Hyperthermia After Dental

[MaryJane]

My boy Adam went to have a dental and gum flap done last week and while the surgery went well, there was an event after (ace and hydro anesthesia).

 

When I went to pick Adam up and the nurse brought him in - he was really stressed and panting up a storm. My first thought -- "this is not good". The vet tech/nurse was unaware that my boy was heading for a crisis. I told her to get a thermometer, cold & wet towels, and the doctor. During the next 2 hours my boy's temp spiked to 105 but we were able to cool him down and ease some of the stress with a sedative and the temperature finally went down to a bit over 100. I suppose that this also could have also been a reaction to the Ace -- however, I'm thinking that it was primarily stress. It was touch and go all night as I monitored him every 20 minutes or so just in case we had to head out to the ER. It took a bit more than 2 days for my Adam to get somewhat back to normal - during that time, I was not sure whether the high temperatures could have affected his brain.

 

I love this vet however, she left at 4 pm that day and my dog was left in the care of the vet tech/nurse for the 2 hours until I picked him up at 6pm. She didn't notice that my dog was having a problem - I'm finding it very hard to believe that my dog went into stress overload walking from the kennel to the office where I was. The vet called me the next day and checked to see how Adam was doing and I expressed my concerns about the nurse's "lack of awareness".

 

This same vet has done a dental on my seizure dog and treated her very well with no issues. I trust the vet completely - however and because of this situation ... not the vet tech.

 

Having said all this -- 2 questions -- Has anyone had a similar experience after a dental and if yes, did you go back to that vet after the incident ?

[palmettobug]

macoduck's had some experience with this, I believe.

[KF_in_Georgia]

https://greytarticles.wordpress.com/medical-first-aid/anesthesia-surgical/about-malignant-hyperthermia/

https://www.ngap.org/malignant-hyperthermia-y608.html

It may be inadvisable for Adam to have any anesthesia procedure in the future--with any vet. If there's an emergency and he requires anesthesia, make sure that vet knows what happened this time.

[MaryJane]

https://greytarticles.wordpress.com/medical-first-aid/anesthesia-surgical/about-malignant-hyperthermia/

 

https://www.ngap.org/malignant-hyperthermia-y608.html

 

It may be inadvisable for Adam to have any anesthesia procedure in the future--with any vet. If there's an emergency and he requires anesthesia, make sure that vet knows what happened this time.

 

 

Thank you for the links - I had read the first article but not the second.

[KF_in_Georgia]

Suggestion, print both articles--especially the second--as a PDF and email it to yourself (and maybe your vet). Keep it in your email storage and have it ready to email to any ER vet or anyone else who needs the info on short notice. Or print it, and keep a printout in the trunk of your car. I keep vet records in a folder in the trunk and digital x-rays on my phone. We haven't had this happen, but my boy has a screw in his hock, and I want his x-rays handy if we have a weekend emergency.

[juliemac]

I'm so glad your boy is doing better, and that you were able to see the signs so he could get treated 'quickly'. What a horrible experience. Unfortunately, my experiences have usually been with the *vets* and their lack of awareness; in the most recent case, I continued with the same vet practice but made it known when i made appointments that i wouldn't allow Dr. X even trim my dogs nails (hmmm, Dr X was gone from the practice before I went in for that appointment ... ).

 

For a situation like yours, I would like to think that I would give the vet practice another chance, including the vet tech involved. I know how stressed out my dogs get while recovering from anesthesia, so I'm not sure whether I would know the difference between stress and distress (except in my own dogs). And I'm betting that vet tech learned a lot from this emergency (not that I'd ever volunteer for a repeat!) I'm so very glad that you had the knowledge and experience to get the needed care for your pup when you arrived. So, I would probably continue going to the practice if the vet assures me that additional protocols are put in place, and I would discuss what actions *I* could take to reduce the risks of future problems.

[tbhounds]

It was the hydromorphone

[krissy]

https://greytarticles.wordpress.com/medical-first-aid/anesthesia-surgical/about-malignant-hyperthermia/

 

https://www.ngap.org/malignant-hyperthermia-y608.html

 

It may be inadvisable for Adam to have any anesthesia procedure in the future--with any vet. If there's an emergency and he requires anesthesia, make sure that vet knows what happened this time.

