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Consent to Perform Splenectomy

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

INTRODUCTION be taken to minimize these risks, but they can never be eliminated.
We want to make sure that you understand the planned surgical The decision to perform this surgery is based on the assessment
procedure to be performed on your pet. You should know why the that the benefits outweigh the anesthetic risks.
surgery has been suggested, what the potential benefits are for
your pet, and the most common/important risks of the operation. FORESEEABLE RISKS TO THE PROCEDURE
Alternatives to this surgery, when applicable, will be discussed with A splenectomy is a major abdominal surgery. Surgical risk includes
you. It is also important that you recognize that medicine is not an bleeding, which can be severe or life-threatening if it cannot be
exact science, and that the outcome cannot be guaranteed. We controlled. If the bleeding originates from the spleen, removing the
encourage you to ask us as many questions as required for you spleen can actually help stop excessive bleeding. Many patients
to make a well-informed decision. require a blood transfusion if a large volume of blood is lost. Patients
might develop low blood pressure during or after splenectomy,
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE requiring specific treatment and additional in-hospital monitoring.
A splenectomy is a surgical procedure to remove the spleen. The Splenectomy can also cause abnormal heart rhythms, which are
spleen is an organ in the abdomen that has normal functions that generally temporary but can be serious and require medications.
include protection from infectious disease and production of blood Additional risks associated with any abdominal surgery include
cells. Despite these roles, dogs and cats can live a normal life infection, fever, complications with the incision, or even breakdown
without a spleen. Depending on the underlying disease, splenectomy of the sutures within the incision requiring an additional surgery.
can be a treatment (for example, when removing a tumor that Most pets will require at least one night in the hospital following
is actively bleeding) as well as a diagnostic test (by allowing us surgery for supportive care, pain medications, and monitoring.
to submit the spleen for examination of splenic tissue under a Finally, there is a risk that we will not identify a specific cause of
microscope). your pet’s illness despite submitting biopsies on the spleen, or
that we will not cure disease (especially cancer) by removing the
EXPLANATION OF THE PROCEDURE spleen if the disease process is “occult” (remains hidden despite
The spleen functions to help make, store, and filter blood and to the most complete evaluation).
help the immune system work more efficiently. Because of these
functions, the spleen has a very rich blood supply. Compared to Other anticipated risks specific to your pet:___________________
other organs, the spleen is at an increased risk for certain infections
or types of cancer, especially those that involve the blood cells or _________________________________________________________
blood vessels. It can also be easily injured if there is trauma to the
abdomen, as often happens when animals are hit by cars. Because
the splenic tissue is fragile, it is generally easier to remove the whole ALTERNATIVES TO THE PROCEDURE
organ than to try to remove part of the spleen. Other tests may help with the diagnosis of diseases of the spleen,
Surgery to remove the spleen involves making an incision in although these may be suggestive but not conclusive (and when
the abdomen (belly) through the skin and muscles. The spleen has they are inconclusive, a splenectomy may be performed). Imaging
several major blood vessels. These vessels are tied off (sutured studies, such as x-rays, ultrasound, or CT scan/MRI may help
closed) and then the connective tissue that holds the spleen in identify an enlarged spleen or the presence of a tumor or other
place is cut. The entire organ and any associated masses or blood mass on the spleen but cannot determine alone if cancer is present.
clots are removed at once. Once removed, the spleen can then be Blood tests may be helpful if an infection or internal bleeding is
sent to a laboratory for biopsy or other testing. Often, splenectomy suspected. If the spleen is diffusely (uniformly) enlarged, obtaining a
is combined with an “exploratory laparotomy” that allows all of the needle biopsy with ultrasound guidance can obtain a small sample
abdominal organs to be examined. of cells from the spleen to look for evidence of certain infections
Additional procedures planned for your pet at the same time or certain types of cancers. Broadly, diffuse enlargement of the
as the splenectomy: spleen usually is approached with other techniques first, rather
than splenectomy initially, whereas splenic masses generally are
____________________________________________________________ approached with splenectomy first because the other tests often
are inconclusive or too risky with nonsurgical approaches.
USE OF SEDATIVES OR ANESTHESIA If the spleen is actively bleeding or severely injured, a good
Splenectomy and related abdominal surgeries require general outcome is unlikely without surgery. Animals with bleeding splenic
anesthesia. This means that your pet will be unconscious. Although tumors might improve temporarily with supportive care but a
anesthesia is performed routinely with good outcomes, it does bring cancerous spleen is likely to bleed again in the near future. In such
risks, including a small risk of anesthetic-related death. These risks cases, euthanasia or hospice care may be considered if surgery
may be increased for animals with severe disease. Precautions will is not an option.

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.