Time Under Vs Teeth That Need To Be Pulled

[Guest Addie]

Logan has a dental at the end of next month. I brush his teeth everyday since I got him and have tried everything from sprays to gels to chews to bones, and they have just been getting worse. The vet said he can see 6 that need to be pulled. I told them to get the worst ones out first and to wake him up after 1.5 to 2 hours, I don't want him under any longer then that. So am I a neglectful owner? I don't want my VERY bad experience to get in the way of his well being, but at the same time I want to bring him home that day. I don't think the dental cleaning itself will take very long, it will just be the pulling. (The bad teeth are 4 bottom premolars and 2 top molars. They also said the top incisors may need to be pulled.)

[PatricksMom]

I'm not sure what happened in the past but I do understand worrying because I had a dog with anesthesia problems. My understanding is the issues tend to be going under and coming out of anesthesia. Unless my vet advised against it or there were medical issues to suggest against it, I would rather have my dog under once for longer than risk having to put then under twice.

[KF_in_Georgia]

It may be possible for the vet to draw blood to check potassium levels (I assume that's what you're worried about--the article here), then proceed if the levels continue to look okay.

 

Also, your vet can check with Tufts before the surgery, to find out more about countering with calcium.

 

You're a good mom, just a worried one. I was, too. I lost two girl greyhounds before they turned 9, and I had to have my 8-year-old's teeth cleaned in April--with one extraction. She was fine, but I watched my vet read that article the week before the dental. (One of the two dogs I lost died under anesthesia.)

 

Don't forget the amicar...

[MaryJane]

Someone already mentioned Amicar - that's important as not all vets carry it and may need to be ordered beforehand. Also, stop any fish oil supplements at least 1 week before surgery. Fish oil has aspirin type tendencies and could prolong bleeding.

[Guest Addie]

I already have Amicar lined up.

As for the potassium, we are going to check it every half hour and we will be using saline instead of lactated ringers (I guess they have potassium in them) I also discontinued all his supplements in preparation.

I am under the impression that if his teeth are this bad already he will unfortunately need another dental/ extraction in the future after this one. So, I''l be forced to go thru this every few years, regardless

[tbhounds]

Not sure why you are concerned about the length of anesthic time-did your hound have prior problems? Obviously, you want to wake them ASAP but, so long as they are being monitored properly (blood pressure, body temperature, co2...) and their parameters are stable I would extract every tooth your veterinarian has evaluated as diseased.

Personally, I have never heard of or have had an issue with changing potassium values.

[kikibean]

2 hrs is the absolute max we will leave them under. If it's a senior with a really bad mouth or something, we will do half the mouth and the go back and do the other.

The problem is that if they're under longer than 2 hrs, when they flip them back over their blood pressure drops dramatically and combined with the anesthesia they can stroke out. My friend's group recently lost a dog during a spay / dental when she was under for like 2.5 hrs. Just not worth the risk as far as we're concerned. We'd rather do two dentals a month or two apart.

[Guest fastcasper]

My girl had/has bad teeth through no one's fault. About 2 months after I got her she needed to have some teeth extracted. My vet pulled 23 (yes, 23!) teeth and she was under for 2 hours. No Amicar was needed, she was sent home with Tramadol and an antibiotic. They monitor the pups very closely when they are under. She recently had another 6 teeth pulled. She is down to 8 teeth in her head. The molars can be tough to get out as they have to break them up and removed them that way. The top and bottom "fangs" are a real bear to remove because of their long roots.

[kikibean]

They might not need Amicar, but it's not always easy to find so I'd recommend you have it on hand in case it's needed. We are in a fairly decent sized metro area and it is hard to find a pharmacy that has it in stock, normally it takes a day or two to order in.

 

They can monitor the vitals and still have an issue. To me it's just not worth it to have them under more than 2 hours since there is the risk.

 

I just had a girl in for a spay and dental and she was under less than two hours. They did complete bloodwork, monitored her blood pressure, temp, etc. and she still crashed as they were finishing up and they barely got her back (had to do chest compressions and the whole bit).

[Guest Addie]

No problem with Logan. I lost my girl 2 years ago under anesthesia, everything went off with out a hitch until the gas was turned off and her heart just stopped and they couldn't bring her back. She was 6 years old and under for 3 hours. It absolutely devastated us (and if we lost another..... ) So the problem is totally with me, I'm just trying to find the best way to do things. I have talked everything over with my vet and he is very confident.

[MaryJane]

Just a note that you also want to check who is going to be doing the dental. In many practices the vet DOES NOT DO IT. Instead, it is the dental tech. This might be acceptable for many people but, if my dogs are going under, I want to have a vet doing the procedure as this makes me more comfortable that they will be diligent in monitoring the vitals during the operation. It does not take long for a procedure to go haywire and having a vet right there gives more options for survival.

[kikibean]

I'd say if your girl was under 3 hrs and you lost her, the problem was probably what I was describing. They probably turned it off, flipped her back over and she stoked out.