 

This is unlikely to have been malignant hyperthermia. MH occurs DURING the anesthetic, a time when it is unlikely to go unnoticed since temperature is something that it typically monitored very closely during anesthetic. It is unlikely Adam would have survived to the end of the surgery or discharge without being treated if it was MH. It is a response to inhalant anesthetics and happens every time, so the fact that this dog has previously had normal anesthetics (well, we assume his neuter was normal anyway since it wasn't mentioned when he was adopted) also suggests it is not MH.

 

Greyhounds can have another problem, which is rebound hyperthermia. Maintaining temperature during anesthesia is a problem for all patients, particularly the very small and patients with little insulation like greyhounds. Most clinics do their best to try to keep patients warm during anesthesia, but we don't always win that battle. Problem is that greyhounds have such a large muscle mass that if they get a bit cool, once they wake up they start shivering and can actually cause themselves to heat up too much. It is adviseable to monitor temp post op a little longer than other breeds.

 

Hydro can cause excessive panting, and both hydro and ace can cause dysphoria and anxiety in greyhounds which could contribute to an elevated temperature.

[KF_in_Georgia]

I felt the second post was valuable for its discussion of preventing trouble and bringing down the dog's temperature.

[macoduck]

My recently adopted 10 year old greyhound, Allen, had hyperthermia twice in one day. This was back in 2014 with his previous owner. I am grateful that the owner saved all his medical records. His vet also did a lengthy write up in the notes.

 

Allen had no prior problems with dentals until that one. He became highly stressed. his temp spiked to 109.1. They got it down and he was ok for a while. Within an hour or so of returning to near normal it spiked to 104.9 109 again. Vet thought the first time was from the procedure and the second time from stress at being in their office.

 

Owner was given the option to transfer him to a specialty clinic for overnight observation even though his temp was normal again. She chose the second option which was to be him home and monitor his temp. He was fine after that.

 

I have noticed that he was quite anxious with my vet and made sure they had copies of all reports. There were no long term affects from such a high peak of temperature twice in a day.

 

Edited to correct second rise in temp.

Edited May 13, 2017 by macoduck

[MaryJane]

It was the hydromorphone

 

 

I did have thoughts that it might have been that or the ace but, I went through some of my old stuff on recommended anesthesia and what they used was protocol for greyhounds and it came from Ohio State. I thought maybe I had given them an old copy but, it looks like that is what Ohio State recommends. However, looking back on some of the threads on anesthesia, it looks like some people have had issues with Ace and the Hydro.

 

I went back and checked what they used on my seizure dog - who didn't seem to have any issues from her dental 2 years ago. They used Butorphanol and Midazolam for pre-anes, induction was Propofol and inhalant was Sevoflurane. I left it off with the vet that I was no longer comfortable using the Ace and Hydro combination with him or any of my other greyhounds in the future.

[MaryJane]

 

This is unlikely to have been malignant hyperthermia. MH occurs DURING the anesthetic, a time when it is unlikely to go unnoticed since temperature is something that it typically monitored very closely during anesthetic. It is unlikely Adam would have survived to the end of the surgery or discharge without being treated if it was MH. It is a response to inhalant anesthetics and happens every time, so the fact that this dog has previously had normal anesthetics (well, we assume his neuter was normal anyway since it wasn't mentioned when he was adopted) also suggests it is not MH.

 

Greyhounds can have another problem, which is rebound hyperthermia. Maintaining temperature during anesthesia is a problem for all patients, particularly the very small and patients with little insulation like greyhounds. Most clinics do their best to try to keep patients warm during anesthesia, but we don't always win that battle. Problem is that greyhounds have such a large muscle mass that if they get a bit cool, once they wake up they start shivering and can actually cause themselves to heat up too much. It is adviseable to monitor temp post op a little longer than other breeds.

 

Hydro can cause excessive panting, and both hydro and ace can cause dysphoria and anxiety in greyhounds which could contribute to an elevated temperature.

 

When I got there - the issue was the panting/anxiety and that (in my opinion) caused the temperature to spike. They gave Butorphanol for calming about 1/2 hour after his temperature started to climb.

My recently adopted 10 year old greyhound, Allen, had hyperthermia twice in one day. This was back in 2014 with his previous owner. I am grateful that the owner saved all his medical records. His vet also did a lengthy write up in the notes.

 

Allen had no prior problems with dentals until that one. He became highly stressed. his temp spiked to 109.1. They got it down and he was ok for a while. Within an hour or so of returning to near normal it spiked to 109 again. Vet thought the first time was from the procedure and the second time from stress at being in their office.

