Page 3280 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Abdominocentesis

VetBooks.ir Patient name:_________________________________
Pet owner’s name:_____________________________ Med rec #____________
Best contact during/after procedure (e.g., cell phone number):____________________

INTRODUCTION necessary. Sedation will make your pet drowsy, but he or she will
We want to make sure that you understand the planned medical remain conscious. Sedation is a very safe procedure, but there is
procedure to be performed on your pet. You should know why the some small risk of complication.
procedure has been suggested, what the potential benefits are for
your pet, and the most common/important risks of the procedure. FORESEEABLE RISKS TO THE PROCEDURE
Alternatives to this procedure, when applicable, will be discussed Abdominocentesis is quite safe. Occasionally, there will be minor
with you. It is also important that you recognize that medicine is bleeding or fluid leakage where the needle was inserted. If the
not an exact science, and that the outcome cannot be guaranteed. volume of fluid is small, it is also possible that we could nick (cut)
We encourage you to ask us as many questions as required for an abdominal organ with the needle (this risk is minimized by use
you to make a well-informed decision. of ultrasound guidance, and by keeping the patient very still during
the procedure). Another extremely small risk is introduction of germs
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE into the abdomen that might cause an infection called peritonitis.
Abdominocentesis is a minimally invasive procedure that allows
us to obtain a sample of fluid from your pet’s abdominal cavity Other anticipated risks specific to your pet:___________________
(belly). Normally, there is only a tiny amount of fluid free in the
abdominal cavity. When there is excessive fluid, evaluation can help _________________________________________________________
us determine the cause for your pet’s illness. This procedure is not
a treatment for disease, but a tool to help find a diagnosis for a
treatable disease. That said, when there is a very large volume of ALTERNATIVES TO THE PROCEDURE
fluid accumulation, removing some of that volume can make your The alternative to this procedure would be to perform surgery
pet more comfortable and make it easier for him/her to breathe. in order to obtain fluid samples while evaluating the rest of the
abdominal organs. However, this is an invasive alterative, and
EXPLANATION OF THE PROCEDURE abdominocentesis may allow us to determine if surgery would be
An area of skin will be shaved and cleaned prior to inserting a small indicated in the future.
needle into the abdomen. If there is only a small amount of fluid, we Regardless of the method used to obtain tissue samples, without
may use an ultrasound machine to help guide us to the best spot(s) the additional information provided by analysis and inspection of
to collect the fluid. Once the needle is in the abdomen, a syringe is the tissue, we would need to develop a treatment plan without a
used to draw back fluid. Samples of this fluid will be submitted for confirmed diagnosis, which might lead to a suboptimal outcome.
evaluation under the microscope. In some cases, the fluid may be
submitted for additional testing such as bacterial culture. If there AUTHORIZATION
is a large volume of fluid, we will continue to remove fluid even By signing this form below, you agree that:
after we have the appropriate diagnostic samples, with the goal of • You understand how/why the procedure is likely to help your
removing enough fluid to make your pet more comfortable. Once pet
we are done, the needle is simply removed. There is no need for • You understand what will be done to your pet during the
sutures (stitches). procedure
Additional procedures planned for your pet at the same time • You understand the known risks that accompany the procedure,
as the abdominocentesis: and also understand that unforeseen complications may occur
• You understand that the procedure may not produce the results
____________________________________________________________ we hope to achieve
• You understand the alternatives to this procedure for your pet
USE OF SEDATIVES OR ANESTHESIA • You agree that you have been given time to ask questions regard-
In most cases this procedure is performed without sedation or ing the procedure, that these have been answered satisfactorily,
anesthesia. If your pet is not able to stay still, sedation may be and that you are free to decline the procedure.

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