Page 3300 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Cystotomy

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

INTRODUCTION procedure and recovery from anesthesia. The decision to proceed
We want to make sure that you understand the planned surgical with this surgery is based on having assessed that the anticipated
procedure to be performed on your pet. You should know why benefit is greater than the anesthetic risks.
the surgery has been suggested, what the potential benefits are
for your pet, and the most common/important risks of the surgery. FORESEEABLE RISKS TO THE PROCEDURE
Alternatives to this procedure, when applicable, will be discussed The risks of a cystotomy are those associated any surgery, including
with you. It is also important that you recognize that medicine is bleeding and postoperative pain. Additionally, there is the risk of
not an exact science, and that the outcome cannot be guaranteed. urinary leakage (uroabdomen), seroma (fluid-filled pocket around
We encourage you to ask us as many questions as required for incision), infection, and dehiscence (opening of incision). There is
you to make a well-informed decision. also the chance of recurrence of clinical signs, despite appropriate
therapy. Finally, there is a risk that we may not identify the specific
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE cause of your pet’s illness and/or be able to fix the underlying
Cystotomy is a surgical operation that involves opening the urinary problem, despite performing a cystotomy.
bladder. It allows for some or all of the following: removal of urinary
calculi (bladder stones) that pose the risk of urinary obstruction, Other anticipated risks specific to your pet:___________________
identification and biopsy of masses within the urinary bladder, repair
of ectopic ureters, and/or to obtain culture samples to target antibiotic _________________________________________________________
therapy for chronic bladder infection.
EXPLANATION OF THE PROCEDURE ALTERNATIVES TO THE PROCEDURE
While under general anesthesia, your pet will have hair shaved In some instances, bladder stones can be dissolved with medication
from his/her abdomen (belly) and the skin will be prepared for and diet without a need to perform surgery. If the stones are small
sterile surgery. An incision will be made into the abdomen, and the enough, it is possible that they can be removed in other ways.
urinary bladder will be identified. The surgeon will make an incision Urohydropropulsion is used to flush stones out of the bladder, but
into the urinary bladder and evaluate the inside surface. If bladder it should not be performed if there is worry that the stones are too
stones are present, they will be removed and submitted for analysis large or will become “stuck”. Another option may be lithotripsy,
as well as culture. A sample of the urinary bladder wall may be in which stones are broken apart with a very specialized piece
obtained for biopsy and/or culture. The urinary bladder will then be of equipment found mostly only in veterinary specialty hospitals.
closed with suture and evaluated to ensure no urine leakage. The If the cystotomy is recommended for diagnosis of bladder disease
remainder of the abdomen will be evaluated by the surgeon for instead of removal of stones, there may be other alternatives. If your
any abnormalities, with the potential to obtain biopsies from other dog is large enough, a camera can be inserted into the bladder
tissue/organs if they have an abnormal appearance. The abdomen by means of the vagina or penis to examine and even biopsy the
will be flushed with sterile saline, and the abdominal incision will be bladder. A procedure known as “traumatic catheterization” can
closed with multiple layers of suture +/- surgical staples. Following sometimes be used to diagnose bladder cancer. Often, a specialist
surgery, your pet will be monitored in hospital for postoperative in small animal internal medicine would perform these specialized
complications. procedures.
Additional procedures planned for your pet at the same time
as the cystotomy: AUTHORIZATION
By signing this form below, you agree that:
____________________________________________________________ • You understand how/why the procedure is likely to help your
pet
USE OF SEDATIVES OR ANESTHESIA • You understand what will be done to your pet during the
This procedure requires general anesthesia, which is the administra- procedure
tion of injectable and inhaled anesthetic medications in order to • You understand the known risks that accompany the procedure,
cause your pet to become unconscious. Anesthesia is performed and also understand that unforeseen complications may occur
routinely with good outcomes, but it does come with risks, including • You understand that the procedure may not produce the results
aspiration pneumonia (infection in the lungs) or even a small risk we hope to achieve
of death. These risks are higher for animals that have multiple or • You understand the alternatives to this procedure for your pet
severely debilitating comorbidities (poor health ailments). Patients • You agree that you have been given time to ask questions regard-
with a urinary obstruction are at a higher risk of complications. To ing the procedure, that these have been answered satisfactorily,
minimize the risks, your animal will be monitored closely during the 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.