Rabbit Pre-Anesthesia Consent Form Client/Patient InformationClient's NamePatient's NameYour E-mail AddressPrimary Contact NumberBy signing this form, you authorize the doctor to treat your pet as necessary should he/she be unable to contact you at the number(s) provided above.Procedure(s) to be performed todayChecklist (ALL MUST BE CHECKED!) Patient has no history of seizures. Patient has no history of adverse drug reactions. Patient has been eating and drinking normally. Patient has no other signs of illness.Pre-Anesthetic Blood Work At Cheat Lake Animal Hospital, we strive to practice quality medicine. Human hospitals require laboratory testing before anesthetic procedures to proceed in the safest manner possible. We STRONGLY RECOMMEND that pets are also properly screened. The results of blood work screening can warn us about underlying conditions that could lead to possible complications. We are especially concerned with the condition of the liver and kidneys as these are primary organs that metabolize anesthetic drugs. Listed below is a description of blood work we offer. Please check the level of screening that you would like for your pet. FOR ALL ANIMALS, a PCV and Total Protein are required. *Note that several of the laboratory tests done in rabbits need to be sent to an outside lab. If you choose these screening tests, you will need to bring your rabbit into our hospital several days before the scheduled procedure so that the results will be returned before the date of the procedure. Please select bloodwork(s) to be done: PCV/Total Protein:Indicates oxygen levels for healing. REQUIRED MINIMUM Blood Glucose:Measures the blood sugar. Chemistry Profile:Checks kidney and liver functions, blood glucose, and electrolytes. HIGHLY RECOMMENDED for pets over 4 years of age. CBC:Indicates immune function, platelet status for blood clotting during surgery, and oxygen carrying capacity. (Includes PCV) Full Panel Chemistry Profile and CBC:Gives the most information on the health of your pet.SPECIAL NOTES, PLEASE READ: Rabbits cannot vomit, therefore fasting is not mandatory. Your rabbit may have food and water until admission into the hospital on the day of surgery. We like to see rabbits eating and drinking as soon as they are awake from surgery. If your rabbit drinks from a bottle, please let us know so that we can provide one after recovery from anesthesia. We offer timothy hay post-surgery. You are welcome to bring hay that your rabbit prefers or leafy greens to be offered after recovery from anesthesia. It is essential that rabbits eat, drink and defecate normally within the first 24 hours after a surgical procedure. For this reason and for the comfort of your rabbit, pain medication is required for rabbits. Please give this medication as directed. If your rabbit has not had a physical examination by our veterinarians within a 3 month period, for safety he/she will need to be examined prior to anesthesia at a pre-surgical exam fee. If parasites (fleas, ear mites, cheyletiella mites, etc.) are found on your pet while visiting our facility, we will treat the pet with necessary treatment at the owner’s expense for the protection of your pet and that of others in the hospital. Clients that are having their female rabbit spayed should be aware that if she is pregnant, the fetuses will be aborted during the surgery. There is an additional charge for spaying a pregnant animal. Anesthesia agents are considered very safe, although there is always risk involved with anesthesia and surgery. Rabbits often become significantly stressed in the hospital setting. This may negatively impact your rabbit's anesthesia. Their small chest cavity also increases the risk of anesthesia when compared to dogs and cats. We will strive to provide the safest anesthesia possible for your rabbit. The Cheat Lake Animal Hospital will not be held responsible for any reactions your pet may have to these medications. By signing below, you are giving consent to the veterinarians of the Cheat Lake Animal Hospital to anesthetize and perform the above listed procedures and acknowledge that you understand the special notes explained. Your rabbit should be dropped off for his/her procedure between 7:30 am and 9:00 am. This allows our veterinarian and technicians to begin any blood work or pre-operative procedures that your rabbit may need. Your rabbit's procedure will be performed between the hours of 10:00 am and 3:00 pm depending on the veterinarian's surgery schedule. We ask that you call our office around 2:30 pm-3:00 pm on the day of your rabbit's procedure to check on him/her and at that time we will update you on your pet's recovery and schedule a time for your pet to be discharged.Advance Directive for Resuscitation To provide the safest anesthesia for your pet, we perform a thorough pre-surgical examination and recommend pre-anesthetic bloodwork. During anesthesia your pet is being continuously monitored by a nurse anesthetist in addition to the use of a heart and ECG monitor. Despite all of the precautions we take, anesthesia is never completely without risk. For this reason, we ask all clients about their wishes regarding CPR. Our hospital mission is to provide the best care for your pet and to update you regarding any changes in the condition of your hospitalized pet. In the event of a life threatening situation, we will contact you immediately. Please advise us whether you would wish CPR (cardiopulmonary resuscitation) to be performed on your pet: Yes, please perform CPR in the event that it becomes necessary for my pet. No, please do not perform lifesaving measures. Do Not Resuscitate.I have read and understand the above information.Signature of owner or agent Sign Here Submit Form