ROMI's Website

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Warning:  Due to the nature of this page, while you have it on your screen it is supposed to automatically play the music, "ZORBA" as the most appropriate song title for this page - feel free to turn your speakers off at any time you've "over-dosed" as I haven't figured out how to control it [yet]!  Thank you for your understanding.


PART #9: 

11/05/04
 
Lee Zavala, Investigator
State of Washington
Department of Health
Board of Governors
(copy to: Darlene.Tiffany@DOH.WA.GOV to be added to complaint)
 
Re:    ADD-ON #9:  SUPPLEMENTAL INFORMATION
        Case #: 2004-04-0008 VT    
        Lawrence Williams/Burien Veterinary Hospital
        Hammond/Meyer/Baty/Five Corners Veterinary Hospital
        Murnane/Jewett/Phoenix Central Lab
 
Dear Mr. Zavala,
 
Thank you very much for meeting with me today at Sudden Printing and copying the additional Exhibits #76 through #118, along with the four (4) items from the packet labeled Exhibit #104.
 
Per our discussion(s) during the 'copy fest', I would like to provide you with additional information as follows:
 
1.    I would appreciate it if you are able to determine the actual "status" of DVM Rachel Meyer, as to whether or not she was duly licensed to practice veterinary medicine by or in the State of Washington on the date of 4/25/04, when she told me that I only had a choice of either authorizing CPR on ROMI [which she admitted to me would do nothing to bring ROMI out of the coma she was in] OR euthanasia, which was based on both the opinion(s)/diagnosis of herself and DVM Hammond at Five Corners that the 'diagnosis' as determined by the Hammond/Five Corners group was a 'severe neurological problem', and 'most likely 'a brain tumor' [despite all of the information I had provided to them that ROMI was having a massive RIMADYL toxicity reaction].  As I told you with respect to Exhibit #116, I had not been able to determine DVM Meyer's license status from the WA Provider "Look Up";
 
2.    As you had made copies from the ADE Survey Response packet, [WA Vet Exhibit #104] which was limited to Washington State residents having the "RIMADYL experience", and expressed a specific interest in knowing about any WA Vet Board complaint filings regarding RIMADYL from those individuals, I have e-mailed "Marta", the one instance where it IS my understanding a WA Vet Board complaint has been filed and is also still "under investigation", and have asked her permission to provide copies of additional pertinent information she had provided to me and I am waiting on her response and verification of the case number, etc. - that is CASE #2004-02-0010 VT (if correct).  It might possibly also make sense to have her contact you directly. 
 
3.    I had provided to you as a part of Exhibit #104, printed out sheets of the ADE [adverse drug event] responses collected by me between 8/12/04 and 8/24/04, those responses of Washington State only, who also have had "the RIMADYL experience", those sheets being provided today from the large packet as #8, #10 [mine], #12 and #13 to Exhibit #104.  The ADE Survey Report and Summary WAS included in what became Part #5 of my complaint filed by e-mail on 9/26/04, the first of the series of e-mails to the WA Vet Board in which no receipt acknowledgement was ever provided.
 
As I stated to you, the original purpose of my doing the ADE Survey and collecting the Responses and doing the Summary of same, was to provide it to a reporter, Chris Hayes, of KPHO in Phoenix, AZ, who was going to be doing and did do a report on RIMADYL.  I apologize for resending it [below] but have done so in order that you can now print that portion out and match it up with those print-outs on the 2nd Exhibit Listing as #104:  
 
 
WA VET BOARD
EXHIBIT #104 ADE SURVEY REPORT (and cover letter)
[sent to reporter Chris Hayes, KPHO TV in Phoenix, AZ at e-mail Chris.Hayes@kpho.com on 8/24/04 and the Responses are not included here, other than those provided to Mr. Zavala on 11/05/04 as #8, #10, #12 and #13 for Washington State residents only]
 
8/24/04
 
Dear Chris:  As part of this e-mail I have included the completed/returned ADE [adverse drug event] responses received by me [as of 8/24/04] to the survey which begins with short summaries of the FDA/CVM ADE reports [and their verification sites] and the statistical information on this survey for you.  Please let me know that you received this e-mail [ASAP, so I know it didn't get lost in 'cyber-space'] and if the information was helpful to you. Please let me know if you are going to use this as it's going to you FIRST and then it will be available to other reporters.  Thanks! Ginger
 
*******
 
ADE [adverse drug event] Information, SURVEY and Summary - 8/24/04
 
I.    A.   FDA/CVM Statistics: This article presents a descriptive overview of the 9,731 post-market adverse drug event (ADE) reports received by the U.S. Food and Drug Administration, Center for Veterinary Medicine (FDA/CVM) during calendar year 1999.
SITE: http://www.fda.gov/cvm/index/fdavet/2001/May_Jun.htm#adverse
 
Table 1.
ADE Reports by Year
Year Number
1992 1,011
1993 1,250
1994 1,746
1995 3,193
1996 3,112
1997 4,738
1998 9,385
1999 9,731
 
NOTE: the official FDA/CVM ADE 'doggy body bag' statistics, normally at the official FDA site: http://www.fda.gov/cvm/index/ade/ade_cum.htm]
is presently showing the following messages [as of 8/24/04]:
  • Note:  The August 2004 updated cumulative report will be delayed due to technical difficulties.
  • Note: file is 11.70 MB (it takes between 8-11 minutes to download a one megabyte file using the average dial up internet connection)
B.    An excellent chart with the most current and available FDA/ADE statistics can be found at: http://dogsadversereactions.com/nsaid/comparison.html
 
II.    Doghealth2 ADE Survey done August 24, 2004:
 
Total number of responses: 44    Deaths: 40 [91%]
[please note there are/were possibly four [4] survivors in this group][8%]
 
Drug Reported Involved [question #3] and statistical percentiles:
State/Country [question #6]:
 
Arizona: 1
California: 3
Canada, Alberta: 1
Colorado: 4
Florida: 5
Georgia: 1
Great Britain: 2
Illinois: 1
Iowa: 1
Michigan: 1
Minnesota: 1
Missouri: 1
New Hampshire: 1
New Jersey: 1
New York: 3
New Zealand: 1
North Carolina: 2
Ohio: 1
Pennsylvania: 1
South Carolina: 4
Texas: 1
Vermont: 1
Washington: 4
Wisconsin: 2
 
Question #7: whether or not your veterinarian informed you of the potential/possible risks/side effects BEFORE dispensing the named drug, stating whether such information was provided verbally and/or in written form [and statistical percentiles]:
Additional comments/info provided verbally by vet: "doggy aspirin", "mild pain killer", "treats", "safer than aspirin", "verbal discussion did not include ‘EM’ as possible/potential reaction" [had taken before and blood work done], "routine blood work done, but no information provided", "give with food", "provide lots of water".
 
III.   
FULL REPORTS PROVIDED FOR REPORTER VERIFICATION
===================================================
 
4.  As we had also discussed what a "definition of safety" and/or risk might be regarding RIMADYL, I am additionally providing you with some of the most recent 'statistics' on RIMADYL from the FDA, which had not been available on the FDA/CVM website due to the problems listed at their website during 08/04, and which I am now marking as Exhibit #119, [please add to your list also].  Again as I stated to you, while it would appear that PFIZER's "position" with regards to RIMADYL reactions is considered to be that they are "statistically insignificant" to both PFIZER (who makes a great deal of money by continuing to market this drug to veterinarians) and to the FDA/CVM, whose apparent 'function' is to merely count the "doggy [body] bags" for their own statistical purposes (and does NOT "guarantee" the safety of ANY drug or product that they "approve" for marketing) while the FDA and/or FDA/CVM does as a matter of FACT collect "annual user fees" to keep products on the market on behalf of the manufacturers, it is ALSO a fact that this problem/situation does have a direct and horrible negative effect on dog owners in the State of Washington and behind each and every 'report' of individual pet loss or health damage due to and/or contributed to or set into motion by RIMADYL, is an unbelievable amount of personal grief and financial loss to Washington residents (as well as across the entire "world") that the Washington State, Veterinary Board of Governors must really get a 'handle on' via their control over the veterinary practice in the State of Washington.
 
UPDATE (10/10/04): the figures from the most current FDA/CVM report for RIMADYL DEATHS were kindly provided by Jean Townsend via the posting of same at the doghealth2@Yahoo.com website:
 
FDA CVM - Cumulative Adverse Drug Effect Report for the drug CARPROFEN (Rimadyl):  Introduced to the U. S. Market January 1997

October 1, 2004
Treated 12,919
Reacted 12,516 (97%)
Died 2,349 (19%)

June 7th 2004
Treated 12,913
Reacted 12,510 (97%)
Died 2,346 (19%)

April 1st 2004
Treated 12,791
Reacted 12,388 (97%)
DIED 2,315 (19%)

March 1st. 2004
Treated 12,758
Reacted 12,355 (97%)
DIED 2,302 (19%)

January 31, 2004
Treated 12,680
Reacted - 12,278 (97%)
DIED - 2,292 (19%)

Dec. 30, 2003
Treated 12,611
Reacted 12,209 (97%)
Died 2,274 (19%)

November 28, 2003
Treated 12,507
Reacted 12,107 (97%)
Died  2,255 (19%)

October 31, 2003
Treated 12,349
Reacted 11,950 (97%)
Died 2,226 (19%)

Sept. 30, 2003
Treated 12,263
Reacted 11,871 (97%)
Died 2,201 (19%)

Aug. 31 2003
Treated 12,241
Reacted 11,849 (97%)
Died 2,193 (19%)

July 8, 2003
Treated 12,187
Reacted 11,805 (97%)
Died 2,182 (18.4%)

June 4, 2003
Treated 12,089
Reacted 11,710 (97%)
Died 2,153 (18.4%)

May 1, 2003
Treated 12,025
Reacted 11,650 (97%)
Died 2,133 (18.3%)


Please be aware, that according to the FDA Center for Veterinary Medicine, veterinarians are the weakest link in the Rimadyl chain.
 
Mr. Zavala, I do apologize for the length of this e-mail, particularly as I'd really hoped that "Part #9" was the very 'end' of my 'sends', but as I stated to you and to the WA Vet Board in other Add-Ons to my complaint, this situation/problem with the casual and/or inappropriate prescribing/dispensing of RIMADYL, however "statistically insignificant" the manufacturer, PFIZER, believes the death/damage toll might be, really does need to be fully examined by the State of Washington, Veterinary Board of Governors, not just for my own personal grief and financial loss over the needless and unnecessary death of ROMI, but for ALL dog owners who have already also been adversely impacted and who are continuing to be put at risk in the State of Washington.
 
Thank you and I hope and pray that I really am 'done' this time.
 
Ginger Sanchez
e-Mail: [ONLY]: GingerLSanchez@aol.com

[copy sent to Washington State, Veterinary Board of Governors, Washington State Investigator, Murnane/Jewett/Phoenix Central Laboratory on 11/13/04.  NOTE: It appears that the "Squeaky Wheel", sending at last count 700 e-mail copies of my complaint against Murnane/Phoenix to them, has succeeded in stimulating the Murnane/Phoenix group to contact the Hammond/Five Corners group who is NOW giving me the options of either having ROMI's "remains" sent to Hammond/Five Corners for my "pick up" or for Murnane/Phoenix to do a cremation.  These are not viable choices for me, although it would definitely satisfy the needs/wants of all of the veterinarians involved as well as PFIZER.  Given Murnane/Phoenix's "position" that none of the "items" needed for a 2nd necropsy and DNA ID would ever be available to anyone without a court order in a filed civil litigation case by attorneys, what they appear to be offering is only a choice of what's left of ROMI's frozen carcass after the necropsy was performed to be sent to Hammond/Five Corners, who does not have any adequate refrigeration for same, or cremation - BOTH "options" would successfully eliminate ANY 2nd necropsy and DNA ID ever being done - for me, this merely shows just how FAR these folks are willing to go to continue their cover-ups.] 
11/13/04
 
Margaret Baty
Five Corners Veterinary Hospital
 
Re:    ROMI's "remains"   
        State of Washington, Veterinary Board of Governors
        Case #: 2004-04-0008 VT  (investigation pending)  
        Lawrence Williams/Burien Veterinary Hospital
        Hammond/Meyer/Baty/Five Corners Veterinary Hospital
        Murnane/Jewett/Phoenix Central Lab
 
In response to your two (2) e-mails to me and the one (1) I received from "Linda Jewett" at the Phoenix Central Laboratory (all copied below for your convenience), please be advised that you and/or Hammond/Meyer/Baty/Five Corners Veterinary Hospital and/or Murnane/Jewett/Phoenix Central Lab are to MAINTAIN the 'status quo' of ALL of ROMI's "remains", which include but are not limited to
  • ALL "histopathological slides" and/or specimens,
  • "representative portions of all organ systems [that] are preserved in formalin",
  • "Adipose, heart, lung, kidney and liver frozen" and
  • "Remainder of the carcass frozen" per the Murnane/Phoenix Central Laboratory necropsy report dated 4/26/04
pending the State of Washington, Veterinary Board of Governors decision(s) in this matter and/or I have informed you in writing of the arrangements made for a 2nd necropsy and DNA Identification of same.
 
You are additionlly instructed not to make any further contact with me of any sort.  Thank you.
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSanchez@aol.com
 
*******
In a message dated 11/10/04 5:38:11 PM Pacific Standard Time, MargaretB@petschoice.com writes:
I have been unsuccessful in attempting to reach you at your home telephone
number.  I have received a call today from Phoenix Labs which requires your
response. 

Please contact me at the number listed below.

Margaret K. Baty, OTL
Five Corners Veterinary Hospital
206.243.2982  Telephone
206.248.0264  Fax
 
In a message dated 11/10/04 5:38:11 PM Pacific Standard Time, MargaretB@petschoice.com writes:
I have been unsuccessful in attempting to reach you at your home telephone
number.  I have received a call today from Phoenix Labs which requires your
response. 

Please contact me at the number listed below.

Margaret K. Baty, OTL
Five Corners Veterinary Hospital
206.243.2982  Telephone
206.248.0264  Fax

11/10/04
 
Margaret Baty
Five Corners Veterinary Hospital
 
Ms. Baty: I do not use telephone communication, only e-mail - please state what you need/want to state via e-mail.  Thank you.
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSanchez@aol.com
 
In a message dated 11/10/04 6:30:18 PM Pacific Standard Time, MargaretB@petschoice.com writes:
I have received a call from Phoenix Labs regarding Romy.  Romy is still residing in their morgue. 
 
Phoenix Labs can send Romy to Five Corners and you can claim him here.  Or, they can send Romy remains to be cremated.   
 
Please advise how you want this handled. 
 
Margaret K. Baty, OTL
Five Corners Veterinary Hospital
206.243.2982  Telephone
206.248.0264  Fax
In a message dated 11/12/04 11:02:02 AM Pacific Standard Time, LindaJ@pclv.net writes:

Dear Ginger,

I am responding to your email to our pathologists (fayes@pclv, bobm@pclv,and Kristin@pclv) on behalf of Phoenix Central Laboratory.   Again, we ask that you please contact your veterinarian/veterinary clinic for a resolution to your complaint.  Arrangements can be made through your veterinary clinic for recovery of the body your companion pet.  This has always been possible.

On a personal note, I am very disappointed that you have chosen to name me in your complaint.  When we ended our conversation many months ago (a phone call that I took out of courtesy due to the distressed nature of the call), you thanked me for listening (for over an hour) to your concerns and expressed grief for having lost your friend and companion, Romy.  From your complaint, I have learned one of those unkind lessons of life and will undoubtedly think twice before taking another call of this sort.

Again, please contact your veterinarian/veterinary office.  I have been advised that they have been unable to get through to you by phone because your line is busy.

Sincerely,

Linda Jewett  

Linda Jewett

Marketing Manager

Phoenix Central Laboratory


UPDATE Re: Washington State Veterinary Board of Governors

01/12/05

The February 2005 Veterinary Board of Governors Meeting has been cancelled.

The next meeting is scheduled for April 11, 2005 in Kent beginning at 9:00 a.m.

Janelle C. Teachman, Program Manager
Veterinary Board of Governors
Department of Health, HPQA Section Three
P. O. Box 47868
Olympia, WA 98504-7868
(360) 236-4876
Fax: (360) 664-9077
E-mail:  janelle.teachman@doh.wa.gov

"The Department of Health works to protect and improve the health of the people of Washington State"


 1/24/05

 
Lee Zavala, Investigator
State of Washington
Department of Health
Board of Governors
 
NOTE: e-Mail copy sent to: Darlene.Tiffany@DOH.WA.GOV to be added/included with the complaint file/materials previously submitted in this matter. 
 
Re:  ADD-ON #10: NEW EVIDENCE/ALLEGATIONS and
                 SUPPLEMENTAL INFORMATION
    
        Case #: 2004-04-0008 VT    
        Lawrence Williams/Burien Veterinary Hospital
        Hammond/Meyer/Baty/Five Corners Veterinary Hospital
        Murnane/Jewett/Phoenix Central Lab
 
Dear Mr. Zavala,
 
Through a peculiar stroke of fate, I have now received a certified letter from Pfizer containing a copy of the written report taken/made by them in response to DVM Williams' ADE [adverse drug event] report via telephone to Pfizer on 7/12/04 regarding the death of my dog, ROMI, which occurred 4/25/04.  This letter and the ADE form report must be considered new evidence and added to the complaint, as it not only further supports allegations already made by me along with questions I have raised regarding some of the potential allegations, it sheds a great deal of "clarity" upon the behavior(s) and apparent activities of all the veterinarians who have been named in this complaint and this new document will now be Exhibit #120.
 
Mr. Zavala, I have recently become employed [1/04/05] at a part-time job, but would very much appreciate meeting with you at the copy place again as before on any Tuesday through Friday, at 3:30 p.m. that's convenient for you, so that you can not only have a copy of this letter and ADE form [which I can afford to pay for this time], but so you can see the original documents yourself for verification of their legitimacy.
 
As I'm certain you already know, the filing of an ADE report by a veterinarian is completely voluntary, although once a drug manufacturer receives an ADE report it is mandatory for the drug company to provide it to the FDA/CVM. 
 
As previously stated by me in this complaint, it does not make any sense whatsoever for a veterinarian to voluntarily file an ADE report with either the drug manufactorer or the FDA/CVM if the veterinarian believes that there is no connection between the drug, in this case RIMADYL, and the "reaction/results".  The only exception is in the instance when the drug does not 'work', which is not the case here. 
 
