# Puppy Died At Vet's Office During Spay



## suzimalteselover (Mar 27, 2006)

Recently, Lynn had a thread on Secret's dental. I mentioned in her thread that my friend emailed me about losing her puppy during a spay procedure at her vet's office. I have more details now. Her puppy was 4 mos. old and 7 lbs. at the time of the spay. (A complete blood panel was ran before the procedure and everything was normal.) The vet states, the puppy went through the entire spay procedure fine. She was in the recovery room and her heart stopped beating. They performed CPR on her without success. The vet sent for an autopsy report to their local University. The autopsy reports states that mucus filled her lungs and she quit breathing. She was allergic to the anesthesia. The vet says it wasn't a health issue, so, the breeder isn't at fault. But, the vet also states it isn't his fault.....because, there was no way of knowing ahead of time that this puppy would have an allergic reaction to anesthesia. So, the vet claims no one is at fault. (My friend accepts this and supports her vet's theory.) 

I am confused. Can anyone shed some light on this for me? I don't know what type of anesthesia was used. But, I know my vet is extremely careful when putting my fluffs under and uses Isoflurane. He initially uses Propofol to put them under, which lasts 5 minutes or so, I think. Then, uses the Isoflurane. He told me that with the Isoflurane, he can carefully monitor the heartbeat constantly and bring them "to"......quickly, during the procedure, if needed. So, is this possible? This allergic reaction that occurred could not have been known in advance??? (I inquired about the isoflurane and she never answered to the type of anesthesia her vet used. So, I'm thinking the vet didn't use Isoflurane.) I still think the vet is at fault. Or, am I wrong? Or, was this just a rare occurrence that could not have been avoided as this vet states?

I feel terrible for her.  But, I don't understand her allegiance to her vet. I would be livid with my vet if this happened and wouldn't feel comfortable having him put any of my other fluffs under again. So, is this vet at fault or not?

Edited to add: To add to the confusion.....her breeder states it was my friend's fault. Because, the spay was done at 4 mos. of age. The breeder says this is way too young for a spay. This caused the death. So, my friend is actually upset with the breeder and not the vet. I don't see how this would be accurate, either. I thought the puppy was a purebred. But, I'm finding out now, that the breeder was breeding for "designer dogs," ugh. So, now, the vet has told my friend this occurred due to being a "designer" breed and not his negligence.


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## bellaratamaltese (May 24, 2006)

Oh how sad for your friend!

I am not too knowledgeable on different types of anesthesia used but I'm not sure any blame can be dished out here. Unless the vet office was negligent, of course.

I do have to agree with the breeder - 4 months is too young to be spayed, IMO but I don't think that is what contributed to her death. Did your friend have a maltese? Or a shih tzu? 

Sad and scary story for all of us


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## Snowbody (Jan 3, 2009)

Suzi - that's so sad. Please pass on my condolences to your friend. I think that things like that can happen. They certainly happen with people - sudden, unexpected fatal reaction to something. If my 2 year old almost died from a sip of milk, I'm sure that anesthesia could cause a fatal reaction too. And not sure if it can be picked up and reversed soon enough. I know that one of my aunts had cataract surgery on one eye and was fine. They used a sort of valium type of anesthesia. For the second eye she ended up suddenly becoming very agitated after they already started the surgery and moving all around and she ended up being blinded in that eye. They said with some people, especially older people, they get the opposite reaction - instead of calm they become agitated and no way to know. So I don't really know if the vet is to blame and from time to time you hear cases like that. 

Not sure about the neuter issue and what age is or isn't right. Thought shelters neuter at that young an age when placing dogs out of their system. Was this an ethical breeder? When I saw the pup was 7 lbs at 4 months I wondered. I think it's horrible for the breeder to put blame on your friend -- that's the last thing she needs. I wondered if she worried that your friend would want a replacement pup and thus did that. Otherwise it just seems cruel to me. JMO.


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## michellerobison (Dec 17, 2009)

I've heard of pups being spayed at that young age,but isn't it too young?
Sounds like too much aenesthesia and her lungs filled w/ fluids,during surgery,once they took her off the vent she drowned in her own mucus... Maybe the pups lungs weren't large enough or maybe some very slight inflamation developed during the spay or the venting that she couldn't expell the mucus,mucilary clearance.....adequate air exchange...hard to explain in a post.

I'm no expert but that's what it sounds like.