 

Owner was given the option to transfer him to a specialty clinic for overnight observation even though his temp was normal again. She chose the second option which was to be him home and monitor his temp. He was fine after that.

 

I have noticed that he was quite anxious with my vet and made sure they had copies of all reports. There were no long term affects from such a high peak of temperature twice in a day.

 

 

That is a high temperature - Adam's went to 105 for a very short time but was already in the process of stabilizing.

 

Do you know what they did to bring the temperature down ?

[greysmom]

Last week when Toni's temp spiked to 106, the vet did IV fluids and IV steroids (I forget the name) for a couple hours, which dropped her temp quickly.

 

My vet only uses the second anesthesia protocol for the greyhounds that she sees. Despite the recommendation by Ohio State, I would never use the ace/hydro combo on any greyhound, whether they had had previous issues under/following anesthesia or not. The chance of *having * an issue seems to be higher with that combo.

[MaryJane]

Last week when Toni's temp spiked to 106, the vet did IV fluids and IV steroids (I forget the name) for a couple hours, which dropped her temp quickly.

 

My vet only uses the second anesthesia protocol for the greyhounds that she sees. Despite the recommendation by Ohio State, I would never use the ace/hydro combo on any greyhound, whether they had had previous issues under/following anesthesia or not. The chance of *having * an issue seems to be higher with that combo.

 

After talking to my vet about this the day after, she only uses the other anesthesia protocol in special cases. Most vets have anesthesia protocols that they are comfortable with and as long as they were not adverse, I was usually willing to have them use a protocol they are familiar with. With this incident, it has changed my mind.

[macoduck]

MaryJane, here's the vet notes. Two photos but second includes text from first.

Edited May 13, 2017 by macoduck

[MaryJane]

MaryJane, here's the vet notes. Two photos but second includes text from first.

 

 

This is invaluable - thanks so much for this. It didn't look like his temperature was at the 109 for too long and then it came down. It looks like it happened right after the Butorphanol. The description of his condition is similar to how Adam was - panting so fast that his whole body was shaking so hard.

 

Again, thanks for sharing this - I have printed it up and it's going in Adam's folder for future reference.

[Pennymom]

Something similar happened with our first greyhound, Penny. I arrived to pick her up from her dental and she was on the floor panting and sort of "checked out." I had a thread on here about it at the time. At first they told me it was likely from the ace, and that they'd avoid giving it to her in future. Later I learned that the clinic had ordered large animal atropine instead of small animal and had essentially overdosed her. The worst part was that it was a tech who told me, in a casual way during another appointment weeks later. The vets never told me what had happened. I had a fit. I did return to that vet, as I've been using that practice for 20 years. Going forward they changed Penny's anesthesia protocol to include neither ace nor atropine. They also had me stay with her until they were ready to do the dental rather than have her stay in a crate alone, the idea being that she would get less anxious. It was a scary event. We had to take her home and use cold towels and fans to bring her temp down, and kept checking it periodically. It took her several days to get back to her normal self. I'm sorry this happened.

[tbhounds]

Something similar happened with our first greyhound, Penny. I arrived to pick her up from her dental and she was on the floor panting and sort of "checked out." I had a thread on here about it at the time. At first they told me it was likely from the ace, and that they'd avoid giving it to her in future. Later I learned that the clinic had ordered large animal atropine instead of small animal and had essentially overdosed her. The worst part was that it was a tech who told me, in a casual way during another appointment weeks later. The vets never told me what had happened. I had a fit. I did return to that vet, as I've been using that practice for 20 years. Going forward they changed Penny's anesthesia protocol to include neither ace nor atropine. They also had me stay with her until they were ready to do the dental rather than have her stay in a crate alone, the idea being that she would get less anxious. It was a scary event. We had to take her home and use cold towels and fans to bring her temp down, and kept checking it periodically. It took her several days to get back to her normal self. I'm sorry this happened.

Confused-neither ace nor atropine would do as you described. Never heard a large animal atropine. Questioned what this "tech" told you.

