Surgery/Anesthesia Check-in Form Logo
  • Surgery/Anesthesia Check-in Form

  • West Coast Animal Hospital

    5269 Linda Vista Rd
    San Diego, CA 92110
    United States
    (619) 431-1423
    info@westcoast.vet


    Consent for Surgery / Anesthesia


    AUTHORIZATION


    I verify I am the Owner (or Authorized agent for the owner, at least 18 years or older) of the above named animal and authorize the above procedure to be performed. I authorize the use of sedation, anesthesia and other medication as deemed necessary by the veterinarian and understand that hospital personnel will be employed in the procedure(s) as directed by the veterinarian. I have been advised as to the nature of this procedure to be performed and the risks involved. I understand also that there is always a risk associated with any sedation or anesthesia episode, even in apparently healthy animals and have discussed my concerns with the veterinarian. While I accept that all procedures will be performed to the best of the abilities of the veterinarians and staff at this hospital, I understand that no guarantee or warranty has been made regarding the results that may be achieved. I understand that any estimates provided for such procedures are for non-complicated procedures and that any unforeseen complications may result in additional costs. I understand that it may be necessary to provide medical and/or surgical intervention which were not anticipated for the safety or care of my pet. I hereby consent to and authorize the performance of such altered and/or additional procedures as are necessary in the veterinarian’s professional judgment. I accept responsibility for any result in additional charges. I agree to be responsible for any charges incurred while my pet is in the care of this facility and understand payment is due at the time my pet is released from the hospital. I understand no staff will be attending to my pet overnight (pets needing special care may be referred to a 24 hour hospital).

     

     

  • Pre-Anesthetic Testing Information


    PLEASE READ CAREFULLY.


    Our greatest concern is the well-being of your pet. Your pet is scheduled for a procedure that requires anesthesia or sedation. Prior to anesthesia, a veterinarian will perform a basic physical examination to identify any existing medical conditions that could complicate the procedure & compromise the health of your pet. There is a possibility that a physical exam alone will not identify all of your pet’s health problems. Therefore, pre-anesthetic testing can be performed and is always recommended prior to anesthesia. Blood tests can reduce the risk of complications as well as identify medical conditions that could require medical treatment in the future. At our hospital, animals over the age of 5 years are required to have a blood test prior to anesthesia unless otherwise specified by the veterinarian. We also highly recommend chest radiographs on patients7 years of age or older.


    The Pre-Anesthetic Blood Profile helps alert the veterinarian to the presence of dehydration, anemia, infection, diabetes and/or kidney or liver disease that could complicate the procedure. These conditions may not be detected without a pre-anesthetic profile thus not allowing for the most appropriate and safest anesthetic regime to be administered. These tests are similar to those your own physician would run if you were to undergo anesthesia. In addition, these tests may be useful if your pet’s health changes to develop faster, more accurate diagnoses and treatments.

  •  Please Select the Following Options for Pre-Anesthetic Testing:

  • If your pet is in for anesthesia/surgery, there are inherent risks that are unavoidable. We will perform a full physical examination on your pet before administering the anesthesia. However, we highly recommended a pre-anesthetic blood profile to be performed for the purpose of ensuring that your pet has normal major organ function before anesthesia. This includes indicators of anemia, dehydration, kidney function, and liver function. By performing this pre-op blood profile, we will be better able to rule out pre-existing internal problems that may not be evident physically but could lead to serious complications. If you decline the pre-anesthetic blood testing, you accept all risks and responsibilities that go with West Coast Animal Hospital not having the benefit of the blood testing results.

  • Includes the test described above plus a complete blood count (CBC). This measures HCT (Anemia), White Blood Cell Count (Infection or Inflammation) & Red Blood Cell Count (Anemia/Bleeding Disorder)

  • This may be included in your estimate. Chest radiographs are recommended for senior pets. They will be performed before anesthesia and reviewed by the doctor, chest radiographs allow us to view your pet's lungs and heart to check for any abnormalities and ensure they are safe to go under anesthesia.

  • Whether on preventatives or not, we highly recommend this test be performed annually starting at 6 months of age. This checks your pet for heartworm and 5 other potentially deadly diseases.

  • We highly recommend this test be performed on all feline patients at least once in their lives because Feline Leukemia and Feline Immunodeficiency Virus (Feline Aids) are viruses for which no cure exists. Please ask questions if you would like to learn more about Feline Leukemia and Feline Aids.

  • Surgical Information


    PLEASE READ CAREFULLY


    Anesthetic Procedure


    We use a combination of pre-anesthetic medications/injectable and/or inhalant anesthetics to achieve optimum levels of anesthesia and pain control that are safe for your pet. For short procedures, an injectable anesthetic is given alone that produces a good plane of anesthesia with a quick recovery. For most procedures, your pet is anesthetized and then intubated (insertion of a tube into the trachea or wind pipe). This will ensure that your pet is able to receive oxygen at all times and prevents aspiration of any fluids into the lungs. Anesthesia is maintained with a gas anesthetic, Isoflurane, which is very safe. Our experienced veterinary technicians will adjust the anesthesia as directed by the veterinarian. Only a licensed veterinarian is allowed to perform surgery.


    Monitoring & Pain Management


    Throughout their procedure and stay, your pet will be closely monitored by an experienced technician who will utilize our state of the art monitor that records heart rate, pulse rate, oxygen levels, respiration, ECG, and core body temperature. They will assist and alert the veterinarian of any issues before, during, or after the procedure. We strongly believe in compassionate, quality, medical care for our patients. As a result, all surgery patients will receive pain management before, during, and after surgery as needed. Additionally, pain medication may be prescribed to go home. Additional information will be given at discharge. We hope this protocol will reduce any discomfort experienced and aid in a quicker recovery.


    Intravenous Catheterization & Fluids


    For most procedures, an intravenous catheter and fluid therapy will be administered to help support blood pressure, hydration, aid in anesthetic recovery, and have quick access to the circulatory system in case of an unforeseen emergency. We will have to shave a small patch of fur on your pet’s leg to do so.


    Potential Risks/Complications for Common Surgeries


    Spay: Bleeding, Infection, Suture Material Reaction, Recurrent Heat, Urinary Incontinence, Weight Gain


    Neuter: Bleeding, Infection, Scrotal Swelling, Suture Material Reaction, Weight Gain


    Tumor/Lump Removal: Bleeding, Infection, Swelling and Drainage, Tumor Re-growth, Suture Material Reaction


    It is important for you to understand that there is always a risk of anesthetic and surgical complications anytime these procedures are performed. We strive to take the highest quality care of your pet and take all the added precautions you allow to avoid potential problems. Thank you for entrusting your pet’s care to us.

  • Clear
  • Should be Empty: