Stream Valley Veterinary Hospital

Review: On June 11 2013, we brought our cat [redacted] to Stream Valley. She was lethargic, not eating, and constipated. We had provided all prior Vet history, and noted that she had a similar illness earlier on in the year which was controlled by an Antibiotic. Despite this information, they did multiple teats and continued to go in a different direction. After being recommended to repeat prior tests I decided to take [redacted] else ware. At this point they had performed one duplicate test that was deemed unnecessary and another that the Dr. said she was not qualified to read. We had run up $750+ in charges and were then being told we should probably see an internal medicine Vet.

I took her back to our prior vet that we had stopped seeing (after moving from [redacted] to [redacted]) on June 18th. he gave [redacted] an antibiotic. The next evening, [redacted] was feeling better. by June 20th she was back to her normal health. The total costs of two visits was $129.46.

We went back to Stream Valley to discuss the care [redacted] received and all of the tests we were recommended. Dr. [redacted] told us that [redacted] was suffering from a fever of unknown origin and wanted to look over her info and we would have a follow up. After multiple attempts to meet with her for a follow up, on 7/13 she canceled her second scheduled meeting. She then called and left a voicemail stating [redacted] has a fever of unknown origin and it clearly looks like feline anemia and we can discuss 7/22. Then she sent this letter. I have multiple documents to support this.Desired Settlement: When we started our conversation with Dr. [redacted] we asked to review the process and had asked for nothing. She then cancel multiple meetings. After the claims that [redacted] has feline anemia and there was no testing in this direction, I am looking for a refund for full amount.

Business

Response:

November 19, 2013

Dear **. [redacted],

The pet involved with this case presented to us on June 11, 2013 after, according to her owners, she had been ill for four to five days. We began diagnostics and treatments consistent with her symptoms and presentation. We did have access to her medical history from her previous veterinarian, and this gave us valuable information as we pursued to root cause of her illness. For example, recurrent symptoms may be a sign of a chronic disease. If symptoms of such a condition do recur, that may mean that any previous treatment was not successful and another method of treatment may best manage or cure the disease. Additionally, no matter how similar a presentation is to past illnesses, we cannot assume that the issue is exactly the same and treat blindly, without ruling out other possible causes. This would be dangerous and sub-standard medicine. Several different conditions manifest with similar symptoms; therefore, we must consider each situation unique until the evidence leads us to a diagnosis. In this case, the evidence we saw did not point to a condition that would be effectively treated with antibiotics. A bacterial infection is not a likely cause of constipation with dehydration; rather, gastrointestinal or metabolic problems are more often to blame. Radiographs, ultrasound, and lab work were ordered to help us investigate, and hospitalization, fluid therapy, enemas, laxatives, and feeding assistance helped us monitor the pet and make her more comfortable.

The pet’s family was presented with treatment plans/estimates outlining the above, and they approved these plans. In terms of the test that these owners call “unnecessary,” we did inadvertently repeat a routine test that was run during a well pet visit the month before. The test was useful in that it let us know that the conditions screened for were not the apparent culprits. However, because the original test was performed just a few weeks prior and because the owners had not yet paid for the second test, we simply found it easier to remove the charges for a family who seemed so upset in the face of their pet’s illness. As for a test “that the Dr. [sic] said she was not qualified to read,” no such diagnostics were performed. We did not run any test that we could not interpret. We do feel, with certainty, that we addressed the initial issues of constipation and dehydration, and though we were not given the opportunity to continue diagnostics to ascertain the root cause, our treatments would account for the pet “feeling better” and appearing “back to normal” shortly after her hospitalization with us. In short, any and all diagnostics we performed for this particular pet were to ensure that she would receive safe and appropriate treatment.

Beyond the high quality medical care provided by my Associate Veterinarian and medical staff, the pet owners have questioned my review, as Practice Owner, of the situation. I spent a large amount of time going over both the pet’s previous veterinary records along with my staff s work and notes. When they initially set up an appointment time to speak with me, I was a bit confused because I had not been involved in the case, so I asked one of my staff members to contact them and confirm that they did indeed wish to speak with me. In light of that, I asked to reschedule the meeting so that I would have time to gather all the facts and address their concerns in an informed way. We met to discuss their situation, and based on that meeting and even further subsequent research, I could find no basis to refund payments for services that were rendered (short of the above-described test that the pet owners did not pay for initially). I called the family to relay this decision. Still, the pet owners requested a second meeting with me, and my staff added it to my appointment schedule in a time slot that should have been reserved for a pet with active medical needs. Because I felt that we had already reached an appropriate resolution, I had my staff cancel this appointment. Our business-client relationship had become so strained, and it had become evident that these clients could not be pleased or move beyond this incident. Therefore, we provided copies of the pet's medical records with a letter reiterating our position and asking that they seek veterinary care elsewhere.

It is worth noting that these pet owners requested that their credit card company return the charges to them. The credit card company did not see fit to take the money back from our business because this was payment for services actually rendered. Additionally, if the family had a valid complaint about our medical services and standards, we can only assume that they would contact the Virginia State Veterinary Board. To date, we have not been contacted by the Board, and there is no open investigation.

In conclusion, from both a medical and a business perspective, we find no basis for refunding any payments in this particular case. My staff acted in good faith and according to our high standards of practice. Please feel free to contact me with any other questions or concerns.

Sincerely,