Page 3292 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Cerebrospinal Fluid Tap

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

INTRODUCTION The decision to perform this procedure is based on the assessment
We want to make sure that you understand the planned medical that the benefits of pursuing an accurate diagnosis outweigh the
procedure to be performed on your pet. You should know why anesthetic risks.
the procedure has been suggested, what the potential benefits
are for your pet, and the most common/important risks of the FORESEEABLE RISKS TO THE PROCEDURE
procedure. Alternatives to this procedure, when applicable, will A CSF fluid tap is a commonly performed neurologic diagnostic test
be discussed with you. It is also important that you recognize that usually causes no problems, but like any medical procedure
that medicine is not an exact science, and that the outcome there are some risks. The worst complication is the risk of further
cannot be guaranteed. We encourage you to ask us as neurologic injury from the procedure, either from injury to the nerves
many questions as required for you to make a well-informed caused by the sampling needle, or through bleeding, swelling, or
decision. pressure changes in the spinal cord or brain. These complications
are uncommon but can be severe and life threatening if they occur.
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE Sudden death, breathing difficulty, or brain damage that may be
A cerebrospinal fluid tap (CSF tap) is a diagnostic procedure that permanent is possible but rare. MRI scans often help to identify
allows us to collect a sample of the fluid that surrounds the brain those pets who are at highest risk from this procedure and this
and spinal cord. This fluid is then analyzed to provide important is why MRI is often recommended before performing a CSF tap.
information about inflammation, infection, or other processes that Finally, there is a risk that we will not identify a specific cause of
may be affecting the brain and spine. your pet’s illness despite performing this test.
EXPLANATION OF THE PROCEDURE Other anticipated risks specific to your pet:___________________
Cerebrospinal fluid is the fluid that surrounds and nourishes the
brain and spinal cord. Because it is so closely related to these _________________________________________________________
structures, it can often provide us with information regarding the
health of the brain and spinal cord. In situations where a neuro-
logic disorder such as meningitis, severe inflammation, infection, ALTERNATIVES TO THE PROCEDURE
or certain types of cancer are suspected based on your pet’s Other tests may help with the diagnosis of neurologic conditions. A
symptoms, this fluid can be analyzed and used to help determine a thorough evaluation of your pet’s general health will be performed
diagnosis. and may provide diagnostic information if a disease outside of
A CSF tap, also sometimes referred to as a spinal tap, is a the nervous system is suspected to be causing neurologic signs.
diagnostic procedure that involves using a specialized needle inserted Blood tests can help identify certain types of infections or cancers
into the space around the spinal cord either at the base of the skull that can affect the nervous system. Imaging studies of the brain
or between the bones of the lower back to collect a small amount of and spinal cord can help diagnose visible changes like tumors.
cerebrospinal fluid. This procedure is often performed in combination Without the additional information provided by the cerebrospinal
with other diagnostic tests, such as magnetic resonance imaging fluid analysis, we may not be able to determine a specific diagnosis,
(MRI) of the brain or spinal cord. In some cases, if severe changes which may negatively affect our ability to treat your pet in the most
are seen on the MRI, the CSF tap may not be performed due to appropriate manner.
higher risk of complications.
Additional procedures planned for your pet at the same time AUTHORIZATION
as the CSF tap: 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
USE OF SEDATIVES OR ANESTHESIA procedure
Cerebrospinal tap is a delicate procedure and it is necessary that • You understand the known risks that accompany the procedure,
your pet be perfectly still to reduce risk of complications. For that and also understand that unforeseen complications may occur
reason, general anesthesia is required. This means that your pet will • You understand that the procedure may not produce the results
be unconscious. Although anesthesia is performed routinely with we hope to achieve
good outcomes, it does bring risks, including small risk of death. • You understand the alternatives to this procedure for your pet
These risks may be increased for animals with severe disease or • You agree that you have been given time to ask questions regard-
disease affecting their central nervous system. Precautions will be ing the procedure, that these have been answered satisfactorily,
taken to minimize these risks, but they can never be eliminated. 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.