Month: February 2011

Anesthesia in Veterinary Dental Care

Sick-cat-on-operating-table-in-veterinary-office

Written by The Animal Medical Center

When people go to a human dentist, we sit in the dentist’s chair, often time grasping the armrests tightly with white knuckles in anticipation of the procedure about to happen. When the dentist or hygienist tells us to say “ahhhhhhhh” or turn our head, or open our mouths, we may be reluctant, but we can follow their directions to facilitate their work. When they place x-ray films or digital sensors in our mouths and tell us to hold them while they walk out of the room, we do as they say.

February is Veterinary Dental Month. Our pets need the same dental care as we do; maybe more, since they don’t brush or floss twice a day. Our pets are not as cooperative when it comes to saying “ahhhhhhhh” or when it comes to following directions, yet they often experience the same anxiety as their owners when a stranger is poking and squirting things around their mouths.

There has been recent movement to perform anesthesia-free dental cleanings on veterinary patients. The rationale for performing dentistry on awake dogs and cats is that it will be cheaper for the client and safer for the patient. This movement is in direct opposition to the American Veterinary Dental College’s position statement entitled, “Companion Animal Dental Scaling without Anesthesia.”

I understand that many people are reluctant to perform proper dental procedures because of the need for general anesthesia, especially in the older patient. I am a firm believer that “age is not a disease,” and age should not be the deciding factor in determining the safety of general anesthesia for any patient. Pre-anesthesia testing can help determine the risk associated with general anesthesia and aid in the decision whether or not to perform a dental procedure. These tests help determine the function of the internal organs such as the liver, kidneys, heart and lungs, which are necessary to help the body safely handle anesthesia.

Vet cleaning cat teeth
Image Credit: Pixel-Shot, Pixabay

Proper anesthesia starts with the pre-op testing but also involves choosing the proper anesthetic drugs safest for each pet. The Animal Medical Center’s Dental Service always places an intravenous catheter to administer drugs, fluids and emergency drugs if needed. We also place an endotracheal, or breathing, tube to protect the airway and deliver the anesthetic gas and oxygen mixture to the lungs. Anesthetized dogs and cats at the AMC are connected to various monitoring equipment to measure the vital signs such as pulse rate, blood oxygen levels, blood pressure, electrocardiogram, and carbon dioxide levels. Finally, we monitor at regular intervals to make sure the vital signs are stable. If any painful procedures need to be performed, we also have the ability to utilize local anesthesia to minimize the amount of general anesthesia needed.

There are many advantages to performing any dental procedures under general anesthesia. First, when we scale the calculus (also known as tartar) off the teeth, there are often large or small pieces of calculus removed. If an animal is properly intubated with a breathing tube, then this calculus cannot be aspirated into the lungs or “swallowed down the wrong pipe.” The biggest advantage to working on a patient under general anesthesia is the ability to work around every side of every tooth. In the awake patient, the veterinary dentist has a very limited view of most of the teeth in the mouth. It’s easy to see the outside of the front teeth, but virtually impossible to evaluate the inside surfaces of many teeth and impossible to see many of the back teeth. A proper cleaning involves cleaning off all of the calculus from every surface of every tooth, both above and below the gum line. In the awake patient, the area below the gum line cannot be seen, yet under anesthesia it is much easier to fully visualize this area.

Once the teeth are cleaned, they need to be evaluated for periodontal disease. This involves gently probing under the gum line in several areas around each tooth in the mouth to measure periodontal pockets, or separation of the gums from the tooth root surface. Imagine trying to do this in an awake dog.

Veterinarian examining teeth of Persian Cat
Image Credit: dididesign021, Shutterstock

Approximately 75% of cats presenting for dental procedures have a decay of their teeth called tooth resorption. These are holes or decay in the teeth that often start at the gum line. They are quite painful and diagnosed by probing along the gum line with an instrument called an explorer. Again, this is not the type of procedure that could be tolerated by a cat without general anesthesia.

Proper dental procedures require intra-oral x-rays to make a diagnosis. A piece of film or a digital x-ray sensor is placed in the pet’s mouth. The person taking the x-ray steps out of the room and exposes the film or sensor and then walks back in the room. Not too many awake pets will tolerate this type of procedure.

Finally, with 75% of cats having tooth resorption and 80% of all dogs over the age of 5 years having periodontal disease, most veterinary dental patients need some type of surgical procedure to correct the abnormality. Finally, it is much easier to perform oral surgery when I’m not working on a moving target.

Given the complexity of the procedures necessary to clean, diagnose and treat a pet’s mouth, it is easy to understand why general anesthesia is so vital to performing proper veterinary dental care. My recommendation to anxious pet owners over the years is to use a little general anesthesia every year in order to maintain a healthy mouth, rather than wait until the mouth has severe disease and needs several hours of surgery to clean up a messy and painful mouth.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

You may also enjoy reading:

Safe Anesthesia for Pets

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Featured Image Credit: megaflopp, Shutterstock

About the author

Preventative Dental Care for Your Cat

Vet cleaning cat teeth

Dental disease is the most frequently diagnosed health problem in cats.  Seventy to ninety percent of cats have some level of dental disease.  If left untreated, it can lead to health problems for your cat, ranging from bad breath, dental pain and loose teeth to systemic illnesses that can be life-threatening.

