Banfield Pet Hospital

My grandmother and I took my cat to the Banfield Pet Hospital in Milford, Ohio on September 7th, 2013 at 10:45 a.m. He had not urinated all morning, nor had there been any urine in his litter box on Friday. We believed he had another urinary tract infection since he has had a history of them starting 4-6 years ago. We believed that treatment would be the same as in the past where they weigh him, perform a physical exam, an exam of his urine, and prescribe him antibiotics and perhaps a special food for a few weeks. However, that is not what happened and this is my account of events from that day.
There was some initial confusion upon intake because I thought my mother had scheduled his appointment that morning at Banfield since I had gotten him a Wellness Plan through them, but she had actually scheduled it at his old vet. Since his old vet closed early on Saturdays and was much further away, and we were already at Banfield we chose to stay there, especially since the treatment was so simple. However, if I had known the severity of his illness then I would have tried to make it to his old vet before they closed instead of staying. I had already filed a complaint against Banfield through their client advocacy center in June 2013 for the following reasons: it took sending them his records 3 times before they would input them, they gave him a vaccination booster he did not need because of their lack of records (and made me bring him in on an extra trip), and when I called to verify an appointment the person who answered the phone told me he needed a parvo shot and they did not deworm him when they said they would (it was not in the records but was on the bill). The veterinarian said that it was a new staff so she was still training them and working out the kinks but the lack of communication and knowledge was so disconcerting that despite getting the Wellness Plan to have his teeth cleaned, I would not schedule the teeth cleaning because I had seen a lack of competence and did not feel comfortable with them doing the cleaning.
I did think that the vet was capable of prescribing an antibiotic and there wasn’t much that could go wrong so I went ahead and took the drop-off appointment they offered (since they had no scheduled appointments available that day). And although that was a selling point of their Wellness Plans that they offered drop-off, weeknight, and weekend hours, I found out they were going to charge $25 because it was not covered by the plan. The medical authorization form I signed at in-take clearly stated that if treatment was to exceed $50 then I was to be called for authorization of any treatment, or if they could not reach me then my mother, could make decisions for my cat on my behalf.
They also wanted me to sign a paper that if he had fleas, they could treat him with Capstar for an additional fee of approximately $20. I did not want him treated with a flea medicine that I had no knowledge of since it could react negatively with his current flea treatment or with the antibiotic I thought they would prescribe. Instead of simply signing the paper, I wrote “Do Not Treat” in large print and then signed and dated the form. I also signed the digital keypad to allow them access to the Wellness Plan, (or so I was told that is what I was signing). The digital keypad only has a box with an x and a line so there is nothing to tell you what you are signing other than the person checking you in at the time. Apparently though this is where they are supposed to inform you about what you are authorizing and that there is no overnight hospitalization available through Banfield. We were not told any of this; we were only told that the vet would see my cat as soon as possible and call us about treatment.
The vet called me at home at 1:45 p.m. after she examined my cat physically. She told me that it was not a urinary tract infection but a urinary tract blockage. She said it was urgent that they removed the blockage immediately because his bladder was completely distended and as hard as a baseball. She said she determined this by palpitating his abdomen and by our statements that he was not urinating. She said that if the if the blockage wasn’t removed soon then he would die. I began to cry because I had not realized that he was so seriously ill and that it was possible I could lose him. She said that they could do the procedure there but she failed to tell me that that could not provide care or hospitalization he would require afterward. She described the procedure as inserting a catheter and flushing out the blockage so they could empty his bladder. They would also run tests on the urine to determine what caused the blockage, crystals or a mucous plug. She then told me that they had calculated that the procedure would cost $596. I wasn’t sure I wanted them to do the procedure and I wasn’t sure I could get the money so I told her I would call her back in a few minutes.
My grandmother, who was with me at the time had overheard the conversation, or at least my part, and filled her in on the rest. I was trying to calm down and decide what to do so I went to find some tissues. While I was doing that my grandmother had called Banfield back and told them to do the procedure. If I had had a chance then I would have called my Mom or tried to get a hold of his old vet for advice first to get advice or a second opinion. My grandmother was unaware of my prior problems with Banfield and these employees in particular but she was trying to help since I was so upset.
And even though my grandmother had identified herself clearly and was not authorized to make the decision, the vet accepted her authorization and performed the procedure. We were called a little while later and told we had to pick him up by 4:45 p.m. because they were closing. At this point, both my grandmother and I were completely unaware that they had no night-time hospitalization. Nor had we been made aware that cats who suffer from urinary tract blockages require such hospitalization afterwards.