[MaryJane]

Something similar happened with our first greyhound, Penny. I arrived to pick her up from her dental and she was on the floor panting and sort of "checked out." I had a thread on here about it at the time. At first they told me it was likely from the ace, and that they'd avoid giving it to her in future. Later I learned that the clinic had ordered large animal atropine instead of small animal and had essentially overdosed her. The worst part was that it was a tech who told me, in a casual way during another appointment weeks later. The vets never told me what had happened. I had a fit. I did return to that vet, as I've been using that practice for 20 years. Going forward they changed Penny's anesthesia protocol to include neither ace nor atropine. They also had me stay with her until they were ready to do the dental rather than have her stay in a crate alone, the idea being that she would get less anxious. It was a scary event. We had to take her home and use cold towels and fans to bring her temp down, and kept checking it periodically. It took her several days to get back to her normal self. I'm sorry this happened.

 

I still find it hard to be OK with what happened. Adam has come out of this OK however, my trust has been eroded and I wonder whether I will ever do a routine surgery on my dogs again given the risk of anesthesia with greyhounds. I'm sorry what happened with your dog and I'm gad that she did came back to normal.

[krissy]

... At work. Will edit later

Edited May 18, 2017 by krissy

[krissy]

Sorry, I was working yesterday and then I had an ultimate game in the evening and got home really late.

 

 

Here's the unfortunate reality for sighthounds. They're more sensitive to almost all drugs compared to other breeds, and pain control is necessary with surgical procedures. And further to the point of opiates... there aren't many injectable pain medications or sedatives that aren't opiates.

 

Non-opiate sedatives: Ketamine, Acepromazine, Dexdomitor, Diazepam/Midazolam.

 

Ketamine is a heavy hitter in my experience so I usually only use it on very aggressive, healthy patients. No pain control and HAS to be given with something else to avoid nasty side-effects, usually with Diazepam or Midazolam, otherwise with an opiate.

Acepromazine can be a problem for greyhounds. OSU uses it at very low doses and that seems to be okay usually (0.5 mg total per hound, not mg/kg). No pain control. But frankly, I've never been a huge fan of Ace and I rarely use it on any patient anymore, regardless of breed.

Dexdomitor is a dream, but is generally avoided in senior patients or those with known/suspected heart conditions. I love it. Heavy sedation that I can reverse - patient is out like a light in seconds to minutes and then awake again within minutes of getting the antidote. No pain control.

Diazepam/Midazolam provides only very mild sedation. We typically combine it with an opiate to use for elderly or debilitated patients. No pain control.

 

Non-opidate pain killers (injectable): NSAIDs

NSAIDs have no sedative effect, can't be given to patients with kidney concerns or GI concerns or those that are dehydrated or debilitated.

 

Opiates: Hydromorphone, Butorphanol, Buprenorphine, Morphine

All of these drugs provide pain control as well as sedation and can be given by any injectable route in most cases, and in some cases can also be given orally.

Butorphanol is the mildest, providing the least pain control and the least sedation. However, it is typically my choice of opiate for sighthounds as it doesn't tend to cause dysphoria. That said though, any dog can have a bad reaction to any drug as evidenced by Macoduck's Allen who had a pretty significant adverse reaction to Butorphanol. Those reactions can't be anticipated.

 

Anesthetizing greyhounds makes even ME stressed out. It's a no win scenario. If I don't use enough drugs then the dog is painful after surgery... and owners don't tend to like it when their dog is really painful (understandably!). If I use heavy opiates and get better control on pain then the dog is probably going to be dysphoric (panting, anxious, crying, etc), and even if no actual complications (like the temperature spike)... again, owners don't like it when their dogs are dysphoric (understandably!). If I do what I would do with my own dog, then the dog is quite sedate for an extended period of time (but not dysphoric and not painful)... and owners also don't like that. I do my sighthound patients early in the day and then keep them very late before sending home.

 

When I had Kili spayed I used a huge concoction of drugs. She was sedated with Butorphanol/Dexdomitor. Then once her IV was placed I started a low dose constant rate infusion of Lidocaine/Ketamine/Dexdomitor. I ran this constant rate infusion of these 3 drugs all through surgery and for several hours after. She unfortunately had to be an afternoon surgery, finished around 4:30 PM, so I went home and ate dinner before coming back to get her. I took her home on her triple drip of drugs, and I ran it all evening and for most of the night. It ran out around 2AM. On those drugs she was comfortable and very sedate. I was personally very pleased with this protocol and will probably do the same when I decide to spay Kenna. It controlled pain very well. And because she was sleepy/sedate I didn't have a dysphoric dog crashing around after waking up suddenly. She woke up and then basically went back to sleep (rousable but reluctantly) and then once the infusion stopped it took another few hours to clear all the drugs so she woke up nice and slowly through the night. Problem is, I don't think this is a protocol you can really use on a client greyhound, but gosh it was amazing.