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## Cosy (Feb 9, 2006)

I would question the vet, since he did the spay at such a young age. Then on the otherhand, the dog was a good size and not tiny. I don't know that a mixed breed would be more susceptible to a reaction to anesthesia than any other dog. We certainly try to get everyone who owns a dog (mixed or not) to spay/neuter, so that theory doesn't quite make sense to me. I think it was either wrong type of anesthesia for a small dog or just one of those things that happens. I hope the vet didn't use the wrong anesthesia.


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## The A Team (Dec 1, 2005)

I just think it's sad for everyone involved. I feel so bad for your friend.


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## pammy4501 (Aug 8, 2007)

It is very hard to predict anesthetic reactions in humans, and I can imagine even more so in animals. The anesthetic death rate in pets is higher than in humans (I checked). This is almost certainly due to the fact that there are no dedicated anestheologists in the OR during veterinary surgeries. It is more difficult to accurately monitor blood pressure in animals than it is in humans and blood pressure is probably the earliest indicator of problems with anesthesia. Due to the difficulty in measuring B/P in pets, most Vets don't use that parameter in surgery, they use pulse oximetry. The pulse ox is good, but it doesn't always allow early recognition of trouble (ie drops inB/P). Continuous monitoring of patient temperature is also helpful and is often available. There is a condition called malignant hyperthermia that is impossible to predict, and fatal if unrecognized. It is unusual for surgical anesthesia to be monitored by a another veterinarian and extremely unusual for a vet practice to have a board certified anesthesiologist monitoring patients. I have had these converations with my vet. So when a crisis occurs, the veterinarian doing the surgery suddenly becomes both the surgeon and the anestheologist. This results in an inability to do a really good job dealing with either the surgery or the anesthesia --- and the result is that veterinary patients have a higher death rate from anesthesia. This is not an allergy to anesthesia, nor is it even a particular sensitivity, in many cases. Something unforeseen happens, such as a slight sensitivity to anesthesia, or a drop in blood pressure due to surgical manipulations, or surgical blood loss --- and a downward spiral in patient stability results. In many instances in veterinary surgery the first visible sign of this is cardiac or respiratory arrest, since there is no one monitoring the patient to pick up on the more subtle signs that occur earlier. Cardiac or respiratory arrest is a bad point to be starting the process of dealing with the problem. It isn't the practice in vet medicine to provide dedicated anesthesiologists. Mainly due to cost factors. In humans, the anesthesia death rate is lower but the cost of surgery is dramatically higher, due in part to having a dedicated anestheologist and an assistant surgeon, and circulating nurses to assist with any and every need of the surgical team.​


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## jmm (Nov 23, 2004)

Yes that is possible and the vet may not have done anything wrong. There is risk with any anesthetic procedure. In the last 10 years I've seen only a handful of anesthetic deaths, most explained by unfortunately medical conditions we could not have known about without unreasonable testing (or animals who were known to be very high risk but had to have the procedure), but a few with no reason why, one of which was my own 6 month old pup who had a normal necropsy. It sucks and it unusual, but it can happen.


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## pammy4501 (Aug 8, 2007)

jmm said:


> Yes that is possible and the vet may not have done anything wrong. There is risk with any anesthetic procedure. In the last 10 years I've seen only a handful of anesthetic deaths, most explained by unfortunately medical conditions we could not have known about without unreasonable testing (or animals who were known to be very high risk but had to have the procedure), but a few with no reason why, one of which was my own 6 month old pup who had a normal necropsy. It sucks and it unusual, but it can happen.


 Jackie, do dogs ever get malignant hyperthermia? Just curious.


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## jmm (Nov 23, 2004)

Pam, not in my experience, but you might want to inquire somewhere doing more complicated, longer surgical procedures than a general practice.


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## mfa (Oct 5, 2009)

oh no, that is just horrible!:smcry:
sounds to me like the vet was at fault, 
since the puppy was so young.