Nevertheless, DVM Williams' filing of the ADE on ROMI with Pfizer does provide a wealth of information that goes towards exposing some additional extremely unprofessional and unacceptable conduct regarding this matter.  I am taking each section/area of the DVM Williams' ADE report and providing my comments and additional allegations, which now puts a focus on the behaviors of all of the veterinarians named in this suit in what appears more and more to be a big effort to cover-up information and facts after ROMI's horrific death.
 
NEW INFORMATION/EVIDENCE/ALLEGATION #1:
DVM Williams/BVH: "The vet relayed that he does not have medical records as his office manager gave the owner the originals to copy and they were never - (more on page 3) returned."
SANCHEZ: As previously stated in my complaint, when I called almost a week ahead of time to request a copy of ROMI's FULL medical records, I was told that their policy was to only provide a "summary" sheet, and after my insisting that I wanted a complete copy of ALL of the records and offered to pay any copy charges, I was informed when I could pick the full set of records up.  When I arrived to pick up the complete copy of all the records on ROMI from DVM Williams/BVH, the office girl tried to palm off on me a single sheet "summary" in a sealed envelope, saying "that's it".  When I persisted on receiving a copy of the full set of records, a mature blond-haired woman [whose name or title/position I don't know] initially stated that I could not have a copy of the full records.  When I asked if she was telling me that it was going to be necessary for me to get a court order to obtain a full copy of the records, she backed down from that position and then began making copies.  When she brought the copies to the counter, along with their file on ROMI, I asked to compare the file contents with the copies provided to make sure everything was there and did so, finding there was a stapled packet of documents that had been faxed to DVM Williams from the DVM Hammond/Five Corners group on top of the chart.  I asked that I also have a copy of that packet and the mature blond-haired woman said that since that packet was not DVM Williams' records, it was considered to not be part of their records and would be thrown in the "trash".  I then stated that if they were only going to throw away the packet, that I wanted it or a copy of it and she handed me the entire packet without another word.  They have their own copy machine; they had finally and after my insistance made copies of the records for me on the spot- why EVER would it now be claimed that I was given the "medical records" to copy somewhere else and then failed to return them? And HAD that been "true", why did no one from DVM Williams/BVH ever contact me about the "packet"?  While it's true that my single phone line is a dedicated Internet connection, DVM Williams/BVH certainly never had any problem with MAIL getting to me, as evidenced by the "booster shot reminder card" that I'd responded to.  The only rational explanation that I can see for this 'story' is that DVM Williams KNEW and or suspected he didn't have any 'right' to the 'confidential medical records' of DVM Hammond/Five Corners without my permission, which he did not have, and it's more likely than not that DVM Williams did not realize that an ADE filing would result in being asked to provide records that he was not entitled to.  As to those records of DVM/Hammond that he HAD but he was NOT entitled to, in addition to the fax packet he'd received, which I was given as "trash", the records of DVM Hammond/Five Corners show that DVM Williams continued to be provided copies of those records at his request on multiple occasions and after he'd gotten that first packet of copies faxed to him by DVM Hammond/Five Corners.  "Baty"[office manager] for the Five Corners group asked for my permission, which was denied by me, but the "permission" was asked for after several sets of records had already been provided to DMV Williams/BVH by them.  This area of information provides an additional basis for the apparently 'cozy relationship' between DVM Williams/BVH and DVM Hammond/Five Corners that's resulted in a blatent breach of 'confidentiality' as well as DVM Williams/BVH supplying FALSE information to Pfizer.  It would now appear that DVM Williams' continuous denials to me regarding RIMADYL toxicity  may very well have greatly contributed to DVM Hammond/Five Corners insisting on mis-diagnosing ROMI, despite the information I'd provided and may well be the excuse/explanation for why DVM Hammond/Five Corners never bothered to contact Pfizer's veterinarian "hot line" to verify the RIMADYL toxicity and find out about treatment options as I'd instructed when I took ROMI into Five Corners ER facility.
 
NEW INFORMATION/EVIDENCE #2:
DVM Williams/BVH: "The case is in litigation so the vet cannot get copies of the necropsy report from the pathologist or ER clinic because the owner has requested her records not be released."
SANCHEZ: The "case" was never in litigation, unless DVM Williams believes that the WA Vet Board investigation is 'litigation', which it patently is not.  I have never retained an attorney for even potential 'litigation' as it has been as difficult to locate an attorney/law firm with sufficient expertise and ethics as it is apparently as difficult to locate a veterinarian with sufficient expertise and ethics. 
 
As to the 'records' which DVM Williams claimed to Pfizer that he did not have, according to the records of DVM Hammond/Five Corners, all of their records had been already provided to him on multiple ocassions without my consent and/or knowledge and DVM Hammond/Five Corners apparently then stopped providing additional copies of same only when I provided DVM Hammond/Five Corners a demand, both verbal and written, that they STOP providing anyone other than a duly authorized/official WA Vet Board investigator with any further records.
 
NEW INFORMATION/EVIDENCE #3:
DVM Williams/BVH: "The dog was obese and had a history of GI issues following administration of Ibuprofan."
SANCHEZ:  This statement goes directly to the heart of my allegation that the prescribing/dispensing of RIMADYL for ROMI was completely inappropriate and can only be viewed as falling into the categories of veterinarian malpractice, incompetence and negligence on the part of DVM Williams/BVH.  According to the FDA, Ibuprofan is in the same category of drugs known as NSAIDs [non steriod anti inflammatory drugs] that RIMADYL belongs to and is known for the same risk factors.  The only rational explanation for DVM Williams prescribing/dispensing RIMADYL for a dog with a "history of GI issues following administration of Ibuprofan" is veterinarian malpractice at it's worst and colossal ignorance and indifference to animal health, safety and welfare at best and the result [ROMI's horrific and needless death] speaks for itself, especially in view of the fact that the only information ever provided to me by DVM Williams about RIMADYL was that "it's totally safe" and "it'll fix her right up".  However, according to BOTH Pfizer and the FDA/CVM labeling information:
"As a class, COX-inhibitory NSAIDs may be associated with gastrointestinal and renal toxicity. When NSAIDs inhibit prostaglandins that cause inflammation, they may also inhibit prostaglandins which maintain normal homeostatic function. The most frequently reported effects have been gastrointestinal signs. "
 
and, "RIMADYL, like other drugs of its class, is not free from adverse reactions. Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with drug intolerance. Serious adverse reactions associated with this drug class – including but not limited to gastrointestinal, renal and hepatic signs – can occur without warning and in rare situations result in death. Owners should be advised to discontinue RIMADYL therapy and contact their veterinarian immediately if signs of intolerance are observed." 
 
INSTEAD, when I contacted DVM Williams to report ROMI's symptoms, he instructed me to continue the RIMADYL, which I refused to do after reading some of the information that was on the Internet provided by both Pfizer and the http://srdogs.com site, and which DVM Williams claimed was not 'true', further stating there was "no way" ROMI could have been having a RIMADYL reaction or any other reaction, that the RIMADYL was "totally safe", that he had "used it a lot with no problems" and further, as previously stated in the prior sections of this complaint, he never offered or suggested in any way that ROMI even might need any further 'medical care' other than saying just to "push fluids" and let him "know how she did".

NEW INFORMATION/EVIDENCE #4:
DVM Williams/BVH: "The vet believes the next day 4/23/04 the dog was presented to the ER clinic."
SANCHEZ: I "believe" that DVM Williams received medical record copies from DVM Hammond/Five Corners, according to their records, at least 3 times before I ordered DVM Hammond/Five Corners to stop providing same without my permission.
 
NEW INFORMATION/EVIDENCE #5:
DVM Williams/BVH: "Labs revealed mild elevation in liver enzymes.  The dog "crashed" and the owner elected to euthanize the dog."
SANCHEZ:  I was verbally told by DVM Hammond/Five Corners that ROMI's liver enzymes were "off the chart", as evidenced by the DVM Hammond/Five Corners lab results which DVM Williams received at least 3 copies of and which can be seen on Exhibit 7.  As to "electing" to euthanize ROMI, I asked DVM Meyer/Five Corners if we could just give ROMI more time to pull out of it on her own, and DVM Meyer said "absolutely not" that the only choices were either doing CPR, which DVM Meyer admitted would not change ROMI's comatose state or doing the euthanasia.  And I again allege that DVM Meyer's status as a currently licensed veterinarian at the time of ROMI's "care" on 4/25/04 is in question per the Washington Provider Search which still shows that while "active", DVM Myer's license had not been renewed since 2/13/04.
 
NEW INFORMATION/EVIDENCE #6:
DVM Williams/BVH:  "The vet dispensed a free trial of 100mg Rimadyl BID for 10 days."
SANCHEZ: per Pfizer
"Packaging - RIMADYL Chewable Tablets are scored and contain 25 mg, 75 mg or 100 mg of carprofen per caplet or tablet. Each Chewable Tablet size is packaged in bottles containing 7, 14, 30, 60 or 180 tablets. "
 
and,  "Always provide a Client Information Sheet with prescription. " 
This area has been previously covered in the other sections of the complaint including the copy made of the container from DVM Williams/BVH and one of the tablets as exhibits and there were no 'warnings', no information of any nature whatsoever provided by DVM Williams/BVH at any time.  I have previously alleged and now again allege that the prescribing/dispensing of the RIMADYL without providing the "client information sheet" was in violation of both Pfizer's and the FDA/CVM's specific instructions to veterinarians, which DVM Williams/BVH chose to blatently ignore.  The 'fact' that the RIMADYL was not charged for doesn't change the deadly and needless results or justify in any manner the cover-up behaviors that have followed.

NEW INFORMATION/EVIDENCE #7:
DVM Williams/BVH: "A necropsy revealed no gastrointestinal changes or ulceration and the liver was normal. The vet reported the pathologist like himself did not believe the dog's signs were related to Rimadyl, but no definitive diagnosis was determined"
SANCHEZ: Amongst the records that were provided at least 3 times to DVM Williams by DVM/Hammond Five Corners prior to the filing of this ADE report with Pfizer on 7/12/04, was a copy of the necropsy report, which DVM Williams received the first time long before I even received a copy.  The necropsy report was provided previously as Exhibit #4, and while it's true that "no definitive diagnosis was determined" by the veterinarian/pathologist's necropsy report, the liver was not "normal", the spleen, kidneys and pancreas were not "normal", as were many other systems "not normal".  As to DVM Williams' ADE report to Pfizer stating: " no gastrointestinal changes or ulceration" being revealed, on the "final" necropsy report that was added onto the preliminary one and which DVM Williams/BVH received multiple times according to the DVM Hammond/Five Corners records:
"There are a spectrum of lesions some of which may be related . . . the large intestinal mural lesions suggest penetrating foreign body although a variety of other scenarios are feasible.  This lesion potentially could have been multicentric histologically, and consequences of this type of lesion could result in hepatic changes, and even pulmonary and multicentric inflammation via toxemia/septicemia.  This is of course speculative." 
This is further false information provided by DVM Williams/BVH to Pfizer.
 
With regard to DVM Murnane/Phoenix Central Laboratory: The entire necropsy report as to any actual definitive diagnosis of ANYTHING is "speculative", but there is no denying that there is a very long list of "findings" that are not "normal", and ALL of these findings ARE consistent with the FDA/CVM's listing of known symptoms/conditions that are caused by and/or associated with a "reaction" following the administration of RIMADYL, as are ALL of the symptoms documented within the records of DVM/Hammond/Five Corners.
 
I have previously stated in my complaint to the WA Vet Board that it's my belief and therefore an 'allegation' that the necropsy report [ASSUMING a necropsy actually took place] was 'whitewashed' and I restate that again here and further state that such 'whitewashing' of a necropsy report is nothing short of fraud, deceit and deception.  I have previously provided the information available at the FDA/CVM website as to the listing of the known symptoms/conditions caused by and/or associated RIMADYL per the ADE reports they received following the administration of RIMADYL and am now providing an alphabetized listing with terminology definitions of those symptoms/conditions for the WA Vet Board as Exhibit #121 at the bottom of this e-mail for your convenience.  The list is quite extensive and while not everything that's on the list applied to ROMI, everything ROMI suffered from before she died and after the necropsy was allegedly performed IS on the list.  It shouldn't take a rocket scientist to figure out that there's a "potential cause and effect" in operation and to continue 'denying' the relationship between the administration of RIMADYL and ROMI's subsequent "crash" and death can only be viewed as fraud, deceit, deception and quite frankly, just outright lying.  
 
Based upon the FDA/CVM information regarding the known symptoms/conditions that they provide, I must now add to the allegations against DVM Murnane/Phoenix Central Laboratory of "gross incompetence" at best regarding his necropsy report as it's obvious DVM Murnane is either horribly not up to date education-wise or chose to NOT use the information that is known about RIMADYL toxicity.  DVM Murnane's necropsy report is NOT consistent with the facts per the FDA/CVM, but was instead indeed a 'whitewashed' report, i.e., yet another situation involving fraud, deceit and deception via "mumbo-jumbo". 
 
NEW INFORMATION/EVIDENCE #8:
While I had demanded an itemization of the billing charges in the sum of $1,100.00 [less 10% senior discount] for the necropsy from DVM Hammond/Five Corners many times, which has never been produced, I now offer a choice of allegations against either or both DVM Hammond/Five Corners and DVM Murnane/Central Phoenix Laboratory regarding both the CONDITION and the present 'true' LOCATION of ROMI's body and/or her "bits and pieces/frozen carcass":
 
Throughout the DVM Murnane/Central Phoenix Laboratory necropsy report, it is repeatedly stated that there are/were apparently problems/difficulties making determinations/assessments due to "autolysis".  My understanding now of the term "autolysis" is decomposition
GIVEN that I was charged by DVM Hammond/Five Corners [verbally] for 'a whole lot of ice', how much 'decomposition' would have occurred when the preliminary report was written/dated 4/26/05 ? ROMI was euthanized on 4/25/04 and in the responses made by DVM Hammond/Five Corners to the Better Business Bureau [previously supplied] that DVM Hammond offered that she could "attest" to ROMI's body having been picked up/transported by 3:00 p.m. on 4/25/04, that same day.  Was ROMI even transported to DVM Murnane/Phoenix Central Laboratory?  Or is it just possible that ROMI's body was otherwise 'disposed of' and the necropsy report written with the purpose of destroying the evidence of the cause of ROMI's death?  
 
IF PROPER/ADEQUATE REFRIGERATION HAD BEEN DONE both prior to the alleged necropsy being performed [per their notes in the DVM Hammond/Five Corners records regarding the preservation requirements] and during the time-frame(s) the alleged necropsy took place, why then was there so much alleged "autolysis" [decomposition] which then became the excuse/explanation for an inability to definitely state anything regarding the alleged 'findings'? 
 
On page 2 of the DVM Murnane/Central Phoenix Laboratory necropsy report, where it begins the "final report", dated 4/29/04, the statement is made: "Tissues exhibit moderate to more often extensive autolysis significantly impeding evaluation (postmortem condition is downgraded to poor)." and "autolysis" is repeated a number of times in the "Microscopic" section as being the explanation/excuse for the alleged inability to arrive at any definitive diagnosis: "Examination of virtually all organs/tissues is impeded and description and diagnoses are as such tentative."  It would appear that DVM Murnane/Central Phoenix Laboratory also did not provide adequate refrigeration for ROMI's necropsy, again assuming that an actual necropsy even took place.
 
I previously provided the WA Vet Board with the information regarding the alleged 'location' of ROMI's body from both DVM Hammond/Five Corners and DVM Murnane/Phoenix Central Laboratory in which I was given a "choice" that was obviously designed to eliminate any possibility of a 2nd necropsy and DNA identification of ALL of ROMI's remains and based upon that "choice" I hereby allege that BOTH DVM Hammond/Five Corners and DVM Murnane/Phoenix Central Laboratory have "worked in concert" to cover up the true cause of ROMI's death and to continue to fail to provide any evidence that a necropsy was even actually performed. I additionally allege that it's more likely than not that the 'body only' being offered to me [without any of the parts allegedly preserved or access to any of the alleged histology slides] or a choice of 'cremation' may well not even have been ROMI's.  If everything regarding the necropsy was 'legitimate', why is nothing of use for a 2nd necropsy and DNA identification available? Exactly what is being hidden here?   
I again request/demand that the WA Vet Board determine the truth as to all of above in order that informed decisions can be made regarding this entire situation.
 
The alphabetized FDA/CVM's known symptoms/conditions caused by and/or associated with RIMADYL administration per their ADE reports is below.  Thank you.
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSanchez@aol.com
 
* * * * * * *
 
The below FDA/CVM ADE report information was taken from the Internet, is dated 11/03/04 and lists the reported symptoms/conditions caused by and/or associated with the administration of Carprofen [RIMADYL].  I have taken the liberty of only placing the conditions in alphabetical order for readability, assigned many of the listed conditions to a 'body system' for convenience, which is underlined, and where I could find a definition have provided one from MedLine or the Merck Veterinary Manual.
 
The below listing is from the FDA/CVM's ADEs [Adverse Drug Event reports].  It is assumed that a veterinarian would not turn in an ADE for NO reaction, except for the reporting of a lack of effectiveness of the drug, but in my own personal case DVM Williams/BVH, who continuously denied to me that an ADE had occurred from the RIMADYL, turned in an ADE report to Pfizer on 7/12/04 which was approximately three [3] MONTHS after ROMI was euthanized and 30 days after I had provided the Washington State Veterinary Board of Governors Investigator with the first 75 documents/exhibits to my complaint. 
 
BECAUSE every below symptom, condition and/or side effect is/was known to be caused by and/or related to the administering of RIMADYL, and each condition also has other potential causes, it's understandable, to a degree, why even 'good' veterinarians and/or veterinarian/pathologists might have problems correctly diagnosing RIMADYL toxicity, but there is absolutely NO excuse for a licensed veterinarian and/or veterinarian/pathologist to fail to arrive at a correct diagnosis of RIMADYL toxicity when they have been provided ALL of the information beforehand, as in the case with both DVM Hammond/Five Corners and DVM Murnane/Phoenix Central Laboratory unless they have some other "agenda", which once again goes to the heart of fraud, deceit and deception .
 