When my grandmother and I arrived to pick him up, we were ushered into the exam room farthest to the left. The veterinarian, came in and told us that everything had gone well and the catheter was flowing well. She came in alone and both thick wooden doors were closed for privacy, (so I do not understand how as they are claiming, that the vet assistant that was supposed to be prepping my cat to go home overheard anything, especially with such a soft-spoken person). She said she had flushed his bladder several times and that the substrate was really gritty, like sand. She said they were running tests to determine what kind of crystals had formed the blockage but they did not know what they were yet. She told us he was “an extremely sick kitty and if we had not gotten him in there, he would have been dead by tomorrow”. She told us that one of the tests that were complete was a test for BUN level and that his was a 130 when the normal was only 29. She did not fully explain what this BUN level was although I did discover what it meant later on in this process. She said she was sending him home with some pain medication in syringes and a prescription. She said because the prescription needed to be compounded, the only pharmacy close by that it could be filled at was Hill’s Pharmacy in Milford but we didn’t need to worry about getting it tonight or tomorrow, if they were closed.
Then the vet said we would take him home and bring him back tomorrow for IV fluids at 10 a.m. when they opened and that the catheter would stay in for 4 or 5 days where we would have to bring him in a second time. When my grandmother started asking her how we would care for him in that time, the vet became flustered. She suggested we confine him to a small room, like a bathroom or closet, because with the catheter constantly leaking, it would stink and he would need to be monitored. She did not tell us that he should not be moving a lot with the catheter in or how to monitor urine flow. When my grandmother questioned if he needed to go to an emergency facility, the vet said only if you see something wrong then yes you need to take him but she did not refer us to a facility. So we asked what we should look for and she said lots of blood coming from the catheter. When my grandmother asked why they didn’t provide care after surgical procedures and why they didn’t inform us of this before they did this, the vet said that because they were in the Petsmart building, they could not monitor the animals overnight. According to her, the building is locked and alarmed at night which prevents them from having access to the animals and from the way she said it; that was common knowledge. She said we could leave him there but there would be nobody to watch him.
My grandmother said then they are not a “Pet Hospital”, because hospital implies that you provide 24/7 care for the patients in your care. the vet said no it does not and that they could still perform surgical procedures even if they did not have after-care facilities and are not open overnight to monitor the animals afterwards. This debate did start to become heated between both of them and my grandmother said “well, that is not a hospital then”. The vet became irate and said, “Well, I would be happy to refer him elsewhere.” And then she stormed out of the room. This was the only mention of a referral made and it was not to emergency care or that emergency care was absolutely necessary with the level of toxins in his bloodstream. This flippant response is not what I would call notification that my cat was in serious need of remaining on IV fluids for several hours following the insertion of the catheter, which we later found was an absolute necessity for his survival. She didn’t even provide the names, numbers or addresses for the 24 hour emergency centers in our area, let alone a written referral or records that we could give them if we needed to take him.
A few minutes later, one of the veterinary assistants, entered with my cat in his carrier. My cat's head was facing the back of the carrier so that all we could see was his tail right inside the metal grate. He was not moving even when we stuck our fingers in to pet his tail. The vet assistant went over the medication in the bag again quickly and asked if we had any questions. We asked if my cat could move around and he said yes but to keep him in a small area. (Later, we found out it is better to keep them as still as possible to prevent the catheter from becoming dislodged, something they neglected to mention but apparently the medical director for Banfield knew and shared with me.) He asked if we had a playpen and we said no but that we could go get my grandma’s old dog cage. He said that would work. We asked if we should take my cat with us to go to her house and get it or if we should take him home first then go get it. The vet asistant said it would be fine to take him because he wouldn’t wake up for another few hours yet. We thought it was strange that they would send my cat home even though he had not awoken from the anesthesia yet but neither of us had much experience with animals that had undergone surgical procedures and did not know how long he would be out.
