yorkietalkjilly (Post 4206593)
The only time I ever saw a human patient with a pneumo in a practice was when a doctor accidentally stuck the upper lobe of the lung doing a cervical trigger-point injection lower down in the upper back. It was pretty bad to see. I know it can happen spontaneously but when it happens during liver-shunt surgery, it is likely from a nick. I hope you get some expert help.

Did the surgeon tell you what caused the death and/or the pneumo himself? Did he/she own it?
It can also happen from excessive air pressure during mechanical ventilation (maybe this was done during surgery to keep the puppy breathing?):

"Medical procedures, such as the insertion of a central venous catheter into one of the chest veins or the taking of biopsy samples from lung tissue, may lead to pneumothorax. The administration of positive pressure ventilation, either mechanical ventilation or non-invasive ventilation, can result in barotrauma (pressure-related injury) leading to a pneumothorax." (from Wikipedia article on pneumothorax)

yorkietalkjilly 05-07-2013 08:40 AM
Quote:
Originally Posted by pstinard (Post 4206604)
It can also happen from excessive air pressure during mechanical ventilation (maybe this was done during surgery to keep the puppy breathing?):

"Medical procedures, such as the insertion of a central venous catheter into one of the chest veins or the taking of biopsy samples from lung tissue, may lead to pneumothorax. The administration of positive pressure ventilation, either mechanical ventilation or non-invasive ventilation, can result in barotrauma (pressure-related injury) leading to a pneumothorax." (from Wikipedia article on pneumothorax)
Yep, a nick is a hole - whatever made it - air pressure, end of a rib, tube, fingertip, scapel, needle, etc. We just call them nicks.


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