Brachycephalic Form IntroductionThis resource is intended to inform you of potential risks related to: anesthesia, hospitalization and sedation for pets with brachycephalic features. It also provides Animal Eye Care with relevant information regarding your pets health status. While not every risk listed may apply to your pet, these conditions are more prevalent in short nosed breeds; and may become more apparent or worsened due to: stress, travel, or medical care.Name First Last What Does "Brachycephalic" Mean?The term "brachycephalic" refers to breeds (both cats and dogs) where the skull is shortened. Typically these individuals also have compressed, narrow airways. Breeds included in this designation are: Bulldogs (all), Shih Tzu Chow Chows, Boston Terriers, Pugs, Persian cats, Exotic Shorthairs, Himalayan, Scottish Folds and many others. Higher Risk for Brachycephalic PetsBrachycephalic pets have unique challenges when receiving veterinary care, including breathing difficulties that can be worsened by sedation, anesthesia, or restraint. These conditions may result in inflammation, airway obstruction, inadequate oxygen intake, stomach content aspiration, increased body temperature, and, in severe cases, fatal complications. Environmental factors, stress, and travel can further heighten these risks. While surgical procedures may help correct airway issues, they do not completely eliminate them.Pre-Procedure AssessmentPlease answer the following questions to help us assess your pet’s condition:Has your pet ever experienced difficulty breathing, loud snoring, intolerance to exercise, or episodes of collapse?(Required) Yes No Has your pet ever suffered from gagging, vomiting, or regurgitation?(Required) Yes No Has your pet been diagnosed with aspiration pneumonia?(Required) Yes No Has your pet undergone corrective airway surgery?(Required) Yes No Is your pet currently on steroid medication (e.g., prednisone) or a non-steroidal anti-inflammatory drug (NSAID) such as aspirin or Rimadyl?(Required) Yes No If you have any questions regarding the above, please discuss them with your veterinarian before proceeding.Acknowledgment & ConsentPlease read and initial the following statements to confirm your understanding of the risks involved:I understand that my pet’s physical characteristics may increase risks associated with sedation, anesthesia, and hospitalization.(Required)Initial I acknowledge that sedation and anesthesia may lead to complications such as breathing difficulties, aspiration pneumonia, airway blockages, and even death.(Required)Initial I understand that emergency interventions, including airway intubation, may be necessary.(Required)Initial I agree that my pet will be monitored in a specialized care unit following anesthesia or sedation, and I accept any associated costs.(Required)Initial I confirm that I have had the opportunity to ask questions and discuss potential risks with the veterinary team.(Required)Initial SignatureBy signing below, I acknowledge that I have read and understood this information and consent to the necessary treatments for my pet.(Required)Please SignDate(Required) MM slash DD slash YYYY