[dmswartzfager]

Just a note that you also want to check who is going to be doing the dental. In many practices the vet DOES NOT DO IT. Instead, it is the dental tech. This might be acceptable for many people but, if my dogs are going under, I want to have a vet doing the procedure as this makes me more comfortable that they will be diligent in monitoring the vitals during the operation. It does not take long for a procedure to go haywire and having a vet right there gives more options for survival.

 

While this is a valid concern, I would like to point out that it's impossible to monitor vitals, particularly feeling for pulses, watching respirations, and counting pulse and respiration rate and recording all vital signs such as BP, MAP, SpO2, EtCO2, pulse and respiration on the anesthetic record every five minutes, while actually doing the dental procedure. Thus at our practice, while I am doing the scaling, polishing, and full mouth dental radiographs, the veterinarian is monitoring the patient, and then while the veterinarian is doing the extractions, I'm monitoring the patient, and communicating with the veterinarian about any changes in those vitals.

Edited May 29, 2014 by dmswartzfager

[Guest Addie]

At my clinic the vet and the tech do the dentals.

[tbhounds]

2 hrs is the absolute max we will leave them under. If it's a senior with a really bad mouth or something, we will do half the mouth and the go back and do the other.

The problem is that if they're under longer than 2 hrs, when they flip them back over their blood pressure drops dramatically and combined with the anesthesia they can stroke out. My friend's group recently lost a dog during a spay / dental when she was under for like 2.5 hrs. Just not worth the risk as far as we're concerned. We'd rather do two dentals a month or two apart.

Just curious about this-where was this documented???? I monitor patients daily and I have never had a patient's BP drop as you described. We monitor bps very carefully-with our vet spec machine & manually with our Doppler.

[kikibean]

I don't know how much it has been documented, other than we've had it happen and that was what our vet determined was the cause of the dogs dying. When other people have lost dogs during dentals and I ask, they're almost always under more than 2 hrs and everything is fine until they get ready to wake them up.

 

I just had a friend lose a dog during an uneventful dental / spay and when I asked the dog had been out 2.5 hrs. Everything was fine, flipped the dog over and she crashed and died.

 

I'm not a vet so I can't give you technical info. Our group vets 75-100+ dogs a year and has been around since 1994. We take a lot of seniors and special needs. Every dog, no matter age, gets bloodwork before we put them under - which I know a lot of groups don't do. I'd rather err on the side of caution than have a dead dog. We use Amicar on Irish dogs and dogs with Flying Oak in their bloodline since we've found those dogs more prone to bleeding issues. It's been a long time since we've lost a dog during surgery and, like I said, we vet a good number of dogs every year.

 

Just putting out our experience. I would suggest people discuss it with their own vet or do what they're comfortable with.

[JJNg]

Flipping a dog over, or any position change, during anesthesia can cause significant changes in blood pressure. It doesn't matter how long they've been under anesthesia.

 

The concern about potassium seems to be an extremely rare issue that has only been documented in a few isolated cases. When asked about this, Dr. Couto said he'd never seen a case and had only heard about 2. At Ohio State, they anesthetized hundreds of greyhounds routinely, and as a teaching hospital, a number of the procedures lasted longer than 2 hours with no complications.

 

As PatricksMom stated, most of the anesthetic complications happen while the pet is being put under, and during recovery. During the procedure, while the anesthetic plan is steady, you're less likely to have problems, especially if monitoring closely to ensure that vitals remain stable. So as long as your dog is doing well under the anesthesia, no reason to not complete the procedure and finish pulling all the teeth that need to be extracted.

[tbhounds]

Thanks Jennifer--I never felt there was an egg timer to be watched-parameters yes.

[GeorgeofNE]

My understanding is it isn't the length of time the dog is under that causes the problems.

 

Also, if your dog is one of the many who is just genetically predisposed to dental disease, you can brush until the cows come home and it really doesn't help.

 

I myself would ask the vet to pull everything questionable at once versus doing the procedure twice.

 

My dog had a bad experience with a simple cleaning, so I do not have his teeth cleaned and they're fine because he's one of the lucky Greyhounds with good teeth. I give him bones and do not brush. His teeth are awesome.

 

It's really the luck of the drawn I think. Siamese cats are the same way; genetic predisposition towards periodontal disease. One of mine lost all his teeth from the "fangs" back when he was 5 years old.

[kikibean]

OP asked for opinions on if there is a time under vs teeth pulled and I was sharing our experience as a group who's been around 20 years and vetted 1,000+ dogs. We haven't lost one that I can remember in probably 10 years during routine surgery and we take a lot of seniors and special needs dogs and work with multiple vets.

 

I respect the opinions of the vets and vet techs. We're not vets.

 

We would just rather do two dentals over a couple of months and spend the extra money than risk having a dog under longer than we're comfortable with based on past experience.