Mobile Veterinary Surgeon Dr. Paul Newman 615-519-0647
Carpal/Tarsal Luxation Consent Form
Your pet has been diagnosed with a luxated joint. Whenever ligaments are torn in the carpus or tarsus, conservative treatment with splints and casts is seldom successful. In most cases, radiographs alone are insufficient to diagnose the full extent of the injuries. Some cases need careful palpation of the joint under anesthesia while others require surgical exploration to visually examine the long and short ligaments on both side of the joint. Surgical repair of the torn ligaments is the best course of action for these injuries. In most cases, in addition to attempting to suture the torn ligaments, additional support is needed by placing an artificial ligament through bone tunnels or metal bone anchors placed across the joint. The joint must be immobilized after the surgery with a cast or custom molded splint for 4-6 weeks and in some cases, a trans-articular external fixator. This is followed by a firm padded bandage for another 2-4 weeks. Strict confinement to a leash with no running, jumping, or playing is critical to the success of the surgery and to minimize “cast disease” (see bandage handout). After 8 weeks, a slowly progressive increase in exercise is then allowed starting with leash walking and progressing to short periods of free exercise. This is slowly increased in intensity for another 4-6 weeks at which time most patients are able to return to near-normal activity. On occasion, despite our best attempts, the ligament repair is unsuccessful or arthritis develops which necessitates a second surgery where the joint is “fused” in a normal walking position. If your pet has a “shearing injury” of the tarsus where the bones on the inside of the joint are worn off by friction on pavement (usually hit by car), multiple surgeries are usually necessary to deal with the soft tissue damage. The average patient requires 1.7 procedures for shear injuries but 91% have good to excellent outcomes.
After fully discussing the planned surgical procedure and associated risks with your doctor or the surgeon, please sign the consent for surgery below.
The undersigned owner or authorized agent of admitted patient ______hereby authorize the admitting veterinarian (and his/her designated associates or assistants) to administer such treatment as is necessary to perform the below-mentioned procedure. The nature of the procedure(s) has been explained to me and no guarantee has been made as to results or cure. I understand that there may be risk involved in these procedures.
I consent to the administration of such anesthetics or tranquilizers as are necessary.
Anesthetic Risks: (Although every effort is made to make anesthesia as safe as possible including vital sign monitoring and use of the most up to date anesthetic agents and equipment, I understand that anesthesia carries inherent risks) The incidence of complications from anesthesia are extremely low and we do not anticipate any complications in your pet but on rare occasions the following can occur:
1. Allergic reaction to the anesthetic agents
2. Heart rhythm abnormalities
3. Untoward reactions to the gas including drops in blood pressure or respiratory difficulties
4. Just like in humans, on very rare occasions, general anesthesia can result in death.
We are prepared and will treat any anesthetic reactions if they occur, but general
anesthesia is never completely without risk.
Procedure: Carpal/Tarsal Ligament Reconstruction; Casting/Splinting/Trans-articular External Fixator Placement with Hinge for additional support; Epidural Anesthesia For Rear Leg Injuries
Surgical Risks Include:
1. Infection (less than 3%) which may require additional testing and medication at an additional cost.
2. Failure of the artificial ligament (usually due to over activity)
3. Premature pull out of the bone anchors if used
4. Suture reaction (rare) necessitating early removal of the suture.
5. Arthritis of the joint that may require fusion of the joint at additional cost
6. Loss of range of motion of the joint and a slight limp
7. Failure of the repair necessitating fusion of the joint at additional cost
8. Skin sores from the cast/splint
9. Fixator pin complications (infection, loosening, breakage) if utilized
10. Epidural complications are extremely rare but include transient (temporary) urinary retention, allergic reaction, itching at site of injection, infection and transient rear leg weakness for 1-2 days.
Strict adherence to post-surgical care and medicating of your pet will minimize these potential complications and serious problems are very uncommon in most cases.
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Date Pet Owner/Agent Signature
Client Information Series # 77