Page 3308 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Endoscopy, Lower GI (Colonoscopy)

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

INTRODUCTION to perform this procedure is based on having assessed that the
We want to make sure that you understand the planned medical anticipated benefit is greater than the anesthetic risk.
procedure to be performed on your pet. You should know why the
procedure has been suggested, what the potential benefits are for FORESEEABLE RISKS TO THE PROCEDURE
your pet, and the most common/important risks of the procedure. Complications associated with this procedure are rare but can be
Alternatives to this procedure, when applicable, will be discussed associated with either the preparation step or the procedure itself.
with you. It is also important that you recognize that medicine is During the preparation, a large volume of oral laxative is often given
not an exact science, and that the outcome cannot be guaranteed. by mouth or by stomach tube. Although uncommon, this liquid
We encourage you to ask us as many questions as required for can enter the airways and lungs after a pet vomits, or by accident
you to make a well-informed decision. of misplacement. Depending on the volume of liquid aspirated,
this can be a very serious complication that can compromise
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE the pet’s ability to breathe. Risks of the procedure itself include
Lower gastrointestinal (GI) endoscopy is a minimally invasive abdominal discomfort, excessive bleeding, or very rarely intestinal
procedure that will allow us to inspect the lower gastrointestinal perforation. Intestinal perforation, should it occur, would require
tract. It is usually performed to investigate the cause of chronic immediate surgical intervention. Although we will look carefully,
diarrhea, straining to defecate, or bloody stools. Not only can we diseased tissue does not always look abnormal to the eye, so we
see inside the lower intestines (also known as the large bowel, might miss seeing an area of disease. Further, endoscopy only
or the colon), but we can also obtain tissue samples that can allows for sampling of the innermost layer of the gastrointestinal
help us determine the cause for pet’s clinical signs. This pro- tract, and not all layers. You should understand that there is a risk
cedure is not a treatment for disease, but a tool to help find a that we will not identify a specific cause of your pet’s illness from
diagnosis for a disease. In people, a similar procedure is called this procedure, but that we feel it is the next logical step in seeking
“colonoscopy”. the cause of your pet’s health concern.

EXPLANATION OF THE PROCEDURE Other anticipated risks specific to your pet:___________________
In order to inspect the lower gastrointestinal tract, it must be empty
of stool. Procedures to “clean” the bowel are called preparation. _________________________________________________________
Preparation procedures vary, but often includes administration of a
laxative and/or enemas. Your veterinarian may prescribe a laxative to
be administered at home, or your pet may need to be admitted to ALTERNATIVES TO THE PROCEDURE
the hospital 24-48 hours before the procedure in order to undergo The alternatives to this procedure depend on the specific reason
preparation. Once your pet’s large intestine is empty and clean, it has been suggested. For masses near the anus, proctoscopy
a small camera (endoscope) will be inserted rectally and pushed (endoscopy with a shorter, usually rigid version of the endoscope)
all the way to the place where the large intestine meets the small may be an alternative to lower GI endoscopy. Surgery could be
intestine. The camera will allow the large intestine to be visually another option. If the reason for the endoscopy is investigation
inspected for the presence of ulcers or tumors. An instrument is of chronic diarrhea, after blood tests, parasite examinations and
used to obtain small samples of the innermost layers of the large noninvasive imaging studies have been exhausted, endoscopic
intestine (approximately the size of a grain of rice). These samples biopsies is often the necessary next step for diagnosis. Without
are sent to a laboratory for analysis under a microscope. There the additional information provided by analysis and inspection of
are no incisions made for this procedure, and no sutures will be the tissue, any treatment plan without a confirmed diagnosis could
necessary. Sometimes, this procedure is combined with endoscopic lead to a suboptimal outcome.
examination of the small intestine.
Additional procedures planned for your pet at the same time AUTHORIZATION
as the lower GI endoscopy: 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
procedure
USE OF SEDATIVES OR ANESTHESIA • You understand the known risks that accompany the procedure,
This procedure requires general anesthesia. General anesthesia and also understand that unforeseen complications may occur
causes your pet to become unconscious. Although anesthesia • You understand that the procedure may not produce the results
is performed routinely with good outcomes, it does bring risks, we hope to achieve
including a very small risk of death. These risks are increased for • You understand the alternatives to this procedure for your pet
animals with severe disease. To reduce these risks, your pet will • You agree that you have been given time to ask questions regard-
be supplied with extra oxygen, and will be monitored closely during ing the procedure, that these have been answered satisfactorily,
both anesthesia and during recovery from anesthesia. The decision 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.