VCA Jordan River Animal Hospital

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3. The metronidazole was discontinued on 9/25/2007 but the seizures continued beyond 10/1/2007. This is where dskullz's comments about a kidney problem (which was actually presented and a liver shunt possibility) are addressed in the medical record. On 9/26/2007 due to continued seizures the ddx of drug toxicity was amended to include the possibility of a portosystemic shunt (liver shunt). This abnormality is most commonly observed in young patients whose liver blood vessels have not formed correctly; consequences of this abnormality include a variety of central nervous system abnormalities, vomiting, unexpected or unpredictable responses to most medications, and unexpected delay in metabolizing medications. Thus only after several days of observing and treating the more common and more predictable causes of the patient's problems, observing a poor response to a drug side effect that very rarely occurs, and often resolves quickly was a workup for the shunt advocated and was only pursued as far and initial blood tests. During that time dskullz elected to take his puppy home. The blood tests were reported back to him as being normal and the recommendation was to pursue the workup further ONLY if the seizures get worse. Through the next month we advised dskullz multiple times on treatments other than metronidazole to help control vomiting and diarrhea and had a final report on 11/2/2007 that dskullz's puppy was doing well.



4. I had no indication that dskullz did not understand the rationale and the appropriateness of the tests that were done. While the surgery he references was discussed, it was late in the treatment process not initially, as he describes. dskullz remembers the fee, (which was quoted to him only because he asked what it would cost to correct if his puppy had the shunt not because we were advocating that it be done), very accurately. However, when I reviewed the invoicing for his puppy's treatment, it was only slightly over half of the $2k he states he paid. It seems he could have reviewed his bank statements for an accurate reporting of this figure.



It is unfortunate that dskullz elected not to voice his concern in a forum that would have allowed better resolution of his concerns. While I suspect that even reviewing the facts of his case will not change dskullz's opinions because as I read reviews like his that are written about us and those of our colleagues who are willing to allow reviews on their websites, most of the review is written from an emotional rather than a factual standpoint. The rational for responding to such reviews is minimally toward deflecting negative perceptions of our organization. But more importantly it is to provide the many readers who in their daily lives try to provide value to their clients and customers the perspective that with a few exceptions the members of this profession work equally hard to provide quick and cost effective solutions for them and their pets. Medical records would not fit in space provided.

Our organization takes client concerns very seriously and we feel it best to be proactive whether the client gives us the opportunity to respond or not. When I saw dskullz's review I surveyed recent records and could not find any cases that matched the review I initially didn't know how to respond to dskullz's assertions. It was only after searching back 3 years that I found the case dskullz references. While one might wonder why the event did not get posted until 11/4/2010 and why it was posted on the same date as a more positive review of one of our colleagues, I'll try to avoid the conjecture and misrepresentation of the facts that would place this review in the same ethical category as the one to which I am responding. I will instead refer to the medical record which is unalterable after it has been input and shows what was done, when it was done, and a history of the dialogue between dskullz and our doctors. A few contrasting observations will be put forth here.

1. Any good diagnostician, whether MD, DVM, Criminal Investigator, or Researcher when presented a problem or illness must form a list of possible causes of the problem upon which to justify the procedures they will use to uncover what caused the problem. Most often a failure to adequately solve the problem starts with a failure to consider all the possible causes because if a cause is not considered it is rarely checked for. In this case on the initial visit a ddx, (differentials list) was stated that included the most plausible causes of vomiting for this patient based on the client provided history and the age and type of the patient. In this case that list included viral, bacterial, and protozoal infectious diseases, the possible ingestion of indigestible materials (plastic, cloth, rocks, bones) that cause vomiting due to blockage of the intestinal tract, congenital diseases because at that time the patient was a puppy, the possibility of toxin exposure, or other organ dysfunctions that can adversely affect the gi tract and cause a patient to present with vomiting. Contrary to dskullz's statements, the radiograph was taken to investigate the possibility of gi obstructive causes because many, many patients will test positive for giardia and show no symptoms. Thus, because diarrhea is the common presenting sign and the patient had no history of diarrhea, missing a potential life-threatening cause of vomiting was not in the patient or client's interest, and the radiograph was done to insure that obstruction was not present.



