Business ProfileforCrooked Creek Animal Hospital, Inc.

Crooked Creek has been our veterinarian for all our pets until recently. The veterinarian refused to write a prescription to continue the Keppra treatment for seizers because I did not want to pay to have a Keppra drug level preformed. Keppra is not a drug that requires to be monitored. In fact, there is no therapeutic range established for dogs. Our pet has been treated with this medication by them for 4 years and all of the sudden they want to do the expensive test where the results has on outcome on the treatment. Keppra does not effect any organs of an animal and they wanted to do liver test. I have been a Laboratory scientist for over 30 years and recently talked with other experts and they confirm there is no need to monitor Keppra. I am sadly disappointed with Crooked Creek Animal Hospital and their decision to tell us to take our business elsewhere.

Mr. *** ******** and his wife ***** have stated that Crooked Creek Animal Hospital has served as their pets' veterinarians until recently. They started coming to Crooked Creek Animal Hostipal in 2018 when one of our neighboring veterinarians retired. He claims that one of his dogs has seizures and needs to be treated with Keppra. We have never seen or had documented by video any such seizures. As a licensed veterinarian in the state of Mississippi, we are required to have a valid Veterinarians- Client-Patient- Relationship (VCPR). This VCPR exists when your veterinarian knows your pet well enough to be able to diagnose and treat any medical conditions your animal develops. The owner's part of the VCPR is allowing your veterinarian to take responsibility for making those judgements about your pet's health, asking questions to make sure you understand, and following your veterinarian's instructions. Your veterinarian's part of the VCPR involves making those judgements; accepting the responsibility for providing your pet with medical care; keeping a written record of your pet's medical care; advising you about the benefits and risks of different treatment options; providing oversight of treatment, compliance (your follow-through on their recommendations) and outcome: and helping you know how to get emergency care for your pet if the need should arise. A VCPR is established only when your veterinarian examines your animal in person and is maintained by regular veterinary visits as needed to monitor your animal's health. If a VCPR is established but your veterinarian does not regularly see your pet afterwards, the VCPR is no longer valid, and it would be illegal and unethical for your veterinarian to dispense or prescribe medications or recommend treatment without recently examining your pet. In the four years the ********s claim their dogs were under our care, one was presented for an exam by the veterinarian two times, and the other, one time. He even had the audacity to call and ask if he could forego a physical examination and just send the money for the exam fee because he knew that was all we cared about. Keppra is a prescription anticonvulsant medication used singularly or as an add-on for seizure disorders. Mr. ******** is correct in that there are no established therapeutic drug levels for Keppra in veterinary Species. He is incorrect in his assumption that Keppra does not affect any organs of an animal. Keppra is well absorbed orally with/without food and is eliminated by metabolism (plasma and liver) and renal excretion. Depending on patient condition and other drugs being administered, monitoring of a Complete Blood Count (CBC), Biochemistry Profile, Urinalysis and Biles Acids every six months may be indicated. Renal insufficiency would indicate reducing the dose 50% of total daily dose. Renal insufficiency would be diagnosed by annual bloodwork. We made recommendations to the ********'s for the care and evaluation of their pets. They refused to follow the very minimal standards that we had set forward, thus ending the VCPR and our responsibility to write any prescriptions or make recommendations for further treatments. They were notified in writing of that decision. Their records were sent to the veterinarian of their choice, and they were provided with contact information for emergency veterinary care. We are very appreciative and thankful for all our clients and their pets. We strive daily to practice the best quality of veterinary medicine. We have a team that is committed to the quality veterinary medicine. We are sorry that the ********'s were displeased with our efforts to provide the best quality veterinary medicine.

The response from Crooked Creek Vet was inaccurate in that Keppra is processed by the liver, it is not. It targets the brain neurons and is execrated through the Kidneys in it's whole form. Their words of metabolism (plasma and liver) and renal excretion is not correct. There are published articles that I will present that state otherwise. the blood work is not necessary either "monitoring of a Complete Blood Count (CBC), Biochemistry Profile, Urinalysis and Biles Acids every six months may be indicated". If this is true, why wait over 4 years to require it. My pet has been totally asymptomatic for the entire process. I am a laboratory scientist with 35 years experience including drug monitoring and know better. This will be played out in front of a judge very soon.