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Consent to Perform Bone Marrow Biopsy

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

INTRODUCTION are increased for animals with severe disease. To reduce these
We want to make sure that you understand the planned medical risks, your animal will be monitored closely during both anesthesia
procedure to be performed on your pet. You should know why the and during recovery from anesthesia. The decision to perform this
procedure has been suggested, what the potential benefits are for procedure is based on having assessed that the anticipated benefit
your pet, and the most common/important risks of the procedure. is greater than the anesthetic risk.
Alternatives to this procedure, when applicable, will be discussed
with you. It is also important that you recognize that medicine is FORESEEABLE RISKS TO THE PROCEDURE
not an exact science, and that the outcome cannot be guaranteed. Bone marrow aspirate or biopsy is generally quite safe but there
We encourage you to ask us as many questions as required for are risks. There can be bleeding at the needle entry site, although
you to make a well-informed decision. bone marrow samples can be obtained successfully even in pets
with very low numbers of platelets (the cells responsible for forming
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE blood clots). Another risk is infection; however, using sterile technique
A bone marrow aspirate or biopsy involves inserting a needle into the significantly reduces this risk. Your pet should not be bathed or
center your pet’s bone to take a small sample of bone marrow cells allowed to swim and should not lick or chew at the sampling site
or tissue, respectively. The bone marrow is responsible for making for 10-14 days because these would increase the risk of infection.
new red blood cells, white blood cells, and platelets to replenish Perhaps the most serious risk, but one that is very uncommon, is
the blood as these cells are used up. By examining a sample, a fracture (breakage) of the bone. Diseased underlying bone (such
pathologist can assess how well the bone marrow is making new as bone infection or a bone tumor) can increase the small risk of
cells, identify areas of fibrosis (scarring), identify cancer, or get fracture. There is also a risk of injury to nearby tissues (nerves,
clues to the presence of immune-mediated disease or toxicoses muscles, or joints) while taking the biopsy. Finally, there is a risk
(poisoning). Bone marrow aspiration or biopsy is recommended that we will not identify a specific cause of your pet’s illness despite
when blood cell counts are low, abnormal cells are seen in blood performing the bone marrow aspirate or biopsy.
samples, and to assess for cancer spread. This procedure will not
treat your pet’s condition but will give us information to come up Other anticipated risks specific to your pet:___________________
with the best treatment plan.
_________________________________________________________
EXPLANATION OF THE PROCEDURE
To perform a bone marrow aspirate or biopsy, your pet will be put
under general anesthesia (as described below). This will prevent your ALTERNATIVES TO THE PROCEDURE
pet from having memory of the biopsy or feeling pain. The area of The bone marrow sampling procedure is the only way to obtain
the procedure will be shaved and scrubbed as for surgery to keep a complete picture of the structure and content of the bone
it as clean as possible, and sterile gloves and instruments will be marrow. The bone marrow aspirate is the same as a biopsy but
used. A local numbing agent will be injected under the skin in the only samples the fluid in the bone marrow and does not remove
area of the procedure to reduce pain when your pet wakes up. a cylinder of tissue. Thus, an aspirate can show us the cells in the
Bone marrow samples are taken from the upper front limb (humerus marrow but not the architecture. Aspirate carries the same risks
bone), the upper hind limb (femur bone), or the hip (ileum bone) as marrow biopsy. Without the additional information provided by
depending on the size of your pet. A very small incision (less than a bone marrow aspirate or biopsy, we would need to develop a
1 8 inch) is made through the skin, and a hollow needle is inserted treatment plan without a confirmed diagnosis, which might lead
in to the center of the bone. Liquid marrow is withdrawn with a to a suboptimal outcome.
syringe (aspirate), or when the needle is removed, a small round
cylinder of bone is removed as well (biopsy). These samples are AUTHORIZATION
submitted to a pathologist for microscopic evaluation. Usually the By signing this form below, you agree that:
skin incision is allowed to heal on its own because it is so small, • You understand how/why the procedure is likely to help your
but occasionally a suture (or a “stitch”), a skin staple, or tissue glue pet
is used to hold the skin in the area together while it heals. • You understand what will be done to your pet during the
Additional procedures planned for your pet at the same time procedure
as the bone marrow aspirate or biopsy: • You understand the known risks that accompany the procedure,
and also understand that unforeseen complications may occur
____________________________________________________________ • You understand that the procedure may not produce the results
we hope to achieve
USE OF SEDATIVES OR ANESTHESIA • You understand the alternatives to this procedure for your pet
General anesthesia causes your pet to become unconscious. • You agree that you have been given time to ask questions regard-
Although anesthesia is performed routinely with good outcomes, ing the procedure, that these have been answered satisfactorily,
it does bring risks, including a very small risk of death. These risks and that you are free to decline the procedure.

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