College Connection | Winter 2025
Member assessment was determined to be appropriate
College Connection | Winter 2025
LEARNING IN PRACTICE
Member assessment was determined to be appropriate
Case Summary
The member examined a cat for a possible fracture due to a fall. The cat was ambulatory on all four limbs, able to walk and jump, and did not exhibit crepitus, swelling or pain during the orthopedic assessment.
Pulse oximetry was conducted, and thoracic and abdominal focused assessment with sonography for trauma scans were performed to evaluate for the presence of free fluid, thoracic effusion, or pneumothorax. The tests revealed normal oxygen saturation and no abnormalities. The member recommended further diagnostic testing, including bloodwork and radiographs, but these were declined. The cat was given 25 mg of gabapentin and was discharged with a prescription for gabapentin.
The client returned later that day with concerns about an asymmetrical, firm lump on the cat’ s leg. The orthopedic assessment revealed moderate swelling in the right metatarsal region, specifically around the second to third digits and mild instability. Radiographs confirmed a comminuted, dorsolaterally displaced fracture of the third metatarsal bone, accompanied by palpable instability. A splint was applied under sedation to provide stability and support fracture healing. The cat was discharged with gabapentin and Metacam.
Case Outcomes
The Complaints Committee panel found the allegations did not warrant a referral to the Discipline Committee and decided not to take any action.
Case Considerations
In considering the complaint, the panel reviewed the medical records, written submissions, and statements provided by all parties. As is standard for all investigations, the panel considered any previous proceedings.
The member informed the client there was no evidence of a fracture or other issue concerning the cat’ s injured leg. The client was concerned the discharge summary, didn’ t indicate the cat’ s leg had been evaluated. The member indicated the discharge instructions serve as a brief summary of the visit and typically include only abnormal findings. They did not observe any swelling or orthopedic abnormalities in the cat’ s leg so no orthopedic findings were included. A detailed account of the examination was recorded in the medical records.
The client was concerned the member failed to diagnose the cat’ s fracture. The member indicated they performed a thorough assessment and recommended sedated orthopedic radiographs to rule out fractures, noting that smaller bone fractures can be difficult to detect through physical examination alone. The client declined. The member also discussed thoracic and abdominal radiographs to assess for internal trauma, baseline bloodwork, and hospitalization for monitoring to ensure the cat remained stable. The client chose outpatient management with analgesics. The possibility of delayed onset of neurological, cardiovascular, or orthopedic complications were also discussed.
In the panel’ s opinion, the member’ s assessment of the cat appeared to be appropriate. The panel noted that while there was no documentation specifically referencing a lump, the medical records indicated the member appeared to conduct an appropriate triage assessment.
It is unfortunate the metatarsal fracture was not identified, however, the panel noted that fractures, particularly those with mild instability may not be readily apparent if there is no displacement at the time of assessment, and swelling or palpable abnormalities may develop or become more evident over time. In the panel’ s opinion, it appears the member conducted an appropriate and reasonable orthopedic assessment.
Veterinarians have a responsibility to provide safe, quality care. The College assists veterinarians in doing so when matters are reviewed by the Complaints Committee. The public has a right to ask questions about the care that was provided to their animal( s) and this process provides veterinarians with feedback on whether they have met the standards of practice or whether there are improvements needed to mitigate risks in practice. The Committee provides advice or may request a veterinarian enter into an undertaking when remediation would reduce risks and support a veterinarian in meeting the standard of practice. Only the most serious cases, where there is bad intent, incompetence, reckless behaviour, or a history of failure to remediate at-risk behaviour are referred to the Discipline Committee for a discipline hearing to determine if an act of professional misconduct or serious neglect may have occurred. This example is taken from a case that was reviewed by the Complaints Committee and is offered as a self-reflection tool to support veterinarians in understanding how to meet the standards of practice.
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