2. dskullz further contends that the doctors appeared to be unaware that metronidazole can cause seizures and that the doctors missed or ignored that obvious fact that he uncovered on Google. Yet the medical record indicates that 2 days later 9/25/2007, when dskullz returned concerned that his pet was foaming and shaking, the first and only possibility discussed was a possible reaction to metronidazole and the recommendation was to discontinue the drug and assess response. While central nervous reactions to metronidazole are very rare and the justification to use that drug is that in this country there is almost no other good therapy for giardia, the record indicates that an immediate awareness of the possible concern was communicated to the client and the immediate recommendation was not surgery it was to withdraw the drug and look for the problem to resolve. Resolution of toxicity from only a few doses to metronidazole is expected to be rapid.

We took our terrier puppy in because he was throwing up. They did several tests that came back negative so they wanted to do an x-ray on him. After they did the x-ray the vet came back and said that he had read the test wrong and our dog had giardia. We were still charged for the x-ray. It seems to me like that was his mistake and he should've either not charged us or at least not charged us full price for it. He gave us some medicine and sent us home.

After about 48 hours our dog started having seizures. We took him back in and they kept him there for a couple days. All the while they were telling us that he probably had this rare kidney problem where the blood vessel was turned the wrong way. They said he would have to have a surgery that would be about $5,000. We were heartbroken because we would've just had to put him down there was no way we could afford that on top of all the care we were already paying for.

Neither of the vets ever mentioned that it could be a side effect from the medicine they had given him for the giardia. Don't you think that is something a vet should know and think of and then relay to you??? I mean really the dog is on a medicine that is known to cause seizures in terriers and that's not the first thing you go to but instead jump to an expensive surgery for a very rare problem? We ended up wondering about the medicine ourselves and googling it. Sure enough it was a side effect to it. Google should not give me more information than the people I'm paying 2K to take care of my dog. It was the medicine and when it had cleared out of his system he was fine. By the time the whole ordeal was over we decided they either had no idea what they were doing or were just trying to get as much money out of us as possible.

I started taking my 4 pets (children) to Jordan River Animal Hospital last year; they have done so much for our family and have taught me so much. Every clinic I have ever gone to has always been about vaccines, Meaning you’re in, You’re out, You’re on your way. Not this hospital...They want the very best for your animals. The doctors spend the time to sit in the exam rooms and answer your questions, to educate clients about preventive health care, and all around just love being such great and understanding doctors. When my cat had her first dental I felt comfortable leaving her in the hands of the wonderful techs and doctors. I recommend everyone to go Jordan River Animal Hospital because they are the best out there. Thank you all at JRAH for taking such good care of my furry family members!

My husband and I are avid Labrador Retriever owners who train, compete and hunt with our Labs. For almost two decades, we have come to rely upon Dr. Silkman and the Jordan River Animal Hospital for the highest quality of care available for our dogs. With outstanding veterinarian practioners and well-trained staff, Jordan River Animal Hospital (AAHA Accredited) is equipped with state of the art medical technology to provide the best care for our dogs.



An example of what “highest quality care” has meant to us;



1) While training in the state of Maine, one of our dogs experienced traumatic spinal discomfort and was barely able to move. At that time, there were only three board certified neurological specialists (DVM’s) in the country and one was in Maine. After a lengthy and expensive exam by the specialist, we were told that our dog had a rare cancer and needed to have immediate surgery. Having doubts about the diagnosis, we contacted Dr. Terry Silkman due to our belief in his level of knowledge and care provided one of our dog at an earlier time. He went above and beyond the call of duty by agreeing to come into the clinic to examine our dog as soon as our plane arrived (on a Sunday). This was his day off, yet he made the time and the effort to be there for us. A long story made short is that our dog did not have cancer, did not require surgery and after appropriate treatments and medication, made a full recovery. Our trip across country, from Maine to Utah, was not in vain. COMMITMENT TO PATIENTS and CUSTOMER SERVICE. OUTSTANDING VETERINARIAN KNOWLEDGE/SKILLS with PROBLEM SOLVING SKILLS.

I have been going to this hospital for years and I would recommend this hospital to anyone and everyone that cares deeply about their pets. Everyone is friendly and patient. My last visit the staff helped me to understand what was wrong with my dog, and what needs to be done to prevent her from getting sick again. It is clear that they genuinely care about what they do and the animals they serve. I love the Doctors, I love the technicians, I love the cleanliness of the hospital; I will continue to be a dedicated JVAH client.