You’ve dropped them off fasted the morning of the surgery and passed over your fur-baby to the staff at the hospital- so now what happens.
We bring “Fluffy” into the treatment room where he has a physical examination including taking his temperature and listening to their heart and lungs (asculted) to make sure there are no abnormalities that might increase their risk to undergo general anesthesia. The next step is to draw some blood (venipuncture), and his blood is analyzed for its chemical and cellular constituents. The kidneys, liver and lungs primarily process the medications and drugs used for general anesthesia and pain control. The blood tests provide the veterinarian indicators of your pets organ health so it can be determined if they are fit to withstand the general anesthesia.
A word about general anesthesia. It is a requirement for proper dental cleaning (dental prophylaxis) and possible extractions. The majority of dental disease happens UNDER the gum line. There is no way that a pet will sit still and hold their mouth open for cleaning under the gum line (subgingival scaling) or for any extractions.
Once your pets blood work has been reviewed by the veterinarian, and they are deemed healthy enough for the procedure, they proceed with an intramuscular injection of sedative medications. This helps them to relax and makes the transition from being awake to under anesthesia (induction) smoother and more comfortable on them.
When the sedatives have made your pet sleepy, the RVT’s (Registered Veterinary Technicians- highly trained veterinary nurses) place an intravenous catheter (IV) in a vein (usually in a front leg). This is why there is a shaved spot on one or several legs. The IV catheter allows venous access for administration of IVF (Intravenous fluids) and medications during the procedure. The IV fluids help to maintain their blood pressure, keep them hydrated, fluids are often warmed to help keep the patient warm and to help support their kidney’s, liver, lungs and other organs as they process the medications given. After the IV catheter is in place an injection of a drug is injected, and this puts your pet under general anesthesia. This is the stage wherein human medicine they tell you to start counting backwards from 100, and you only make it to 98! Once they are ‘induced’ an ET tube (endotracheal tube) is placed into their trachea (windpipe) to provide oxygen and deliver the maintenance gas anesthesia (isoflurane) that will keep the ‘asleep’ during the
procedure.
During the anesthesia, your pet’s heart rate, respiration rate, SpO2 (how much oxygen is in their blood), and blood pressure are monitored. Once all of the monitoring equipment is set up and attached to your pet – the dental procedure can begin.
The RVT removes any significant accumulations of calculus (the hard brown coloured stuff on their teeth) and then ‘charts’ their teeth (takes an inventory of which teeth they have and if they are diseased). The veterinarian then examines each tooth visually and by using a probe around the gum line to look for signs of periodontal disease ABOVE and at the gum line. Dental radiographs are taken to look for signs of periodontal disease BELOW the gum line. Think of teeth like icebergs – you only see 90% of the tooth- the rest is under the gums and in the bones of the jaw.
Once, infected teeth have been identified, intraoral dental nerve blocks (numbing agents) are given to your pet, so they do not feel the extractions happening. Teeth that have two and three roots have to be sectioned (cut) into individual pieces using a dental drill. This makes the removal easier and faster, which is better for your pet. Often the gums had to be incised (cut) and reflected (pushed back) from the teeth and bone to make extraction more comfortable and prevent damage to the sensitive gums. Once the tooth is removed the gums are sutured (stitched) back together to cover the defect (hole) where the tooth was. The suture material used is absorbable (will dissolve on its own and doesn’t need to be removed). Some teeth are extracted very easily/quickly, but other’s- like the large canine teeth or the carnassial teeth (the BIG molar like the tooth on the top jaw) can take half an hour!
After all the diseased teeth have been extracted, the RVT will scale and polish all remaining teeth. The dental procedure is now complete, and your pet is recovered and woken up from the anesthesia. The pet stays on the IV fluids for several hours after they have woken up to maintain venous access for administering medications, to help keep them hydrated and to support their body as their organs continue to process the drugs they were given.
Hopefully, this helps unveil some of the ‘mystery’ behind what happens after you drop your pet off for the dental procedure. If you have any questions- don’t hesitate to contact your veterinary team.
Written by Dr.Nichelle Peck, DVM