From:  http://www.governmentguide.com/govsite.adp?bread=*Main&url=http%3A//www.governmentguide.com/ams/clickThruRedirect.adp%3F55076483%2C16920155%2Chttp%3A//www.fda.gov
taken from FDA internet site on 11/14/04, dated 11/03/04
 

Annual and Cumulative Veterinary Adverse
Drug Experience (ADE) Reports

(Adverse experiences are listed by generic drug name)

CARPROFEN (RIMADYL)

Veterinary ADE Annual Summaries

Reviews    Treated    Reacted   Died 
12247      12919      12516      2349


ABSCESS, SKIN
ACCIDENTAL EXPOSURE
ACIDOSIS  from MedLine:  an abnormal condition of reduced alkalinity of the blood and tissues that is marked by sickly sweet breath, headache, nausea and vomiting, and visual disturbances and is usually a result of excessive acid production.
ADIPOSE, INFLAM  from MedLine: of or relating to fat; see adipose tissue: connective tissue in which fat is stored and which has the cells distended by droplets of fat
ADRENAL GLANDS: PR-ADRENAL(S), LESION(
AGRANULOCYTOSIS, BLD  from MedLine: an acute febrile condition marked by severe depression of the granulocyte-producing bone marrow and by prostration, chills, swollen neck, and sore throat sometimes with local ulceration and believed to be basically a response to the side effects of certain drugs of the coal-tar series (as aminopyrine) -- called also agranulocytic angina, granulocytopenia
ANA POS
ANAPHYLAXIS/TOID from MedLine: Anaphylaxis is a life-threatening type of allergic reaction Anaphylaxis is an severe, whole-body allergic reaction. After an initial exposure to a substance like . . .  toxin, the . . . immune system becomes sensitized to that allergen. On a subsequent exposure, an allergic reaction occurs. This reaction is sudden, severe, and involves the whole body.  Tissues in different parts of the body release histamine and other substances. This causes constriction of the airways, resulting in wheezing, difficulty breathing, and gastrointestinal symptoms such as abdominal pain, cramps, vomiting, and diarrhea.  Histamine causes the blood vessels to dilate (which lowers blood pressure) and fluid to leak from the bloodstream into the tissues (which lowers the blood volume). These effects result in shock. Fluid can leak into the alveoli (air sacs) of the lungs, causing pulmonary edemaHives and angioedema (hives on the lips, eyelids, throat, and/or tongue) often occur. Angioedema may be severe enough to block the airway. Prolonged anaphylaxis can cause heart arrhythmias. Some drugs may cause an anaphylactoid reaction (anaphylactic-like reaction) on the first exposure. This is usually due to a toxic reaction, rather than the immune system mechanism that occurs with "true" anaphylaxis. The symptoms, risk for complications without treatment, and treatment are the same, however, for both types of reactions.  Anaphylaxis can occur in response to any allergen. Common causes include insect bites/stings, horse serum (used in some vaccines), food allergies, and drug allergies. Pollens and other inhaled allergens rarely cause anaphylaxis.
ANEMIA, APLASTIC
ANEMIA, BLD LOSS
ANEMIA, HEINZ BODY
ANEMIA, SPHERO from MedLine: a condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume
ANESTH RECOV PROLONGED
ANISOCORIA  from MedLine: inequality in the size of the pupils of the eyes
APLASIA, BONE MARROW  from MedLine: APLASIA: incomplete or faulty development of an organ or part:  BONE MARROW: a soft highly vascular modified connective tissue that occupies the cavities and cancellous part of most bones and occurs in two forms: a : a whitish or yellowish bone marrow consisting chiefly of fat cells and predominating in the cavities of the long bones -- called also yellow marrow b : a reddish bone marrow containing little fat, being the chief seat of red blood cell and blood granulocyte formation, and occurring in the normal adult only in cancellous tissue especially in certain flat bones -- called also red marrow
ARTHRITIS
ASCITES  From MedLine: Ascites is an accumulation of noninflammatory transudate in one or more of the peritoneal cavities or potential spaces. The fluid, which accumulates most frequently in the two ventral hepatic, peritoneal, or pericardial spaces, may contain yellow protein clots.
ATONY, BLADDER  from MedLine: atony: lack of physiological tone especially of a contractile organ
ATROPHY
BEHAVIOR DISORDER
BEHAVIOR: ABN ODOR, URINE
BEHAVIOR: ACIDOSIS  from MedLine:  an abnormal condition of reduced alkalinity of the blood and tissues that is marked by sickly sweet breath, headache, nausea and vomiting, and visual disturbances and is usually a result of excessive acid production.
BEHAVIOR: AGGRESSION
BEHAVIOR: APNEA from MedLine: transient cessation of respiration whether normal (as in hibernating animals) or abnormal (as that caused by certain drugs)
BEHAVIOR: APPREHENSION
BEHAVIOR: BALANCE DISORDER
BEHAVIOR: BITING/CHEWING
BEHAVIOR: BREATHING ABNORMAL
BEHAVIOR: BREATHING, DIFFICULT
BEHAVIOR: BREATHING, PERIODIC
BEHAVIOR:
CIRCLING
BEHAVIOR: CONFUSION
BEHAVIOR: COUGHING
BEHAVIOR: DEFECATION ABN
BEHAVIOR: DELIRIUM
BEHAVIOR: DEMENTIA from MedLine: a condition of deteriorated mentality that is characterized by marked decline from the individual's former intellectual level and often by emotional apathy
BEHAVIOR: DESTRUCTIVENESS
BEHAVIOR: DIARRHEA, PROJECTILE
BEHAVIOR:
DIARRHEA, WATERY
BEHAVIOR: DIFFICULTY RISING
BEHAVIOR: DISSOCIATION  from MedLine: the act or process of dissociating : the state of being dissociated:the separation of whole segments of the personality (as in multiple personality) or of discrete mental processes (as in the schizophrenias) from the mainstream of consciousness or of behavior with loss of integrated awareness and autonomous functioning of the separated segments or parts
BEHAVIOR: DISCOMFORT
BEHAVIOR: DISTRESS
BEHAVIOR: DISTRESS, RESP
BEHAVIOR: DRY MOUTH SYNDROME
BEHAVIOR: DYSPHAGIA from MedLine: loss of or deficiency in the power to use or understand language as a result of injury to or disease of the brain
BEHAVIOR: DYSURIA from MedicineNet:  Dysuria: Painful or
difficult urination. This includes burning on urination. Dysuria is most commonly due to bacterial infection of the urinary tract causing inflammation of the bladder (cystitis) or kidney (pyelonephritis.  There are many other causes of dysuria including irritation from chemicals.
BEHAVIOR: EXERCISE INTOLERANCE
BEHAVIOR: FLATULENCE
BEHAVIOR: FROTH, MOUTH/LIP(S)
BEHAVIOR: GAGGING
BEHAVIOR: GRINDING TEETH
BEHAVIOR: HEAD BOBBING
BEHAVIOR: HEAD PRESSING
BEHAVIOR: HIDING
BEHAVIOR: HYPERACTIVITY
BEHAVIOR: HYPERESTHESIA from MedLine: unusual or pathological sensitivity of the skin or of a particular sense to stimulation
BEHAVIOR: HYPERSALIVATION Slobbering, excessive drooling
BEHAVIOR: HYPOSALIVATION  from MedLine: diminished salivation
BEHAVIOR:
HYPERSENSITIVE, SOUND
BEHAVIOR: HYPOPNEA  from MedLine: abnormally slow or especially shallow respiration
BEHAVIOR: INCONTINENCE, URINARY
BEHAVIOR: INSOMNIA
BEHAVIOR: JERKING
BEHAVIOR: LARYNGITIS  from MedLine: inflammation of the larynx
BEHAVIOR: LICKING
BEHAVIOR: LICKING, FEET/DIGIT(S)
BEHAVIOR: LOCOMOTION DISORDER
BEHAVIOR: LOSS OF CONDITION
BEHAVIOR: MORIBUND from MedLine: being in the state of dying ; approaching death; in the moribund patient deepening stupor and coma are the usual preludes to death.
BEHAVIOR: MYOSITIS from MedLine: muscular discomfort or pain from infection or an unknown cause
BEHAVIOR:
NAUSEA
BEHAVIOR: NERVOUSNESS
BEHAVIOR: NOCTURIA  from MedLine: urination at night especially when excessive -- called also nycturia
BEHAVIOR: OLIGURIA from MedLine: reduced excretion of urine
BEHAVIOR: PACING
BEHAVIOR: PAIN
BEHAVIOR: PICA  from MedLine: Pica: A craving for something not normally regarded as nutritive. For example, dirt.
BEHAVIOR: POLLAKIURIA  from MedLine: abnormally frequent urination
BEHAVIOR: PROSTRATION  from MedLine: complete physical or mental exhaustion
BEHAVIOR: REFLEX(ES) ABNORMAL
BEHAVIOR: REGURGITATION
BEHAVIOR:
RELUCTANT TO CLIMB
BEHAVIOR: RELUCTANT TO MOVE
BEHAVIOR: RESPIRATORY DISORDER
BEHAVIOR:
SCENT DEFICIT
BEHAVIOR: SHAKING
BEHAVIOR: SHAKING, HEAD/FACE
BEHAVIOR: SLEEP ABN
BEHAVIOR:
SNEEZING
BEHAVIOR: SOMNOLENCE from MedLine: the quality or state of being drowsy; sleepiness
BEHAVIOR: SOUND ABN, VOICE
BEHAVIOR:
SPASM
BEHAVIOR: STAGGERING
BEHAVIOR: STARING
BEHAVIOR: STOOL ABNORMAL
BEHAVIOR: STOOL, MUCOID
BEHAVIOR: STOOL, PALE/GRAY
BEHAVIOR: STUMBLING
BEHAVIOR: STUPOR - From MedLine: Stuporous see Consciousness - decreased: Decreased consciousness refers to diminished alertness or awareness.  Decrease in consciousness,
unconsciousness, and coma almost always require medical evaluation (with the possible exception of alcohol intoxication, simple fainting, or a previously recognized seizure disorder).
BEHAVIOR: TENESMUS, RECTAL from MedLine: a distressing but ineffectual urge to evacuate the rectum or urinary bladder
BEHAVIOR: THRASHING/PADDLING
BEHAVIOR: TORTICOLLIS  from MedLine: a twisting of the neck to one side that results in abnormal carriage of the head and is usually caused by muscle spasms
BEHAVIOR: TREMBLING
BEHAVIOR: TREMBLING, FACE
BEHAVIOR: 
TWITCH
BEHAVIOR: UNCONSCIOUS
BEHAVIOR: UNPALATABLE, WON'T EAT
BEHAVIOR: VOCALIZATION
BEHAVIOR: VOICE DISORDER
BEHAVIOR: VOMITING, SEVERE
BEHAVIOR: VOMITING, UNPRODUCTIVE
BEHAVIOR: WHEEZING
BLADDER, PARALYSIS
BLEEDING:
BLD, ABDOMEN
BLEEDING:
BLD, ANUS
BLEEDING: BLD Abnormal bleeding
BLEEDING: CAPILLARY REFILL PROLO
BLEEDING: BLD, EAR(S)
BLEEDING: BLD, FEET/DIGIT(S)
BLEEDING: BLD, INCISION SITE
BLEEDING: INJ SITE BLD
BLEEDING: BLD, JOINT(S)
BLEEDING: BLD, MOUTH/LIP(S)
BLEEDING: BLD, MULT SITES
BLEEDING:
BLD, PASSING
BLEEDING: BLD, PENIS
BLEEDING: BLD, RECTUM
BLEEDING: BLD, RETINA
BLEEDING: BLD, THORAX from MedLine: thorax: the part of the mammalian body that is situated between the neck and the abdomen and supported by the ribs, costal cartilages, and sternum
BLEEDING: BLD, VAGINA
BLEEDING: EPISTAXIS  epistaxis, melena, gingival bleeding, retinal hemorrhage, hematoma formation, and prolonged bleeding after venipuncture or surgery. Immunologic and inflammatory mechanisms cause increased platelet consumption and decreased platelet survival.
BLEPHAROSPASM  from MedLine: spasmodic winking from involuntary contraction of the orbicularis oculi muscle of the eyelids
BLINDNESS, NIGHT
BLOAT
from Merck Veterinary Manual: Bloat is an overdistention of the rumenoreticulum with the gases of fermentation, either in the form of a persistent foam mixed with the ruminal contents—called primary or frothy bloat, or in the form of free-gas separated from the ingesta—called secondary or free-gas bloat.
BLOOD: AGRANULOCYTOSIS, BLD  from MedLine: an acute febrile condition marked by severe depression of the granulocyte-producing bone marrow and by prostration, chills, swollen neck, and sore throat sometimes with local ulceration and believed to be basically a response to the side effects of certain drugs of the coal-tar series (as aminopyrine) -- called also agranulocytic angina, granulocytopenia
BLOOD:
A/G RATIO HI, BLD
BLOOD: A/G RATIO LO, BLD
BLOOD: ALBUMIN HI, BLD
BLOOD: AMMONIA HI, BLD
BLOOD: ANION GAP HI, BLD  
BLOOD: AMYLASE HI, BLD
BLOOD: ANEMIA, AUTOIMMUNE HEM from MedLine: Acquired Thrombocytopenia
BLOOD: ANEMIA, HEMOLYTIC
BLOOD: ANEMIA, REGEN
BLOOD: ANEMIA, SPHERO
BLOOD: BANDS HI, BLD
BLOOD: BASOS HI, BLD
BLOOD: BILE ACIDS HI, BLD
BLOOD: BILIRUBIN(DIR) HI, BLD
BLOOD: BILIRUBIN(IND) HI, BLD
BLOOD: BLD, ABNORMAL
BLOOD: BLD, GI
BLOOD: BLD, SEMEN
BLOOD: BLD, SQ
BLOOD: BUN LO, BLD
BLOOD: CA HI, BLD
BLOOD: CA LO, BLD
BLOOD: CA/P RATIO LO, BLD
BLOOD: CHOLESTEROL HI, BLD
BLOOD: CO2 LO, BLD
BLOOD: CO2 HI, BLD
BLOOD: COAGULATION DISORDER
BLOOD: CPK HI, BLD
BLOOD: EOSINOS HI, BLD
BLOOD: CHLORIDE LO, BLD
BLOOD: CHLORIDE HI, BLD
BLOOD: CHOLESTEROL LO, BLD
BLOOD: CREATININE LO, BLD
BLOOD: EOSINOS LO, BLD
BLOOD: FIBRINOGEN HI, BLD
BLOOD:
FIBRINOGEN LO, BLD
BLOOD: GGT HI, BLD
BLOOD: GLOBULIN HI, BLD
BLOOD: GLOBULIN LO, BLD
BLOOD:
GLUCOSE HI, BLD
BLOOD: GLUCOSE LO, BLD
BLOOD: HCO3 HI, BLD
BLOOD: HCO3 LO, BLD
BLOOD: HEMATOCHEZIA from MedLine: Decreased red blood cell production
BLOOD: BLD(HEMATOMA)
BLOOD: K HI, BLD
BLOOD: K LO, BLD
BLOOD: KIDNEY VALUES HI, BLD
BLOOD: LDH HI, BLD
BLOOD: LIPASE HI, BLD
BLOOD: LIPIDS HI, BLD
BLOOD: LIVER PROFILE HI
BLOOD:
LYMPHS HI, BLD
BLOOD: LYMPHS LO, BLD
BLOOD: MG HI, BLD
BLOOD: MG LO, BLD
BLOOD: MONOS HI, BLD
BLOOD: MONOS LO, BLD
BLOOD: NA HI, BLD
BLOOD: NA:K LO, BLD
BLOOD: NA LO, BLD
BLOOD: P LO, BLD
BLOOD: PANCREAS ENZYMES HI, B
BLOOD:
PLATELETS HI, BLD
BLOOD: POLYCYTHEMIA From MedLine: Polycythemia:  Too many red blood cells.  The opposite of anemia.  Polycythemia formally exists when the hemoglobin, red blood cell (RBC) count, and total RBC volume are all above normal.
BLOOD: PRESSURE HI, BLD
BLOOD: PRESSURE LO, BLD
BLOOD:
PR-MULT SITES, BLD
BLOOD: PROTEIN(TOT) HI, BLD
BLOOD: PROTEIN(TOT) LO, BLD
BLOOD: PT PROLONGED, BLD
BLOOD: PTT PROLONGED, BLD
BLOOD: RBC ABNORMAL
BLOOD: RBC, ANISO
BLOOD: RBC, MICRO
BLOOD: RBC, NUCLEATED
BLOOD: RBC, POLYCHROM
BLOOD: RETICULOCYTES HI, BLD
BLOOD: RETICULOCYTES LO, BLD
BLOOD: SEGS HI, BLD
BLOOD: SEGS LO, BLD
BLOOD: THYROID HORMONE(S) HI
BLOOD: THYROID HORMONE(S) LO
BLOOD: TRIGLYCERIDES HI, BLD
BLOOD: WBC LO, BLD
BORBORYGMI from MedLine: a rumbling sound made by the movement of gas in the intestine
BRONCHITIS
CALCULI, KIDNEY  from MedLine: a concretion usually of mineral salts around organic material found especially in hollow organs or ducts
CALCULI, URINE
CAPILLARY REFILL PROLO
CATARACT(S)  from MedLine: a clouding of the lens of the eye or its surrounding transparent membrane that obstructs the passage of light
CELLULITIS  from MedLine: diffuse and especially subcutaneous inflammation of connective tissue 
CHEMISTRY ABN
CNS INFARCT
from MedLine: CNS: abbreviation central nervous system; Infarct: an area of necrosis in a tissue or organ resulting from obstruction of the local circulation by a thrombus or embolus
CNS DISORDER  from Medline:  CNS: abbreviation: central nervous system
CNS: ENCEPHALOPATHY  from MedLine: a disease of the brain ; especially : one involving alterations of brain structure
CNS: NEUROPATHY  from MedLine: an abnormal and usually degenerative state of the nervous system or nerves ; also : a systemic condition (as muscular atrophy) that stems from a neuropathy
CNS: PR-BRAIN, LESION(S)
CONGESTION
CONGESTION, EAR(S)
CONGESTION, MUCOUS MEM
CONGESTION, SINUS
COOMBS TEST POS
  from MedLine: Autoimmune Hemolytic Anemia and Thrombocytopenia: Drugs, vaccines, or infections also can precipitate attacks of hemolytic anemia or thrombocytopenia . . . 
CSF ABN
CULTURE/TITER DATA ABN
CYANOSIS
from MedLine: a bluish or purplish discoloration (as of skin) due to deficient oxygenation of the blood
CYANOSIS, MUCOUS MEMBR
DEAFNESS
DEAFNESS, PARTIAL
DEAFNESS, TEMP
DEFECATION
DEFECATION ABN
DEHISCENCE  from MedLine: the parting of the sutured lips of a surgical wound example: wound dehiscence resulting from infection
DEHYDRATION
DELIRIUM
DEMENTIA from MedLine: a condition of deteriorated mentality that is characterized by marked decline from the individual's former intellectual level and often by emotional apathy
DIABETES  from MedLine: any of various abnormal conditions characterized by the secretion and excretion of excessive amounts of urine
DIABETES INSIPIDUS
DIABETES M, POOR REGUL
DIABETES MELLITUS
DIARRHEA, MILD
DIARRHEA, PROJECTILE
DIARRHEA, SEVERE
DIC  per the Merck Veterinary Manual online at:   http://www.merckvetmanual.com, I was not able to find "DIC", but the search engine provided 14 "articles" for that search, the first of which is: "Acquired Coagulation Protein Disorders" and states: "Most coagulation proteins are produced primarily in the liver. Therefore, liver disease characterized by necrosis, inflammation, neoplasia, or cirrhosis often is associated with decreased production of coagulation proteins, particularly Factors VII, IX, X, and XI." and refers on to: "(see rodenticide poisoning)". A search of : http://www.medterms.com using "DIC" provided: "3 articles" for search keyword or phrase "DIC", the titles of which are: "Leukemia in the Family", "Acute promyelocytic leukemia" and "APL" which provides a potential definition of "DIC" as "APL is consistently associated with a disorder that resembles (but is not identical to) disseminated intravascular coagulation (DIC). "There is in APL a pronounced tendency to hemorrhage (bleeding). The bleeding can manifest itself as petechiae (little bleeding spots in the skin or elsewhere), small ecchymosis (bruises), epistaxis (nose bleeds), bleeding in the mouth, hematuria (blood in the urine), bleeding from venipuncture and bone marrow sites. . . " so apparently the "translation" of "DIC" is disseminated intravascular coagulation.  
DILITATION, ESOPHAGUS  from MedLine: [no such word]: dilatation: 1 : the condition of being stretched beyond normal dimensions especially as a result of overwork or disease or of abnormal relaxation <dilatation of the heart> <dilatation of the stomach>
DILITATION, STOMACH
DISCHARGE, EAR(S)
DISCHARGE, EYE(S)/LID
DISCHARGE, EYE(S)/LID(S)
DISCHARGE, INCISION SITE
DISCHARGE, MOUTH/LIP(S
DISCHARGE, VULVA  from MedLine: the external parts of the female genital organs
DISCOMFORT, MOUTH/LIP(S)
DISSOCIATION  from MedLine: the act or process of dissociating : the state of being dissociated:the separation of whole segments of the personality (as in multiple personality) or of discrete mental processes (as in the schizophrenias) from the mainstream of consciousness or of behavior with loss of integrated awareness and autonomous functioning of the separated segments or parts
DISTRESS
DISCHARGE, NOSE
DISTENSION, BLADDER
DIZZINESS
DIZZINESS: VESTIBULAR DISORDER  vestibular apparatus (motion sickness,  vestibulitis). Toxins or drugs directly stimulate the chemoreceptor trigger zone (CTZ) because it is not protected by a complete blood-brain barrier.
DRY MOUTH SYNDROME
DYSMETRIA  from MedLine: impaired ability to estimate distance in muscular action
DYSPHAGIA from MedLine: loss of or deficiency in the power to use or understand language as a result of injury to or disease of the brain
EARS: DISCHARGE, EAR(S)
EARS: OTITIS  from Medline: inflammation of the ear
EARS: PRURITIS, EAR(S)
EARS: SWELLING, EAR(S)
EARS: ULCER(S), EAR(S)
ECG, ABN
EDEMA from MedLine: an abnormal excess accumulation of serous fluid in connective tissue or in a serous cavity -- called also dropsy  
EDEMA, BRISKET/CHEST
EDEMA, CORNEA(S)
EDEMA, EYE(S)/LID(S)
EDEMA, FEET/DIGIT(S)
EDEMA, HEAD/FACE Swelling
EDEMA, LARYNX
EDEMA, LIMB(S) Swelling
EDEMA, MULTIPLE SITES
EDEMA, NECK
EDEMA, PREPUCE
  from MedLine: see foreskin:  a fold of skin that covers the glans of the penis -- called also prepuce a similar fold investing the clitoris
EDEMA: PR-LUNG(S), EDEMA
EDEMA, SCLERA
EDEMA, SCROTUM
EDEMA, VENTRAL from MedLine: 1 : of or relating to the belly : ABDOMINAL  2 a : being or located near, on, or toward the lower surface of an animal (as a quadruped) opposite the back or dorsal surface b : being or located near, on, or toward the front or anterior part of the human body
EFFUSION  from MedLine: 1 a : the escape of a fluid from anatomical vessels by rupture or exudation b : the flow of a gas through an aperture whose diameter is small as compared with the distance between the molecules of the gas
2 : the fluid that escapes by extravasation
EFFUSION, JOINT(S)
EFFUSION, PERICARDIAL
EFFUSION, PERITONEAL from MedLine: 1. a : the escape of a fluid from anatomical vessels by rupture or exudation b : the flow of a gas through an aperture whose diameter is small as compared with the distance between the molecules of the gas  2 : the fluid that escapes by extravasation - 1 : an exudation of fluid from the blood or lymph into a pleural cavity - 2 : an exudate in a pleural cavity
ELECTROLYTE DISORDER  from MedLine: any of the ions (as of sodium, potassium, calcium, or bicarbonate) that in a biological fluid regulate or affect most metabolic processes (as the flow of nutrients into and waste products out of cells)
ENCEPHALOPATHY  from MedLine: a disease of the brain ; especially : one involving alterations of brain structure
ENDOCRINE DISORDER  from MedLine: 1 : secreting internally ; specifically : producing secretions that are distributed in the body by way of the bloodstream <an endocrine system> 2 : of, relating to, affecting, or resembling an endocrine gland or secretion <endocrine tumors> ; see endocrine system: the glands and parts of glands that produce endocrine secretions, help to integrate and control bodily metabolic activity, and include especially the pituitary, thyroid, parathyroids, adrenals, islets of Langerhans, ovaries, and testes
ENLARGEMENT(S)
ENLARGEMENT(S), SKIN
ENTERITIS  from MedLine: 1 : inflammation of the intestines and especially of the human ileum 2 : a disease of domestic animals (as panleukopenia of cats) marked by enteritis and diarrhea
EPIPHORA  from MedLine: a watering of the eyes due to excessive secretion of tears or to obstruction of the lacrimal passages
EPISTAXIS  from MedLine: epistaxis, melena, gingival bleeding, retinal hemorrhage, hematoma formation, and prolonged bleeding after venipuncture or surgery. Immunologic and inflammatory mechanisms cause increased platelet consumption and decreased platelet survival.
ERECTION, ABN
ERUCTATION
  from Medline: an act or instance of belching 
ERYTHEMA MULTIFORME  from MedLine: a skin disease characterized by papular or vesicular lesions and reddening or discoloration of the skin often in concentric zones about the lesions
ESTRUS BEHAVIOR  from MedLine: the correlated phenomena of the endocrine and generative systems of a female mammal from the beginning of one period of estrus to the beginning of the next -- called also estral cycle, estrus cycle
ESTRUS CYCLE ABNORMAL
EXFOLIATION, SKIN
 
