THIS SECTION OF THE CONSENT PROCESS CONSISTS OF 2 PARTS: THE NATURE OF THE PROCEDURE AND THE RISKS OF THE PROCEDURE
We consider brachycephalic dogs a high risk population. Please be sure that you have considered and talked with your pet’s doctor about the following:
1. Any medical and/or surgical treatment alternatives for your pet
2. The details of this consent form below and how they apply to your dog
3. How fully your pet might respond or recover and how long it could take
4. The most common complications and how serious they might be
By proceeding with this form, reading and signing it, you acknowledge that you understand that informed consent is a process, and apart from this form and discussion with SCV staff today, you have had the opportunity to consider the risks and benefits of the procedure. This may have included participating in social media group discussions, reading information on our website, anecdotal discussions with other owners and possibly discussion during the BAS breathing assessment consult or virtual consult (if you had one).
Part 1: Nature of procedure
This part of the consent form is necessary as there is a lot of varying opinions about what components of BAS should occur.
Your pet may have a lateral x ray prior to proceeding with surgery, depending on surgeon preference.
I understand that each airway surgery is different due to each animal’s anatomy being different and so authorise the surgeon and associates at Southern Cross Veterinary Clinic to perform whichever of above they feel is justified and warranted.
Part 2: Risks of the procedure
I am aware that my pet has physical characteristics that make anaesthesia and sedation more challenging and more risky than for the average dog with a longer nose.
The following are some of the components of the deranged anatomy in brachycephalics and are all possible to address with BAS surgery:
- Stentotic nares
- Enlarged tonsils
- Long soft palate surgery
- Thick soft palate surgery
- Exerted laryngeal saccules
- Swollen and thickened sinuses (diagnosed on CT)
Which of the above we do depends on each case and is decided during the BOAS surgery itself.
Normally (1) (3) is always addressed (5) (6) (2) are addressed if they are present. (4) done if x-ray shows thickened soft palate.
Your pet may have a lateral x ray prior to proceeding with surgery, depending on surgeon preference.
I understand that each airway surgery is different due to each animal’s anatomy being different and so authorise the surgeon and associates at Southern Cross Veterinary Clinic to perform whichever of above they feel is justified and warranted.
Part 2: Risks of the procedure
I am aware that my pet has physical characteristics that make anaesthesia and sedation more challenging and more risky than for the average dog with a longer nose.
I am aware that brachycephalic breeds, such as the English and French bulldog, Boston Terrier, Pug, and Pekingese have a shortened skull, resulting in a compressed nasal passage and abnormal throat anatomy. The abnormal upper airway anatomy causes increased negative pressure while taking a breath, leading to inflammation, deformation of throat tissues, and obstruction of breathing.
I have been offered by Southern Cross Vet the anaesthesia service with Sydney Veterinary Anaesthesia to provide a veterinary anaesthetist to monitor my pet and the importance of this and I have elected to PROCEED with this option.
I am aware that if my brachycephalic pet undergoes sedation or general anaesthesia the potential complications in addition to the anaesthesia for another condition include:
Partial or complete airway obstruction during recovery which could lead to the insertion of a temporary tracheostomy tube to allow breathing and to facilitate the safe recovery of your pet until the inflammation of the surgery site diminishes.
Regurgitation/vomiting which could lead to aspiration pneumonia that could result in a lengthy hospitalisation
Haemorrhage, gagging, or coughing from the soft palate bleeding or swelling can occur immediately post-operatively necessitating re-anesthetizing your pet and temporary intubation.
Dehiscence (breakdown) of the Caiman-sealed soft palate can occur which requires suturing and another anaesthesia a few days after surgery
Dehiscence (suture breakdown) of the stenotic nares resection can occur if your pet frequently licks or rubs his/her nose. Healing will then occur by second intention leaving a pink scar of depigmented tissue. If your pet is not a show dog, this complication is negligible as the pink scar is usually temporary and mostly cosmetic in concern
Scarring or stenosis after laryngeal saccule resection (if your pet has it performed) can cause voice changes, loss of bark, respiratory noise, or progressive signs of upper airway obstruction.
I have been advised that all of the above complications are extremely rare, and while Southern Cross Vet will do everything to prevent complications, I know that it is not possible to predict how likely it will be that my pet experiences one of the above. This is because each pet responds differently to surgery, just like humans do.
I have been informed that all of the above may require transfer to a 24 hour emergency clinic for observation and management and this would incur additional costs at your expense.
With airway surgery, Southern Cross Vet has not experienced a fatality, death has been reported in the literature in Australia and overseas as a possible but rare complication. This varies between 0% and <3% of brachycephalic airway surgery cases.
I understand that there are other surgeons in small animal available in the area and have had the opportunity to seek a second opinion and am satisfied with the level of care and experience that Southern Cross Veterinary Clinic has.
THIS SECTION OF THE CONSENT FORM RELATES TO THE POST-SURGERY MONITORING OF YOUR PET
For the monitoring post op overnight I have been given the following options and have selected the option circled below:
1. I will monitor my pet at home and be in contact with clinic with any concerns
2. I will allow Southern Cross Veterinary Clinic to transfer my pet to their Surry Hills location where Dr Viktoria will monitor periodically, not intensively, through the night. There is no additional cost for this option.
3. I request that Southern Cross Vet will make arrangements for The University Veterinary Teaching Hospital to monitor my pet intensively through the night. I understand there will be additional costs for me to discuss with the University for this option.
I have read the above, understood it and I authorise the surgeons and/or associates of Southern Cross Veterinary Clinic to perform surgery on my pet.
I hereby certify that I am the owner of the below-named animal or am responsible for it and have the authority to execute this consent. I hereby authorise the performance of the following procedure(s):
General anaesthesia and Brachycephalic Airway Surgery (Could include: stapphyllectomy, nares widening, sacculectomy (if present), palate thinning (if neccessary), tonsillectomy (if required).