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## MaryH (Mar 7, 2006)

pammy4501 said:


> It is very hard to predict anesthetic reactions in humans, and I can imagine even more so in animals. The anesthetic death rate in pets is higher than in humans (I checked). This is almost certainly due to the fact that there are no dedicated anestheologists in the OR during veterinary surgeries. It is more difficult to accurately monitor blood pressure in animals than it is in humans and blood pressure is probably the earliest indicator of problems with anesthesia. Due to the difficulty in measuring B/P in pets, most Vets don't use that parameter in surgery, they use pulse oximetry. The pulse ox is good, but it doesn't always allow early recognition of trouble (ie drops inB/P). Continuous monitoring of patient temperature is also helpful and is often available. There is a condition called malignant hyperthermia that is impossible to predict, and fatal if unrecognized. It is unusual for surgical anesthesia to be monitored by a another veterinarian and extremely unusual for a vet practice to have a board certified anesthesiologist monitoring patients. I have had these converations with my vet. So when a crisis occurs, the veterinarian doing the surgery suddenly becomes both the surgeon and the anestheologist. This results in an inability to do a really good job dealing with either the surgery or the anesthesia --- and the result is that veterinary patients have a higher death rate from anesthesia. This is not an allergy to anesthesia, nor is it even a particular sensitivity, in many cases. Something unforeseen happens, such as a slight sensitivity to anesthesia, or a drop in blood pressure due to surgical manipulations, or surgical blood loss --- and a downward spiral in patient stability results. In many instances in veterinary surgery the first visible sign of this is cardiac or respiratory arrest, since there is no one monitoring the patient to pick up on the more subtle signs that occur earlier. Cardiac or respiratory arrest is a bad point to be starting the process of dealing with the problem. It isn't the practice in vet medicine to provide dedicated anesthesiologists. Mainly due to cost factors. In humans, the anesthesia death rate is lower but the cost of surgery is dramatically higher, due in part to having a dedicated anestheologist and an assistant surgeon, and circulating nurses to assist with any and every need of the surgical team.​


Thank you, Pam, for such an indepth response. Many years ago we had a liver shunt repaired on one of our rescue dogs. Mack was over a year old, fully grown, but obviously in poor health because of the shunt so the surgery was extremely risky. Mack's blood pressure dropped criically low during the surgery and only that there was a surgical team (surgeon, anesthesiologist, surgical resident and ICU vet tech) present did they have the expertise and equipment right there to pull him through. But for that surgery we paid over $4,000. We ask and expect a lot from our vets on a regular basis. And yet we would never tolerate a 1-person surgical team for ourselves.


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## Sylie (Apr 4, 2011)

This is a very sad story. Every time any of my (many) dogs have had to be sedated I was a nervous wreck until I picked them up. Why? Because I know that there is always a risk. Nobody is to blame. Not the vet. Not the breeder. Not the poor dog's mommy who followed the law by having her spayed at 4 months. Nobody is to blame. And dear sweet little angel is still with us...still in the universe...still a part of the All.


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## suzimalteselover (Mar 27, 2006)

bellaratamaltese said:


> Oh how sad for your friend!
> 
> I am not too knowledgeable on different types of anesthesia used but I'm not sure any blame can be dished out here. Unless the vet office was negligent, of course.
> 
> ...


She was a Pom. I thought she was a purebred. I'm not sure what other breed was mixed in her. 




Snowbody said:


> Suzi - that's so sad. Please pass on my condolences to your friend. I think that things like that can happen. They certainly happen with people - sudden, unexpected fatal reaction to something. If my 2 year old almost died from a sip of milk, I'm sure that anesthesia could cause a fatal reaction too. And not sure if it can be picked up and reversed soon enough. I know that one of my aunts had cataract surgery on one eye and was fine. They used a sort of valium type of anesthesia. For the second eye she ended up suddenly becoming very agitated after they already started the surgery and moving all around and she ended up being blinded in that eye. They said with some people, especially older people, they get the opposite reaction - instead of calm they become agitated and no way to know. So I don't really know if the vet is to blame and from time to time you hear cases like that.
> 
> Not sure about the neuter issue and what age is or isn't right. Thought shelters neuter at that young an age when placing dogs out of their system. Was this an ethical breeder? When I saw the pup was 7 lbs at 4 months I wondered. I think it's horrible for the breeder to put blame on your friend -- that's the last thing she needs. I wondered if she worried that your friend would want a replacement pup and thus did that. Otherwise it just seems cruel to me. JMO.


