Straight Talk: Anesthesia & Your Pet

...and the questions YOU need to ask!

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Monday Medical Dental Health Series: Part 3

Previous:   2/4/13: Overview

                2/11/13: Interview with Dr. Huber, part 1

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If you've ever had your pets teeth cleaned, you know that feeling of anxiety that comes with knowing your pet is being given anesthesia for this procedure.

Maxwell examines Faraday's teeth up close & personal.
"Dood, you need to start flossing!"

Some people worry less about it, others more. There's always the tale about the friend of a friend who unexpectedly lost their beloved pet from complications due to anesthesia. And it's not just with animals - a friend who volunteers at our local shelter told me one night recently that she lost a very close [human] friend to unexpected complications under anesthesia, too.

I have to admit, my concerns ramped up a while back when a vet tech at our shelter informed me that cats need to be monitored closely as they often stop breathing while sedated.

So I asked our veterinarian about it. You met Dr. Sara Huber last week during part 1 of this interview on dental health. Now she answers my concerns about anesthesia. First up: do cats stop breathing under anesthesia?

Dr. Huber:  Certain drugs that we use to intubate patients can cause what we call a transient apnea. This means that they will hold their breath for several seconds. But in 99% of cases, these patients will spontaneously begin to breathe again on their own.

For the other cases, we will use a bag on our anesthetic machine to administer a few breaths for the patient until their own respiratory center takes over and tells them to breathe again.

In very rare cases, the animal will not breathe on his own. Should that occur, a technician will administer breaths for them throughout the procedure.

I personally have never had a patient that had to be 'bagged' the entire time, but it is a remote possibility. This is just another reason why we have continuous electronic and hand monitoring of the patient throughout the procedure. If a patient does stop breathing for whatever reason, we have many ways to help them return to spontaneous respiration.

Green bag allows a technician to breathe for your pet
(this unit from shopmedvet.com)

As I mentioned last week, we tailor our anesthesia protocols for each patient, taking into account such things as their age, any underlying disease, or tendency toward respiratory distress.

The entire time he's under anesthesia your pet’s breathing, pulse, oxygen level, and heart activity is being monitored, and a blood pressure is taken every 3-5 minutes.

This way we know we’ve taken every possible precaution to keep your pet safe and healthy while anesthetized. And this is standard procedure in most veterinary practices.

A Tonk's Tail: We've heard that cats have more trouble coming out from under anesthesia than dogs do. We've also heard that some breeds are more prone to respiratory distress than others.
Do you do anything differently in these situations?

DH: I think it's far more important to base our care on an individual basis rather than a breed basis. Yes, some dog and cat breeds may have shortened nasal passages. Of course we take that into account, but any veterinarian will tell you that it's far more important to know an animal's specific medical history and current state of health.

Champion Persian (GNU Free License)

During recovery, all animals are monitored by a technician for any distress and a veterinarian is always nearby to address any emergent issues.

Every anesthetic procedure comes with some degree of inherent risk (and by the way, this goes for human beings as well!). So I emphasize again the importance of pre-anesthetic testing and continuous monitoring to give your pet the best chance for a routine procedure and a healthy recovery.

The only cat I've ever seen lost to complications post-anesthesia was a cat whose owner refused to give permission for a pre-dental blood screening.

Thankfully, our practice refuses to perform a procedure like this without a full blood panel. These tests tell you so much, and give warning for conditions that can be life-threatening where anesthesia is concerned. 

ATT: Are there any actions a pet owner should take prior to a dental cleaning?

DH:  I would say that before you agree to any procedure, you should have a detailed discussion with your vet.

If your veterinarian does not offer up the following information, here are several important questions that I think should be raised:

1. What pre-anesthetic blood testing do you perform prior to the procedure?
2. What monitoring equipment is used during and post procedure?
3. Will the doctor be present for the entire procedure?
4. Do you have dental radiography?
   This is a very important question! Dental x-rays can help diagnose suspected disease definitively and often will uncover disease we did not know was present. It can also help the doctor to assure that the entire root was removed after an extraction - an invaluable tool.
5. What kind of home care do you recommend following the procedure?

ATT: Do you have any last words of advice you'd like to leave us with?

Quite the under bite! (Photo: public domain)

DH: The longer you wait to get a dental procedure done, the higher the risk your pet will need to have other procedures such as teeth extractions. These will ultimately end up costing you more money and causing your pet more pain.

