Your pet is having an echocardiogram examination today, which your family veterinarian has requested. The echocardiogram examination will be done to look for any abnormalities in your pet. Typically, your pet will be taken to have the echocardiogram while you wait. Occasionally, you may be asked to leave your pet for a longer period of time.

Any medical procedure can have complications. Complications of echocardiogram examinations are very rare. Examples of risks of sedation, if necessary, include hypotension and drug reaction. Some medical conditions/diseases may put your pet at risk for complications if they need to be sedated. Examples of such conditions include: heart, kidney or liver disease, neurologic conditions that can cause seizures, certain types of cancer, pancreatitis, anemia, and excessively high or low blood pressure, among others. If you have any concerns regarding the above risks, please discuss with your family veterinarian.

Please affirm below that you understand the procedures to be done and the possible risks and complications (see below).

I give consent for the procedure and am aware of the following:

• Your pet may be clipped (shaved) for the procedure.
• As with all diagnostic procedures, echocardiograms may not always provide a diagnosis.
• All communication will be through your family veterinarian.
• If we are concerned about your pet and have to get the doctor more involved, there will be additional charges.
• All results and recommendations will come from your primary care vet 7 to 10 days after the test.
• The cost of the outpatient echocardiogram is $525. Payment is taken at the time of check in. Skyline does not allow payment plans nor do we accept checks.

Following the procedure today please contact your family veterinarian to discuss the results and plan.