Introduction
A review of the "Clinical Summary" provided by Massey University, even without the full Medication Administration Records (MAR) still being withheld, reveals a sequence of events that transitions from clinical negligence to what appears to be a manufactured terminal diagnosis.
The sudden, "massive decline" of the patient, Harry, was not a natural progression of disease, but a predictable outcome of pharmacological provocation used to justify an intensive push for euthanasia.
A parallel review of the invoice associated with the patient's stay in the facility reinforces these concerns as well as adding significantly to them. The
linked article
comments in detail on the various highly concerning line items on the invoice,
and points to the many red flags that any qualified, supervising veterinarian should have seen well in advance of the catastrophic end result.
I. Pharmacological Catalyst: Contraindication and Potentiation
The records confirm that Harry, a 15-year-old dog with significantly impaired kidney function and dehydration, was administered Gabapentin - a drug the veterinary literature identifies as strictly contraindicated in patients with renal compromise.
- Renal Status: The intake notes explicitly record "CKD" (Chronic Kidney Disease). Blood tests were conducted to confirm the severity.
- Mechanism of Toxicity: Gabapentin is primarily excreted unchanged by the kidneys. In a patient with this degree of renal failure, the drug cannot be cleared.
- Cumulative Load:
Despite the clear risk, the initial 1am dose (Gabapentin (Nupentin) 50mg Caps PRE-SPLIT - 50mg) along with Maropitant (Prevomax) 10mg/ml Inj 20ml (per ml) - 3.6mg. ("Gabapentin (Nupentin) 50mg Caps PRE-SPLIT - 50mg"). Both were given yet again at 1.26am 2 x @@ Gabapentin (Nupentin) 100mg Capsule 100's (per capsule) and 1.19am respectively 0.36 x Maropitant (Prevomax) 10mg/ml Inj 20ml (per ml) and then Gabapentin again at 9am (Gabapentin (Nupentin) 50mg Caps PRE-SPLIT - 50mg).
This represents a massive cumulative toxicity in a biological system physically unable to process it.
II. The Consent Failure: Ignoring History and Protocol
Beyond the pharmacological contraindication, the administration of these non-essential pharmaceuticals was conducted without informed consent. This represents a systemic failure to consult the person with the most intimate knowledge of the patient's medical history.
- Documented Hypersensitivity: Two months prior to this admission, Harry had suffered an extreme adverse reaction to a dose of Gabapentin described by his local veterinarian as being at the "lowest end of the scale" for his weight.
- Preventable Outcome: Had Massey staff adhered to the requirement for owner consent, this prior history would have been disclosed. The "convenience sedation" would have been blocked by the owner, and the subsequent toxic accumulation - which Massey's own experts should have anticipated - would have been avoided.
III. Neurological Mimicry: A Diagnostic Loop
The primary side effects of Gabapentin toxicity - ataxia (loss of co-ordination), nystagmus (involuntary eye movement), and profound sedation - are the exact clinical manifestations Massey staff used to diagnose a "terminal neurological event".
- The Literature: The
Merck Veterinary Manual
and
Plumb’s Veterinary Drug Handbook explicitly state that Gabapentin toxicity causes ataxia, lethargy, and neurological depression.
- The Failed Differential:
There is no evidence in the summary that the ICU vet, "Steffi", or the unnamed neurologist performed a differential diagnosis to rule out drug-induced stupor. Instead, they performed a neurological examination on a patient currently at the peak of a "stacked" dose of Gabapentin.
- The Invalid Exam: Under standard neurological protocols (e.g., de Lahunta's), a valid exam cannot be performed on a sedated patient. Drugs that depress the Central Nervous System (CNS) result in "false positives" for delayed proprioception and altered mentation.
IV. The "Passing Off" and Coerced Termination
By 03:00 PM, 15 hours after the first unauthorised dose, Harry was presented in a semi-comatose state. The ICU staff "passed off" this pharmaceutical shutdown as an irreversible "neurological event".
