We recently went in for an annual for our cat, and a dental cleaning was recommended. My only concern is that I’ve heard of many animals dying under anesthesia, but also concerned about their dental care.
1. How are the heart rate, oxygen levels, respiration monitored? I’ve heard of some vets using EKG meters, End-tidal CO2 monitor, and a device called the pulse oximeter.
The most important monitor of all is an experienced technician. All anesthetic patients are closely monitored by a trained and experienced technician. These team members record vital signs including heart rate, respiratory rate, oxygen saturation (the amount of oxygen in the blood which is related to how well a patient is breathing…measured with a piece of equipment called a pulse oximeter), blood pressure, and electrical activity of the heart (measured with an EKG).
2. Do you use an IV catheter in the cat\’s leg for IV fluid support?
Yes. Our anesthetic protocol dictates the placement of IV catheters in all canine and feline patients undergoing anesthetic procedures. We even strive to place catheters in the smallest of anesthetic patients including small birds, rabbits, rats, and even guinea pigs. IV catheters provide immediate access for emergency drugs, as well as allowing for the administration of IV fluids during anesthesia to maintain stable blood pressure.
3. I was told that blood work is done first, and just wanted to confirm?
Yes. We perform preoperative blood work and a full physical examination as part of our preanesthetic assessment of every patient. This assesses red cell counts, white cell counts, platelet counts, blood glucose levels, kidney function, liver function and total protein levels. These tests can usually be performed the same day as the anesthetic procedure. Depending on physical exam findings, other preanesthetic tests may be ordered including urinalysis, thyroid levels, chest radiographs (x-rays), EKG and/or echocardiogram (ultrasound of the heart). These preanesthetic tests help to identify any risk factors that we need to know about during the anesthetic episode.
4. Also interested in knowing what type of anesthesia is used? I’ve heard of isoflurane gas used with an endotracheal tube to maintain anesthesia, and an induction agent is also used. I’d like to know what is used and the risks involved in their use?
A full discussion of all the drugs that are used in anesthesia is really beyond the scope of this forum; however, we tailor the anesthetic protocol to the individual patient. For instance, the drugs used for anesthetizing a 6-month old healthy, energetic Labrador Retriever would be very different from the drugs chosen for a calm 15-year old Lhasa Apso with a heart murmur undergoing anesthesia for a dental cleaning. The medications chosen for a healthy energetic kitten would be very different from those used in a placid middle-aged cat; I would encourage you to discuss the particular anesthetic protocol planned for your pet with your veterinarian if you have concerns.
We do everything possible to minimize untoward events; however, as with all medical procedures, there are risks involved with general anesthesia. A recent journal article concluded the following regarding general anesthetic risk : in healthy dogs, the overall risk of anaesthetic and sedation-related deaths was estimated to be 0.05% (1 in 2000), cats 0.11%(1 in 900), and rabbits 0.73% (1 in 137) . In patients with significant systemic disease, the risk in dogs, cats and rabbits was estimated at 1.33% (1 in 75), 1.40% (1 in 71), and 7.37% (1 in 14)respectively. (Brodbelt et al. The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet Anaesth Analg. September 2008;35(5):365-73.)
5. The reason for all the questions is my fear of losing my pet in one of these cleanings, versus waiting for something more serious needing to be done before putting the pet under anesthesia.
Anesthesia for dental cleanings in otherwise healthy pets is a low-risk procedure. The benefits gained by keeping the mouth healthy far outweigh the risks of anesthesia. If we simply wait until a problem is perceived, many painful conditions will go untreated as our pets hide disease. Imagine if as humans we didn’t seek any dental care until such time as we had a huge swollen face or stopped eating entirely. Anyone who has had a toothache knows how painful it can be without causing visible swelling or preventing you from eating. Your pet can’t tell you it when it hurts. Anesthesia-free dental cleanings in pets are worthless. At best they only accomplish a cosmetic cleaning of the visible portion of the pet’s teeth, at their worst they are painful and miss the majority of the causes of dental disease: that which is invisible to the naked eye under the gum-line.
Please feel free to discuss any further concerns with your veterinarian at the time of your pet’s