Normal teeth in cats should be white or just a little yellow.  Gums should be light pink and smooth (except in breeds with pigmented gums).

What is dental disease?

Dental disease begins with a build up of plaque and tartar in your cat’s mouth.  Without proper preventive and therapeutic care, plaque and tartar buildup leads to periodontal disease, which manifests in red and/or swollen and tender gums, bad breath, and bleeding.  When the gums are swollen, they can be painful – a good rule of thumb is that if it looks like it might be painful, it probably is.

As bacteria from the inflammation and infection associated with periodontal disease is released into the bloodstream, this can lead to damage to other organs such as the heart, kidney and liver, resulting in serious health problems.  Dental disease in cats can also be an indicator of immune system disorders.

Owner-hand-opening-adult-cats-mouth-for-showing-bacterial-plaque-on-sharp-teeth-surface
Image Credit: RJ22, Shutterstock

One common dental problem that generally shows up around the age of four or five in 25-70% of cats are feline odontoclastic resorptive lesions, also known as neck lesions, cavities or root absorptions.    Patients affected with FORLs may drool, bleed, or have difficulty eating.  A portion of affected cats do not show clinical signs.

What are the symptoms of dental disease?

  • bad breath
  • decreased appetite
  • changes in eating habits
  • drooling
  • chewing on one side of the mouth
  • loose or missing teeth
  • red or swollen gums
  • pain when mouth or gums are touched
  • bleeding from the mouth

Since cats are such masters at hiding pain, they frequently don’t show any symptoms until the situation is literally life-threatening.  They will eat even when their level of chronic mouth pain would send a person to the emergency room.  They almost never paw at their face, even with loose or abscessed teeth.  They can get pretty smelly breath from eating cat food, so it’s tough to tell by smelling the breath whether your cat has dental disease or has just eaten.  But even though they don’t show us much in the way of outward symptoms, chronic dental/periodontal disease can cause severe and often irreversible damage to internal organs.

What can you do to prevent dental disease in your cat?

Regular veterinary exams, at least once a year, and twice a year for cats seven and older or for cats with a known history of dental problems, are a must.  During the exam, the veterinarian will assess your cat’s teeth to determine the degree of dental disease.

Since our cats won’t just sit still and open their mouths to have their teeth cleaned like humans, dental procedures for pets require general anesthesia, something that makes many pet owners nervous.  While there are always risks with anesthesia, they can be minimized with a thorough pre-anesthetic check up, including bloodwork to assess kidney and liver function and rule out other underlying health issues.  This will allow your veterinarian to customize the anesthesia to your pet’s health status and potential special needs.  Keep in mind that leaving dental disease untreated may present a far greater risk than anesthesia.

brushing-cat-teeth
Image Credit: belchonock, depositphotos

What can you do at home to keep your cat’s teeth healthy?

Brushing

The most effective way to prevent dental disease is to brush your cat’s teeth.  Ideally, you get your cat used to this when she’s still a kitten, but even older cats can learn to accept having their teeth brushed.

Diet

Contrary to what you may have heard, dry food does not clean your pet’s teeth.  Most cats don’t chew their kibble long enough for any of the scraping action that is the theory behind this myth to kick in.  What little they do chew shatters into small pieces.  Some pet food manufacturers offer “dental diets” that are made up of larger than normal sized kibble to encourage chewing, but in my years at veterinary practices, I’ve seen many cats swallow even those larger size pieces whole.  Additionally, dry food leaves a carbohydrate residue in the cat’s mouth that actually encourages growth of tartar and plaque.

Cats do best on a grain-free canned or raw diet.  In fact, the moisture in these diets may actually help wash away some of the plaque, rather than allowing it to adhere to teeth.  Additionally, the enzymes present in raw food may help prevent plaque.  You can also give your cat raw chicken necks to chew on.  Never give cooked bones to your cat, they are brittle and can splinter and lodge in your cat’s intestines.

Dental treats 

Dental treats such as Greenies are simply dry food in disguise, and won’t do anything to prevent plaque.  The chlorophyll added to some of these treats may help your cat’s breath smell better, but this may mask more serious health problems.

cat being fed a cat treat or cat food by hand
Image Credit: Jakub Zak, Shutterstock

Dental sprays or water additives

There are a number of dental sprays and water additives on the market that claim that they can prevent and even eliminate plaque.  Be very careful when evaluating these products.  Some may help, but others, at best, do nothing except provide cosmetic benefits by making the teeth appear whiter and masking more serious disease, and at worst, may actually harm your cat.  Any product taken internally can have harmful side effects, even if it’s “natural” or “herbal.”  Be especially wary of “proprietary formulas” and/or products that don’t disclose their ingredients.

