Age is not a disease. If a dog's 12 or if a dog's 20, I want to treat them in a way that's going to maintain their quality of life for as long as possible. When we're dealing with an older patient that may have some other health conditions, we need to weigh what sort of quality of life the impact the dental disease is having, which in many dogs can be pretty significant if they have painful or loose teeth. It can make it hard for them to eat and just be very uncomfortable. As long as we don't have any significant health condition that could make anesthesia essentially deadly, I think it's at least worth considering looking at the procedure and looking at how this might benefit the patient.

If your dog has had problems before, we would want to be extra careful. As I mentioned, we evaluate every dog as an individual. We look for risk factors based on their breed, based on their age, or based on concurrent health problems. Having that dedicated technician there monitoring for any problem as it comes up is the best we can do to ensure your dog stays safe. Anesthesia is never 100% free of complications. We can't guarantee that. But we do everything we can to make sure your dog is safe. In general, I feel like we have an excellent safety record and do well. I hope I'm not jinxing myself by saying that.

We administer antibiotics in a situation where we have an immunocompromised dog or one that has some sort of an orthopedic implant. There was some thought years ago that dogs that have heart disease might benefit from antibiotics, but that's fallen out of favor. Pretty much every dog that undergoes a dental procedure, even just a cleaning, will get at least a single dose of anti-inflammatory pain medication just because we are going up under the gum line to remove tartar and poking around in there. We want them to be comfortable. Certainly, if we have a dog that's receiving any sort of an extraction, we want to have adequate pain control onboard for a minimum of five to seven days afterward.

Some vets indeed offer this. It's more commonly seen at grooming facilities or things like that. The veterinary dentist, in general, believes that this is not a great idea. Some of the reasons include what I talked about before in that we have sharp instruments in the dog's mouth, so there are some safety concerns there. But also, when you don't have a dog that's not anesthetized, you can't evaluate under the gum line. You can't monitor the roots or check for gum health, or things like that. By just cracking that tartar off or scraping it off, you're also damaging the enamel. Without polishing out those scratches and scrapes, we can damage the enamel over time and cause more problems.

All of our patients undergoing anesthesia have the same general routine in terms of their anesthesia. We tailor our medications and dosages to the individual patient based on their age, any health concerns, and what the procedure is going to be. All of our patients coming into the hospital that will stay with us take pre-visit medications that include an anti-nausea medication and a mild anti-anxiety medication. By taking these things before they even enter the hospital, it reduces stress and allows us to use less anesthesia because we're not overriding a significant Cortisol or stress response just from walking in the door.

Then before the procedure, they receive an injection. It includes pain medication and a mild sedative to help them relax so we can place an IV. Once the IV is in place, we will induce anesthesia with another medication, typically a combination of a medication called Ketamine and Propofol. This helps your dog to fall completely asleep so that we can put in a breathing tube, also called intubation, and then hook them up to an anesthesia machine. All of our patients under anesthesia are monitored with a very complex anesthetic monitor that looks at their breathing, heart rate, oxygenation, CO2 levels, and blood pressure. On top of that, we always have a technician whose only job is to sit there and monitor your dog.

We love our machines, but we trust our techs even more. So, we have that human intervention to make sure that the machine is telling us the truth and changing anything if we need to at a moment's notice.