Dear Sher973,
Please accept my condolences on the unexpected death of your dog. There is nothing I can say that will make this right for you, nor can I truly know what occurred which led to this sad and unfortunate result.
As a veterinarian I am both upset for you and also embarrassed that this type of event occurs, and then without adequate explanation being given to the grieving pet owner afterwards. It is events such as these that make people fear general anesthesia: The seeming randomness of unexpected death leaves many pet owners fearful and as a result many pets suffer with correctable conditions that owners are just too fearful to allow. Its hard to blame them. There just isnt enough transparency in this area of practice and veterinarians are to blame, because we fear blame, whether sometimes justified or not.
It is important to distinguish between malpractice, when a doctor is truly careless or negligent and mal-result, when bad things happen despite a doctors appropriate efforts. Still, proper management of anesthesia requires that complete information about a pet's health be known prior to the planned anesthesia or surgery and that measures are taken to minimize risk. Not doing so is gambling and making the kind of phone call you received is a horrific event. It has happened to me on the opposite end.
What I know is that complete honesty and openness, while not bringing a pet back, preserves trust and creates understanding.
For any pet (or person for that matter) anesthetized today, advance blood tests and an electrocardiogram are important. During anesthesia electronic monitoring of blood pressure and the electrocardiogram and also maintenance of blood pressure (fluid therapy as needed), body temperature and appropriate depth of anesthesia are all important to avoid anesthetic complications. Providing these services is practical and desriable, but does add costs when trying to achieve maximal safety. A technician dedicated only to monitoring anesthesia while the doctor is focused on the procedure itself is required for early warning and quick reaction to impending issues while under anesthesia. Adequate equipment is also required. In this area, compromises don't work.
Complicating the provision of services at this level is the fact that while many pet owners (all) will say they want the best care, some do not want to pay for it and veterinary practice often reflects the majority of client types a given practice sees. The public that desires a true high level of care cannot tell the difference and doesnt know what to ask to establish what is done to ensure anesthetic safety. The low caring public also claims to be high caring and just doesnt ask about such details: price or convenience may rule. It thus is up to our profession to collectively provide anesthetic services at the highest level possible without compromise. Achieving this is an evolutionary process and great strides have been made over the last 20 years.
I cannot say exactly why your dog died, however, I can surmise that development of an abnormal heart rhythm, low blood pressure, low body temperature, anesthetic depth resulting in inadequate respiratory depth or frequency or other common reasons occurred. The veterinarian may not even be sure but he/she does owe you an explanation.
Not being perfect myself, and having personally had to make that phone call during my career, I can tell you it is the worst thing to have to do, except of course to be the one who receives the call. Our profession needs to be as transparent as possible in this area and advise people of the risks but also what measures are provided to minimize those risks. When disaster occurs, a full explanation, to the extent of what is known must be offered. We also must re-evaluate our procedures in light of such events and make adjustments and improvements wherever possible. When we do not do so, the public becomes fearful of what we have to offer, and fewer pets are helped.
Many people remain afraid of anesthesia. No anesthesia is without some risk, however as a professor of mine once said: "There is no such thing as unsafe anesthesia, just unsafe anesthetists." You have the right to know what is done to ensure safety. If something bad occurs you have the right to know why.
Again, please accept my condolences. You may also want to read a similar post I responded to a few days ago at:
http://www.medhelp.org/posts/Animal-Surgery/Never-Recoverd-after-surgery/show/1168918
Sincerely,
Arnold L. Goldman DVM, MS
MedHelp & PDOC