Page 3290 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Castration, Canine

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

INTRODUCTION include excessive bleeding, bruising, infection, or opening of the
We want to make sure that you understand the planned medical incision site (dehiscence). It is important to follow postoperative
procedure to be performed on your pet. You should know why the instructions to restrict activity and prevent your dog from licking at
procedure has been suggested, what the potential benefits are for the incision to lower the risk of these complications.
your pet, and the most common/important risks of the procedure.
Alternatives to this procedure, when applicable, will be discussed Other anticipated risks specific to your dog:___________________
with you. It is also important that you recognize that medicine is
not an exact science, and that the outcome cannot be guaranteed. _________________________________________________________
We encourage you to ask us as many questions as required for
you to make a well-informed decision.
ALTERNATIVES TO THE PROCEDURE
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE Although attempts have been made to create a drug that can cause
A castration (also called neuter) is the surgical removal of a dog’s chemical castration, none is as effective in reducing male sexual
testicles, performed under general anesthesia. This procedure hormones as surgical removal of the testicles.
is performed to eliminate the possibility of reproduction. Certain
behaviors associated with male hormones are reduced after castra- AUTHORIZATION
tion, such as marking, aggression, roaming, and unwanted sexual By signing this form below, you agree that:
behaviors. Castration prevents testicular cancer and is associated • You understand how/why the procedure is likely to help your pet
with a decreased risk of certain prostate diseases. • You understand what will be done to your pet during the procedure
• You understand the known risks that accompany the procedure,
EXPLANATION OF THE PROCEDURE and also understand that unforeseen complications may occur
During this procedure, your dog will be anesthetized. The surgical • You understand that the procedure may not produce the results
site is shaved and cleaned, and a small incision is made between we hope to achieve
the penis and the scrotum. The sperm ducts and the blood vessels • You understand the alternatives to this procedure for your pet
supplying the testicles will be tied off with sutures and then cut to • You agree that you have been given time to ask questions regard-
allow removal of the testicles. The incision is closed with multiple ing the procedure, that these have been answered satisfactorily,
layers of suture, and depending on the surgeon’s preference, surgical and that you are free to decline the procedure.
staples or skin glue may be used. The entire process, including
the induction of general anesthesia and recovery, usually takes
approximately 30-60 minutes. Pain medication may be given during ____________________________________ ______________
the procedure, and additional pain medication may be given after
the procedure depending on your dog’s needs. Signature of pet owner/owner’s agent Date
Additional procedures planned for your pet at the same time
as the canine castration: ____________________________________ ______________
Witness to consent (signature) Date
____________________________________________________________
USE OF SEDATIVES OR ANESTHESIA ____________________________________
Canine castration requires the use of general anesthesia, which
causes your dog to become unconscious. Although anesthesia Witness to consent (printed name)
is performed routinely with good outcomes, it does bring risks,
including a very small risk of death. These risks are increased for
animals with severe disease. To reduce these risks, your dog will
be supplied with extra oxygen, and will be monitored closely during
both anesthesia and during recovery from anesthesia. The decision
to perform this procedure is based on having assessed that the
anticipated benefit is greater than the anesthetic risk.
FORESEEABLE RISKS TO THE PROCEDURE
A castration is considered a routine surgery, and the overall risk is
low. Complications during surgery are rare and usually related to
the use of general anesthesia. After surgery, complications may
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.