dog dies after routine anesthesia

[catspaw]

Our dog has just died after what was supposed to be a very routine procedure and I'm trying to find some answers....not to cast blame, but to help me understand what might have happened.

One day I noticed that our 8-year-old lab appeared to be having problems urinating. She would try repeatedly, but had no success. This went on most of the day and it was clear she wasn't going to be able to urinate and she was getting really miserable. I called the vet after office hours (it was a Saturday) and she said if it wasn't better by the next day, to bring her in. The next morning, she was still in the same condition, but was even more miserable so I immediately took her to the vet's office. The vet, one of two in the practice, is fresh out of vet college, but appears knowledgable, caring and competent. When we arrived she agreed there was a problem with Josey's urination, and noted that she had a very full bladder. She tried several times to cateratize her to drain the urine, but could not get it properly inserted, even after giving Josey some injected sedation. The vet then called the older, very experience vet to help her with the process. He arrived and was also unable to get it inserted. Then they inserted a large needle directly into her bladder to aspirate the urine. It took two times to get it all, and it was bloody, indicating an infection. Then the older vet manually manipulated her bladder, trying to express any remaining urine. The sedation apparently was beginning to wear off by then (it had been about an hour) because Josey then acted like she was in a lot of  pain and wailed and snarled, which she never does. So the vets slipped a muzzle on her and gave her gas to put her under. They then continued manipulating her bladder (for a brief time) and did an ultrasound, which showed she had several large stones that had been blocking her urine flow. They then removed the gas, which had been on her for about 15-20 minutes. They prescribed a special food, antibiotic and pain medication and the older vet left while the younger one and I waited for Josey to rouse. It took a long time and we finally were able to get her up and into the car. Before leaving the vet, she gave Josey a shot of pain killer, because she said the dog probably would not want to take a pill orally later. I asked about what to watch for as she continued to come out of the anesthesia and was told she'd be tired, groggy etc. After getting her home (she was practically unconsious all the way home) I got her onto her bed in the living room so we could keep an eye on her. She was breathing very shallow, very fast and was never very alert at any time. I guess I didn't think much of it, assuming the vet would have told me if those things were indicators of a potential problem. She seldom raised her head and when she did she whimpered in pain, which I was told would be normal. About 7 hours later, my family was sitting near her, to keep an eye on her, and about 10 minutes after looking at her, finding her still breathing shallow and fast and laying in the same position she had all day, I looked again and she had stopped breathing. She also had vomited or drooled a small amount of brownish material, similiar to mud.

I called the vet immediately but she had no answers as to why an otherwise healthy dog would have died after what was supposed to be a fairly routine and simple procedure. So now I'm wondering if it might have been a combination of the injected sedative, gas and injected pain medication, or if I should have called the vet about her rapid, shallow breathing and continuing lethargy. I'd never brought a pet home so soon after they received anesthesia, so I'm afraid maybe there were signs I should have been alert to. Did I miss something? Should I have called about those issues? What might have caused us to lose Josey? Again, I'm not looking to cast blame on the vet. They did what they thought was best and I'm sure they weren't negligent. I just want answers, in part to help figure out what happened so if there's ever a next time, the same thing doesn't happen again.

Thanks for any help you can give me.  

[ginger899]

This seems not quite right to me. I don't wish to stir your feelings as what you need is peace, but I know you are also asking questions -WHY?
Whatever you do, or know, or don't know, cannot bring Josey back. It was her time to leave this Earth, though her love will still be with you in Spirit. Please do belive that as I have found it to be true.

However, I question the procedure, or rather -elements of the procedure. Not pointing a finger at either vet particularly...but some things do not seem correct.

For instance -there is a very strict protocol pre-surgery which vets usually adhere to. One is an overnight fast and no breakfast before anesthesia.
Now that is usually for a scheduled surgery. Usually if a dog is not in critical conditon, the surgery protocols are still adhered to, and palliative care/supportive care is started until the surgery time (usually early morning after admission.) That is to prevent possible aspiration of vomited food during the procedure.
The second protocol is bloodwork, and general health checks to see if a dog is fit enough for a surgical procedure. And the third is immediate post-surgical care/resuscitation.

I was a bit shocked to be honest, that no disciplines seemed to have been followed pre-anesthetic. I was also shocked, that your dear Josie was sent home still unconscious! (or semi-conscious.)
It is normal practice for a vet to stabilise the patient and make sure they have regained proper consciousness before letting them go home!

I am so sorry for your loss. My heart goes out to you.

[philiaravon]

I realize this is nearly 8 years old post, but I have to point out the vomit.  That is the biggest key to what happened.  We were told to not eat anything for 8 hours prior to going under and for a damn good reason.  I am no expert on why or how but I know that bile and leftover food can block the airway very easily.  Thats why they stress on do not feed the pet breakfast!

[catspaw]

The thought of a rupture crossed my mind, as did the possibility of too much of the injected sedative and/or gas/pain shot. They did an ultra sound after the manipulations and said everything looked ok, but not being a vet, I didn't know what I was looking at on the screen. And it's possible they didn't see a rupture as well. I just wish I'd known what, if any, signs to look for that might have indicated she was in trouble after I got her home.

Thanks for the input. It really helps, and I appreciate it.

[peekawho]

I wonder if her bladder ruptured as a result of the manipulation?  I know that blocked dogs can die from bladder ruptures (if the stone is preventing the passage of urine completely).  

I'm just wondering, if the urine was bloody, if there wasn't a rupture or if all the manipulation they did may have inadvertently caused a bladder rupture?

Or it could have been an overdose of the pain medication.  Or both.

Without a necropsy, it will be impossible to ever know.

My heart goes out to you.  This is a terrible thing to go through.  I'm so sorry.

[catspaw]

Thanks for the kind words, and for the information about the 7years. I didn't realize that dogs that young might not tolerate anesthesia. That definitely will give me something to ask about, if I've ever got thissituation again, and unfortunately, I probably will, since several of our pets are considerably older than Josey. And I think the vet opted to let her go home because it was a fairly simple procedure and she thought she'd be more comfortable at home and maybe more likely to do her business than if she was confined at the scarey vet's office.

Again, thanks for the info and the sympathy. I really needed a dose of both today.

[have 2 kids]

I'm sorry for your loss.    We have been told by our vet that after 7 years of age some dogs are unable to tolerate anesthesia.   There is a blood test our vet does before teethcleaning, etc  to make sure older dogs have the best chance at recovering.   However, since this was an emergency situation your vet probably figured they needed to proceed and the benefits outweighed the risks.   I am surprised they let her leave so soon but it's not unheard of.
One of our dogs is terrified of being confined.   Even though he was deathly ill they had has take him home because they didn't want him stressed out even more.  
Again,  I am sorry for your loss.    Sometimes there really aren't answers to our questions.