from MedLine: the action or process of exfoliating: as a : the peeling of the horny layer of the skin (as in some skin diseases) b : the shedding of surface components (as cells from internal body surfaces when diseased) c : the shedding of a superficial layer of bone or of a tooth or part of a tooth
EYE DISORDER
EYES: ADIPSIA  from MedLine: adipsia: a purulent ocular exudate
EYES: ANISOCORIA  from MedLine: inequality in the size of the pupils of the eyes
EYES:
 BLD, EYE(S) bleeding
EYES: BLD, RETINA
EYES: BLD, SCLERA  from MedLine: sclera: the dense fibrous opaque white outer coat enclosing the eyeball except the part covered by the cornea -- called also sclerotic, sclerotic coat
EYES: BLEPHAROSPASM  from MedLine: spasmodic winking from involuntary contraction of the orbicularis oculi muscle of the eyelids 
EYES:
BLINDNESS
EYES: BLINDNESS, NIGHT
EYES: BLINDNESS, PARTIAL
EYES: BLINDNESS, TEMP
EYES: CATARACT(S)  from MedLine: a clouding of the lens of the eye or its surrounding transparent membrane that obstructs the passage of light
EYES:
CONGESTION, EYE(S)/LID
EYES: CONJUNCTIVITIS from MedLine: inflammation of the conjunctiva conjunctiva: the mucous membrane that lines the inner surface of the eyelids and is continued over the forepart of the eyeball
EYES: EDEMA, CORNEA(S)
EYES: EDEMA, EYE(S)/LID(S)
EYES: EDEMA, SCLERA
EYES: EPIPHORA  from MedLine: a watering of the eyes due to excessive secretion of tears or to obstruction of the lacrimal passages
EYES: GLAUCOMA 
from MedLine: a disease of the eye marked by increased pressure within the eyeball that can result in damage to the optic disk and gradual loss of vision
EYES:
HORNER'S SYNDROME from MedLine: a syndrome marked by sinking in of the eyeball, contraction of the pupil, drooping of the upper eyelid, and vasodilation and anhidrosis of the face, and caused by injury to the cervical sympathetic nerve fibers on the affected side
EYES: HYPHEMA from MedLine: a hemorrhage in the anterior chamber of the eye
EYES:
IRIS(BLD)
EYES: IRIS, INFLAM
EYES: KERATOCONJUNCTIVITIS from MedicineNet: Keratoconjunctivitis: Inflammation of the eye involving both the cornea and the conjunctiva.
EYES:
MYDRIASIS from MedLine: excessive or prolonged dilation of the pupil of the eye
EYES:  MIOSIS  from MedLine: excessive smallness or contraction of the pupil of the eye
EYES:
  NEURITIS, OPTIC  from MedLine: inflammation of the optic nerve
EYES:  NYSTAGMUS from MedLine: a rapid involuntary oscillation of the eyeballs occurring normally with dizziness during and after bodily rotation or abnormally after injuries (as to the cerebellum or the vestibule of the ear)
EYES:  NYSTAGMUS, HORIZONTAL back and forth/horitontal
EYES:
  NYSTAGMUS [vertical] from MedLine: nystagmus characterized by up-and-down movement of the eyes
EYES:  NYSTAGMUS, POSITIONAL
EYES:  NYSTAGMUS, ROTARY  from MedLine: circular motion
EYES:  NYSTAGMUS, VERTICAL
EYES:  OPACITY, CORNEA(S)
EYES:  PARAESTHESIA, EYE(S)/L  from MedLine: a sensation of pricking, tingling, or creeping on the skin having no objective cause and usually associated with injury or irritation of a sensory nerve or nerve root
EYES:  PROLAPSE, THIRD EYELID 
from MedLine: the falling down or slipping of a body part from its usual position or relations
EYES:
  PROTRUSION, EYE(S)
EYES:  PUPIL(S), AREFLEXIA  from MedLine: absence of reflexes
EYES:
 
PRURITIS, EYE(S)
EYES:  RETINA ABNORMAL
EYES:  STRABISMUS  from MedLine: inability of one eye to attain binocular vision with the other because of imbalance of the muscles of the eyeball EYES:  SWELLING, EYE(S)/LID(S
EYES:  ULCER(S), CORNEA(S)
EYES:  UVEITIS  from MedLine: inflammation of the uvea:  Uvea:  the middle layer of the eye consisting of the iris and ciliary body together with the choroid coat -- called also vascular tunic
EYES:
  VISION DISORDER
FERTILITY, LACK OF
FEVER, JOINT(S)
FIBRILLATION, ATRIAL
 