- The "Last Hurrah" Dismissal: When Harry attempted to respond to his owner's voice - a documented phenomenon where a bonded animal fights sedation to acknowledge their owner - the clinician dismissively labeled it a "last hurrah". This facilitated the manufactured sense of urgency needed to secure consent for euthanasia.
V. Institutional Failure: The Dean’s Refutation
On January 31, the Dean of the Veterinary School, Dr. Jon Huxley, responded to these concerns with a refutation of the "overdosing" claim.
- The Dean’s Position:
Huxley asserted that
"Harry received only those medications clinically indicated for his condition and in full accordance with accepted veterinary standards".
- Rebuttal: This assertion ignores the fundamental rule of veterinary pharmacology: a "standard" dose becomes a toxic overdose when the patient's kidneys cannot excrete it. In the context of Harry’s confirmed renal failure,
any
administration of Gabapentin - let alone repeated dosing -
represented a dangerous and lethal error.
The Diagnostic Loop
The sequence provided by the university reveals a closed-loop of institutional failure:
1. Administration:
A contraindicated sedative is given without consent to a renal patient to induce silence ("Convenience Sedation").
2. Observation:
The resulting drug-induced stupor is recorded as a "neurological decline".
3. Examination:
A neurologist confirms "deficits" without accounting for pharmaceutical interference or the patient's history of sensitivity.
4. Termination: The manufactured stupor is used to coerce the owner into a "calculated clinical killing" to cover up mismanagement and possibly the additional deleterious impacts of likely invasive teaching-related procedures and/or student observation activities.
CONCLUSION:
Harry did not die of a neurological event; he was rendered neurologically non-viable by the very people tasked with his care, effectively masking a patient who could have survived with appropriate emergency intervention elsewhere.
Regarding your "It Was NOT 'Euthanasia'" article and the clinician's "It's just his last hurrah" claim, this dismissal of a patient who was fighting to respond to his owner highlights the lack of clinical empathy and the manufacture of urgency.
It compounds a tragedy that appears less like a "mistake" than it does
active interference with survival.
____________________
Additional Commentary:
1. Pharmacokinetic Red Flags
Any veterinarian understands that Gabapentin is almost exclusively renally excreted.
If it is established that a patient is in a state of confirmed renal failure, the administration of repeated doses becomes a documented risk. A competent clinician would recognise that a "standard dose" for a healthy dog becomes a "toxic load" for a renal patient.
"Stacking" doses - where the second dose is given before the first can be cleared - is the height of clinical incompetence, especially under this patient's circumstances.
2. The Violation of Diagnostic Protocol
It is a standard rule in veterinary neurology that an assessment of mentation, proprioception (paw placement), and cranial nerve reflexes is invalid if the patient is currently under the influence of CNS-depressing medications.
Attempting to "diagnose" the patient while at the peak of a Gabapentin dose is a significant procedural failure. To settle on a "prognosis" and convey this to the owner as "terminal" is astounding.
3. The Failure of "History" (Anamnesis)
Clinicians are taught that "the history is 80% of the diagnosis".
The fact that the owner possessed specific knowledge of a prior extreme reaction to the same drug is a vital clinical data point.
If a hospital fails to consult the owner before administering a non-essential sedative to a frail patient, they have bypassed the most important safety check in veterinary medicine.
A professional would view the failure to elicit this history as a breach of standard "Informed Consent" and "Duty of Care" protocols.
The hospital has essentially:
- Induced a symptom (sedation/ataxia).
- Observed the symptom.
- Diagnosed the symptom as a terminal disease.
This "Diagnostic Loop" is a known trap in emergency and critical care.
The clinical logic presented herein is consistent with how a peer-review or a board of inquiry would analyse a case of suspected medical mismanagement.
For a full list and breakdown of the specific violations of the VCNZ Code of Professional Conduct, the Animal Welfare Act, and the Consumer Guarantees Act associated with this case,
read the formal Summary of Breaches here.
