Tag Archives: Anesthesia

Dental Care for Pets

Just like humans, pets require dental care. Preventative measures such as brushing teeth can help reduce or eliminate the need for more intensive dental cleaning. The need for dental care may vary given a pet’s age, species, breed, and diet. We hope this article will help you develop the best possible maintenance care routine for your pet, and understand what is involved in a veterinary dental check-up and cleaning. When teeth are diseased and painful, a veterinarian may elect to extract them, but many of the same techniques used to save a person’s tooth (root canals, caps, and periodontal surgery) can be applied to dogs and cats as well.

Preventative Care
It is easy to understand why preventative care is important for our pets’ teeth – the same is true for our own teeth! Residue of food (especially sugars/carbohydrates) left on the surfaces of the teeth after eating create a breeding ground for bacteria. A slimy layer of tartar develops first, and with time (just a few days!), this material becomes calcified. While the initial layer of tartar can be brushed away (as we do for ourselves once or twice daily), once this material becomes calcified, brushing can no longer remove it. This accumulation is what a human would have removed during their own routine dentist visits.

There are a variety of chew toys, dental treats, and water additives that can be used as a component of preventative dental care. There are two important factors to keep in mind:

1. Not every product that is marketed as a “dental” treat or toy is necessarilyvohc helpful. Anybody can make a treat in the shape of a toothbrush – that doesn’t mean it’s going to clean teeth!! Ask your veterinarian what they recommend. You can also check the package for the “VOHC Accepted” stamp – This means the product has been tested by the Veterinary Oral Health Council and demonstrated to be effective.

2. Dental treats, mouthwash products, and chew toys are not a complete substitute for brushing. Imagine if you used mouthwash every day, but never brushed your teeth. Your breath might smell better, but without the abrasive action of brushing, a lot of material would remain stuck on and between the surfaces of your teeth, ultimately leading to gum disease. Some pets may not tolerate having their teeth brushed, and for them, other dental products are the “next best thing.” Use them if they are helpful, or if they are all your pet will allow you to do. Please don’t expect them to do the brushing for you!

Is There A Problem?
Hints at trouble brewing in your pet’s mouth can include any of the following:

  • Bad breath
  • Redness at the gumline
  • Pawing at the mouth
  • Salivating excessively
  • Grinding teeth (especially in cats)
  • Chewing food on only one side of the mouth
  • Accumulation of tan/brown material (tartar or calculus) covering the surfaces of teeth and gums
  • Reduced interest in food (or more specifically, appearing excited about mealtime but then eating relatively little)
  • Teeth that are loose, severely worn down, broken apart, or appear discolored (especially a gray-brown color)
  • Severe pain upon opening the mouth

Pets who are especially at risk of developing dental disease include:

  • Pets who have not had preventative care
  • Older pets (over seven years old)
  • Dogs who spend a lot of time chewing bones, rocks, or hooves
  • Breeds with relatively short snouts, for example, pugs, bulldogs, shih tzus, and Persian cats.

What Happens During A Dental Cleaning?

A veterinary dental exam begins with a simple visual evaluation of the teeth and gums. Some pets will tolerate this initial examination while awake, others will not (especially if their mouth is painful). While a human can be told to remain still for an exam or have a procedure done under local anesthesia, a pet simply cannot be expected to cooperate and remain comfortable for a thorough dental cleaning (and treatment if necessary) without anesthesia.

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Many owners express concern at the need for anesthesia – especially given the fact that the pets who need dental care the most are often older! Your veterinarian understands your concerns, and certainly would not recommend a dental cleaning or procedure if they felt that your pet could not safely undergo anesthesia. There are many steps taken to minimize anesthetic risk and make sure the procedure goes without a hitch. Bloodwork will be done prior to the procedure to assure the pet is healthy enough to tolerate anesthesia. An initial dose of pain medication is administered before the procedure begins. While asleep, your pets’ heart and respiratory rate, blood pressure, heart electrical function, and depth of anesthesia are monitored continuously (we really mean continuously!! They receive IV fluids continuously, and IV medications if needed. A technician is literally sitting next to your pet monitoring them at every moment throughout the procedure). If any concern should arise – for example, low blood pressure, an arrhythmia, or a rapid heart rate – steps will immediately be taken to fix the problem.