 

When I did Summit last year at almost 11 years old, I did Butorphanol/Midazolam for his sedation. However, he only had a very small lump to come off and a routine dental cleaning with no extractions... so pain was a minor factor. When he had surgery for his spine a few months later I left it up to the referral centre. I have no idea what they used for the actual anesthesia, but I do know that they had him on a drip of methadone afterwards so he was super sedate for hours after (but not dysphoric). That dog seems to handle his opiates okay which is fortunate.

Greyhounds suck to anesthetize sometimes. I totally agree. However, avoiding necessary care because of the risks of anesthesia is not any better for the dog. Girls that aren't spayed get cancers and life-threatening uterine infections. Boys can get testicular cancer. Bad teeth lead to a host of other health concerns and is incredibly painful. Anesthesia is a risk in ANY breed, and yes it can be even a little scarier for those of us with sighthounds. But trust me, living with a rotten mouth is not something any dog would choose. I know it is difficult and scary, but I would encourage you to continue to perform anesthetic procedures when they are necessary. Do as much as you can at home to avoid needing anesthetic procedures (brush teeth daily, use a water additive, use a dental diet if possible, give dental treats, get lumps checked out early, etc) and do anesthetic procedures earlier than later. A routine dental cleaning is way easier on a hound than one with a bunch of extractions... pain control is a problem as we've already discussed and anesthetic time is very much prolonged by needing to do a lot of work. And finally, use a vet that you are comfortable with. And by comfortable, I mean that if something goes wrong (and it can with any dog or cat or rabbit or human) that your first reaction won't be "I've lost trust in them" but "I know they took the best care of him that they could".

 

I'm very sorry this happened to you and Adam, and I'm so glad he's doing better.

[palmettobug]

Kristie, great post, as always! Are any of the drugs listed NOT approved for use in the US?

[krissy]

Kristie, great post, as always! Are any of the drugs listed NOT approved for use in the US?

 

Oh, that I don't know. But usually it's the other way around... we tend to approve stuff after we see you guys test it out first. So it's more typical for us to not be able to get stuff that is available in the US.

[MaryJane]

Sorry, I was working yesterday and then I had an ultimate game in the evening and got home really late.

 

 

Here's the unfortunate reality for sighthounds. They're more sensitive to almost all drugs compared to other breeds, and pain control is necessary with surgical procedures. And further to the point of opiates... there aren't many injectable pain medications or sedatives that aren't opiates.

 

Non-opiate sedatives: Ketamine, Acepromazine, Dexdomitor, Diazepam/Midazolam.

 

Ketamine is a heavy hitter in my experience so I usually only use it on very aggressive, healthy patients. No pain control and HAS to be given with something else to avoid nasty side-effects, usually with Diazepam or Midazolam, otherwise with an opiate.

Acepromazine can be a problem for greyhounds. OSU uses it at very low doses and that seems to be okay usually (0.5 mg total per hound, not mg/kg). No pain control. But frankly, I've never been a huge fan of Ace and I rarely use it on any patient anymore, regardless of breed.

Dexdomitor is a dream, but is generally avoided in senior patients or those with known/suspected heart conditions. I love it. Heavy sedation that I can reverse - patient is out like a light in seconds to minutes and then awake again within minutes of getting the antidote. No pain control.

Diazepam/Midazolam provides only very mild sedation. We typically combine it with an opiate to use for elderly or debilitated patients. No pain control.

 

Non-opidate pain killers (injectable): NSAIDs

NSAIDs have no sedative effect, can't be given to patients with kidney concerns or GI concerns or those that are dehydrated or debilitated.

 

Opiates: Hydromorphone, Butorphanol, Buprenorphine, Morphine

All of these drugs provide pain control as well as sedation and can be given by any injectable route in most cases, and in some cases can also be given orally.

Butorphanol is the mildest, providing the least pain control and the least sedation. However, it is typically my choice of opiate for sighthounds as it doesn't tend to cause dysphoria. That said though, any dog can have a bad reaction to any drug as evidenced by Macoduck's Allen who had a pretty significant adverse reaction to Butorphanol. Those reactions can't be anticipated.

