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West Houston Veterinary Medical Associates Anesthesia Consent Form

I hereby consent and authorize the performance of the following procedure(s) on my pet,
At West Houston Veterinary Medical Associates, we use the safest anesthetics and sedatives available in veterinary medicine. Every pet under anesthesia is continuously monitored with an EKG, respiratory monitor, and blood pressure reading to quickly alert us to any potential problems. We also use a pulse oximeter that monitors the amount of oxygen circulating throughout the tissues. Isoflurane and Sevoflurane are some of the safest inhalant anesthetics and are the most commonly used in human medicine. They are rapidly removed from the body and have minimal effects on the heart and respiration.
Listed below are the items that are included in our anesthetic package for your pet’s health and safety:
Pre-Anesthetic Blood Profile:
We believe every pet undergoing an anesthetic procedure should have a pre-anesthetic blood profile, which alerts us to any underlying internal conditions that are undetectable on external examination. This profile screens for diabetes as well as assessing the live and kidney function of your pet. If we have not done bloodwork in the last thirty (30) days, this pre-anesthetic blood profile will be processed prior to your pet’s procedure.
IV Catheter
Fluid therapy is given during the anesthetic procedure as it helps maintain a constant blood pressure and keeps vital organs such as the kidneys well hydrated. An IV catheter will be placed before the anesthetic; IV fluids will be given to ensure proper hydration. Although we do not anticipate and complications, having an IV catheter in place also assures that our veterinary staff has quick access to administer any drugs that may be needed.
Pain Management
Research shows that pets recover from procedures faster, and have fewer complications, when pain and stress are minimized. Our post-operative pain management package includes an injection given before the procedure, and oral medications to be given at home.
Dental Cleaning – at the time of surgery
I would like the doctor to examine my pet’s teeth and if needed have a nurse perform ultrasonic cleaning and polishing of the teeth. Combining this dental with other procedures not only prevents my pet from undergoing a second anesthetic procedure at a later date but will also save a considerable amount on cost. The estimated cost for dental cleanings are based on the grade of your pet’s teeth and can range anywhere from $600 to $800 (extractions and medications are not included.)

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Extractions | Periodontal Therapy | Dental X-Rays
During a dental cleaning after removing the tarter, it may become evident that the gums are badly infected, or the tooth has abscessed at the root and may have sustained bone loss. Any diseased teeth affecting the health of the pet will be removed unless declined by the owner and against the medical advice of the veterinarian. Dental x-rays taken at this time could mean the difference between saving the tooth or extracting it. In addition to the dental, an antibiotic injection as well as an antibiotic prescription may be needed to control the infection. ** If antibiotics are needed, we will call you with an estimated cost for the injection along with the additional medications needed. **

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Sanos Sealant - $84.00
A dental barrier sealant designed for both cats and dogs to help keep the oral cavity clean and extend the benefits of a dental cleaning.

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Growth Removal
Some lumps and bumps can be cancerous. Surgical removal and a histopathology report are highly recommended to aid in early detection and control. (Costs vary by size and range from $225 to $400 and does not include biopsy)

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Microchip - $112.00- comes with lifetime registration.
A pet identification chip can be placed while your pet is here today. The chip is implanted via a quick injection and is a permanent means of identification that will stay with your pet throughout his/her life. The cost of this process is $101.25, which includes a lifetime registration with the national database. I would like to have a Home-Again Microchipped placed during this procedure.

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Senior Pet Cancer | Arthritis Screen - $225– valued at $558 (Pets 7 years and older)
Our senior pet cancer and arthritis screen includes x-rays of the chest and abdominal cavity as well as the bones and joints most commonly affected by arthritis. An ultrasound sound screening of the chest, abdomen and major organs is also included.

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Young Pet Preventative Medical Screen - $225 – valued at $558 (Pets under 7 years of age)
Our young pet preventative screening includes x-rays of the chest, abdomen, along with the bones and joints. An ultrasound screening of these areas along with the major organs is also included.

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Ear Flushing with Auriflush - $65.00
If your pet has a history of ear infections or allergies, we can remove accumulated wax, hair, and infectious matter at the time of the procedure.

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I understand that during the performance of the foregoing procedure, unforeseen conditions may be revealed that require and extension of the procedure or operation, or a different procedure than those set forth above. Therefore, I hereby authorize and consent to the performance of such procedures as they are necessary and desirable in the exercise of the veterinarian’s professional judgement. I also authorize the use of appropriate anesthetics and any other medication, and I understand that the hospital support staff will be used as deemed necessary by the veterinarian. I have also been advised as to the nature of the procedures and the risks involved. I realize the results cannot be guaranteed. ** We will call or text you an update as to when your pet is out of surgery as well as to confirm when he or she will be ready to pick up **

Phone number to text updates

Signature of Owner

Signature

Alternative daytime phone number