from MedLine: very rapid uncoordinated contractions of the atria of the heart resulting in a lack of synchronism between heartbeat and pulse beat -- called also auricular fibrillation
FIBROSIS  from MedLine: a condition marked by increase of interstitial fibrous tissue : fibrous degeneration; see cystic fibrosis: involves functional disorder of the exocrine glands, and is marked especially by faulty digestion due to a deficiency of pancreatic enzymes, by difficulty in breathing due to mucus accumulation in airways, and by excessive loss of salt in the sweat; called also fibrocystic disease of the pancreas, mucoviscidosis
FLY BITING
FROTH, MOUTH/LIP(S)
G-HAIR, ABN COLOR
GASTRITIS
  from MedicineNet: Gastritis:
Inflammation of the stomach. From the Latin gastricus meaning stomach + -itis, meaning inflammation.
GINGIVA, ABNORMAL  from MedLine: GUMS: the tissue that surrounds the necks of teeth and covers the alveolar parts of the jaws ; broadly : the alveolar portion of a jaw with its enveloping soft tissues
GINGIVITIS 
from MedLine: inflammation of the gums
G.I. TRACT:
BLD, GI
G.I. TRACT: BORBORYGMI from MedLine: a rumbling sound made by the movement of gas in the intestine
G.I. TRACT:
COLITIS
G.I. TRACT: CONSTIPATION
G.I. TRACT: DEFECATION ABN
G.I. TRACT: DIARRHEA, MILD
G.I. TRACT: DIARRHEA, MUCOID
G.I. TRACT: DIARRHEA, PROJECTILE
G.I. TRACT: DIARRHEA, SEVERE
G.I. TRACT: DIARRHEA, WATERY
G.I. TRACT: ENTERITIS  from MedLine: 1 : inflammation of the intestines and especially of the human ileum 2 : a disease of domestic animals (as panleukopenia of cats) marked by enteritis and diarrhea
G.I. TRACT:
GI, ABNORMAL
G.I. TRACT: HYPERMOTILITY  from MedLine: abnormal or excessive movement ; specifically : excessive motility of all or part of the gastrointestinal tract
G.I. TRACT: INCONTINENCE, FECAL
G.I. TRACT: PERFORATION, GI
G.I. TRACT: PERITONITIS
Inflammation of intestinal lining/mucosa
G.I. TRACT:
PR-GI, LESION(S) 
G.I. TRACT: PR-INTEST, LESION(S)
G.I. TRACT: PR-SM INTEST, LESION(S)
G.I. TRACT: PR-PERITONEUM, LESION(S)
G.I. TRACT: PR-SM INTEST, LESION(S)
G.I. TRACT: PR-STOMACH, LESION(S)
G.I. TRACT: STOOL ABNORMAL
G.I. TRACT: STOOL, MUCOID
G.I. TRACT: STOOL, PALE/GRAY
G.I. TRACT: TENESMUS, RECTAL from MedLine: a distressing but ineffectual urge to evacuate the rectum or urinary bladder
G.I. TRACT: ULCER(S)
G.I. TRACT: ULCER(S), GI
G.I. TRACT: ULCER(S), PYLORUS
G.I. TRACT: VOLVULUS, STOMACH from MedLine: a twisting of the intestine upon itself that causes obstruction - aka: torsion: 1: the twisting of a bodily organ or part on its own axis <intestinal torsion> 2: the twisting or wrenching of a body by the exertion of forces tending to turn one end or part about a longitudinal axis while the other is held fast or turned in the opposite direction ; also : the state of being twisted
GRANULOMA, LICK  from MedLine: a mass or nodule of chronically inflamed tissue with granulations that is usually associated with an infective process 
GLAUCOMA 
from MedLine: a disease of the eye marked by increased pressure within the eyeball that can result in damage to the optic disk and gradual loss of vision
GLOSSITIS 
from MedLine: inflammation of the tongue
GRANULOMA  from MedLine: a mass or nodule of chronically inflamed tissue with granulations that is usually associated with an infective process
HAIR, ABNORMAL
HAIR, ABN COLOR
HEALING IMPAIRED
HEART: ARREST, HEART
HEART: ARRHYTHMIA from MedLine: Arrhythmias are pattern and/or speed changes from the normal heart rhythm.
HEART: BRADYCARDIA from MedLine: relatively slow heart action whether physiological or pathological
HEART: CARDIOMEGALY from MedLine: enlargement of the heart
HEART: ECG, ABN
HEART: FIBRILLATION, ATRIAL  from MedLine: very rapid uncoordinated contractions of the atria of the heart resulting in a lack of synchronism between heartbeat and pulse beat -- called also auricular fibrillation
HEART:
HEART DISORDER
HEART: HEART FAILURE
HEART: EFFUSION, PERICARDIAL
HEART: PALPITATIONS  from MedLine: a rapid pulsation ; especially : an abnormally rapid beating of the heart when excited by violent exertion, strong emotion, or disease
HEART: PR-HEART, LESION(S)
HEART:
MURMUR, HEART
HEART: TACHYCARDIA From MedLine: Rapid heart beat
HEART: TACHYCARDIA, VENTRICUL
HYPERADRENOCORTICISM  from MedLine: 1 : the presence of an excess of adrenocortical products in the body 2 : the syndrome resulting from hyperadrenocorticism that is often a complication of medication with adrenal hormones, fractions, or stimulants
HYPERESTHESIA from MedLine: unusual or pathological sensitivity of the skin or of a particular sense to stimulation
HYPERKERATOSIS  from MedLine: 1 : hypertrophy of the stratum corneum layer of the skin  2 a : any of various conditions marked by hyperkeratosis b : a disease of cattle that is marked by thickening and wrinkling of the hide, by formation of papillary outgrowths on the buccal mucous membranes, and often by a watery discharge from eyes and nose, diarrhea, loss of weight, and abortion of pregnant animals and that is caused especially by ingestion of the chlorinated naphthalene of various lubricating oils, by arsenic poisoning, or by inherited congenital ichthyosis -- called also X-disease, XX disease from Merck Veterinary Manual: Hyperkeratosis of footpads, ferret. Note the yellowish crusty lesions found on the ventral surface of the main footpads. Crusts were also present on the muzzle of this ferret; Cutaneous ichthyoses are characterized by abnormal and hypertrophic epithelial proliferation, with accumulation of extensive scale and hyperkeratosis on the skin surface.; In dogs, the body is covered with large adherent scales that may flake off in large sheets. The planum nasale and digital pads are usually markedly thickened, and the latter usually is associated with apparent discomfort.; Marked hyperkeratosis precedes the development of hair coat abnormalities, which begin as the loss of normal hair kinkiness and progress to patchy alopecia.
HYPERMOTILITY 
from MedLine: abnormal or excessive movement ; specifically : excessive motility of all or part of the gastrointestinal tract
HYPERPIGMENTATION, SKIN  from MedLine: excess pigmentation in a bodily part or tissue (as the skin)
HYPERSENSITIVE, SOUND
HYPERTONIA  from MedLine: [no such word]: see hypertonic: 1 : exhibiting excessive tone or tension <a hypertonic baby> <a hypertonic bladder> 2 : having a higher osmotic pressure than a surrounding medium or a fluid under comparison <animals that produce urine which is hypertonic to their blood>
HYPOADRENOCORTICISM from Medline:  abnormally decreased activity of the adrenal cortex (as in Addison's disease)
HYPOESTHESIA  from MedLine: impaired or decreased tactile sensibility
HYPOPNEA  from MedLine: abnormally slow or especially shallow respiration
HYPOSALIVATION 
from MedLine: diminished salivation
HYPOSMIA  from MedLine: impairment of the sense of smell
HYPOTHERMIA
HYPOTHERMIA, BODY
From MedLine: Hypothermia is dangerously low body temperature [most suseptible are:  Very old or very young, chronically ill, especially with heart or circulation problems, malnourished, overly tired, under the influence of alcohol or drugs
ICTERUS from MedLine: Icterus:
Jaundice. At least one medical dictionary defines icterus as the presence of jaundice seen in the sclera of the eye. This is incorrect. Icterus is synonymous with jaundice. They are one and the same thing.
ICTERUS, SERUM (see above definition)
ILL
IMMUNE DISORDER from MedLine: not susceptible or responsive ; especially : not having a high degree of resistance to a disease; not protected by either specific or non-specific mechanisms against infectious disease.
IMMUNOSUPPRESSION  from MedLine: suppression (as by drugs) of natural immune responses
IMPROVEMENT, UNEXPECT
INCISION SITE, ECCHYMOSIS
INCONTINENCE from MedLine: inability of the body to control the evacuative functions
INEFFECT
INEFFECT, ANTIINFLAM
INEFFECT, ANALGESIA from MedLine: insensibility to pain without loss of consciousness
INEFFECT, LOSS OF EFFE
INEFFECT, OTHER DRUG(S)
INFARCT  from MedLine: an area of necrosis in a tissue or organ resulting from obstruction of the local circulation by a thrombus or embolus
INFECTION
INFECTION, EYE(S)
INFECTION, FEET/DIGIT(
INFECTION, UTERUS
INFLAM
INJ SITE BLD
INJ SITE INFECT
IRIS(BLD)
IRIS, INFLAM
IRRITATION, ESOPHAGUS
IRRITATION, EYE(S)/LID
IRRITATION, PHARYNX/TH
IRRITATION, MOUTH/LIP(S)
IRRITATION, PERINEUM
  from MedLine: an area of tissue that marks externally the approximate boundary of the pelvic outlet and gives passage to the urogenital ducts and rectum ; also : the area between the anus and the posterior part of the external genitalia especially in the female
IRRITATION, PHARYNX/TH
IRRITATION, SKIN
JERKING
JOINT DISORDER
KETOSIS  from MedLine: an abnormal increase of ketone bodies in the body in conditions of reduced or disturbed carbohydrate metabolism (as in uncontrolled diabetes mellitus)
KIDNEY: ANURIA  Acute renal failure occurs when a major insult to the kidneys results in inability to regulate water and solute balance; this may occur when urine flow is reduced.
KIDNEY: AZOTEMIA  Inability of the kidneys to function normally may be classified as prerenal, renal, or postrenal in origin. Prerenal azotemia is the result of reduced blood flow to the kidney
KIDNEY: CALCULI, KIDNEY  from MedLine: a concretion usually of mineral salts around organic material found especially in hollow organs or ducts
KIDNEY DISORDER
KIDNEY FAILURE
KIDNEY: NEPHRITIS  from MedLine: acute or chronic inflammation of the kidney affecting the structure (as of the glomerulus or parenchyma) and caused by infection, a degenerative process, or vascular disease
KIDNEY:
  PR-KIDNEY(S), LESION(S)
LARYNGITIS  from MedLine: inflammation of the larynx
LESION(S)
LESION(S), MOUTH/LIP(S)
LEUKODERMA  from MedLine: a skin abnormality that is characterized by a usually congenital lack of pigment in spots or bands and produces a patchy whiteness
LICKING, FEET/DIGIT(S)
LIVER DISORDER, OBSTRU
LIVER: ICTERUS Chronic hepatitis
LIVER FAILURE
LIVER: HEPATITIS from MedLine: 1: inflammation of the liver 2 : a disease or condition (as hepatitis A or hepatitis B) marked by inflammation of the liver
LIVER: HEPATOMEGALY
from MedLine: Liver enlargement
LIVER:
LIVER DISORDER
LIVER: NEOPLASM, LIVER
LIVER PROFILE HI
LIVER: US-LIVER ABN
LOCKJAW
LOSS OF CONDITION
LUNGS: APNEA
from MedLine: transient cessation of respiration whether normal (as in hibernating animals) or abnormal (as that caused by certain drugs)
LUNGS:
 BLD, LUNG(S)/TRACHEA
LUNGS: BREATHING ABN
LUNGS: BREATHING, DIFFICULT
LUNGS: BREATHING, PERIODIC
LUNGS: BRONCHITIS
LUNGS: 
CONGESTION, LUNG(S)
LUNGS: 
DISTRESS, RESP
LUNGS: DYSPNEA 
Respiratory diseases are common in dogs and cats. Although clinical signs such as coughing and dyspnea are commonly referable to primary problems of the respiratory tract, they may also occur secondary to disorders of other organ systems (eg, congestive heart failure).  Fever is usually absent. The degree of dyspnea and coughing is related to the severity of inflammation within the airways and alveoli.
LUNGS:
EDEMA, LUNG(S)/TRACHEA
LUNGS: EFFUSION, PLEURAL from MedLine: 1: an exudation of fluid from the blood or lymph into a pleural cavity 2: an exudate in a pleural cavity
LUNGS: HYPERPNEA  from MedLine: Differentiation from other causes of a chronic cough or nasal discharge (eg, parasitic bronchiolitis) is based on the history and other diagnostic procedures such as endoscopy, evaluation of a tracheobronchial exudate, and chest radiography. In its most subtle form, the only clinical sign may be hyperpnea at rest. Cytologic examination of fluid obtained from a tracheal wash or bronchoalveolar lavage usually shows a preponderance of neutrophils with generally normal morphology.
LUNGS: HYPOPNEA  from MedLine: abnormally slow or especially shallow respiration
LUNGS: PNEUMONIA, ASPIRATION  from MedLine: a disease of the lungs characterized by inflammation and consolidation followed by resolution and caused by infection or irritants
LUNGS: PR-LUNG(S), EDEMA
LUNGS: PR-LUNG(S), LESION(S)
LUNGS: RESPIRATORY DISORDER
LUNGS: SOUND ABN, RESPIRATORY
LUNGS: WHEEZING
LYMPH NODES: ENLARGEMENT, LYMPH NOD
LYMPH NODES: PR-LYMPH NODE(S), LESIONS from MedLine:  Lymph Node: any of the rounded masses of lymphoid tissue that are surrounded by a capsule of connective tissue, are distributed along the lymphatic vessels, and contain numerous lymphocytes which filter the flow of lymph passing through the node - Lesion(s): an abnormal change in structure of an organ or part due to injury or disease ; especially : one that is circumscribed and well defined
MASS
MIOSIS
  from MedLine: excessive smallness or contraction of the pupil of the eye
MORIBUND from MedLine: being in the state of dying ; approaching death; in the moribund patient deepening stupor and coma are the usual preludes to death.
MOUTH/LIPS/GUMS: ULCER(S), MOUTH/LIP(S)
MUCOUS MEMBR, ABN COLO
MUCOUS MEMBR, MUDDY
MUCOUS MEMBR, RED
MUSCULO-SKELETAL: ARTHRITIS
MUSCULO-SKELETAL: ATROPHY, MUSCLE(S) from MedicineNet: muscle wasting
MUSCULO-SKELETAL: CACHEXIA from MedLine: general physical wasting and malnutrition usually associated with chronic disease
MUSCULO-SKELETAL: COLLAPSE
MUSCULO-SKELETAL: DIFFICULTY RISING
MUSCULO-SKELETAL: DYSMETRIA  from MedLine: impaired ability to estimate distance in muscular action
MUSCULO-SKELETAL: EXERCISE INTOLERANCE
MUSCULO-SKELETAL:
FEVER, JOINT(S)
MUSCULO-SKELETAL: HEAD TILT
MUSCULO-SKELETAL: JOINT DISORDER
MUSCULO-SKELETAL: LAMENESS
MUSCULO-SKELETAL: LOCOMOTION DISORDER
MUSCULO-SKELETAL: MYOSITIS from MedLine: muscular discomfort or pain from infection or an unknown cause
MUSCULO-SKELETAL: NECK, VENTROFLEXION  from MedLine: [no such word], flexion: a bending movement around a joint in a limb (as the knee or elbow) that decreases the angle between the bones of the limb at the joint
MUSCULO-SKELETAL: OPISTHOTONOS  from MedLine: a condition of spasm of the muscles of the back, causing the head and lower limbs to bend backward and the trunk to arch forward
MUSCULO-SKELETAL:
  PARESIS  Spastic paresis is a progressive unilateral or bilateral hyperextension of the hind limb(s).
MUSCULO-SKELETAL: PARESIS, HIND LIMB(S)
MUSCULO-SKELETAL: PARALYSIS, HIND LIMB(S
MUSCULO-SKELETAL: PR-BONE MARROW, LESION
MUSCULO-SKELETAL: RECUMBENCY  from Merck Manual: [downer cow] Lifting usually reveals that the hindlimbs are unable to support weight 
MUSCULO-SKELETAL: RELUCTANT TO CLIMB
MUSCULO-SKELETAL: 
STIFFNESS
MUSCULO-SKELETAL: 
STIFFNESS, FRONT LIMB(
MUSCULO-SKELETAL: STUMBLING
MUSCULO-SKELETAL: SWELLING, JOINT(S)
MUSCULO-SKELETAL: SWELLING, LIMB(S)
MUSCULO-SKELETAL: TORTICOLLIS  from MedLine: a twisting of the neck to one side that results in abnormal carriage of the head and is usually caused by muscle spasms
NAIL DISORDER
NAUSEA
NECK, VENTROFLEXION  from MedLine: [no such word], flexion: a bending movement around a joint in a limb (as the knee or elbow) that decreases the angle between the bones of the limb at the joint
NECROSIS
NEOPLASM
  from MedicineNet: Neoplasm: A
tumor. An abnormal growth of tissue. The word neoplasm is not synonymous with cancer. A neoplasm may be benign or malignant.
NEOPLASM, LYMPH NODE(S)
NEOPLASM, SKIN
  from MedLine: a new growth of tissue serving no physiological function
NEPHRITIS  from MedLine: acute or chronic inflammation of the kidney affecting the structure (as of the glomerulus or parenchyma) and caused by infection, a degenerative process, or vascular disease
NEURITIS, OPTIC  from MedLine: inflammation of the optic nerve
NEUROLOGICAL DISORDER
NEUROPATHY  from MedLine: an abnormal and usually degenerative state of the nervous system or nerves ; also : a systemic condition (as muscular atrophy) that stems from a neuropathy
NOCTURIA  from MedLine: urination at night especially when excessive -- called also nycturia
NOSE ABN 
ODOR
ODOR, MOUTH
ODOR, URINE
OPACITY, CORNEA(S)
OPISTHOTONOS  from MedLine: a condition of spasm of the muscles of the back, causing the head and lower limbs to bend backward and the trunk to arch forward
OTITIS  from Medline: inflammation of the ear
PD-TABLET(S), ABN
PAIN
PAIN, BACK
PAIN, EYE(S)/LID(S)
PAIN, HEAD/FACE
PAIN, HIND LIMB(S)
PAIN, JOINT(S)
PAIN, LIMB(S)
PAIN, MOUTH/LIP(S)
PAIN, NECK
PALLOR, MUCOUS MEMBRAN
PALPITATIONS  from MedLine: a rapid pulsation ; especially : an abnormally rapid beating of the heart when excited by violent exertion, strong emotion, or disease
PANCREAS: BILIRUBIN(DIR) HI, BLD
PANCREAS DISORDER
PANCREAS:
PR-PANCREAS, LESION(S)
PANCREATITIS
PANCYTOPENIA  from MedLine: an abnormal reduction in the number of red blood cells, white blood cells, and blood platelets in the blood ; also : a disorder (as aplastic anemia) characterized by such a reduction 
PAPULE(S)  from MedLine: a small solid usually conical elevation of the skin caused by inflammation, accumulated secretion, or hypertrophy of tissue elements
PARALYSIS
PARALYSIS, ALL LIMBS
PARALYSIS, FACIAL NERV
PARALYSIS, HIND LIMB(S)
PARESIS, FORE LIMB(S) from MedLine: Paresis: slight or partial paralysis
PARESIS, FORELIMB(S)  from MedLine: Paresis: slight or partial paralysis
PARAESTHESIA, EYE(S)/L  from MedLine: a sensation of pricking, tingling, or creeping on the skin having no objective cause and usually associated with injury or irritation of a sensory nerve or nerve root
PARESTHESIA, MOUTH/LIP from MedLine: a sensation of pricking, tingling, or creeping on the skin having no objective cause and usually associated with injury or irritation of a sensory nerve or nerve root 
PERFORATION  from MedLine: a rupture in a body part caused especially by accident or disease
PERIODONTAL, ABSCESS
PHALLITIS  from MedLine: [NO SUCH WORD] see phallus:  penis; see itis:  inflammation; or possibly intended as: PRIAPISM from MedLine: an abnormal, more or less persistent, and often painful erection of the penis ; especially : one caused by disease rather than sexual desire
PHLEBITIS  from MedLine: inflammation of a vein
PHOTOPHOBIA  from MedLine: intolerance to light ; especially : painful sensitiveness to strong light
PHOTOSENSITIZATION  from MedLine: the condition of being photosensitized ; especially : the development of an abnormal capacity to react to sunlight typically by edematous swelling and dermatitis
PLATELETS ABN
PNEUMONIA
PNEUMONIA, ASPIRATION  from MedLine: a disease of the lungs characterized by inflammation and consolidation followed by resolution and caused by infection or irritants
POLYCYTHEMIA(ABSOLUTE)  from MedLine:  a condition marked by an abnormal increase in the number of circulating red blood cells
POLYCYTHEMIA(RELATIVE) from MedLine: a condition marked by an abnormal increase in the number of circulating red blood cells
POLYPHAGIA from Medline: excessive appetite or eating
PRIAPISM from MedLine: an abnormal, more or less persistent, and often painful erection of the penis ; especially : one caused by disease rather than sexual desire
PROPRIOCEPTIVE DISORDE - Search results - 1 articles found on MedicineNet for keyword or phrase: proprioceptive disorder: See: Vestibular Balance Disorders
PROSTATOMEGALY  from MedLine: [no such word]: prostate: a firm partly muscular partly glandular body that is situated about the base of the mammalian male urethra and secretes an alkaline viscid fluid which is a major constituent of the ejaculatory fluid called also prostate; megaly: enlargement of 
PROSTRATION  from MedLine: complete physical or mental exhaustion
PR-ADRENAL(S), LESION(S)
PR-ASCITES
PR-BLADDER, LESION(S)
PR-BLD VESSEL(S), LESI
PR-BRAIN, LESION(S)
PR-BRONCHI, LESION(S)  from MedLine: either of the two primary divisions of the trachea that lead respectively into the right and the left lung
PR-CECUM, LESION(S)  from MedLine: cecum: the blind pouch at the beginning of the large intestine into which the ileum opens from one side and which is continuous with the colon
PR-CEREBRUM, LESION(S)  from MedLine: 1 : BRAIN 2 : an enlarged anterior or upper part of the brain ; especially : the expanded anterior portion of the brain that in higher mammals overlies the rest of the brain, consists of cerebral hemispheres and connecting structures, and is considered to be the seat of conscious mental processes
PR-COLON, LESION(S)
PR-ESOPHAGUS, LESION(S
PR-EYE(S)/LID(S), LESION(S)
PR-GI, EDEMA
PR-PHARYNX, LESION(S)
PR-MENINGES, LESION(S)
  from MedLine: any of the three membranes that envelop the brain and spinal cord and include the arachnoid, dura mater, and pia mater
PR-MESENTERY, LESION(S)  from MedLine: Mesentery: 1 : one or more vertebrate membranes that consist of a double fold of the peritoneum and invest the intestines and their appendages and connect them with the dorsal wall of the abdominal cavity ; specifically : such membranes connected with the jejunum and ileum in humans 2 : a fold of membrane comparable to a mesentery and supporting a viscus (as the heart) that is not a part of the digestive tract
PR-MOUTH/LIP(S), LESIO
PR-MULT SITES, LESION(S)
PR-MULT SITES, CONGEST
PR-MULT SITES, EDEMA
PR-MULT SITES, ICTERUS
  Icterus:
Jaundice. At least one medical dictionary defines icterus as the presence of jaundice seen in the sclera of the eye. This is incorrect. Icterus is synonymous with jaundice. They are one and the same thing.
PR-MUSCLE(S), LESION(S)
PR-NERVE(S), LESION(S)
PR-NOSE, LESION(S)
PR-PERICARDIAL EFFUSIO
PR-PERITONEAL EFFUSION
PR-PLEURAL EFFUSION
PR-RECTUM, LESION(S)
PR-SPINAL CORD, LESION
PR-TONGUE, LESION(S)
PR-TRACHEA, LESION(S)
PR-WHOLE BODY, LESION(S)
PULSE THREADY
PURITIS from MedLine: Pruritus see Itching : Itching is a peculiar tingling or uneasy irritation of the skin that causes a desire to scratch the affected area.  Itching may be over the whole body (generalized), or only in a particular location (localized).
PRURITIS, EAR(S)
PRURITIS, EYE(S)
PRURITIS, FEET/DIGIT(S
RADIOGRAPH(S) ABNORMAL
REACTION, UNSPECIFIED
REFLUX, STOMACH  from MedLine: a flowing back
REGURGITATION
REPRODUCTION DISORDER
RESPIRATORY DISORDER
RUPTURE, STOMACH
SALIVA, ABN
SCENT DEFICIT
SEBORRHEA
  from Medline: abnormally increased secretion and discharge of sebum producing an oily appearance of the skin and the formation of greasy scales
SEDATION  From Medline: 1 : the inducing of a relaxed easy state especially by the use of sedatives  2 : a state resulting from sedation
SEDATION PROLONGED
SEPTICEMIA  from MedLine: invasion of the bloodstream by virulent microorganisms from a focus of infection that is accompanied by chills, fever, and prostration and often by the formation of secondary abscesses in various organs -- called also blood poisoning SEPSIS  from MedLine: a toxic condition resulting from the spread of bacteria or their products from a focus of infection
SHOCK  From MedLine: Cardiac function; intravascular volume; and vascular tone, integrity, and patency are each critical to normal circulation. An abnormality in one or more of these components of circulation leads to compensatory changes in the others in an effort to maintain perfusion. The hemodynamic and cellular changes that develop as a result of these abnormalities are called shock. As shock progresses, oxygen and substrate delivery to the tissues becomes insufficient to meet energy requirements for cellular maintenance and repair. If shock progresses to the point when cellular energy demands cannot be met, the hemodynamic and cellular responses become similar for all types of shock. Organ failure ensues, and when progressive, the end result is death. Early recognition of the type of shock and an understanding of the pathophysiologic processes initiated allow aggressive treatment and optimal chances for recovery.
SHOCK, ENDOTOXEMIA  from MedLine: the presence of endotoxins in the blood; see endotoxins: a toxin of internal origin ; specifically : a poisonous substance present in bacteria (as the causative agent of typhoid fever) but separable from the cell body only on its disintegration 
SINUSITIS
SKIN:  ABSCESS, SKIN
SKIN:  ALOPECIA  Alopecia is the partial or complete lack of hairs in areas where they are normally
SKIN:
  BLD(PETECHIAE)
SKIN:  DERMATITIS, MOIST
SKIN:  BLD(ECCHYMOSES) from MedLine: a minute reddish or purplish spot containing blood that appears in skin or mucous membrane especially in some infectious diseases (as typhoid fever) -- compare ECCHYMOSIS :  ANEMIA Ecchmyotic lesions on abdomen, dog; ANEMIA Ecchymotic lesions on mucous membranes of oral cavity
SKIN:  Acquired thrombocytopenias  from MedLine:  Immunologic and inflammatory mechanisms cause increased platelet consumption and decreased platelet survival. 
SKIN: BLD, SKIN
SKIN: CONGESTION, SKIN
SKIN, DRY
SKIN: ERUPTION(S) from MedLine: 1. the breaking out of an exanthem or enanthem on the skin or mucous membrane (as in measles) 2. something produced by an act or process of erupting: as a : the condition of the skin or mucous membrane caused by erupting b : one of the lesions (as a pustule) constituting this condition
SKIN: ERYTHEMA MULTIFORME  from MedLine: a skin disease characterized by papular or vesicular lesions and reddening or discoloration of the skin often in concentric zones about the lesions
SKIN: EXFOLIATION, SKIN  from MedLine: the action or process of exfoliating: as a : the peeling of the horny layer of the skin (as in some skin diseases) b : the shedding of surface components (as cells from internal body surfaces when diseased) c : the shedding of a superficial layer of bone or of a tooth or part of a tooth 
SKIN:
HAIR, SHEDDING
SKIN: HYPERPIGMENTATION, SKIN  from MedLine: excess pigmentation in a bodily part or tissue (as the skin)
SKIN:
INFECTION, SKIN
SKIN: INFLAM, SKIN
SKIN: LESION(S), SKIN
SKIN: MASS, SKIN
SKIN: SKIN, SCAB(S)
SKIN: SKIN, NECROSIS  from MedicineNet: Necrosis: The death of living cells or
tissues. Necrosis can be due, for example, to ischemia (lack of blood flow). From the Greek "nekros" (dead body).
SKIN: NEOPLASM, SKIN  from MedLine: a new growth of tissue serving no physiological function
SKIN:
 