sx18A dental cleaning and treatment procedure may take anywhere from 30 minutes to a few hours, depending upon the severity of the problems discovered. Depending upon what needs to be done, your pet may also be given nerve blocks (just like novocaine in human dental procedures) to assure they experience as little discomfort as possible following the procedure. Detailed records are kept of all procedures and treatments. X-rays are often taken to further evaluate any suspected problem areas, so that the teeth can be visualized below the gumline. The gums are examined for gaps around teeth (an indicator of disease), teeth may be extracted if issues identified cannot be fixed, the remaining teeth are cleaned (“scaled”) and polished, and antimicrobial products are applied. If teeth have been extracted, the gumline is generally sutured closed to cover the empty space (this is called a “gingival flap” procedure).

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Occasionally, very severe problems are identified (such as the need for a root canal), or a pet has experienced a traumatic injury to their face (such as being hit by a car and having a broken jaw). When necessary, a pet may be referred to a board-certified veterinary dentist/surgeon for an advanced level of care.

After waking up from anesthesia, your pet will remain in a recovery ward for the afternoon (or possibly overnight if they have had a more involved procedure). Careful monitoring assures they remain comfortable, and additional pain medication is given if needed. Your veterinarian will make recommendations for diet and after-care following the procedure. Fortunately, most pets do not require a dental cleaning every year, especially when their dental care at home is excellent.

Establishing a Routine for Brushing Teeth

So you’ve never brushed your pet’s teeth before – how do you begin? Don’t worry if they don’t love the idea right away, it may take a little time for them to get accustomed to.

Begin with a toothpaste intended for use with dogs and cats; they are usually flavored (chicken and vanilla are popular flavors) and fluoride-free, as the dog or cat will ultimately be ingesting the toothpaste. Most pet toothpastes work via enzymes that break up  bacterial plaques, so their action goes beyond the abrasive nature of human toothpaste. First, offer a little bit of toothpaste as a treat. That’s all!

Next (even after a few days of offering the toothpaste as a treat),  offer some toothpaste – but this time, have your pet lick it off your finger as you are touching their teeth. That’s all for step two!

Gradually, allow your pet to get used to the fact that you are going to be touching more and more of their mouth as they get this tasty toothpaste treat. Some may never allow you to brush their whole mouth at once, and that’s ok. Even if you only manage to clean one section at a time, your pet will benefit tremendously.

All along, you have been applying the toothpaste with your finger alone. At this point, you can decide if you would like to have your pet get used to a human toothbrush, a doggie toothbrush, a tiny cat finger-brush, or a textured fingertip brush. Use whatever works easily for you.

Your Pet’s Experience During A Dental Visit

First, we’ll stop by the scale to get an up-to-date weight.

Anesthesia is monitored closely throughout the procedure.

X-rays are taken of every tooth to evaluate it both above and below the surface.

X-rays are the only way to detect all evidence of disease below the gumline.

Here is an example of what a pet’s complete x-ray record looks like.

Dr. Badeau hard at work on a pet’s teeth.

Each tooth is cleaned with an ultrasonic scaler.

Teeth are then polished, which helps prevent bacteria from re-attaching to their surface.

No visit would be complete without some extra hugs from the staff!!

Additional Resources

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Videos, including how to brush your pets’ teeth (scroll down!)

Photos and examples of periodontal disease in pets

Locate a board-certified veterinary dentist

 

 

Dental Care for Pets: view/print as PDF

 

When Your Pet Needs Surgery…

sx01A pet may require surgery and a hospital stay for a variety of reasons, from a routine spay or neuter to an emergency abdominal exploratory surgery. Whether the procedure is planned in advance or comes up unexpectedly, we want to put your mind at ease and show you exactly what your pet experiences when he stays with us in the hospital.

Meet Jebediah – here he is checking in for a routine neuter. His very first stop is the scale in our exam area. Even though he has seen us recently for vaccines, we’ll need a current weight to calculate dosages of the medications he’ll need for his surgery. The doctor will do a full physical exam to be sure nothing else has changed since his last visit.

