Des Moines couple Kenneth and Nonna Newman really loved their dog. When Trali, a Pekingese, developed a herniated disc in 2006, they spent thousands of dollars on MRIs and surgery, according to their attorney, Adam Karp.

Two veterinarians eventually persuaded Nonna that “if she really loved her dog enough, she would consent to euthanasia,” as the Newmans recall in legal documents. The Newmans complied, but later received information that led them to believe that Trali could have been successfully treated and didn’t need to be put to sleep. They filed a complaint with the state’s Veterinary Board of Governors. When the board declined to discipline the vets involved, the Newmans took the matter to court. Last week, the state Court of Appeals ruled that the couple wasn’t entitled to any kind of judicial review.

Karp says the ruling will apply to decisions involving all health professionals—doctors, nurses, psychologists, massage therapists. The judges are saying that it’s up to the state boards and commissions that govern these professions to decide whether discipline is warranted. And if patients (or their owners) don’t like the state’s decisions, there is, in Karp’s words, “nothing you can do about it.” (Though, of course, wronged patients can still sue for malpractice on their own behalf.)

The court ruled that the Newmans didn’t have legal “standing,” in part because they could not prove that they had been injured by the state’s decision not to discipline the vets.

Rather, the court noted, it is license holders—vets, doctors, and so on—who have standing to question disciplinary decisions because they are at risk of losing their livelihoods.

Nonna, who works as a contract bargainer for the SEIU, says the ruling made her feel as though “Trali was killed all over again.” She and her husband, a seafood executive, are considering whether to appeal to the state Supreme Court.