Thank you, Sue. I'm so sorry to hear that about your son and your aunt.  How are they doing now?
I don't have first hand experience with this breeder. But, I personally would not have purchased a puppy from her. I will call the puppy's owner, "Mary". Another gal told Mary not to purchase from this breeder....too many red flags. Mary wouldn't listen at the time. Currently, the breeder has told Mary she would not refund her money, but, would sell her another puppy at a discount. Mary is going elsewhere for her next puppy. 



michellerobison said:


> I've heard of pups being spayed at that young age,but isn't it too young?
> Sounds like too much aenesthesia and her lungs filled w/ fluids,during surgery,once they took her off the vent she drowned in her own mucus... Maybe the pups lungs weren't large enough or maybe some very slight inflamation developed during the spay or the venting that she couldn't expell the mucus,mucilary clearance.....adequate air exchange...hard to explain in a post.
> 
> I'm no expert but that's what it sounds like.


This is what I was kind of wondering, too, Michelle. This vet is a large animal vet. He's used to dealing with horses and cattle. My brother's best friend that is a large animal vet told me years ago to never allow a large animal vet to put a toy breed under. He told me it's just too easy to let them slip away if you're not experienced with anesthesia on a toy breed.



Cosy said:


> I would question the vet, since he did the spay at such a young age. Then on the otherhand, the dog was a good size and not tiny. I don't know that a mixed breed would be more susceptible to a reaction to anesthesia than any other dog. We certainly try to get everyone who owns a dog (mixed or not) to spay/neuter, so that theory doesn't quite make sense to me. I think it was either wrong type of anesthesia for a small dog or just one of those things that happens. I hope the vet didn't use the wrong anesthesia.


I agree. Millions of mixed breed dogs have been spayed. The autopsy report said it wasn't a hereditary nor congenital issue. 








pammy4501 said:


> It is very hard to predict anesthetic reactions in humans, and I can imagine even more so in animals. The anesthetic death rate in pets is higher than in humans (I checked). This is almost certainly due to the fact that there are no dedicated anestheologists in the OR during veterinary surgeries. It is more difficult to accurately monitor blood pressure in animals than it is in humans and blood pressure is probably the earliest indicator of problems with anesthesia. Due to the difficulty in measuring B/P in pets, most Vets don't use that parameter in surgery, they use pulse oximetry. The pulse ox is good, but it doesn't always allow early recognition of trouble (ie drops inB/P). Continuous monitoring of patient temperature is also helpful and is often available. There is a condition called malignant hyperthermia that is impossible to predict, and fatal if unrecognized. It is unusual for surgical anesthesia to be monitored by a another veterinarian and extremely unusual for a vet practice to have a board certified anesthesiologist monitoring patients. I have had these converations with my vet. So when a crisis occurs, the veterinarian doing the surgery suddenly becomes both the surgeon and the anestheologist. This results in an inability to do a really good job dealing with either the surgery or the anesthesia --- and the result is that veterinary patients have a higher death rate from anesthesia. This is not an allergy to anesthesia, nor is it even a particular sensitivity, in many cases. Something unforeseen happens, such as a slight sensitivity to anesthesia, or a drop in blood pressure due to surgical manipulations, or surgical blood loss --- and a downward spiral in patient stability results. In many instances in veterinary surgery the first visible sign of this is cardiac or respiratory arrest, since there is no one monitoring the patient to pick up on the more subtle signs that occur earlier. Cardiac or respiratory arrest is a bad point to be starting the process of dealing with the problem. It isn't the practice in vet medicine to provide dedicated anesthesiologists. Mainly due to cost factors. In humans, the anesthesia death rate is lower but the cost of surgery is dramatically higher, due in part to having a dedicated anestheologist and an assistant surgeon, and circulating nurses to assist with any and every need of the surgical team.​


Pam, thank you for your response. She told me today the vet did not use isoflurane. If this death would have occurred using the isoflurane, I would think it would be more of an accident. But, since standard anesthesia was used....doesn't that make the vet more liable? Or, not necessarily? I know this can get to be a pretty grey area. I understand what you are stating about how it may take a vet longer to pick up on the warning signs vs. a human doctor on humans and no anesthesiologist present at a vet's office. My vet explained your exact response to me when I had Josey spayed 4 yrs ago. Before Josey was put under, my vet had a very indepth conversation about what anesthesia he would be administering and how it worked. He explained that if at any moment.....he could wake her right up. That was key he said. 




jmm said:


> Yes that is possible and the vet may not have done anything wrong. There is risk with any anesthetic procedure. In the last 10 years I've seen only a handful of anesthetic deaths, most explained by unfortunately medical conditions we could not have known about without unreasonable testing (or animals who were known to be very high risk but had to have the procedure), but a few with no reason why, one of which was my own 6 month old pup who had a normal necropsy. It sucks and it unusual, but it can happen.