 

Anesthetizing greyhounds makes even ME stressed out. It's a no win scenario. If I don't use enough drugs then the dog is painful after surgery... and owners don't tend to like it when their dog is really painful (understandably!). If I use heavy opiates and get better control on pain then the dog is probably going to be dysphoric (panting, anxious, crying, etc), and even if no actual complications (like the temperature spike)... again, owners don't like it when their dogs are dysphoric (understandably!). If I do what I would do with my own dog, then the dog is quite sedate for an extended period of time (but not dysphoric and not painful)... and owners also don't like that. I do my sighthound patients early in the day and then keep them very late before sending home.

 

When I had Kili spayed I used a huge concoction of drugs. She was sedated with Butorphanol/Dexdomitor. Then once her IV was placed I started a low dose constant rate infusion of Lidocaine/Ketamine/Dexdomitor. I ran this constant rate infusion of these 3 drugs all through surgery and for several hours after. She unfortunately had to be an afternoon surgery, finished around 4:30 PM, so I went home and ate dinner before coming back to get her. I took her home on her triple drip of drugs, and I ran it all evening and for most of the night. It ran out around 2AM. On those drugs she was comfortable and very sedate. I was personally very pleased with this protocol and will probably do the same when I decide to spay Kenna. It controlled pain very well. And because she was sleepy/sedate I didn't have a dysphoric dog crashing around after waking up suddenly. She woke up and then basically went back to sleep (rousable but reluctantly) and then once the infusion stopped it took another few hours to clear all the drugs so she woke up nice and slowly through the night. Problem is, I don't think this is a protocol you can really use on a client greyhound, but gosh it was amazing.

 

When I did Summit last year at almost 11 years old, I did Butorphanol/Midazolam for his sedation. However, he only had a very small lump to come off and a routine dental cleaning with no extractions... so pain was a minor factor. When he had surgery for his spine a few months later I left it up to the referral centre. I have no idea what they used for the actual anesthesia, but I do know that they had him on a drip of methadone afterwards so he was super sedate for hours after (but not dysphoric). That dog seems to handle his opiates okay which is fortunate.

Greyhounds suck to anesthetize sometimes. I totally agree. However, avoiding necessary care because of the risks of anesthesia is not any better for the dog. Girls that aren't spayed get cancers and life-threatening uterine infections. Boys can get testicular cancer. Bad teeth lead to a host of other health concerns and is incredibly painful. Anesthesia is a risk in ANY breed, and yes it can be even a little scarier for those of us with sighthounds. But trust me, living with a rotten mouth is not something any dog would choose. I know it is difficult and scary, but I would encourage you to continue to perform anesthetic procedures when they are necessary. Do as much as you can at home to avoid needing anesthetic procedures (brush teeth daily, use a water additive, use a dental diet if possible, give dental treats, get lumps checked out early, etc) and do anesthetic procedures earlier than later. A routine dental cleaning is way easier on a hound than one with a bunch of extractions... pain control is a problem as we've already discussed and anesthetic time is very much prolonged by needing to do a lot of work. And finally, use a vet that you are comfortable with. And by comfortable, I mean that if something goes wrong (and it can with any dog or cat or rabbit or human) that your first reaction won't be "I've lost trust in them" but "I know they took the best care of him that they could".

 

I'm very sorry this happened to you and Adam, and I'm so glad he's doing better.

 

 

Thanks for the detailed response. If you don't mind, I'm going to print it out and keep it in my records.

 

First, I love my vet that was involved with this - she is wonderful - smart, looks stuff up, and doesn't get flustered easily. She has done a great job on the dental for one of my other dogs - the seizure one. Very few issues in that case however a slightly different protocol was followed.

 

With Adam, the vet left my dog in stable condition and in the care of the vet tech and that's the period where the problem seems to have arisen. I can understand that a problem arises and we may not have control however, in this case, When I got there, I had to tell the vet tech that there was a problem and what to do (taking temperature, cold towels). I also had to tell her to get the other vet and make her aware of the situation and also to consult with my vet on what to do.

 

My trust issue is with the vet tech ... not the vet. With this incident, the vet was going to implement stricter procedures on situations like this, I can imagine that the vet tech might not be happy with me and unfortunately, if my dogs are there for some reason - it would not surprise me if the vet tech took out her dislike of me on my dogs.

[tbhounds]

Curious to know if this "Vet Tech" is licensed???