Page 3273 - Cote clinical veterinary advisor dogs and cats 4th

in which at least core vaccines would not be recommended for • You understand the known risks that accompany the procedure,
a pet dog. and also understand that unforeseen complications may occur
• You understand that the procedure may not produce the results
Other anticipated risks specific to your pet:____________________ we hope to achieve
VetBooks.ir _________________________________________________________ • You understand the alternatives to this procedure for your pet
• You agree that you have been given time to ask questions regard-
ing the procedure, that these have been answered satisfactorily,
ALTERNATIVES TO THE PROCEDURE and that you are free to decline the procedure.
Unvaccinated dogs are at increased risk of contracting infectious
disease. Additionally, local laws usually require rabies vaccinations.
However, not all dogs require all available vaccinations. We are ____________________________________ ______________
happy to discuss which of the commonly used vaccines, described Signature of pet owner/owner’s agent Date
below, are recommended for your dog.
Core vaccines for a typical pet dog:
• Rabies (as required by law in most areas) ____________________________________ ______________
• Canine distemper virus (CDV) Witness to consent (signature) Date
• Canine parvovirus (CPV)
• Canine adenovirus (CAV2)
Non-core vaccines considered for some pet dogs: ____________________________________
• Canine parainfluenza virus (CPiV) Witness to consent (printed name)
• Bordetella bronchiseptica
• Canine influenza virus (CIV; H3N8 and/or H3N2)
• Canine leptospirosis
• Rattlesnake vaccination (helps protect from snake bite)
After completing the initial series of vaccines and one-year
boosters, protection from some infections can be long lasting.
If vaccination is a concern (for instance, prior immune-mediated
disease), we can consider running blood tests that might help
predict which vaccines can wait a little longer before being repeated.
AUTHORIZATION
By signing this form below, you agree that:
• You understand how/why the procedure is likely to help your
pet
• You understand what will be done to your pet during the
procedure Practice Stamp or Name & Address

Also available in Spanish.

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.