PR-SKIN, LESION(S)
SKIN: PALLOR
SKIN: PAPULE(S)  from MedLine: a small solid usually conical elevation of the skin caused by inflammation, accumulated secretion, or hypertrophy of tissue elements
SKIN:
 PRURITIS  from MedLine: Dry, flaky skin with pruritus wet or weeping spots/sores
SKIN: PUSTULE(S) from MedLine:  Pustule: A pustule is a small collection of pus in the top layer of skin (epidermis) or beneath it in the dermis. Pustules frequently form in sweat glands or hair follicles. Pus is a mixture of inflammatory cells and liquid.  Put somewhat more simply a pustule is a little pimple full of pus.
SKIN:
RASH
SKIN: SCALE(S), SKIN
SKIN: SEBORRHEA  from Medline: abnormally increased secretion and discharge of sebum producing an oily appearance of the skin and the formation of greasy scales
SKIN:
SKIN DISORDER
SKIN: SKIN, CRUST(S)
SKIN: HYPERKERATOSIS  from MedLine: 1 : hypertrophy of the stratum corneum layer of the skin  2 a : any of various conditions marked by hyperkeratosis b : a disease of cattle that is marked by thickening and wrinkling of the hide, by formation of papillary outgrowths on the buccal mucous membranes, and often by a watery discharge from eyes and nose, diarrhea, loss of weight, and abortion of pregnant animals and that is caused especially by ingestion of the chlorinated naphthalene of various lubricating oils, by arsenic poisoning, or by inherited congenital ichthyosis -- called also X-disease, XX disease from Merck Veterinary Manual: Hyperkeratosis of footpads, ferret. Note the yellowish crusty lesions found on the ventral surface of the main footpads. Crusts were also present on the muzzle of this ferret; Cutaneous ichthyoses are characterized by abnormal and hypertrophic epithelial proliferation, with accumulation of extensive scale and hyperkeratosis on the skin surface.; In dogs, the body is covered with large adherent scales that may flake off in large sheets. The planum nasale and digital pads are usually markedly thickened, and the latter usually is associated with apparent discomfort.; Marked hyperkeratosis precedes the development of hair coat abnormalities, which begin as the loss of normal hair kinkiness and progress to patchy alopecia.
SKIN: IRRITATION, SKIN
SKIN: SLOUGH, SKIN  from MedLine: dead tissue separating from living tissue ; especially : a mass of dead tissue separating from an ulcer
SKIN:
ULCER(S), SKIN
SKIN:  URTICARIA from Medline: (Hives, Nettle rash) Urticaria is characterized by multiple plaque-like eruptions that are formed by localized edema in the dermis and that often develop and disappear suddenly.
SLEEP ABN
SLOUGH  from MedLine: slough: dead tissue separating from living tissue ; especially : a mass of dead tissue separating from an ulcer
SLOUGH, FEET/DIGIT(S)  from MedLine: slough: dead tissue separating from living tissue ; especially : a mass of dead tissue separating from an ulcer
SLOUGH, GINGIVA
SLOUGH, TONGUE
SORE(S)
SOUND ABN, VOICE
SPASM
SPERM ABN
SPLEEN:
NEOPLASM, SPLEEN
SPLEEN: PR-SPLEEN, LESION(S)
SPLEEN: SPLENOMEGALY  from MedLine: Enlargement of spleen
STIFFNESS, FRONT LIMB(
STIFFNESS, HIND LIMB(S
STIFFNESS, LIMB(S
)
STOMACH: ASCITES  From MedLine: Ascites is an accumulation of noninflammatory transudate in one or more of the peritoneal cavities or potential spaces. The fluid, which accumulates most frequently in the two ventral hepatic, peritoneal, or pericardial spaces, may contain yellow protein clots.
STOMACH:
 DISTENTION, ABDOMEN
STOMACH: GASTROENTERITIS
STOMACH: MASS, ABDOMEN
STOMACH: PAIN, ABDOMEN
STOMACH: PERFORATION, STOMACH
STOMACH: REFLUX, STOMACH  from MedLine: a flowing back STOMACH: RUPTURE, STOMACH
STOMACH: STOMATITIS  from MedLine: stomach inflammation, irritation
STOMACH: ULCER(S)
STOMACH: ULCER(S), GI
STOMACH: ULCER(S), STOMACH
STOOL, PALE/GRAY
STRABISMUS
  from MedLine: inability of one eye to attain binocular vision with the other because of imbalance of the muscles of the eyeball
SWELLING
SWELLING, ANUS
SWELLING, BRISKET/CHES
SWELLING, HEAD/FACE
SWELLING, FEET/DIGIT(S)
SWELLING, MOUTH/LIP(S)
SWELLING, MULT SITES
SWELLING, NECK
SWELLING, PHARYNX/THRO
SWELLING, PREPUCE
SWELLING, SCROTUM
SWELLING, TONGUE
SWELLING, VENTRUM  from MedLine: [no such word]
SYNCOPE  from MedLine: loss of consciousness resulting from insufficient blood flow to the brain
TACHYCARDIA, VENTRICUL
TEARS, ABN
TEETH, ABN
TENESMUS, URINARY  from MedLine: a distressing but ineffectual urge to evacuate the rectum or urinary bladder
TESTICLE, ABN
THROMBUS  from MedLine: a clot of blood formed within a blood vessel and remaining attached to its place of origin
THYROID HORMONE(S) HI
TONGUE, ABN

TONGUE: ULCER(S), TONGUE
TORTICOLLIS  from MedLine: a twisting of the neck to one side that results in abnormal carriage of the head and is usually caused by muscle spasms
TOX
TRANSUDATE  from MedLine: a transuded substance transuded: to pass through a membrane or permeable substance
TREMBLING, FACE
UDDER, DYSGALACTIA  from MedLine: [NO SUCH WORD]: from Merck Veterinary Manual: a condition associated with cattle and pigs see: mastitis  from MedLine: Mastitis: Inflammation of one or more mammary glands within the breast, usually in a lactating woman. It can be felt as a hard, sore spot within the breast. Mastitis can be caused by an infection in the breast or by a plugged milk duct. Treatment is by rest, applying warm compresses to the affected area, and for those who are lactating, nursing or expressing milk frequently. Women with mastitis recurring during nursing could benefit by consulting a lactation expert through their obstetrician, midwife, or the La Leche League. ; from Merck Veterinary Manual: mastitis: Inflammation of the mammary gland is almost always due to the effects of infection by bacterial or mycotic pathogens.
ULCER(S)
ULCER(S), EAR(S)
ULCER(S), FEET/DIGIT(S
ULCER(S), MUCOCUTANEOU
UNPALATABLE
URINARY TRACT/BLADDER: ANURIA  Acute renal failure occurs when a major insult to the kidneys results in inability to regulate water and solute balance; this may occur when urine flow is reduced.
URINARY TRACT/BLADDER: ATONY, BLADDER  from MedLine: atony: lack of physiological tone especially of a contractile organ
URINARY TRACT/BLADDER:
BLADDER, PARALYSIS
URINARY TRACT/BLADDER: CALCULI, URINE
URINARY TRACT/BLADDER: CASTS, URINE
URINARY TRACT/BLADDER: CYSTITIS
URINARY TRACT/BLADDER: DISTENTION, BLADDER
URINARY TRACT/BLADDER: DYSURIA from MedicineNet:  Dysuria: Painful or
difficult urination. This includes burning on urination. Dysuria is most commonly due to bacterial infection of the urinary tract causing inflammation of the bladder (cystitis) or kidney (pyelonephritis).  There are many other causes of dysuria including irritation from chemicals.
URINARY TRACT/BLADDER: INFECTION, URINARY TRACT
URINARY TRACT/BLADDER:  NOCTURIA  from MedLine: urination at night especially when excessive -- called also nycturia
URINARY TRACT/BLADDER:
  OLIGURIA from MedLine: reduced excretion of urine
URINARY TRACT/BLADDER:  POLLAKIURIA  from MedLine: abnormally frequent urination
URINARY TRACT/BLADDER:  STRANGURIA  from MedLine:  [no such word] One entry found for strangury  Main Entry: stran·gu·ry: Inflected Form(s): plural -ries : a slow and painful discharge of urine drop by drop produced by spasmodic muscular contraction of the urethra and bladder
URINARY TRACT/BLADDER:  TENESMUS, URINARY  from MedLine: a distressing but ineffectual urge to evacuate the rectum or urinary bladder
URINARY TRACT/BLADDER:
  UREMIA from MedLine: 1 : accumulation in the blood of constituents normally eliminated in the urine that produces a severe toxic condition and usually occurs in severe kidney disease  2 : the toxic bodily condition associated with uremia
URINATION
URINATION ABN
URINE: ACID URINE
URINE: ALKALINE URINE
URINE: URINE ABN
URINE: ABN COLOR, URINE
URINE: ABN ODOR, URINE
URINE: BILIRUBIN, URINE
URINE: CASTS, URINE
URINE: CALCULI, URINE
URINE: CLOUDY URINE
URINE:
CORT/CREAT HI, URINE
URINE: CRYSTALS, URINE
URINE: GLUCOSE, URINE
URINE: HEMOGLOBIN, URINE
URINE: INCONTINENCE, URINARY
URINE: K HI, URINE
URINE:
KETONES, URINE
URINE: MICROORANISMS, URINE
URINE: MICROORGANISMS, URINE
URINE: MYOGLOBIN, URINE
URINE:
ODOR, URINE
URINE: P HI, URINE
URINE: PROTEIN, URINE
URINE: SEDIMENT, URINE
URINE: SPEC GRAVITY HI, URINE
URINE: SPEC GRAVITY LO, URINE
URINE: URIC ACID HI, BLD
URINE: UROBILINOGEN HI, URINE
URINE: WBC, URINE
US ABN
VAGINITIS  from MedLine: inflammation (as from bacterial or fungal infection, allergic reaction, or hormone deficiency) of the vagina that may be marked by irritation and vaginal discharge
VASCULITIS  from MedLine: inflammation of a blood or lymph vessel -- called also angiitis  see also: Necrotizing Vasculitis: an inflammatory condition of the blood vessels characterized by necrosis of vascular tissue -- called also necrotizing angiitis, systemic necrotizing vasculitis ; see also: systemic necrotizing vasulitis: an inflammatory condition of the blood vessels characterized by necrosis of vascular tissue -- called also necrotizing angiitis, systemic necrotizing vasculitis
VESICLE(S)/BULLAE, MOU
VESICLE(S)/BULLAE, SKI  from MedLine: Vesicle(s) 1 a : a membranous and usually fluid-filled pouch (as a cyst, vacuole, or cell) in a plant or animal b :
SYNAPTIC VESICLE 2 : a small abnormal elevation of the outer layer of skin enclosing a watery liquid : BLISTER  3 : a pocket of embryonic tissue that is the beginning of an organ -- see BRAIN VESICLE, OPTIC VESICLE - Bullae: 1 : a hollow thin-walled rounded bony prominence  2 : a large vesicle or blister
VESTIBILAR DISORDER from MedLine: of or relating to the vestibule of the inner ear, the vestibular apparatus, the vestibular nerve, or the labyrinthine sense (see dizziness, balance disorder)
VOICE DISORDER
VOLVULUS  from MedLine: a twisting of the intestine upon itself that causes obstruction
VOMITING, UNPRODUCTIVE
WEIGHT INCREASE
XEROSTOMIA  from MedLine: abnormal dryness of the mouth due to insufficient secretions -- called also dry mouth 
 


 2/18/05

 
Lee Zavala, Investigator
State of Washington
Department of Health
Board of Governors
 
NOTE: e-Mail copy sent to: Darlene.Tiffany@DOH.WA.GOV to be added/included with the complaint file/materials previously submitted in this matter. 
 
Re:  ADD-ON #10: NEW EVIDENCE/ALLEGATIONS and
                 SUPPLEMENTAL INFORMATION
    
      ADD ON ITEM: video site:  
http://wbz.dayport.com/viewer/viewerpage.php?Art_ID=8171&tf=video_player.tpl&
 
[NOTE: just click on the above link to view; this has also sent directly to both of you via news station Channel 4 in Boston]
        Case #: 2004-04-0008 VT    
        Lawrence Williams/Burien Veterinary Hospital
        Hammond/Meyer/Baty/Five Corners Veterinary  Hospital
        Murnane/Jewett/Phoenix Central Lab
 
Dear Mr. Zavala,
 
    As I've not received any indication that the video link previously sent to you by me was received, I am sending you yet another video news story, out of Boston, Massachusetts this time, regarding the risks/dangers associated with RIMADYL and the lack of information being provided by veterinarians to pet owners.
 
I think it's safe to state that it's only a matter of time before this "scandal" catches up with and impacts all State Veterinarian Boards that continue to "protect" veterinarian's special interests rather than the "public interests" they are charged, by law, to protect at taxpayer expense.
 
It would be inappropriate for me to inquire as to any opinion[s] regarding this video, but I would greatly appreciate an acknowledgement that you received this e-mail.  Thank you.
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSanchez@aol.com
 


below is a true copy of Part #11 filed with the WA Vet Board to be added to the complaint:

 
Part #11
 
2/23/05
 
Lee Zavala, Investigator
State of Washington
Department of Health
Board of Governors
 
NOTE: e-Mail copy sent to: Darlene.Tiffany@DOH.WA.GOV to be added/included with the complaint file/materials previously submitted in this matter. 
 
Re:  ADD-ON #11: NEW EVIDENCE/ALLEGATIONS and
                 SUPPLEMENTAL INFORMATION/EXHIBITS for same
        Case #: 2004-04-0008 VT    
        Lawrence Williams/Burien Veterinary Hospital
        Hammond/Meyer/Baty/Five Corners Veterinary Hospital
        Murnane/Jewett/Phoenix Central Lab
 
Dear Mr. Zavala and Ms. Tiffany:
 
    While I had believed that I previously listed all of my known allegations with respect to DVM Williams/BVH's veterinarian "care" of ROMI leading to her horrific death, and provided supporting documents regarding same via Parts #1 through #10 in my complaint, there is now a new allegation against DVM Williams/BVH to be added regarding his standard of care for my dog, ROMI:
 
NEW ALLEGATION: A WILLFUL disregard of basic animal health & safety resulting in ROMI's horrific death due to not only the inappropriate/illegal prescribing/dispensing of the RIMADYL, but potentially ALSO due to and/or contributed to by "vaccinosis" compromising her immune system and DVM Williams/BVH doing all of these actions at the same office visit time and without any potential for her to have any recovery time because he did all of this at one office visit, and failing to provide any sort of warning/cautionary information to me as to either there being any risks/dangers regarding vaccinations and failing to provide any information as to possible symptoms of an adverse vaccine reaction (what should be looked for), and after my reporting ROMI's symptoms/condition to DVM Williams/BVH, he provided nothing in the way of either supportive care and/or even any information regarding supportive care other than "just watch her", "push fluids" and "let me know how she does" after I refused to give her any more RIMADYL, as had been advised/insisted upon by DVM Williams/BVH.
During the course of researching what state licensed practicing veterinarians are supposed to know and update their education on, i.e., vaccinations, it has come to my attention that there is apparently somewhat of a "controversy" within the veterinarian community with respect to vaccinating pets and what the appropriate protocols may or may not be regarding those vaccinations [see Exhibit #130 and #131 below.]
 
