Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO:
KRS
321.175,
321.190,
321.193,
321.441,
321.443
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
321.175 establishes that the Kentucky Board
of Veterinary Examiners shall protect the public by ensuring only qualified
individuals are allowed to practice veterinary medicine in the Commonwealth in
the interest of the health, safety, and welfare of the animal population and
the citizens of Kentucky.
KRS
321.235 requires the board to promulgate
administrative regulations in accordance with KRS Chapter 13A to effectively
carry out and enforce the provisions of this chapter.
KRS
321.190 and
321.193 establish that a license
is required for veterinarians to practice veterinary medicine in the
Commonwealth. KRS
321.441 and
321.443 establish that
veterinary technicians and veterinary assistants shall be properly supervised
when assisting a veterinarian with the practice of veterinary medicine. This
administrative regulation sets forth minimum standards for surgical procedures
to ensure the safety and welfare of animal patients, and provides confidence in
basic care and support for clients.
Section
1. Definitions.
(1) "Animal" is
defined by KRS
321.181(5).
(2) "Large animal" includes bovids, camelids,
cervids, equids, swine, or other animals ordinarily raised or used on a
farm.
(3) "Patient" is defined by
KRS
321.181(47).
(4) "Professional arrangements" means that
the veterinary facility where surgery takes place or the veterinarian who
performed surgery shall not list another veterinary facility as able to provide
services to a client unless they have previously confirmed that the alternate
veterinary facility is available to provide services. This shall not need to be
done on a case-by-case basis but may be professionally arranged in advance for
all clients.
(5) "Small animal"
includes any animal not within the definition of large animal, and regardless
of weight includes avians, canids, felines, rabbits, pocket pets, and other
animals typically kept as companion animals.
Section 2. All veterinary surgical procedures
performed in the Commonwealth shall comply with the following basic surgical
standards.
(1) If patients are housed or
retained for treatment in a veterinary facility:
(a) Appropriate housing shall be provided for
each patient before and after surgery; and
(b) Enclosures shall be secure and provide a
flat surface for the patient that is clean, dry, and warm with adequate space
for the patient to turn around, while allowing for safety at various stages of
sedation and anesthesia and sufficient visibility by the
staff.
(2) All drugs and
biologicals shall be labeled in accordance with
201 KAR 16:600, and procured,
managed, and disposed of in compliance with state and federal laws.
(3) During the postoperative period, care
shall be taken to provide patients with a smooth transition from the
anesthetized state.
(4) Plans shall
be in place to handle any emergency that might occur throughout the procedure,
and immediately postoperatively while the patient is with the veterinarian or
in the veterinary facility.
(5)
Immediately prior to release, patients shall be evaluated and deemed adequately
recovered, stable, mobile, and within normal physiological parameters following
anesthesia. A veterinarian shall use their best professional judgment and
medical training to make an appropriate determination about recovery for the
specific species and patient.
(6)
The client shall be provided clear instructions for postoperative care in
writing. For clients who are provided repeated services, a single instance of
written instructions may be provided during the term of the VCPR pursuant to
KRS
321.185.
(7) The client shall be provided options in
writing for follow-up or emergency care during the forty-eight (48) hour period
after surgery that includes information for a twenty-four (24) hour emergency
veterinary facility or with another veterinary facility where professional
arrangements have been made to see clients.
Section 3. Additional Requirements for Small
Animal Patients. All veterinary medical procedures performed on small animals
in the Commonwealth shall comply with Section 2 of this administrative
regulation and the following basic surgical standards.
(1) The operating area shall:
(a) Be dedicated to surgery while in use for
surgical purposes; and
(b) Contain
the necessary equipment for anesthesia, appropriate intubation, administration
of oxygen, and monitoring.
(2) A veterinarian and operating area
personnel shall establish, maintain, and comply with:
(a) Infectious disease protocols to be
performed in an environment to minimize infectious disease;
(b) Aseptic surgical technique
protocols;
(c) Sterile instruments
protocols ensuring separate sterile instruments to be used for each patient.
Cold sterilization shall not be an appropriate method to adequately sterilize
surgical instruments for small animals, except for cold sterilization for
endoscopic, laproscopic, and arthroscopic procedures. In these allowable
instances of cold sterilization, the method is permitted only by use of
FDA-Cleared Liquid Chemical Sterilants and High Level Disinfectants;
(d) Anesthetic protocols that are balanced
and include sedation, the provision of peri- and post-operative analgesia,
stress reduction, muscle relaxation, and controlled, complete recovery of
consciousness prior to discharge;
(e) Pre- and post-op monitoring protocols to
monitor patients; and
(f) Thermal
support protocols.
Section
4. Responsibility for Patient Care.
(1) During the forty-eight (48) hour period
after surgery, a client shall be provided information in accordance with
Section 2(7) of this administrative regulation.
(2) If there are no personnel on the premises
during any time a patient is left at the veterinary facility:
(a) Prior notice of this fact shall be given
to the client in writing and the notification recorded in the medical records;
and
(b) If requested, the client
shall be provided an option to transfer the patient care to a twenty-four (24)
hour facility.
Section
5. Large Animal Patient Standards and Exceptions.
(1) Field surgeries shall be performed within
an appropriate environment as possible.
(2) Appropriate cold sterilization is
acceptable in field work.
(3)
During the postoperative period, care shall be taken to provide patients with a
smooth transition from the anesthetized state. A veterinarian shall use their
best professional judgment and medical training to make an appropriate
determination about recovery for the specific species and patient.
(4) All drugs and biologicals shall be
labeled in accordance with
201 KAR 16:600, and procured,
managed, and disposed of in compliance with state and federal laws.
(5) Plans shall be in place to handle any
emergency that might occur throughout the procedure, and postoperatively while
the patient is with the veterinarian.
(6) The client shall be provided clear
instructions for postoperative care in writing. For clients who are provided
repeated services, a single instance of written instructions may be provided
during the term of the VCPR pursuant to
KRS
321.185.
(7) The client shall be provided options in
writing for follow-up or emergency care during the forty-eight (48) hour period
after surgery that includes information for a 24-hour emergency veterinary
facility or professional arrangements with another veterinary
facility.
STATUTORY AUTHORITY:
KRS
321.175,
321.235(2)(b)
3.c.
