Animal doctor's license suspension sends signal about managing pets' pain

DULUTH - Jazz, a 9-year-old yellow Labrador retriever mangled by a boat propeller in May 2006, lived to tell the tale. Or at least to wag his tail.

What may not live on is the career of 84-year-old Dr. Carl Seemann, the Bemidji, Minn., veterinarian who set Jazz's broken leg and sewed him up, but didn't give him any pain medication when he awoke after surgery.

Jazz's owners, a Bloomington couple, complained to the Minnesota Board of Veterinary Medicine. In a case that has created a buzz in the profession nationwide, the Board suspended Seemann's license on grounds that he has refused to embrace the latest methods to control animal pain.

It marks the first time for such action against a Minnesota veterinarian for inadequate pain control. An unheard of idea in animal hospitals 20 years ago, it is seen as a sign that the new norm for veterinarians is to manage the pain of companion animals almost as aggressively as a physician would for a human.

"Pain management has come progressively more to the forefront as we get a better understanding, more research, and more effective drugs," said Dr. John King, executive director of the Minneapolis-based board, which is scheduled in January to decide whether to take further action against Seemann, including possible revocation of the license he has held since 1948.

A national magazine for veterinarians did a cover story on Seemann, linking his case to an emerging "unwritten mandate" by the public and regulators to aggressively treat pain.

While acknowledging that standards are constantly evolving and that no single set of rules govern what a veterinarian must do, King said it's clear most of the profession now embraces the notion that "the minimal standard of practice is that you do something about [pain]. Doing nothing is no longer an option."

Animals hide pain

Seemann, who with his wife, Margaret, operated Hilltop Animal Hospital in Bemidji from 1957 until the Board suspended his license a year ago, has argued that he is the victim of overzealous regulators and a professional shift based on pressure from animal rights activists as much as on science.

He said that veterinarians have known for generations that some of the pain their patients experience is good. It is, for example, what convinces an animal to be still when it needs to heal.

"I don't want animals to suffer, that's why I became a veterinarian," Seemann said. "But you can't just obliterate all pain until you've made a diagnosis, and with some conditions, if you block the pain, you can't tell if they're getting better."

He said some painkillers have side effects, such as disorientation, that can be more distressing than pain for an animal. And he maintains that "big city" standards shouldn't be imposed on rural veterinarians who may have clients less apt to want to pay for aggressive pain management.

Colleagues disagree

Many of Seemann's colleagues like him personally and respect him for his decades of dedicated service. He is credited with developing a surgical procedure in the 1960s that reduced excruciating back pain in countless animals, and in 2003, the Minnesota Veterinary Medical Association gave him its Distinguished Service Award.

But those colleagues aren't lining up to support him in this battle, which he said has cost him more than $80,000 so far. They say he has dug his heels in on the wrong side of this issue, and they flatly reject the notion that rural veterinarians don't want to manage pain as aggressively.

"I would say that in the last 10 or 15 years there's been a huge awakening in the veterinary community" about pain management, said Dr. Tom Dougherty, owner of Dougherty Veterinary Clinics in Duluth and former president of the Veterinary Medical Association.

Dougherty, said that when he started practicing in 1969, most veterinarians believed animals didn't feel pain as acutely as humans, partly because many animals hide their pain, a stoicism Dougherty believes evolved to help them avoid predators in the wild.

But a growing body of evidence shows that animals not only feel pain acutely, they often heal better and faster when it's relieved, Dougherty said.

Complaining cost $1,000

What has upset some of Seemann's fellow veterinarians is that the board, instead of clearly warning veterinarians about what it considers the latest minimum pain management standard, waited for a complaint and now appears to be spreading the word by making an example of Seemann.

"People like Carl built our profession into what it is today," said Dr. Doug Marshak, owner of Grand Avenue Veterinary Clinic in Duluth. "I think he's wrong with regard to pain management, but if certain behavior precludes you from practicing medicine, it would be nice if the board would outline that beforehand."

Marshak was one of several veterinarians interviewed for this story who said they suspect Seemann's brusque manner has a lot to do with the trouble he's in.

That manner certainly showed when Jazz's owners, Linda Lovegreen and Gerald Johnson, alarmed at the lack of post-operative pain medication, insisted on removing Jazz from Seemann's care the day after surgery.

According to court records, Seemann admits that he responded by adding $1,000 to his fee.

"Most people say this wouldn't have happened to him if he'd been a little more opened-minded and less defensive," Marshak said. "They wonder, 'Did the board just get fed up with a grumpy old codger?' "

Larry Oakes • 1-218-727-7344