I am certainly not qualified to take a position on this controversy, and no doubt each of the Washington State Veterinary Board of Governors, who are veterinarians, have already formed their own individual bias as to whether they are "pro" or "con" on the subject, but these are the FACTS:
In summary, the new allegation against DVM Williams/BVH is that irrespective of whether it was the RIMADYL, or the unnecessary, inappropriate and/or over-vaccination or some combination of the "triple whammy" that compromised ROMI's immune system/health and resulted in her horrific death, DVM Williams/BVH is directly responsible for the results and should be held "accountable" for same by the Washington State, Veterinary Board of Governors in this case.
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSanchez@aol.com
Seattle, WA
 
EXHIBITS REFERENCED ABOVE ARE PROVIDED BELOW
 
EXHIBIT #130:
 
Adverse  Vaccine Reactions
 
W. Jean Dodds, DVM
Hemopet/Hemolife
938 Stanford Street
Santa Monica,  CA 90403
310-828-4804; Fax 310-828-8251
 

Viral disease and recent vaccination with single or combination modified live-virus (MLV) vaccines, especially those containing distemper virus, adenovirus 1 or 2, and parvovirus are increasingly recognized contributors to immune-mediated blood disease, bone marrow failure, and organ dysfunction. 1-11 Potent adjuvanted  killed  vaccines like those for rabies virus also can trigger immediate and delayed (vaccinosis) adverse vaccine reactions.7-10 Genetic predisposition to these disorders in humans has been linked to the leucocyte antigen D-related gene locus of the major histocompatibility complex, and is likely to have parallel associations in domestic animals. 5, 7 
 
Beyond immediate hypersensivity reactions, other acute events tend to occur 24-72 hours afterwards, or 7-45 days later in a delayed type immunological response. 1-4, 6-10  Even more delayed adverse effects include mortality from high-titered measles vaccine in infants, canine distemper antibodies in joint diseases of dogs, and feline injection-site fibrosarcomas. 5,7 The increasing antigenic load presented to the host individual by modified-live virus (MLV) vaccines during the period of viremia is presumed to be responsible for the immunological challenge that can result in a delayed hypersensitivity reaction. 2, 3, 6, 7
 
The clinical signs associated with vaccine reactions typically include fever, stiffness, sore joints and abdominal tenderness, susceptibility to infections, neurological disorders and encephalitis, collapse with autoagglutinated red blood cells and icterus (autoimmune hemolytic anemia) (AIHA), or generalized petechiae and ecchymotic hemorrhages (immune-mediated thrombocytopenia)(ITP).1, 2, 4, 7, 8, 12, 13 Hepatic enzymes may be markedly elevated, and liver or kidney failure may occur by itself or accompany bone marrow suppression.  Furthermore, MLV vaccination has been associated with the development of transient seizures in puppies and adult dogs of breeds or cross-breeds susceptible to immune-mediated diseases especially those involving hematologic or endocrine tissues (e.g. AIHA, ITP, autoimmune thyroiditis). 1,7,10 Post-vaccinal polyneuropathy is a recognized entity associated occasionally with the use of distemper, parvovirus, rabies and presumably other vaccines. 2, 3, 7  This can result in various clinical  signs including muscular atrophy, inhibition or interruption of neuronal control of tissue and organ function, muscular excitation, incoordination and weakness, as well as seizures. 7 Certain breeds or families of dogs appear to be more susceptible to adverse vaccine reactions, particularly post-vaccinal seizures, high fevers, and painful episodes of hypertrophic osteodystrophy (HOD).7, 9   Therefore, we have the responsibility to advise companion animal breeders and caregivers of  the potential for genetically susceptible littermates and relatives to be at increased risk for similar adverse vaccine reactions.1, 4, 6-9, 14-17  In popular (or rare) inbred and linebred animals, the breed in general can be at increased risk as illustrated in the examples below.
 
Commercial vaccines can on rare occasion be contaminated with other adventitious viral agents, 3, 15 which can produce significant untoward effects such as occurred when a commercial canine parvovirus vaccine was contaminated by blue tongue virus. It produced abortion and death when given to pregnant dogs,15 and was linked causally to the ill-advised but all too common practice of vaccinating pregnant animals. The potential for side-effects such as promotion of chronic disease states in male and non-pregnant female dogs receiving this lot of  vaccine remains in question, although there have been anecdotal reports of reduced stamina and renal dysfunction in performance sled dogs. 17   Recently, a vaccine manufacturer had to recall all  biologic products containing a distemper component, because they were associated with a higher than expected rate of central nervous system postvaccinal reactions 1-2 weeks following administration. 17
 
Other issues arise from overvaccination, as the increased cost in time and dollars spent needs to be considered, despite the well-intentioned solicitation of clients to encourage annual booster vaccinations so that pets also can receive a wellness examination.6 Giving annual boosters when they are not necessary has the client paying for a service which is likely to be of little benefit to the pet’s existing level of protection against these infectious diseases.  It also increases  the risk of  adverse reactions from the repeated exposure to foreign substances.   
 
Polyvalent MLV vaccines which multiply in the host elicit a stronger antigenic challenge to the animal and should mount a more effective and sustained immune response. 2, 3, 6  However, this can overwhelm the immunocompromised or even a healthy host that has ongoing exposure to other environmental stimuli as well as a genetic predisposition that promotes adverse response to viral challenge. 1, 2, 7, 14, 16, 17  The recently weaned young puppy or kitten being placed in a new environment may be at particular risk.  Furthermore, while the frequency of vaccinations is usually spaced 2-3 weeks apart, some veterinarians have advocated vaccination once a week in stressful situations, a practice makes [that] little sense scientifically or medically.6
 
An augmented immune response to vaccination is seen in dogs with pre-existing inhalant allergies (atopy) to pollens. 7  Furthermore, the increasing current problems with allergic and immunological diseases has been linked to the introduction of MLV vaccines more than 20 years ago. 3  While other environmental factors no doubt have a contributing role, the introduction of these vaccine antigens and their environmental shedding may provide the final insult that exceeds the immunological tolerance threshold of some individuals in the pet population.  The accumulated evidence indicates that vaccination protocols should no longer be considered as a “one size fits all” program. 9
 
For these special cases, appropriate alternatives to current vaccine practices include: measuring serum antibody titers; avoidance of unnecessary vaccines or overvaccinating; caution in vaccinating sick or febrile individuals; and tailoring a specific minimal vaccination protocol for dogs of breeds or families known to be at increased risk for adverse reactions.6,7,18   Considerations include starting the vaccination series later, such as at nine or ten weeks of age when the immune system is more able to handle antigenic challenge; alerting the caregiver to pay particular attention to the puppy’s behavior and overall health after the second or subsequent boosters; and avoiding revaccination of individuals already experiencing a significant adverse event. Littermates of affected puppies should be closely monitored after receiving additional vaccines in a puppy series, as they too are at higher risk.
 
References
 
1. Dodds WJ. Immune-mediated diseases of the blood.  Adv Vet Sci Comp Med 1983; 27:163-196.
2. Phillips TR, Jensen JL, Rubino MJ, Yang WC, Schultz RD.  Effects on vaccines on the canine immune system.  Can J Vet Res 1989; 53: 154-160.
3. Tizard I. Risks associated with use of live vaccines.  J Am Vet Med Assoc 1990; 196:1851-1858.
4. Duval D, Giger U. Vaccine-associated immune-mediated hemolytic anemia in the dog. J Vet Int Med 1996;10: 290-295.
5. Cohen AD, Shoenfeld Y. Vaccine-induced autoimmunity.  J Autoimmunity 1996; 9: 699-703.
6. Schultz R. Current and future canine and feline vaccination programs. Vet Med 1998; 93:233-254.
7. Dodds WJ. More bumps on the vaccine road. Adv Vet Med 1999; 41: 715-732.
8. HogenEsch H, Azcona-Olivera J, Scott-Moncrieff C, Snyder PW, Glickman LT. Vaccine-induced autoimmunity in the dog. Adv Vet Med 1999; 41:733-744.
9. Dodds WJ.  Vaccination protocols for dogs predisposed to vaccine reactions. J Am An Hosp Assoc 2001; 38: 1-4.
10. Scott-Moncrieff JC, Azcona-Olivera J, Glickman NW, Glickman LT, HogenEsch H. Evaluation of  antithyroglobulin antibodies after routine vaccination in pet and research dogs. J Am Vet Med Assoc 2002; 221: 515-521.
11. Paul MA (chair) et al. Report of the AAHA Canine Vaccine Task Force: 2003 canine vaccine guidelines, recommendations, and supporting literature. AAHA, April 2003, 28 pp.
12. May C, Hammill J, Bennett, D.   Chinese shar pei fever syndrome: A preliminary report. Vet Rec 1992;131: 586-587.
13. Scott-Moncrieff JC, Snyder PW, Glickman LT, Davis EL, Felsburg PJ.  Systemic necrotizing vasculitis in nine young beagles.  J Am Vet Med Assoc 1992; 201: 1553-1558.
14. Dodds WJ. Estimating disease prevalence with health surveys and genetic screening. Adv Vet Sci Comp Med 1995; 39: 29-96.
15. Wilbur LA, Evermann JF, Levings RL, Stoll LR, Starling DE, Spillers CA, Gustafson GA, McKeirnan AJ.  Abortion and death in pregnant bitches associated with a canine vaccine contaminated with blue tongue virus.  J Am Vet Med Assoc 1994; 204:1762-1765.
16. Day MJ, Penhale WJ. Immune-mediated disease in the old English sheepdog. Res Vet Sci 1992; 53: 87-92.
17. Dougherty SA, Center SA. Juvenile onset polyarthritis in Akitas. J Am Vet Med Assoc 1991; 198: 849-855.                          
18. Twark L, Dodds WJ. Clinical use of serum parvovirus and distemper virus antibody titers for determining revaccination strategies in healthy dogs. J Am Vet Med Assoc 2000; 217:1021-1024.
===========================================================
EXHIBIT #131:
 
CHANGING VACCINE PROTOCOLS
 
W. Jean Dodds, DVM
938 Stanford Street
Santa Monica, CA 90403
(310) 828-4804; FAX (310) 828-8251
 

The challenge to produce effective and safe vaccines for the prevalent infectious diseases of humans and animals has become increasingly difficult. In veterinary medicine, evidence  implicating vaccines in triggering immune-mediated and other chronic disorders (vaccinosis) is compelling.  While some of these problems have been traced to contaminated or poorly attenuated batches of vaccine that revert to virulence, others apparently reflect the host=s genetic predisposition to react adversely upon receiving the single (monovalent) or multiple antigen “combo” (polyvalent) products given routinely to animals. Animals of certain susceptible breeds or families appear to be at increased risk for severe and lingering adverse reactions to vaccines. 
 
The onset of adverse reactions to conventional vaccinations (or other inciting drugs, chemicals, or infectious agents) can be an immediate hypersensitivity or anaphylactic reaction, or can occur acutely (24-48 hours afterwards), or later on (10-45 days) in a delayed type immune response often caused by immune-complex formation. Typical signs of adverse immune reactions include fever, stiffness, sore joints and abdominal tenderness, susceptibility to infections, central and peripheral nervous system disorders or inflammation, collapse with autoagglutinated red blood cells and jaundice, or generalized pinpoint hemorrhages or bruises. 
 
Liver enzymes may be markedly elevated, and liver or kidney failure may accompany bone marrow suppression.  Furthermore, recent vaccination of genetically susceptible breeds has been associated with transient seizures in puppies and adult dogs, as well as a variety of autoimmune diseases including those affecting the blood, endocrine organs, joints, skin and mucosa, central nervous system, eyes, muscles, liver, kidneys, and bowel.   It is postulated that an underlying genetic predisposition to these conditions places other littermates and close relatives at increased risk. Vaccination of pet and research dogs with polyvalent vaccines containing rabies virus or rabies vaccine alone was recently shown to induce production of antithyroglobulin autoantibodies, a provocative and important finding with implications for the subsequent development of hypothyroidism (Scott-Moncrieff et al, 2002). 
 
Vaccination also can overwhelm the immunocompromised or even healthy host that is repeatedly challenged with other environmental stimuli and is genetically predisposed to react adversely upon viral exposure. The recently weaned young puppy or kitten entering a new environment is at greater risk here, as its relatively immature immune system can be temporarily or more permanently harmed. Consequences in later life may be the increased susceptibility to chronic debilitating diseases.
 
As combination vaccines contain antigens other than those of the clinically important infectious disease agents, some may be unnecessary; and their use may increase the risk of adverse reactions. With the exception of  a  recently introduced  mutivalent Leptospira spp. vaccine, the other leptospirosis vaccines afford little protection against the clinically important fields strains of leptospirosis, and the antibodies they elicit typically last only a few months. Other vaccines, such as for Lyme disease, may not be needed, because the disease is limited to certain geographical areas. Annual revaccination for rabies is required by some states even though there are USDA licensed rabies vaccine with a 3-year duration. Thus, the overall risk-benefit ratio of using certain vaccines or multiple antigen vaccines given simultaneously and repeatedly should be reexamined. It must be recognized, however, that we have the luxury of asking such questions today only because the risk of disease has been effectively reduced by the widespread use of vaccination programs.
Given this troublesome situation, what are the experts saying about these issues? In 1995, a landmark review commentary focused the attention of the veterinary profession on the advisability of current vaccine practices. Are we overvaccinating companion animals, and if so, what is the appropriate periodicity of  booster  vaccines ?  Discussion of this provocative topic has generally lead to other questions about the duration of immunity conferred by the currently licensed vaccine components.         
In response to questions posed in the first part of this article, veterinary vaccinologists have recommended new protocols for dogs and cats. These include: 1) giving the puppy or kitten vaccine series followed by a booster at one year of age; 2) administering further boosters in a combination vaccine every three years or as split components alternating every other year until; 3) the pet reaches geriatric age, at which time booster vaccination is likely to be unnecessary and may be unadvisable for those with aging or immunologic disorders.  In the intervening years between booster vaccinations, and in the case of geriatric pets, circulating humoral immunity can be evaluated by measuring serum vaccine antibody titers as an indication of the presence of Aimmune memory@. Titers do not distinguish between immunity generated by vaccination and/or exposure to the disease, although the magnitude of immunity produced just by vaccination is usually lower (see Tables).
 
Except where vaccination is required by law, all animals, but especially those dogs or close relatives that previously experienced an adverse reaction to vaccination can have serum antibody titers measured annually instead of revaccination. If adequate titers are found,  the animal should not need revaccination until some future date.  Rechecking antibody titers can be performed annually,  thereafter, or  can be offered as an alternative to pet owners who prefer not to follow the conventional practice of annual boosters. Reliable serologic vaccine titering is available from several university and commercial laboratories and the cost is reasonable (Twark and Dodds, 2000; Lappin et al, 2002; Paul et al, 2003; Moore and Glickman, 2004).
 
Relatively little has been published about the duration of immunity following vaccination, although new data are beginning to appear for both dogs and cats.   
Our recent study (Twark and Dodds, 2000), evaluated 1441 dogs for CPV antibody titer and 1379 dogs for CDV antibody titer. Of these, 95.1 % were judged to have adequate CPV titers, and nearly all (97.6 %) had adequate CDV titers. Vaccine histories were available for 444 dogs (CPV) and 433 dogs (CDV). Only 43 dogs had been vaccinated within the previous year, with the majority of dogs (268 or 60%) having received a booster vaccination 1-2 years beforehand. On the basis of our data, we concluded that annual revaccination is unnecessary. Similar findings and conclusions have been published recently for dogs in New Zealand (Kyle et al, 2002), and cats (Scott and Geissinger, 1999; Lappin et al, 2002).  Comprehensive studies of the duration of serologic response to five viral vaccine antigens in dogs and three viral vaccine antigens in cats were recently published  by researchers at Pfizer Animal Health ( Mouzin et al, 2004).  
When an adequate immune memory has already been established, there is little reason to introduce unnecessary antigen, adjuvant, and preservatives by administering booster vaccines.  By titering annually, one can assess whether a given animal=s humoral immune response has fallen below levels of adequate immune memory. In that event, an appropriate vaccine booster can be administered.
References
Dodds WJ. More bumps on the vaccine road.  Adv Vet Med  41:715-732, 1999.
Dodds WJ.  Vaccination protocols for dogs predisposed to vaccine reactions. J Am An Hosp Assoc 38: 1-4, 2001.
Hogenesch H, Azcona-Olivera J, Scott-Moncreiff C, et al.  Vaccine-induced autoimmunity in the dog. Adv Vet Med  41: 733-744, 1999.
Hustead  DR, Carpenter T, Sawyer DC, et al. Vaccination issues of concern to practitioners. J Am Vet Med Assoc  214: 1000-1002, 1999.
Kyle AHM, Squires RA, Davies PR. Serologic status and response to vaccination against canine distemper (CDV) and canine parvovirus (CPV) of dogs vaccinated at different intervals. J Sm An Pract, June 2002.
Lappin  MR, Andrews J, Simpson D, et al. Use of serologic tests to predict resistance to feline herpesvirus 1, feline calicivirus, and feline parvovirus infection in cats. J Am Vet Med Assoc 220: 38-42, 2002.
McGaw DL, Thompson M, Tate, D, et al. Serum distemper virus and parvovirus antibody titers among dogs brought to a veterinary hospital for revaccination. J Am Vet Med Assoc 213: 72-75, 1998.
Moore  GE, Glickman LT. A perspective on vaccine guidelines and titer tests for dogs. J Am Vet Med Assoc 224: 200-203. 2004.
Mouzin DE, Lorenzen M J, Haworth, et al. Duration of serologic response to five viral antigens in dogs. J Am Vet Med Assoc 224: 55-60, 2004.
Mouzin DE, Lorenzen M J, Haworth, et al. Duration of serologic response to three viral antigens in cats. J Am Vet Med Assoc 224: 61-66, 2004.
Paul MA.  Credibility in the face of controversy.  Am An Hosp Assoc Trends Magazine XIV(2):19-21, 1998.
Paul MA (chair) et al. Report of the AAHA Canine Vaccine Task Force: 2003 canine vaccine guidelines, recommendations, and supporting literature. AAHA, April 2003, 28 pp.
Schultz RD.  Current and future canine and feline vaccination programs.  Vet Med 93:233-254, 1998.
Schultz RD, Ford RB, Olsen J, Scott F.  Titer testing and vaccination: a new look at traditional practices. Vet Med, 97: 1-13, 2002 (insert).
Scott FW, Geissinger CM. Long-term immunity in cats vaccinated with an inactivated trivalent vaccine. Am J Vet Res 60: 652-658, 1999.
Scott-Moncrieff JC, Azcona-Olivera J, Glickman NW, et al.  Evaluation of antithyroglobulin antibodies after routine vaccination in pet and research dogs. J Am Vet Med Assoc 221: 515-521, 2002.
Smith CA.  Are we vaccinating too much?  J Am Vet Med Assoc  207:421-425, 1995.
Tizard  I, Ni Y.  Use of serologic testing to assess immune status of companion animals. J Am Vet Med Assoc 213: 54-60, 1998.
Twark L, Dodds WJ. Clinical application of serum parvovirus and distemper virus antibody titers for determining revaccination strategies in healthy dogs. J Am Vet Med Assoc 217:1021-1024, 2000.
Table 1. “Core” Vaccines *
              Dog        Cat
                            Distemper           Feline Parvovirus
                    Adenovirus                      Herpesvirus
                    Parvovirus           Calicivirus
                    Rabies           Rabies
   _______________________________________
   * Vaccines that every dog and cat should have
 
Table 2.  Adverse Reaction Risks for Vaccines  *
 
  “There is less risk associated with taking a blood sample
  for a titer test than giving an unnecessary vaccination.”
  _______________________________________________
  * Veterinary Medicine, February, 2002.
 
