Canyon Veterinary Hospital Dr. Thomas S. Jenkins, D. V. M surgical Options Form



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Canyon Veterinary Hospital

Dr. Thomas S. Jenkins, D.V.M

Surgical Options Form
******These are all Extra Options other than your Procedure Cost******
Pre-Anesthetic Blood Work

This blood panel tests the body’s functions (liver and kidney functions) as well as a CBC (complete blood count). These blood tests will ensure that your pet is healthy enough to undergo an anesthetic procedure. These tests will not guarantee the absence of anesthetic complications. The cost of the Pre-Anesthetic Blood work is: $ 136.22

______ YES, Please complete the Pre-Anesthetic Blood Work.

______ NO, do not complete Pre-Anesthetic Blood Work.


IV Catheter and Fluids

The catheter and fluids are used to regulate the blood pressure during the surgical procedure. The cost of the IV catheter and IV fluids are: $ 60.70.

_____ YES, please place an IV catheter and run IV fluids.

______ NO, do not place an IV catheter and run IV fluids.
Ultrasonic Dental Cleaning and Polishing

While your animal is under anesthesia, we recommend completing a routine dental cleaning. We clean and polish the teeth, check for any extractions or any sign of dental infection. The cost for the dental cleaning and polishing is $45.00. If there are any needed extractions, additional costs will be incurred.( May not be possible with all other surgical procedures).

______ YES , please complete a routine dental cleaning and polishing.

______ NO, do not complete a routine dental cleaning and polishing.
Dental Extractions

While under anesthesia, Dr. may recommend one or more dental extractions or your pet. The estimated additional cost will be provided before the extractions take place.

______ I authorize for the extractions to go ahead and take place.

______ Please call me before any extractions are performed.


Dental Laser Treatment

While your animal is under anesthesia, we recommend completing a dental laser treatment. Laser therapy can be used to kill the bacteria under the gum line to prevent gingivitis and periodontal disease, decrease pain, and decrease gum inflammation. The cost for the dental laser treatment is : $ 15.00.

______ YES, please complete a dental laser treatment.

______ NO, do not complete a dental laser treatment.

Check, Ears and Medicate

We will look down into your animal’s ear canal while they are under anesthesia and we will check for any fox tails, foreign bodies and we will also check for infection. The cost for this option is: $ 16.00.

_____ YES, please check and medicate my animal’s ears.

______ NO, do not check or medicate my animal’s ears.
Anal Gland Expression

This allows us to empty your pet’s anal glands while they are under anesthesia.



The cost for the expression is: $ 22.48

______ YES, please empty my pet’s anal glands.

______ NO, do not empty my pet’s anal glands.
Additional pain Medication to go Home

This is additional oral liquid or tablets sent home with you to relieve pain. This medication will provide extra pain relief for 5 days after the surgical procedure. The cost for the pain medication ranges between: $ 15.94-$ 80.00

_____ YES, please send home additional pain medication or my animal.

_____ NO, do not send home additional pain medication or my animal.
Home Again Microchip System

If your pet is lost or stolen, this ensures that we are able to locate and contact you, the owners. It is a simple injection of the microchip in the back of the neck, between the shoulder blades. The cost for the microchip and insertion is: $ 45.00 PLUS a separate payment of $ 17.99 to the Home Again Company for the annual registration of the microchip.

_____ YES, please Microchip my animal.

_____ NO, do not Microchip my animal.
Toe Nail Trim

This allows us to trim your animal’s toe nails while they are under anesthesia.



The cost for the toe nail trim is: $ 8.00.

_____ YES, please trim my animal’s toe nails.

_____ NO, do not trim my animal’s toe nails.
Post-Surgical Laser Treatment

While your animal is under anesthesia, we recommend completing a post-surgical laser treatment being done to the surgical site. Laser therapy can be used to help inflammation, decrease pain, and increase healing. The cost for he post-surgical laser treatment is : $ 15.00.

_____ YES, please complete a post-surgical laser treatment.

_____ NO, do not complete a post-surgical laser treatment.



Vaccines

While the patient is recovering from anesthesia, we can give the needed vaccines.
_____ YES, give my dog the Distemper/Parvo Vaccine: $ 28.00 ( additional $ 5.00 with Lepto )
_____ YES, give my dog the Rattlesnake (to increase the chance of survival and lower the veterinary cost if bitten, not effective against Mohave Greens). Vaccine: $ 25.00
_____ YES, give my dog the Lyme ( a disease transmitted by ticks ) Vaccine: $ 25.00
_____ YES, give my dog the Bordatella ( Kennel Cough ) Vaccine: $ 19.75
_____ YES, give my animal the Rabies Vaccine: $ 18.00
_____ YES, give my cat the FDCVR Vaccine: $ 15.00
_____ YES, give my cat the Feline Leukemia Vaccine: $ 26.00
_____ NO, do not vaccinate my animal.

Animal’s Name: _______________________________ Surgical Procedure: ________________________________


Signature: ______________________________________ Date: _______________ Employee: _________________


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