So I would strongly advise all pet owners to heed the recommendations of their veterinarian and have routine dental cleanings performed on their pets.

I understand that they can often be somewhat expensive, but truthfully it saves the pet a lot of possible pain and illness down the road.

Many thanks to Dr. Sara Huber for her time answering these questions on pet dental health!

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Additional sources:

Understanding Anesthesia in Cats
Pet Meds Online: Cat Health
Trupanion Breed Guide Health Concerns

Saturday Doubleheader: "Who Let the Dogs Out!"

*gasp* Did someone say DOGS?

Yep. We had heard that Tillman had a show on The Hallmark Channel, but we'd never watched it. In fact, we've seen Tillman on twitter but we've never before seen him skateboard.

But Friday, all that changed. The episode that caught our collective eye was the one featuring BlowPaws 2012. Many of our friends attend BlogPaws, and in fact, we're sending mom as our representative for the very first time this May to BlogPaws 2013!

So we told Mommy she'd better watch - yanno, so she'd know what to wear at the conference so she didn't embarrass us or anything.

Holy cat! What a fun show! We had never seen Tillman do his thing - and can that dog ride a mean skateboard or what. Color us kitties impressed!

And we absolutely loved seeing some of our friends being interviewed about the conference - and loved being able to glimpse a bit of what the conference will be like. We're excited we'll be represented out there this year and expect our mom to learn loads of cool stuff that she can then put to good use on our behalf.

Mom was especially pleased to see the segment on brushing your pet's teeth since this is so important - and since February is Pet Dental Health Month.

(If you are on the fence about whether or not it's important to clean your pet's teeth, you won't want to miss the first of a new 2-part post coming this Monday, right here, as veterinarian Dr. Sara Huber talks about the dangers of dental disease in older pets...and whether or not they truly feel dental pain like humans do.)

At this point, we discovered this lovely contest being hosted by Tillman over on his blog: they're giving away a 3-night hotel package and a BlogPaws Conference pass to all pet bloggers who post about the show and contest before 11:59 PM (EST) tomorrow. Count us in!

Anyone care to join us?

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Purrs for Sammy from Animal Shelter Volunteer Life - he's at the emergency vet right now....
(Saturday 7 PM CST)

Pet Dental Health Month: 5 Myths

The folks over at Nutro and TRONE Research conducted a study on Oral Health Myths in November, 2011.
Some of the results in this infographic surprised us!

Faraday and Maxwell are scheduled to have their teeth cleaned this month.
Many veterinarians offer discounts during February in honor of Pet Dental Health Month, so we're taking advantage of that.
Are you planning to clean your pets' teeth?

Kitteh Komplaints

I have the Very Meanest Mommy ever to exist on the planet, E-V-E-R!
Rilly!
Listen to what she did to me!!!

First she bundles me up and STUFFS me in this carrier thingy...

And THEN she takes me to this place that smells of doggies..and she... (wait for it)...she...leaves me there. I know, I know...shocking.

They did all sorts of Unmentionable things to me and the next thing I knew I was singing drunken sailor tunes at the top of my lungs and Mommy was laffing at me while we drove home.

But wait! There's More!

We get home, she lets me out of that Horrid Contraption...and I discover this icky Purple Thing has attached itself to my leg!

But do I get any help at all from the Meanest Mommy Ever? Ohhh nooooooooo.... She just gets out the flashy box and proceeds to follow me around. HMPF.

Well, if she's not going to help me, I'm not going to help her. Notice the only thing in focus in any of these shots is the Horrid Purple Thing.

Trying to emphasize a point here: I has the Very Meanest Mommy Ever, can you tell?

I had to just walk away in disgust.

(Note from Mom: Faraday had his teeth cleaned, and the purple bandage was a pressure bandage that had to stay on for one hour only, and then came off. If I'm lucky, I might be forgiven by Chanukah. Just in time to give him more Wand Toys.)

February: Pet Dental Health Month

  

So here we are, halfway through the month and Mother feels it's High Time we discussed Pet Dental Health Month!
I'm the one doing the discussion because, as you can see, Faraday and Maxwell are nowhere to be seen.

