Page 3312 - Cote clinical veterinary advisor dogs and cats 4th

Consent to Perform Enucleation

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

INTRODUCTION to minimize this risk. Your animal will likely have a tube placed to
We want to make sure that you understand the planned medical protect the airway and deliver oxygen and s/he will be monitored
procedure to be performed on your pet. You should know why the closely during the procedure and recovery from anesthesia. The
procedure has been suggested, what the potential benefits are for decision to proceed with this surgery is based on having assessed
your pet, and the most common/important risks of the procedure. that the anticipated benefit is greater than the anesthetic risks.
Alternatives to this procedure, when applicable, will be discussed
with you. It is also important that you recognize that medicine is FORESEEABLE RISKS TO THE PROCEDURE
not an exact science, and that the outcome cannot be guaranteed. The most common risks of enucleation include bleeding, infection,
We encourage you to ask us as many questions as required for and rejection of the implant (if one is used). If all of the tissue around
you to make a well-informed decision. the eye cannot be removed, there is a risk of continued secretions
of tears. Draining tracts can also develop with retained tissue. Other
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE risks include those associated with general anesthesia, as well as
The goal of enucleation is to remove a diseased or damaged globe general risks of surgery, including postoperative infection and/or
rd
(eyeball) as well as the 3 eyelid and the eyelid margin. Usually, pain. Additionally, there is the risk of seroma (fluid-filled pocket
the procedure is performed to resolve pain that can be caused around incision) formation and dehiscence (opening of incision).
by severe ulceration of the eye, glaucoma, trauma to the eye, or There is also the risk that we may not identify the specific cause
other causes. Sometimes, the procedure is performed to remove of your pet’s illness and/or be able to fix the underlying problem,
cancerous tissue or tissue that harbors an infection that cannot despite performing an enucleation. In some conditions, the underlying
otherwise be resolved. disease process can affect the other eye as well, either now or
at a future date.
EXPLANATION OF THE PROCEDURE
Your pet will be placed under general anesthesia, and hair will be Other anticipated risks specific to your pet:___________________
clipped from his/her face around the affected eye. The surgeon
will remove the globe (eyeball) as well as the surrounding tissues, _________________________________________________________
closing the eyelids permanently with stitches. In some instances,
an orbital implant (a ball placed in the eye socket during surgery)
will be placed to mimic a closed eye under the incision. Without ALTERNATIVES TO THE PROCEDURE
an implant, over time, the skin of the eyelids would sink down Depending on the underlying cause of disease necessitating
slightly into the socket. Following surgery, your pet will be monitored enucleation, other procedures may be possible. Many of these may
closely in hospital for postoperative complications, and an Eliza- require evaluation by a veterinary specialist in ophthalmology. For
bethan collar (cone) will be placed to minimize the risk of him/her ocular trauma and/or severe ulceration, surgery to correct the defect
scratching at the surgery site. Sutures will need to be removed in +/- a conjunctival graft could be considered. There are numerous
10-14 days. treatments for glaucoma (medical and surgical) that may be effective
Additional procedures planned for your pet at the same time in some cases.
as the enucleation:
AUTHORIZATION
____________________________________________________________ By signing this form below, you agree that:
• You understand how/why the procedure is likely to help your
USE OF SEDATIVES OR ANESTHESIA pet
This procedure requires general anesthesia, which is the administra- • You understand what will be done to your pet during the
tion of injectable and inhaled anesthetic medications in order to procedure
cause your pet to become unconscious. Anesthesia is performed • You understand the known risks that accompany the procedure,
routinely with good outcomes, but it does come with risks, including and also understand that unforeseen complications may occur
aspiration pneumonia (infection in the lungs) or even death. These • You understand that the procedure may not produce the results
risks are minimal in most patients but can be higher with animals we hope to achieve
that have multiple or severely debilitating comorbidities (poor health • You understand the alternatives to this procedure for your pet
ailments). Patients having ocular surgery are at a higher risk of • You agree that you have been given time to ask questions regard-
vagal events (slowing or stopping of the heart due to pressure on ing the procedure, that these have been answered satisfactorily,
the eye), and part of the anesthetic protocol involves medications 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.