This review is for Dr. Kristin Schafgans (MOVES Internal Medicine that consults for Kenton Animal…read moreHospital)
Lucy, our older dog, was referred by our family vet at Kenton Animal Hospital to a MOVES Internal Medicine consult in fall 2024 for an abdominal ultrasound to evaluate a vague bloodwork abnormality--elevated cystatin B. Unfortunately, the consultation led by Dr. Kristin Schafgans left us with serious concerns. Despite multiple clinical signs pointing toward a gastrointestinal issue, the focus of the visit--and the resulting diagnosis--was misdirected. This misinterpretation delayed meaningful follow-up and contributed to considerable suffering at the end of my dogs life.
In her ultrasound report, Dr. Schafgans wrote: "There is concern for early kidney disease due to small kidneys with loss of corticomedullary distinction and an elevated cystatin B level," and listed differential diagnosis for my dog as "kidney disease versus leptospirosis versus other." Notably, GI disease was not even mentioned. While Lucy did have mild renal changes consistent with age, she had properly concentrated urine and normal creatinine. These findings do not support active or clinically significant kidney disease. Moreover, cystatin B is not a widely accepted or clinically validated diagnostic marker in veterinary medicine, making it a weak basis for excluding more likely causes.
At the time of the ultrasound, Lucy's BUN had risen discordantly to 44 mg/dL, a pattern that strongly suggests upper GI bleeding. She also had low cholesterol (110 mg/dL) and borderline anemia (HCT 37%), both consistent with chronic GI blood loss or malabsorption. She had a history of bile vomiting, intermittent inappetence, and no clinical signs of kidney failure. The most reasonable and likely differential was a gastrointestinal process--yet GI disease was not acknowledged or investigated.
The ultrasound itself lacked depth: the GI tract was dismissed in one vague sentence--"normal wall layering and wall thickness." There was no description of intestinal segments, lymph nodes, or mesenteric fat. Most concerning, the imaging was not sent to a board-certified radiologist for review. This is standard of care, and in my experience, radiologist interpretation is routinely included in the cost of ultrasounds performed by other veterinary internists.
To make matters worse, we were never offered a direct conversation with Dr. Schafgans. The consultation was relayed entirely through our family vet. In hindsight, I used to think a direct discussion might have helped--but now I honestly don't know that it would have. The clinical reasoning was already far from the evidence in front of her.
When Lucy was due for follow-up, we learned--without any advance notice--that Dr. Schafgans had gone out on personal leave. MOVES could not continue Lucy's care, and we were referred to a new internal medicine team. In contrast to the earlier misdirection, the second internist we saw was immediately suspicious of GI bleeding based on Lucy's lab patterns. That contrast only underscored how far off the initial assessment had been.
The delay caused by the MOVES misdiagnosis proved costly. We now know Lucy had undiagnosed gastrointestinal cancer. She declined extremely rapidly over the course of one week in March 2025, and her final week was filled with pain, bleeding, and distress. Her death may not have been preventable, but the way it unfolded could have. If we would have had a clinically accurate workup by MOVES, it is very likely we could have had a peaceful goodbye with our dog before a catastrophic and deeply uncomfortable ulceration of her cancer happened.
I understand that veterinary medicine is complex and that not every outcome is controllable. But Dr. Schafgans, as a board-certified internist, had the training and responsibility to follow the clinical evidence. She should have included GI disease in her differential, documented the ultrasound thoroughly, and involved a radiologist as a matter of standard care. None of that happened--and in my view, this level of oversight and diagnostic failure rises to the level of gross negligence.
If your pet is facing anything medically complex, I urge you: seek a second opinion or work with a specialist who will meet with you personally and thinks critically. A board-certified title does not guarantee careful clinical reasoning. Lucy was deeply loved, and she deserved a better ending to her life.
