I hereby decline the blood work my veterinarian has recommended every 6 months in order to maintain my animal on prescription medication. I understand the medication my animal is taking may have harmful side effects after prolonged use. I understand the blood work recommended would alert me to any of those harmful side effects before the medication did any permanent damage.
Medication(s): Felimazole, Methimazole Transdermal, Y/D
Wellness testing recommended: THYROID MONITORING PANEL – includes a chemistry profile, CBC (complete blood count) and T4.
Recommended every 6 MONTHS
Risks associated with medication: pruritus, low white blood cell count, anemia and iatrogenic hypothyroidism.
Discernable adverse effects: vomiting, anorexia, depression, pruritus and lethargy.
I am aware of the consequences by not performing this blood work. My veterinarian or representative has spoken with me at length about these risks and has answered al of my questions regarding my pet’s condition and the medication. I will make my veterinarian aware if any of these adverse effects occur and understand that blood work may need to be done at that time.