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Jebediah is a young and healthy dog, but we’d like to check a full blood panel just to be sure he is in ideal condition to undergo anesthesia. Sometimes, abnormalities of blood clotting, liver function, or kidney function do not have obvious clinical signs, but will show changes on bloodwork.

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As each pet enters the hospital, whether for surgery or any other type of procedure or care, they receive an identification collar with their name and owner’s name. If a pet’s bedding or toys are accompanying them on their hospital day, we’ll do out best to label that as well and keep track of it while they are here… but if you plan to send items from home to the hospital with your pet, please remember this is a big and busy place, and sometimes things manage to disappear into the laundry!! We can provide your pet with all they need while they are here, and you can keep their “valuables” safe at home waiting for them to return.

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Jebediah has received his first “pre-medication,” a combination of sedatives and pain relievers that will have him drowsy and relaxed as we begin working with him. It is often difficult to predict exactly what time a pet’s surgical procedure will begin as our hospital also sees emergencies, and a pet in need of an urgent surgical procedure may need to skip ahead of the routine procedures.

 

sx08     sx10Now Jebediah is very relaxed, and ready to have his IV catheter placed. IV access allows us to run IV fluids, give medications quickly and easily, and if needed, intervene if a pet has any sort of trouble under anesthesia. While some very brief procedures do not require an IV catheter, for longer and more involved surgeries having an IV catheter in place is the safest way to proceed.

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Jebediah’s IV catheter is used to induce anesthesia, leaving him completely asleep for the rest of the procedure. A tube is placed in his airway, and a combination of oxygen and anesthetic gas is administered to keep him sound asleep. The probe on his tongue measures the oxygen saturation of his blood, leaving us certain he is stable and breathing well under anesthesia.

 

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Jebediah’s owner has chosen to have a microchip implanted, so that if Jeb ever goes missing he has the best chance of being returned to his home. While this can be done in an animal that is awake, the needle used to implant the microchip is larger than the type used for a vaccine, so we prefer to place a microchip when the animal is asleep whenever possible.

 

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This is also a great opportunity to cut toenails!! You don’t even need to ask… Our anesthesia team can hardly be stopped from cutting toenails on a sleeping pet! We will also frequently clean ears, brush out a matted haircoat, and check for fleas or ticks on a sleeping pet.

 

 

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Next, we’ll put socks on Jebediah’s feet… not just because they are adorable, but to keep his feet warm during surgery. Towels, blankets, and a circulating warm water pad are also typically used to keep a pet warm during surgery (especially small pets). Body temperature is checked before surgery begins, during surgery for longer procedures, and as soon as a pet begins to wake up from anesthesia. If it’s too low or high, we’ll continue to check throughout the pet’s hospital stay until it is back on track.

 

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sx14A new sterilized surgery pack is used and the surgeon scrubs in for every procedure. Bolton Vet follows the sterilization procedures required by the American Animal Hospital Association to be sure that all out supplies, however commonly or infrequently used, are clean and ready whenever we need them.

sx15     sx16Jeb’s procedure is completed in about twenty minutes. His heart rate, breathing rate, oxygen saturation, and blood pressure are monitored continuously, and IV fluids are provided throughout the procedure.

 

 

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The procedure is completed, and a small scar remains. We’ll keep a close eye on how this incision looks for the remainder of Jeb’s time in the hospital, and tell the owners to watch it at home too. It is expected to look a little red and swollen at first, but this should decrease from day to day. Any sign of increasing inflammation or yellow-green discharge is suggestive of infection.

 

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Jebediah wakes up with the careful supervision of his anesthesia technician, who has been monitoring him the whole time. He remains a little groggy for the rest of the afternoon, and he will stay in the hospital this evening to be sure he is comfortable and has no trouble with his incision. His pain medication will last for 24 hours after the last dose is given, and depending upon how he seems to feel, he may be given a few more doses at home afterwards.

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Jeb’s recovery is uneventful, and he is back to his usual ridiculous self at home in no time at all.   🙂