I brush Allegra and Ruby’s teeth every night. Despite counseling clients in the veterinary clinics I worked at on how to do this, I confess that I never did it with my own cats until I got these two. I used a four-week program to get them used to having their teeth brushed, and they both took to it surprisingly well. So don’t rule out brushing your cat’s teeth with an immediate “no way” response. Give it a try. It may just be the best thing you do for your cat’s health.


Featured Image Credit: Pixel-Shot, Pixabay

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About the author

Connie Bowen paints portraits of love

Connie Bowen doesn’t just paint pet portraits.  She captures the unique spirit of each pet in each painting, turning the finished work into a lasting treasure for the recipient – a portrait of love.

Connie began drawing at an early age and majored in art at Washington State University. She then completed training and worked for 23 years as a freelance court reporter. Since retiring from court reporting in 1997, she has devoted all her time to the loves of her life: her family, her art, and the expression of Truth.

I’m so pleased to introduce you to this wonderful artist today.

When did you first begin painting pets?

I first began painting pets in May of 2003.

Your pet portraits really capture the unique essence of each animal.  What is the creative process for a pet portrait like for you? 

When I first meet the animal, or view their photo via e-mail, I am immediately drawn to the personality of the animal and the expression on their face. The emotion I feel from them is what I portray in their portrait. Animals have the most expressive eyes and that is the place where I start with each portrait. After the animals’ eyes are painted in, I definitely feel their spirit is with me as I paint.

One time I was working on a challenging cat painting because I was working from a photo that wasn’t very clear. Sometimes when an animal has already passed on, I’m working from cherished photos from long ago and the detail can be lost. I simply asked out loud for help from this particular cat. I went on painting and as I swiveled in my chair, the squeak made an unmistakable spine-chilling “Meow” sound! I have lots of stories like that – of animals coming to my aid as I’m painting.

While pets are featured prominently in your artwork, you also paint other subjects.  What is more challenging – capturing pets, or capturing other images?

For me, capturing pets is my pure joy. The other images are painted more impressionistically. I use the background and other images simply to support the star of the painting – the pet. I take more time capturing the essence of the pet, but time seems to stand still as I do so.

To illustrate my point, one afternoon while I was painting, my husband kissed me good-bye as he left to catch a movie. It seemed like it had been only 20 minutes when he returned. I asked him if he had missed the movie. He surprisingly told me that he had not only seen the movie, but it had been at least two hours that he’d been gone!

The only real challenge for me is when I’m asked to add a person into the painting with the pet. This happens quite a bit with horse paintings. It always takes me twice as long to capture the likeness of the person as for any other subject.

Where does your inspiration come from?

From the photos of the animals, themselves. People e-mail me with the most interesting and adorable photos! I remember one photo in particular had two kitties resting on the bed surrounded by their stuffed animals. I couldn’t wait to start on that painting!

Another photo I received was taken with a phone and the whole image had a lovely peachy tone to it. The pet parent and I decided to leave the colors as they were and the whole painting was done in those colors.  I’m always amazed and inspired by my clients and the creativity that emerges from working together.

Tell us about your own pets, and how they inspire your work.

I have a 10-year old Australian shepherd named Jesse and two cats named Brock and Carma. Brock is a large black male with a little bit of white under his chin. Carma is a small-boned little tabby with huge green eyes. I’ve done quite a few paintings of Brock. He is especially inspiring as he has golden eyes and seems very magical in his poses. It’s hard to find Carma quiet and still. She loves to race around the house, up the cat tree and everything she does is filled with energy. When Carma sees me in my office ready to begin painting and hears the lovely music I am playing, she comes in to sleep in her soft kitty bed and keep me company. She sleeps right by my arm. I love to listen to her purring and kiss her softly and let her know I appreciate her company.

I rescued both cats when they were just weaned. They were both very ill and it took quite a lot of antiseptic baths and all kinds of medicine to get them on the road to health.

My pets inspire my work by being a continual source of positive, loving energy. I delight in their presence.

 

You’re also an author of several inspirational books – tell us a little bit more about them.

My most popular book is the children’s affirmation book, I Believe In Me.  It has sold over 51,000 copies, including the Spanish edition. It won the national Athena Award for book-as-mentor in the category of spirituality. A copy has been donated to each Ronald McDonald House nationally.  I wrote this book for my son when he was one year old. It was published when he was three years old. He’s now in college, and the book is still going strong simply by word-of-mouth.

My second book, I Turn To The Light, is a collection of healing affirmations. This book is meant more for adults, but has reached an audience of children and teenagers.

I illustrated The Sunbeam and the Wave, and also two of author Susan Chernak’s books, Heart In The Wild and All My Relations: Living with Animals as Teachers and Healers. I used pen and ink for Susan’s books. All of my other books were done in ink plus colored pencil.

You can find more information about Connie and her art, along with a huge selection of her stunning paintings, on her website.

All images of paintings © Connie Bowen, used by permission.

About the author