Table 3. Titer Testing and Vaccination *
 
        “While difficult to prove, risks associated with overvaccination
          are an increasing concern among veterinarians. These experts
          say antibody titer testing may prove to be a valuable tool in
          determining your patients’ vaccination needs.”
         _____________________________________________________
         * Veterinary Medicine, February, 2002.
 
Table 4. Vaccine Titer Testing  *
 
  “Research shows that once an animal’s titer stabilizes,
   it is likely to remain constant for many years.”
 _____________________________________________     
  * Veterinary Medicine, February, 2002.     
========================================================
EXHIBIT #132:
 
from: http://merialusa.naccvp.com/view.php?prodnum=1111104
MERIAL LTD.
3239 SATELLITE BLVD., DULUTH, GA, 30096
Telephone:   888-637-4251
Website:   www.merial.com

Every effort has been made to ensure the accuracy of the information published. However, it remains the responsibility of the readers to familiarize themselves with the product information contained on the product label or package insert.

IMRAB® 3 TF

Merial

Rabies Vaccine

Killed Virus

DESCRIPTION: IMRAB® 3 TF contains the same virus strain that is used in the Pasteur Merieux Connaught human vaccine. The virus is grown in a stable cell line, inactivated, and mixed with a safe and potent adjuvant. Safety and immunogenicity of this product have been demonstrated by vaccination and challenge tests in susceptible animals.

INDICATIONS: IMRAB® 3 TF is recommended for the vaccination of healthy cats, dogs, and ferrets 12 weeks of age and older for prevention of disease due to rabies virus.

DOSAGE: Aseptically inject 1 mL (1 dose) subcutaneously or intramuscularly into healthy cats or dogs. Revaccinate 1 year later, then every 3 years. Inject 1 mL (1 dose) subcutaneously in healthy ferrets. Revaccinate ferrets annually.

PRECAUTIONS: Store at 2-7ºC (35-45ºF). Do not freeze. Shake well before using. Do not use chemicals to sterilize syringes and needles. Contains gentamicin as a preservative. This product does not contain thimerosal. A transient local reaction may occur at the injection site following subcutaneous administration. Some reports suggest that in cats, the administration of certain veterinary biologicals may induce the development of injection site fibrosarcomas. In rare instances, administration of vaccines may cause lethargy, fever, and inflammatory or hypersensitivity types of reactions. Treatment may include antihistamines, anti-inflammatories, and/or epinephrine.

1-888-Merial-1 (1-888-637-4251)

Contains

Prod. No

 

50 Doses

5 x 1 Dose (1 mL)

2311-50

RM960R1

Disclaimer: Every effort has been made to ensure the accuracy of the information published. However, it remains the responsibility of the readers to familiarize themselves with the product information contained on the product label or package insert. NAC No.: 11111040

=====================================================
EXHIBIT #133:

1. What is an immunobiologic?

An immunobiologic product (also known as a biological product) is one which modulates the immune system for the prevention, treatment, or diagnosis of disease. Veterinary immunobiologics used to prevent disease include vaccines or toxoids which stimulate an animal to produce antibodies against specific organisms or substances. This is termed active immunization. Passive immunization may be obtained from antibody-containing products such as serum derivatives; they may be used to treat disease. Immunological reactions are increasingly used as the basis of test kits for the diagnosis of disease.

2. How is an immunobiologic produced?

The immunologically active ingredients in an immunobiologic may be either antigens or antibodies. Antigens are derived from killed or attenuated live disease organisms such as viruses and bacteria. Antibodies may be derived from the blood or milk of donor animals who are often immunized against specific antigens. Other components of immunobiologics include the fluid suspension medium, preservatives or antibiotics, stabilizers, and adjuvants, which are substances which enhance the immune reaction. Licensed manufacturers of animal immunobiologics are regularly inspected to verify that production is done in accordance with approved procedures. Products intended for use in animals must be tested for purity, safety, and potency before they may be marketed. As a further check on the manufacturer's quality control, the USDA regularly tests randomly selected lots of all products in its own laboratory.

3. What is the purpose of postmarketing surveillance?

Postmarketing surveillance of veterinary immunobiologics has two main functions. One is to serve as an alert system for detecting the possibility that a product may not be performing as intended. An alert is triggered when information has been received which implicates a product as the cause of events which appear to be unusual in nature or frequency. The immediate response to an alert is an evaluation of the possibility the product is defective. The alert may be confirmed, rejected, or more information may be sought. Confirmation of an alert could trigger an intervention. Fortunately, this is a rare occurrence. Postmarketing surveillance also provides an essential source of descriptive baseline information about the behavior of a vaccine or other immunobiologic when it is used under everyday field conditions. This type of information is a valuable reference in guiding our expectations and comparing situations which appear unusual. Temporal or geographical trends may become apparent.

4. What is an adverse event?

An adverse event is any undesirable occurrence after the use of an immunobiological product, including illness or reaction, whether or not the event was caused by the product.

5. What adverse events may possibly occur after the use of immunobiologics?

Some animals, like people, may be uncomfortable or lethargic the day they are vaccinated. More serious adverse events are a less common possibility. Immune (hypersensitivity) reactions are infrequent but possible after exposure to any immunobiologic as well as many other substances. Acute anaphylaxis with immediate collapse is a dramatic reaction that may happen shortly after vaccination. It is important to observe an animal for at least an hour after vaccination, so that it may be treated if necessary. Other reactions that have been observed within a day of vaccination include loss of appetite, fever, facial swelling, hives, nasal or ocular discharge, respiratory distress, vomiting, or diarrhea. Events occurring a day to two weeks after vaccination include similar events as well as stiffness, local inflammation, and systemic illness which may or may not be based on an immune reaction. If you have any concerns about the health of an animal after the use of an immunobiologic, consult your veterinarian promptly. Your veterinarian is also an important source of guidance about the proper administration of immunobiologics. Not all properly vaccinated animals will be immune to disease under all circumstances. Many factors affect the response of a particular animal to vaccination and the chance that it will subsequently succumb to disease. Such factors include the animal's immune competency, its health at the time of vaccination, stress, environment, and the virulence of the pathogen. Even under optimal conditions, antigens vary widely in the strength and duration of the disease protection they confer. A vaccine may be licensed for the prevention of disease if, in a clinical challenge trial, 80% of the vaccinates were free of the disease. Otherwise, the vaccine may be licensed as an aid in the prevention of the disease.

6. How frequently do adverse events occur?

Good estimates of the rates of various types of adverse events after the use of veterinary immunobiologics are not readily available. The information we have is based on voluntary spontaneous reports to manufacturers and the USDA. While it may be possible to calculate a reporting rate, the relationship between a reporting rate, and an incidence rate is not clear. This relationship may vary by type and severity of event, species, manufacturer, and even from one month to the next. Under appropriate conditions, a reporting rate may sometimes be used to estimate minimum incidence, and for certain comparisons.

7. What happens when an adverse event is reported?

The mission of the USDA is to ensure that animal immunobiologics are in compliance with the Virus-Serum-Toxin Act. Reports are assessed for the possibility of a product deficiency. When necessary, testing is performed or additional information sought. The USDA is, however, unable to make diagnoses or recommendations specific to individual cases. Some of the manufacturers do provide such services. Receipt of a report by the USDA does not necessarily imply that the product caused an adverse event, or even that a particular event actually occurred.

8. How can I report an adverse event?

Veterinary Immunobiologics are regulated by the United States Department of Agriculture, Center for Veterinary Biologics (USDA, CVB) under the Virus-Serum-Toxin Act. The CVB maintains Pharmacovigilance. An adverse event report enters this program through several channels.

Adverse events may be reported to the:

  • Manufacturer. Many biologics manufacturers maintain veterinary services departments to handle such reports and may also offer diagnostic advice, treatment recommendations, and guidance on product use.
  • Center for Veterinary Biologics. Once an adverse event has been reported to the manufacturer, the CVB may be contacted by submission of the electronic Adverse Event Report Form. A PDF version of this form may be downloaded and submitted by FAX to (515) 232-7120 or by mail to the CVB. Adverse events may also be reported by calling the CVB at (800) 752-6255, if necessary.

    Veterinary drugs, medicated feeds, and animals devices are regulated by the Food and Drug Administration, Center for Veterinary Medicine (FDA, CVM) under the Food, Drug and Cosmetic Act. The CVM recommends that you first contact the manufacturers to report an adverse event. To contact the CVM directly, call (888) FDA-VETS.


2/25/05
 
Lee Zavala, Investigator
State of Washington
Department of Health
Board of Governors
 
NOTE: e-Mail copy sent to: Darlene.Tiffany@DOH.WA.GOV to be added/included with the complaint file/materials previously submitted in this matter. 
 
Re:     Case #: 2004-04-0008 VT    
        Lawrence Williams/Burien Veterinary Hospital
        Hammond/Meyer/Baty/Five Corners Veterinary Hospital
        Murnane/Jewett/Phoenix Central Lab
 
Dear Mr. Zavala and Ms. Tiffany:
 
Please acknowledge your receipt of:
 
1. ADD-ON #10: NEW EVIDENCE/ALLEGATIONS and                  SUPPLEMENTAL INFORMATION sent to you 2/18/05.
 
2. ADD-ON #11: NEW EVIDENCE/ALLEGATIONS and                  SUPPLEMENTAL INFORMATION/EXHIBITS for same sent to you 2/23/05.
 
Thank you.
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSanchez@aol.com
 


Subject: RE: RECEIPT REQUEST
Date: 2/25/05 1:13:46 P.M. Pacific Standard Time
From: Lee.Zavala@doh.wa.gov
To: GingerLSanchez@aol.com
Sent from the Internet (Details)

Greetings Ms. Sanchez,
This e-mail is to acknowledge receipt of your e-mail messages. Please be advise I've talked to the Program Manager regarding your additional information and I have forwarded all the messages.  My portion of the investigation is closed and the Board of Vet Governors now have the case in their hands. I have asked that these additional e-mails be included in the case file.  It is my understanding that the messages will be added to the file. 
 
Thanks and best regards,
Lee Zavala, Health Care Investigator
Investigation Service Unit     MS: TB-33A
20435 72nd Avenue South, Suite 200
Kent, WA. 98032
Phone: (253) 395-6711 FAX: (253) 395-6724
E-mail:  lee.zavala@doh.wa.gov

Subject: Re: RECEIPT REQUEST
Date: 2/25/05 1:50:47 P.M. Pacific Standard Time
From: Ginger L Sanchez
To: Lee.Zavala@doh.wa.gov

2/25/05
 
Lee Zavala, Health Care Investigator
Investigation Service Unit     MS: TB-33A

Hi, Mr. Zavala:
 
Thank you for acknowledging receipt of the last two e-mails and especially for letting me know that the investigation portion of the case has now been closed and that the last two e-mails will be added/included with the case file.
 
I am assuming that with your portion of the case now ended, that you either have or will be providing the Board with a summary/report of your findings.  Are you allowed to tell me whether a copy of such summary/report would be available to me, and if so "when" and what must I do to request it?
 
I want to thank you for the professional attention you gave this matter and for all of your cooperation with the copying projects.  I also want to apologize to you personally for the tremendous amount of e-mails generated by me. 
 
I'll look forward to hearing from you regarding the status of your summary/report.
 
Sincerely, 
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSanchez@aol.com


2/26/05

And, 10 months after ROMI's needless/senseless and horrific death, I now listen to the sounds of silence while the Washington State, Veterinary Board of Governors has the complete case.


In a message dated 3/15/05 2:17:13 P.M. Pacific Standard Time, Janelle.Teachman@DOH.WA.GOV writes:
03/15/05
 
Ms. Sanchez,
 
The investigative report and all the information you provided to our office has been forwarded to a board member for review.  Once the board member has had a chance to thoroughly review all documentation, the case will be presented to the Veterinary Board for a decision.  You will be notified in writing when a decision has been made.  A copy of the entire file will be available once the case has been closed.
 
Janelle

* * * * * * *

From: GingerLSanchez@aol.com [mailto:GingerLSanchez@aol.com]
Sent: Tuesday, March 15, 2005 1:48 PM
To: vrippie@pdc.wa.gov
Cc: janelle.teachman@doh.wa.gov; lee.zavala@doh.wa.gov
Subject: Re: Information/Records Request

Dear Ms. Rippie:  THANK YOU for your very  speedy reply - I'll be waiting to hear from Ms. Teachman !
 
Ginger Sanchez
e-Mail [ONLY]: GingerLSnchez@aol.com
* * * * * * *
 
In a message dated 3/15/05 1:39:18 P.M. Pacific Standard Time, vrippie@pdc.wa.gov writes:

Dear Ms. Sanchez:

By copy of this reply, I am forwarding your letter to Janelle Teachman, Department of Health.  It is my understanding that she will know the answer to your question (or at least have better information than I about who can assist you).

The Public Disclosure Commission's mission relates to providing public access to financial information about campaigns, lobbying and the personal financial affairs of state officials and candidates.  However, given this agency's name, it is certainly understandable why you contacted us for assistance.

I hope Ms. Teachman is able to help you.

Vicki Rippie

 -----Original Message-----
From: GingerLSanchez@aol.com [mailto:GingerLSanchez@aol.com]
Sent: Tuesday, March 15, 2005 11:19 AM
To: Vicki Rippie
Subject: Information/Records Request

3/15/05

State of Washington

Public Disclosure Commission 

711 Capitol Way #206 - PO Box 40908
Olympia, WA 98504-0908

I currently have a State of Washington, Veterinary Board of Governors complaint pending, #2004-04-0008 VT, which was originally filed on 4/28/04.

It is my understanding that the "investigative phase" of this complaint was closed and a report was made by the Investigator, Mr. Lee Zavala.

What must I do or whom must I contact in order to obtain a copy of the investigation report?

Ginger Sanchez

CONTACT:  e-Mail [ONLY]: GingerLSanchez@aol.com

 


In a message dated 3/24/05 4:08:39 P.M. Pacific Standard Time, Janelle.Teachman@DOH.WA.GOV writes:

03/24/05

The April 11th and June 6th Veterinary Board of Governors meetings have been cancelled.

The next scheduled meeting will be on August 1st in Kent.


5/09/05: per website on their form: http://governor.wa.gov/contact/govemail.htm

 
On 4/28/04 I filed a complaint with the WA Vet Board due to the needless/senseless death of my companion dog as a direct result inappropriate/incompetent veterinarian care:
 
Case #2004-04-0008VT
 
The complaint was accepted and I was informed that the "investigative phase" was closed 2/25/05 and there presently is no known time frame for any WA Vet Board decision(s) to be made as the last three(3)meetings/agendas have been canceled and the next meeting/agenda may or may not be scheduled for August, 2005.
 
Because further research/investigation on my part revealed not only veterinarian incompetence but consumer fraud as well as inappropriate/illegal drug use, an apparent "cover-up" and subsequent destruction of the "evidence" as to the true cause of my dog's death, inappropriate distribution of confidential medical records without consent, and a filing of false information to the FDA, I continued to provide the WA Vet Board with the additional allegations and supporting evidence before the investigative phase was closed and additionally and continuously asked/demanded that any/all portions of my complaint that were not within the power/territory of the WA Vet Board to deal with and/or rule on to be referred by them to the appropriate agencies to deal with, but I have never been given any information regarding whether or not this was done by the WA Vet Board.
 
By this e-mail, I am respectively requesting that as GOVERNOR you advise me on when the WA Vet Board will be making a decision on my "case" AND what other steps I must take in order that all other appropriate State agencies have the information to deal with their appropriate portions of this matter.
 
As my single phone line is a dedicated Internet connection ONLY, I ask that you contact me via e-mail or U.S. Mail with your response.  Thank you.
 
Ginger Sanchez
e-Mail: GingerLSanchez@aol.com
 
[sent to: http://governor.wa.gov/contact/govemail.htm on 5/09/05]
 
NO RESPONSE AS OF 7/29/05


The SILENCE deepens!



May my beloved partner ROMI rest in peace  - no matter wherever her bits and pieces/frozen carcass are being held hostage.

                            

[What's in YOUR "urn"?]

 

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