201 Ky. Admin. Regs. 16:702

Current through Register Vol. 51, No. 6, December 1, 2024

Section 201 KAR 16:702 - Standards for veterinary surgery

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.

201 KAR 16:702

50 Ky.R. 520, 1312, 1484; eff. 4/2/2024.

STATUTORY AUTHORITY: KRS 321.175, 321.235(2)(b) 3.c.