Page 3294 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Computed Tomography (CT Scan)

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

INTRODUCTION these risks, but they can never be eliminated. The decision to perform
We want to make sure that you understand the planned medical this procedure is based on having assessed that the anticipated
procedure to be performed on your pet. You should know why the benefit is greater than the anesthetic risk.
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 A CT scan is a noninvasive procedure with relatively few risks.
with you. It is also important that you recognize that medicine is Because a CT scan is like a more powerful x-ray, your pet will be
not an exact science, and that the outcome cannot be guaranteed. exposed to radiation equivalent to several sets of x-rays, but this
We encourage you to ask us as many questions as required for is unlikely to cause any harm. If contrast agents are used (and they
you to make a well-informed decision. are not always required), they can on very rare occasions cause
adverse reactions including an allergic response (anaphylaxis) or
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE kidney damage. The use of sedation or anesthesia also presents
A computed tomography (CT, or CAT) scan is a diagnostic imaging an associated risk, especially if your pet is very sick. Finally, there is
test. It is similar to an x-ray except it provides a three-dimensional a risk that we will not identify a specific cause of your pet’s illness
(3D) view of the area of interest and allows us to look at small despite performing the scan.
structures and soft tissues in greater detail than a traditional x-ray.
CT scans can be performed on many different areas of the body, Other anticipated risks specific to your pet:___________________
including the lungs, abdomen, limbs, spine, or head, and can be
used to help plan specific procedures such as complex surgeries _________________________________________________________
or radiation therapy. By administering contrast agents, CT scans
can show small vessels in detail—for instance, to identify blood
clots in the lungs. This procedure is not a treatment for disease ALTERNATIVES TO THE PROCEDURE
but can help provide a diagnosis to help us decide how best to Other tests may help with diagnosis of your pet’s illness. X-rays
treat your pet. provide a two-dimensional picture of the body and can provide
some but not all of the diagnostic information available from a CT
EXPLANATION OF THE PROCEDURE scan. Ultrasound, which uses sound waves to create a picture
For the CT scan, your pet is placed on a table that passes through of an area, can also be used to look at the chest, abdomen, or
a special 360-degree x-ray machine (the CT scanner). Depending certain other structures. Neither x-rays nor ultrasound provide the
on what part of the body is being examined, your pet is likely to be same type of image as a CT scan but they are more widely avail-
given a sedative or placed under general anesthesia to keep him able, seldom require anesthesia, and are generally less expensive.
or her perfectly still for the procedure. The scan itself is generally CT shows more fine detail and can more clearly identify most
very quick, taking only a few minutes. A specialized computer then tissue abnormalities than either x-rays or ultrasound. Without the
processes the images to give us the 3D pictures. In some cases, additional information provided by the CT scan, we may not be able
a contrast agent will be injected into a vein to outline vessels or to determine a specific diagnosis or properly plan for a surgical pro-
tissues more clearly. A CT scan is often done along with other cedure, which might negatively affect our ability to successfully treat
tests to diagnose or monitor a disease or as a preoperative scan your pet.
before certain surgeries.
Additional procedures planned for your pet at the same time AUTHORIZATION
as the CT scan: 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
Because your pet needs to be motionless or even hold his or her • You understand the known risks that accompany the procedure,
breath during a CT scan, sedation or anesthesia is usually necessary. and also understand that unforeseen complications may occur
We will explain whether we are going to use sedatives (medications • You understand that the procedure may not produce the results
to make your pet drowsy and relaxed) or full anesthesia (meaning we hope to achieve
your pet will be unconscious). Although sedation and anesthesia • You understand the alternatives to this procedure for your pet
are performed routinely with good outcomes, it does bring risks, • You agree that you have been given time to ask questions regard-
including a very small risk of death. These risks may be increased for ing the procedure, that these have been answered satisfactorily,
animals with severe disease. Precautions will be taken to minimize 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.