That's because unlike me *preen* they don't have healthy pink gums. *smiles wide for the camera* See? Did I mention they're a healthy PINK, my fave color? *squee!*

Me, having my teeth brushed by Gramma
(see the PINK toothbrush? *giggle!*)

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While Allie may love the fact her gums are PINK, I'm just happy they're healthy. She falls squarely into the category of most cats, who don't face oral heath issues until their middle years (7 is the median age for plaque buildup, gingivitis and the beginning of periodontal disease in most cats).

But there are some who aren't so lucky. Some kitties experience gingivitis at a very young age.  Gingivitis is a fancy label for inflammation of the gums (or "gingivae" - thus the name gingivitis).

This Juvenile Onset Gingivitis can begin to occur in some kitties as young as 3-5 months, or when their permanent teeth begin to come in.

This isn't gingivitis as we normally understand it. It's not caused by plaque building up over time; instead, this form of gingivitis is caused by an oversensitivity to the new teeth coming in.

Sometimes the inflammation is made worse if the kitten has had a history of upper respiratory infection (either URV or Bordetellosis, a disease that rescue groups and shelters are most susceptible to and work hard to control).

This more aggravated form of inflammation is known as Stomatitis/Gingivitis, where the inflammation erupts into blisters.

 Don't assume - ask.

It's common for pet owners to not consider a dental checkup for their cat until its well into its adult life - though we are happy to see an increasing number of veterinarians including this in standard practice for wellness checks even for kittens. We advocate for dental screenings during the first year.

Whether or not your vet is in the habit of checking for gum disease in young cats, the welfare of your baby is in your hands.

So ask your vet to do a thorough examination of your kitty's gums.

The good news is that there are several opportunities to do this during the first year - what with all the booster shots your new baby should be getting!

That's what we did with Maxwell and Faraday. As both boys are oriental breeds, they are more prone to sensitive and inflamed gums than most. And sure enough, they both have it.

Faraday's gums are less inflamed than Maxwell's - and that is probably due to the many ear and upper respiratory infections Maxie suffered as a rescue kitten.

Poor Maxie had his first tooth cleaning at around 9 months - at which point he lost all of his milk teeth. Yep, all 12 front teeth had to be extracted, because the surrounding gums were so sensitive and inflamed that they were causing him a great deal of pain.

The good news is that Max is doing much better now. It took five months of aggressive treatment before we conquered his many ear and upper respiratory infections, but beat them we did.

He's on a grain-free diet and an aggressive form of oral hygiene. And his oral health has improved.

How do you fight
Stomatitis/Gingivitis
in young cats?

The good folks at Manhattan Cat Specialists ( a great blog to follow, too, if you aren't already) have the following advice for cats with juvenile onset gingivitis:

"It has been found that it is imperative to eliminate plaque in these cats.
To do this requires:

• regular dental cleaning and polishing by your veterinarian.
• daily home care, including daily brushing.
• good nutrition, using a diet designed to control plaque.
• use of a plaque-reducing water additive that has the Veterinary Oral Health Council (VOHC) seal."

And that's what we're doing with Maxie. Every 6 months, the boyz get their teeth cleaned. Check with your vet, as many offer a discount during the month of February to promote Pet Dental Health month.

(In fact, the boyz are both going in before the month is out to have theirs cleaned.) We have an additive that we add to their water on a daily basis. We feed the boyz a completely grain-free diet.

And Max gets Biotene, an antisceptic oral gel that is packed with an enzyme that is antifungal, antiviral and antibacterial, applied to his gums on a regular basis.

(Faraday won't begin his application until after his teeth are cleaned, but then he'll join the ranks of the "terminally oppressed by Mom" as I hunt them down and faithfully apply the gel!)

Unfortunately, even with this intensive care, the disease will progress in some young cats. And in that case, the pain becomes so unbearable for the cat that full tooth extraction is the only way to calm the inflammation. It's almost as if the gums have begun to react in an autoimmune manner and refuse all treatment to reduce sensitivity.

Though this sounds drastic, many cats can and do live their whole lives without any teeth at all. Please visit Mario's blog, Mario's Meowsings, to read a firsthand tale of how a kitty can lead a wonderful (and pain-free) life, tooth-free.

And please have your kitty's dental health checked out by your vet. 

It's never too early to start. And they're never too young to need it!
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We're participating in this weekend's Weekend Cat Blog,
which is being hosted this week at PaulChen's foodblog.