Round Rock Animal Hospital 404 Chisholm Valley Drive Round Rock, Texas 78681

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1 404 Chisholm Valley Drive Round Rock, Texas Dennis Sundbeck, DVM David Hocher, DVM Regina Bohmfalk, DVM Lauri Mendelzon, DVM Phone: Fax: Your pet is scheduled for an anesthetic procedure. This procedure will require general anesthesia. Please take a few minutes to read the enclosed brochure and form regarding pre-anesthetic testing. Make your choice regarding this testing and bring the completed form with you when you drop off your pet the morning of the procedure. In addition, to pre-anesthetic testing the doctors recommend the placement of an IV catheter for the administration of fluids and electrolytes during the surgery or dental procedure. These fluids can help prevent the lowering of blood pressure during anesthesia and can help flush out bacteria that may enter the blood stream during the plaque removal phase of dental cleaning. The catheter also allows easy administration of emergency medications, should this unlikely need arise. The catheter is optional for routine procedures, but may be required by the doctor should they feel it is important. It is highly recommended for pets over 8 years of age. If you have any questions, please contact one of our veterinary technicians. Thank You, Round Rock Animal Hospital

2 Help us keep your pet healthy with pre-anesthetic testing. To ensure your pet can properly process and eliminate an anesthetic, we run tests to confirm that your pet s organs are functioning properly and to find hidden health conditions that could put your pet at risk. The top FOUR reasons to test your pet before anesthesia: 1. Enjoy peace of mind. Testing can significantly reduce medical risk. 2. Detect hidden illness. Healthy-looking pets may be hiding symptoms of a disease or ailment. Testing helps detect this kind of illness so we can avoid problems with anesthesia. 3. Reduce risks and consequences. If the pre-anesthetic testing results are normal, we can proceed with confidence. If not, we can alter the anesthetic procedure or take other precautions to safeguard your pet s health. 4. Protect your pet s future health. These tests become part of your pet s medical record, providing a baseline for future reference. To help ensure safe anesthesia for your pet, we will run a combination of the following tests. Hematology Complete Blood Count (CBC) A CBC provides detailed information about red blood cells, white blood cells and platelets. The total white blood cell count, along with individual leukocyte counts, can help identify underlying stress, inflammation, an inability to fight infection and potentially, leukemia. Low platelet numbers can indicate a potential bleeding problem. We might advise that surgery be delayed if anemia, inflammation or especially a low platelet count is present because these conditions could cause serious surgical complications. Blood Chemistry Alkaline Phosphatase (ALKP) An enzyme present in multiple tissues, including liver and bone. Elevated levels can indicate liver disease, Cushing s syndrome or steroid therapy. Total Protein (TP) The level of TP can indicate a variety of conditions, including dehydration, inflammation and diseases of the liver, kidney or intestine. Blood Urea Nitrogen (BUN) BUN is produced by the liver and excreted by the kidneys. Abnormally high levels can indicate kidney disease or dehydration, and low levels can be associated with liver disease. Alanine Aminotransferase (ALT) An enzyme that becomes elevated with liver cell injury. Creatinine (CREA) Creatinine is a byproduct of muscle metabolism and is excreted by the kidneys. Elevated levels can indicate kidney disease, urinary tract obstruction or dehydration.

3 Blood Glucose (GLU) High levels can indicate diabetes. In cats, high levels can also indicate stress, which can be a result of the trip to the veterinary hospital. Low levels can indicate liver disease, infection or certain tumors. Albumin (ALB) A protein that is produced by the liver. Reduced levels of this protein can point to chronic liver, kidney, inflammatory or intestinal disease. Cholesterol (CHOL) Elevated levels of cholesterol are seen in a variety of disorders, including hypothyroidism and liver or kidney disease. Total Bilirubin (TBIL) Bilirubin is a breakdown product of hemoglobin, as well as a component of bile. Blood bilirubin levels are useful in indicating liver disease and may help identify certain types of anemia. Amylase (AMYL) An enzyme produced by the pancreas. The pancreas secretes amylase to aid in digestion. Elevated levels in the blood can indicate pancreatic disease. Phosphorus (PHOS) Elevated phosphorus can be an indicator of kidney disease. Calcium (Ca+) Increased levels can be seen with diseases of the parathyroid gland and kidneys, or as an indicator of certain types of tumors. Electrolytes Sodium, Potassium, Chloride (Na+, K+, Cl-) The balance of these electrolytes is vital to your pet s health. Abnormal levels can be life-threatening. Electrolyte tests are important when evaluating vomiting, diarrhea, dehydration and cardiac (heart) symptoms. Suggested Pre-anesthetic Testing Guidelines Youth (<1 year) Healthy Adult (1 7 years) Healthy Senior (+7 years) Sick all ages * We will administer a sedative if your pet is too anxious or overactive for this procedure.

4 404 Chisholm Valley Dr. Round Rock, TX D.M. Sundbeck, DVM Phone: D.A. Hocher, DVM Fax: R. Bohmfalk, DVM L. Mendelzon, DVM Dear Client, We now offer two microchips for you to choose from. The Home Again and Datamars microchip systems provide a 24 hour retrieval system involving veterinarians, animal shelters, humane societies and animal control agencies. The Home Again microchip has a $17.99 annual membership fee. With the annual $17.99 membership you receive lost pet alerts, access to 24 hour emergency medical phone care, and lost pet insurance. The Datamars microchip offers a conventional retrieval system during the event of an involuntary separation from your pet. There is no registration fee for this microchip. The cost for either microchip is $53.00.

5 Pre-operative Blood work Form Owner s Name: Pet s Name: Date: Please Read Carefully and Sign. Your pet is scheduled for anesthesia/surgery. Please remember your pet should have no food after 10PM the night before the scheduled procedure. Your pet can drink water-freechoice. We need to have your pet here the morning of the procedure by 8AM unless other arrangements have been made in advance. We recommend a blood profile to ensure that your pet is in a low risk category prior to anesthesia. The latest technology has enabled us to run safe and accurate blood chemistries minutes before anesthetic induction. These tests are similar to those your own physician would run were you to undergo anesthesia. In addition, the results of these tests will serve as reference values for future use should your pet become ill. The cost for these tests is in addition to the cost of the surgery. Profile #1 Cost = $23.62 PCV (assesses anemia) Profile #2 Cost = $36.67 Complete blood count (assesses anemia, infection) Profile #3 Cost = $60.15 Complete blood count BUN (kidney) ALT (liver) Electrolytes Profile #4 Cost = $90.37 all the tests in Profile #3 Plus: Glucose (sugar) Creatine (kidney) Albumin (protein) ALK (liver) Phosphorous (kidney) Calcium (certain cancer) Cholesterol Bilirubin (liver) Amylase (pancreas) Globulin (immune status) Though you may choose any of the profiles regardless of your pet s age, we generally recommend the more extensive profiles for the older pets. Profile #1 Profile #2 I do not want any tests performed Profile #3 Profile #4 I would like I.V. catheter placement and fluid therapy for my pet during surgery. $38 I would like the Home Again Microchip for my pet. I would like the Datamars Microchip for my pet (formally ResQ). Surgery release and Authorization I hereby authorize the doctors at Round Rock Animal Hospital to perform surgery on my animal. I understand that this procedure necessitates the use of general anesthesia and that there is some inherent risk involved. Signature of Owner Date