Thank you Joy for your response. But, wouldn't the autopsy report state that the puppy had a prior medical condition....stating it was hereditary or congenital? Instead of just allergic to anesthesia?


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## jmm (Nov 23, 2004)

Yes, the necropsy report should have identified any medical conditions contributing to the death. There is a reason vets push hard for necropsies on deaths such as this - they NEED to know if it was something they did wrong. In my puppy's case, not only did the vet insist, but the breeder also NEEDED to know if there was a problem.


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## Lacy (Feb 14, 2005)

*My 2 cents from a tech*

I just thought I would throw my 2 cents in since I am a licensed veterinary technician and work in a clinic. We routinely will spay and neuter at 16 weeks of age, that is the youngest we will do it. We have the luxury of having a technician with every anesthetized patient so they are monitored from the time of induction to after recovery. I know that this is not the normal practice in most veterinary clinics to have a tech that is able to monitor the patient continuously throughout the whole procedure. We monitor ecg, CO2 levels, pulse oximetry, core temperature, and blood pressure during every procedure. We use propofol for induction and then use either isoflourane or sevoflourane for maintenance. We have an extremely low instance of anesthetic deaths in our practice but I believe that is due to all of the precautions we take. Personally I would ask the vet if they have a tech with the animal at all times during surgery, if they have monitoring equipment, and what kind of anesthetic medications they use because it can really make a difference. :thumbsup:


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## pammy4501 (Aug 8, 2007)

Lacy said:


> I just thought I would throw my 2 cents in since I am a licensed veterinary technician and work in a clinic. We routinely will spay and neuter at 16 weeks of age, that is the youngest we will do it. We have the luxury of having a technician with every anesthetized patient so they are monitored from the time of induction to after recovery. I know that this is not the normal practice in most veterinary clinics to have a tech that is able to monitor the patient continuously throughout the whole procedure. We monitor ecg, CO2 levels, pulse oximetry, core temperature, and blood pressure during every procedure. We use propofol for induction and then use either isoflourane or sevoflourane for maintenance. We have an extremely low instance of anesthetic deaths in our practice but I believe that is due to all of the precautions we take. Personally I would ask the vet if they have a tech with the animal at all times during surgery, if they have monitoring equipment, and what kind of anesthetic medications they use because it can really make a difference. :thumbsup:


Excellent points to ask the vet when scheduling any procedure using anesthetic.


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## suzimalteselover (Mar 27, 2006)

Lacy said:


> I just thought I would throw my 2 cents in since I am a licensed veterinary technician and work in a clinic. We routinely will spay and neuter at 16 weeks of age, that is the youngest we will do it. We have the luxury of having a technician with every anesthetized patient so they are monitored from the time of induction to after recovery. I know that this is not the normal practice in most veterinary clinics to have a tech that is able to monitor the patient continuously throughout the whole procedure. We monitor ecg, CO2 levels, pulse oximetry, core temperature, and blood pressure during every procedure. We use propofol for induction and then use either isoflourane or sevoflourane for maintenance. We have an extremely low instance of anesthetic deaths in our practice but I believe that is due to all of the precautions we take. Personally I would ask the vet if they have a tech with the animal at all times during surgery, if they have monitoring equipment, and what kind of anesthetic medications they use because it can really make a difference. :thumbsup:


:goodpost:

Thanks for your post. My vet had a discussion with me, (similar to your above post) prior to Josey's spay procedure. (My prior vet never discussed any of this.) I think your points are an excellent indicator of a very knowledgeable and experienced vet. I wish all vet clinics were this diligent.


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## angelicag93 (Mar 28, 2011)

This is such a sad story, I feel terrible for your friend. We bought our malt from an AKC registered breeder who shows malts and she told us to wait until she's at least 8 months- 1yr to have her spayed. 4 months does sound very young, esp because malt puppies are already a small breed. If mucous was in her lungs it sounds like michelle is right, it could have been a respiratory issue where the mucous blocked her oxygen intake? That would cause her heart to stop. It's true about medical allergies, sometimes you just have no way of knowing until the damage has already occurred. Hard to say who's at fault but it's terrible in any case. So sorry for her loss...


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## Chalex (Feb 19, 2010)

I don't see how the vet could know that the dog was allergic to the anessthesia. It's terribly sad, but I don't think blame is needed. It's just one of those very unfortunate situations. Doctors/Vets do their best, but they're human.


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