So we left with my cat completely unresponsive, presumably from the anesthesia and expecting that he would wake up soon. It took about an hour to drive to my grandmother’s house, get the cage from the shed, and get back to my house. Once there, we quickly assembled and cleaned the cage and then laid towels in the tray to catch the urine. We opened the carrier door for him to come out but he was still not moving. Since we wanted him to get out easily, I unscrewed the top of the carrier from the bottom so all he had to do was stand and walk out instead of turn around and try to crouch through the door. I placed the bottom of the carrier with him laying on it in the dog cage and we waited. I did notice there was not any urine flowing out of the catheter but there wasn’t any blood flowing out either so we thought maybe the catheter would leak when he tried to sit up or move.
At this point, we could see that he was trying to wake up but he could not seem to keep his eyes open all the way or even keep his head lifted. When he tried to get up he could not get his feet beneath him and his head kept lolling to the side. My mother and nephews came home from their soccer games and my Mom looked at him and said, “That isn’t right. He shouldn’t be out still.” She told me to get on the computer and look up directions to the emergency vet on Red Bank. I did but then I remembered seeing another emergency vet on Kemper Road listed on the window behind the Banfield check-in desk. She told me to try that one because it might be closer. So I looked that one up and got directions to the Care Center.
I didn’t even have time to print them out though because he shuddered and his head fell to the side and his mouth was sort of clinched. His sides were no longer rising and falling and we knew he wasn’t breathing anymore. Everyone was shocked for a second then everyone was screaming and crying; my little nephews were very upset. My Mom told me to get him because she has a bad knee and couldn’t get on the floor like that so I rushed to the cage and pressed his side. I tried shaking him a little and lifted his head but he didn’t move at all and his eyes had completely rolled back in his head. I petted his side and called his name and suddenly his eyes came back down and he started breathing again. My mother grabbed the phone and called the Care Center to let them know what had happened and that we were bringing him in immediately. I took the bottom of the carrier out of the cage with him on it and set it on top of the cage. I scribbled the directions down on the back of his paperwork while my mom and grandma got their keys. We decided that my Mom and I would take my cat and that my grandmother would stay with my nephews and try to calm them down at home.
My cat continued to stay semi-conscious in the truck and remained breathing all the way to the Care Center. We petted him and talked to him the whole way to try to keep him awake and alive. I hadn’t even bothered to get the lid to the carrier because it wasn’t necessary since he could barely move. When we got to the Care Center, a girl came out from behind the long desk and across the waiting room and took the carrier bottom with Gambit on it straight back to the hospital. She came back a few minutes later and said the vet had dropped everything and was working on him now.
Once the emergency veterinarian, had stabilized him, she came to talk with us in one of the exam rooms. She told us that he was on an IV and that the catheter that Banfield had placed had clogged with blood. They had cleared the clog so that it was working better now and that his bladder which had fully distended a second time was emptying. She asked about the surgery, where and when it was performed. She appeared distressed when we told her this was how they sent Gambit home and that he had not been fully responsive since before we dropped him off at Banfield. She asked if the vet at Banfield had said anything about the surgery or the urine tests and I told her what I could. When I told her the BUN, she looked flabbergasted and looked down at the file in front of her. She said “Okay” four or five times and made a note of it. We could tell she was a little dismayed even though she tried to cover it and this she briefly explained what the BUN number meant. It was this point that we realized that he should have been on an IV for at least 12-24 hours to clear all the backed-up toxins from his kidneys. The emergency vet walked me through the treatment and how they would measure input and output from the IV and the catheter. She said they could use the pain medication he already had been given, and fill the prescription he had been given, (although they ultimately decided to give him a different medication). We got to go see him before we left the Care Center and he was already laying upright in his cage. His eyes were not as milky and were wide open just from being placed on the IV.
Unfortunately, the next day I received a call from another emergency vet saying that the catheter was not “positionally correct” and that it needed to be redone to help my cat recover. He said that he believed that he could redo the catheter safely at this point and that it would help his urine output which was lagging behind the fluid intake. I authorized him to proceed and he called me back within a couple hours to tell me that my cat had made it through the procedure okay and that he was already awake from the anesthesia. He did say that when he placed the first replacement catheter, he took an x-ray and realized it would not be as effective because my cat was so long that it did not reach the bladder. However, he was able to place a longer catheter while he was still out and that this one was working a lot better than the old one. My cat remained hospitalized until September 10th on IV fluids to recover, the catheter remained in place until the morning of September 10th and he was monitored all day before being released that night. He is now home and recovering well so far under the guidance of his old vet and a new colleague.
