Why Did My Dog Die In I.C.U. After Cataract Surgery

My 8 year old dog was having Cataract Surgery.  My dog went in on The Friday morning for his yearly vaccinations as he was there the doctor informed me that it was time to do the cataract surgery on my dogs 1 eye. I left my dog to have a check up and his yearly vaccination. My dog was taken into hospital Happy,Healthy and Lively. He was there on Friday until the Monday afternoon when surgery was scheduled. I agreed to this surgery as long as it did not cause him any death. On the Saturday and Sunday I received calls that my dog was eating okay and playful and that the blood tests came back from the lab and all was Normal and I was told this on both days. The Monday I was told that they would perform the surgery later in the afternoon. I was called after surgery and told that the procedure went well and that my dog has awaken from the anesthetic and was recovering in I.C.U.  An hour later I received a call that my dog stopped breathing. They have no answers for me.

Her blood work before the surgery was normal.  They told us they generally only do EKG's on older dogs so we decided not to.  We didn't want her to be too scared by having extra tests done.

The vet called at 11 am and said he would be beginning surgery in 30 - 45 minutes.  At 12:15 he called to say my dog had died at the end of the surgery.  The only explanation is that her heart stopped and they were unable to resuscitate.  We can hardly get over this.  We were not prepared that she might die.  The vet said there was very little risk to the surgery.

Everyone we have told has never heard of such a young dog dying during a fairly routine operation that didn't even last an hour.

[Arnold L Goldman, D.V.M.]

Dear mikeinthailand,

Please accept my condolences on the unexpected loss of your dog. There is little I can say to ease your grief.

As far as why this may I have occurred, anything I might say would be speculative and indeed it seems you have had a complete autopsy and pathology analysis which I am in no position to contradict. Such reports are generated by specialists in pathology with advanced training in autopsy, biopsy and pathologic analysis.

That said, the autopsy results suggest that because the organs were congested with blood, a bleeding disorder existed which led to the dog's death. Coumadin, a human anticlotting drug, is used for potential stroke patients and those with certain heart diseases that may led to stroke. Coumadin contains warfarin, and anti-clotting agent also used in certain rodent poisons. One way for a dog to get that is to eat a rodent bait someone left around somewhere. Another way is to eat an owners medications. Assuming neither of those things happened, the pathologist may have simply been looking for a reasonabe explanation of the findings. Could the findings be wrong? I cannot say,as I do not know the qualifications of the pathologist involved.

It is sadly and unfortunately true that pets die from suboptimally administered anesthesia protocols around the globe. This unfotunate circumstance has lessened over the last 30 years with better, safer drugs and with advancing science and training of veterinarians, but it still occurs too often, even in the US. Indeed even one time is of course too many.

You may also be interested in two other posts I responded to, just this week, on the same subject:

http://www.medhelp.org/posts/Animal-Surgery/Heart-broken/show/1170950

http://www.medhelp.org/posts/Animal-Surgery/Never-Recoverd-after-surgery/show/1168918

Regarding the events you describe here:

"The vet called at 11 am and said he would be beginning surgery in 30 - 45 minutes.  At 12:15 he called to say my dog had died at the end of the surgery.  The only explanation is that her heart stopped and they were unable to resuscitate.  We can hardly get over this.  We were not prepared that she might die.  The vet said there was very little risk to the surgery."

......I can only say that it sounds like an anesthetic death. An ECG may or may not have picked up a reason to take a non-standard precaution or delay the procedure.
I just cant speculate and we can never know.

In closing please accept my condolences and those of all of us here at MedHelp and PDOC for this sad circumstance. I hope you will find comfort in knowing that at least he did not suffer.

Sincerely,

Arnold L. Goldman DVM, MS
MedHelp & PDOC

[mikeinthailand]

Dear Dr. Goldman Thank you for responding to my post but more importantly what I would like to know from you is dont you find it strange that the dog went into the hospital on the Friday and was in great spirits the dog was healthy, Happy Playful, was eating no signs of distress. The dog being in the Animal for four days without showing any symptoms of Coumadin or warfarin intoxication, No Nausea, No Vomiting, No loss of appetite, no drowsiness or weakness? I had a dog in Canada that got into some rat poison and was convulsing in second and foam at the mouth and vommiting we had rushed our dog in Canada to the vet where the vet administered Vitamin K and my dog lived. I just dont see where the dog here in Thailand could get into such a thing as I have another female dog that is still alive and she eats sleeps drinks and always played with my other dog who is now dead. In your real opinion with evidence handed to you what would your conclusion be if you knew that I did not have any of these derivitives on my premises and that my dog did not get it from here what would your final conclusion be.

Thank You Very Much For Your Insight.

Regards,
mikeinthailand

[Arnold L Goldman, D.V.M.]

Dear MIT,

Indeed I do find it inexplicable. And as I may have also said earlier, speculating is impossible as I do not have any first hand knowledge of what occurred. I can only say that a dog properly evaluated pre-anesthetically, ought not to have had any undetected intercurrent illness that might cause death at the time of anesthesia. Existence of such illness would generally exclude the dog from anesthesia at that time.

If instead the dog died under anesthesia from an anesthesia related circumstance such as a previously undetectable heart rhythm disturbance, low blood pressure event or other reasons related to anesthesia we cannot know unless we are told. Perhaps even your doctor is not sure.

The pathologist mentioned hemmorage but all of that was described within the tissues rather than externally. Such hemmorage with color change is also termed organ "congestion", a normal post-mortem change. During congestion blood may also leak from vessels into the substance of the tissues themselves and from their surfaces and cut surfaces. The pathologist can only describe what he/she sees, but not necessarily the events that led to his/her impressions. Congestion always occurs after death.

You can only ask the primary care veterinarian who was to do the surgery, what exactly caused the dogs death? Any hypotheticals I might suggest could be, just plain wrong.

Again, my condolences. For further thoughts, see my recent blog post on MedHelp on the subject of anesthetic deaths.

Sincerely,

Dr G