Banfield Pet Hospital Dr. Nicoline Lee Poor Diagnosis and Treatment San Mateo California

Our dog was poorly diagnosed and treated when it was noted that his liver enzyme levels were climbing. Instead of a strong recommendation for aggressive treatment, no especial concern was expressed and a non-urgent drug treatment was suggested. The result within little more than a month was a sudden diagnosis of late stage liver cancer and death from intense bleeding of the tumor that was beyond control. It is clear in retrospect that in January, the poor dog was dying; what is a shame is that he was misdiagnosed, with no sense of urgency and died earlier than if he had been more knowledgeably and capably treated. 

We had guardianship of Rufus, a pure bred Shihtzu male who was 12 years 7 months old when we took him to a regularly scheduled check-up on behalf of his owner in September 2016. We noted a drop in his weight from 15 pounds, 8 ounces to 13 pounds. Other than that and an elevation in the dog’s liver enzyme levels that the vet described as slight, the dog appeared in satisfactory health.

We took Rufus back to Banfield in December for what we thought was a problem, a bad limp. The limp turned out either not to have been a problem or it simply resolved itself. It was either then or during follow-up in January that we had another round of blood sampling done. We concluded his liver enzyme expression was clearly going in the wrong direction. The dog’s veterinarian, Dr. Nicoline Lee, suggested three possibilities of treatment and diagnosis: An ultrasound to image his liver; a different type of scanning whereby Rufus would be fed a special meal and then scanned to track his digestion and absorption; and a treatment of Demarin that in Dr. Lee’s opinion had a good chance of lowering the lever levels to normal. We briefly discussed all three but we concluded from discussion with Dr. Lee that the dog was in no imminent danger, and that the Demarin treatment was a reasonable course of action. We also discussed reviewing his liver enzyme levels in 60 days to evaluate his progress.

Dr. Lee, who is described on the Banfield San Mateo Webs site as a cat specialist, commented that her experience in veterinary school was that Demarin was a good treatment option for the type of condition we faced. We asked Dr. Lee if Demarin could reduce the elevation of his liver enzymes and the Veterinarian gave her opinion that it was a reasonable treatment option.

Two thirds of the time through February, we decided we did not want to wait any longer. The result of this February examination was that his liver enzyme levels had reduced slightly but were still high. This time we asked more specifically as to what was meant by high. How high were Rufus’s Liver figures and what was the standard for a conclusion of healthy?  Dr. Lee responded specifically when we pressed that his readings were in the 700s where as normal would be a reading under 100. We were shocked to learn of this huge difference between normal readings and wondering why there we were not told of this huge discrepancy earlier. If we had not asked, we would not have been told; and the dog likely would have died suddenly at our home. An ultrasound exam (previously listed as a possible step but not stressed in January in preference for the treatment of Demarin) was ordered up and found that the dog had a large mass on his liver.

We also discovered a build-up of fluid in the dog’s abdomen. A follow-up with a veterinary oncologist followed as quickly as possible. The oncologist took the dog in for additional scanning and diagnosis. Immediately upon beginning the exam, the Oncologist found that the fluid build-up was blood from the tumor on his liver. Efforts to stop or restrain the bleeding failed and the dog died within a short time of arriving at the oncologist’s office.

Cancer, when diagnosed, moves quickly in small dogs. It is not the finding of cancer but the casual attitude and treatment recommended when in retrospect the signs of cancer were there, and there was a lack of aggressive treatment as a result.

We cannot bring our beloved dog back. We are filing this complaint to prevent other dogs from the casual, complacent diagnosis and lack of aggressive treatment that killed our dog when with proper care, he could have had some time with us before the disease killed him.