I believe that my cat suffered from being in the incompetent hands of the Banfield vet. For one, if she knew that the proper treatment for blocked cats included several hours of IV fluids, (which every other vet I talked to did and every article I read on-line insisted), then she should have recommended before the procedure that I pick him up from Banfield immediately and take him to a 24 hour facility for treatment since she knew that they could not provide them the same day. She had a second opportunity to inform me that he required IV fluids when we picked him up after the procedure. However, she once again failed to do so. She did not write a referral to take him somewhere else for the IV nor did she provide us with an IV to take home. (My grandmother has been giving her cat an IV 3 times a week for the past several weeks and could have done it herself if she had known he needed it). It is the veterinarian’s job as the expert to inform pet owners of what their pet needs in regards to treatment are and to inform them of all possible dangers. By neglecting to tell us that my cat needed these IV fluids, she nearly killed our cat.
Furthermore, she did not stop to make sure the catheter she placed was positioned properly to give him the best chance for survival. Since my cat did not move at all following the procedure, the catheter could not have been dislodged by his movement but had never been placed correctly to begin with. She claimed to express the bladder but I find it hard to believe that if she had then she would have noticed the catheter was not long enough like the other vet had and corrected the error. The fact that she did not leads me to believe she did a very half-assed attempt to correct the problem for no other reason than to make money for Banfield and herself. The improperly positioned catheter and placing a catheter that was too small is also what probably caused the catheter to clog so soon after being placed. Lastly, if the vet had monitored my cat after the procedure or even attempted to oversee the two lab assistants that were supposed to have been monitoring him after the procedure, then she should have noticed that the catheter was not working properly. There was no urine on the towel in his carrier so the catheter had clogged while he was still in her care but nobody noticed.
Needless to say, the vet will not talk to me and I believe she knows she messed up. She performed the procedure and then sent my cat home so she could go home and that is medical neglect if not malpractice. Even after her assistant, who had called me the next day to find out why my cat had not shown up for his IV said that she would call me back to talk with me, she did not. Instead, they began to try to cover their tracks. When I requested the medical records, they initially refused to give them to me and I still have not received copies of the authorization forms. According to them, the authorization forms were sent to corporate for storage because they have no room to store such paperwork although they managed to provide one I signed in May of this year. The records I did receive, are so full of holes that the information in there is unreliable at best and useless at worst. All of the surgical and post-op monitoring data was “accidentally” deleted by a supposed software glitch. There are no notes on my cat's monitoring other than he was monitored the whole time and he was fine. Other obvious signs of records tampering include that some entries have been omitted from the records and time coded entries say I declined after-care before I even knew what was wrong with my cat (denied on Sept. 7th from 10:40 a.m. to 1:40 p.m. and not on Sept. 8th after 11 a.m. - my phone records can back me up here). They still can’t give me proof that he received the Convenia antibiotic shot or who administered it and I need that information for his current treatment.
In short, the vet either did not have the basic medical expertise to know how to treat a blocked cat or she did and she didn’t bother to utilize it. Either way this shows a level of incompetence that cannot go unnoticed or this will happen again. I do not know if the two vet assistants are certified or not since they have refused to give their qualifications (I found out they are not) but if they are then they need to be held accountable for their actions or lack thereof for the sake of other pets that may fall under their care. I do not want another cat to suffer needlessly because Banfield is not providing adequate care for pets in emergency situations. Banfield is in business to make money and not care for pets, they should not even be considered a vaccination clinic. They hire untrained vet assistants whose sole purpose is to sell you Wellness Plans and services you don't need and who can't even monitor a hospitalized pet. Furthermore, they charged only a couple hundred less for the same surgery that I got at an emergency clinic, the majority of my expense came from hospitalization following their botched attempt to make my cat well. They have you sign things digitally so you have no idea what your signing and therefore, cannot give informed consent. Even though they almost killed my cat and I am refusing to ever take him back to Banfield, they want me to continue paying his Wellness Plan or pay much higher to cover the price of services they boosted to make money off of me and not for the care of my pet. I have tried asking for records and a refund and all I get is referred to the local General Medical Director who hasn't helped rectify this at all. So I am begging everyone, please do not take your pets to this Banfield or any other because it is not worth the heartache and while my pet survived his experience, the next one might not. You don't save anything by going to them but you might save your pet by going somewhere else.
***This is a modified copy of the complaint I sent to the Ohio Vet Board. I have edited the names out but if you would like the name of the vet or her assistants I am more than happy to provide them in a private message.***