Pomeranian 6 years 6 months old dental cleaning. I'm worried about anesthesia.

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My 6 year 6 month Pomeranian went in for his yearly shots. We finally got a good look in his mouth and found that he has 3 loose teeth. One tooth fell out 2 weeks after his yearly visit so back to the vet on Thursday was told no sign of abscess or infection. I gave him bones used enzymatic toothpaste when HE would allow me yet it didn't work out and I feel terribly about this. He was supposed to go in for a dental last year but I put it off b/c my friends said I was insane to put a dog under anesthesia for a cleaning and I was scared to put him under and didn't know what I know now. Moderate build up on some teeth and he needs a dental. I'm having a consultation w/the vet on Monday and hopefully will have him done next week. He banged his snout a few weeks ago while chasing a cat would that cause the teeth to become loose? Now that's the background here's the issue. I'M DEATHLY AFRAID of him going under the anesthesia. I know tooth loss and decay causes worse problems but I've been crying myself sick and have been ultra nervous about this. I thought I was doing the right thing by giving him bones and brushing with the enzymatic toothpaste but I just couldn't reach all the areas.
I'm afraid he will die at the vets. It's terrible I've lost sleep and can barely eat. I just feel my best friend is going to be lost. Can you please tell me any precautions I can ask the vet to do? I heard certain small breeds don't do well under injection anesthesia and should be given as gas, but on the website it says they pre-medicate with an injection, then IV medication to lose consciousness then gas to keep them under. I heard bad stories about the injections and I'm fearful. This is an animal hospital that is AAHA certified. This isn't a vet dentistry office. Do I need the specialist or am I OK at this vet(this vet also performed my dogs neutering using Isoflurane anesthesia. Does isoflurane involve the injections too or is it just gas? Could his heart and kidneys be damaged?

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Great point. I will definitely be taking him to the vet dentist in 6 months to establish ourselves there and to see what they recommend. Will be repeating the blood work etc. as well. As far as the xray for his back I might just take him in later this week.

We used metacam for pain management after his dental. Funny thing about that if when I gave him his dose he was great. Right before he was due for another does he'd lay down then once I'd give him to dose he'd be great. I'm not sure if that was because of the dental pain of if the metacam was also helping any pain in his back.

The vet mentioned that it seems to be a bone thing and said either arthritis or a malformation. He said just looking at him and testing his range of motion he seems fine but we won't know until we take a look with the xray.

Will update with more info.
Thanks again!

[Jennifer Mathis, D.V.M.]

Honestly I think it's a good vaccine, but not appropriate for all cases.  Odds are that there are more problems in the mouth and we can't say there are or aren't without xrays.  Given that there are likely more problems, I would not do the vaccine at this time.  It can always be done later.
Everything is probably fine and a 6 mo check is good, but better if you plan to do another dental with anesthesia and xrays, as just seeing the teeth are not a fix.  Doing bloodwork in 6 months is appropriate.  Globulins are likely fine.
It is common for small breeds that jump to hurt their back. There are too many possible diagnoses to talk about options really for arthritis.  Which joint/spine?  Bony change or soft tissue? ie Take xrays to narrow down the options.  Treatment will likely be an NSAID (non steroidal anti-inflammatory).  A good choice is metacam as it can be dosed as needed - ie give less as needed.  Human or OTC meds are not appropriate meds as a substitute for NSAIDs designed for pets.  If the body area can be localized, a therapy laser is a non medicine option that gives good results.

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Hi,
We went to our appointment today. Everything healed up well and looks good. He's been eating some hard food with no problems so that is good. The majority of it I soften or feed canned food/mixed.

We talked about the dental vaccine and I don't think I'm going to get that as of right now. Can I ask you your honest opinion of the vaccine?

We also talked about the globulin levels and was told to come back in 6 months for checkup on the teeth and to repeat blood work then. Does that sound about right? I have a copy of his blood results too everything else was fine and in normal range.

With brushing, oravet and the prescription diet my vet feels that the remaining teeth will be fine and the ones filled with gel he feels will make it and he told me that they weren't that bad. We will see.

I did notice though that my dog doesn't like it when I brush his hind quarters. He lets me but it's with much resistance. So I'm taking him back for an xray because the vet checked him out and he whelped when pressure was put on his back. The vet also said the back seems a little weak then also said his knees and legs were strong and he's not sure if there's anything going on. The only way to know is with xray, but he seemed to think I maybe pulled at his skin near his legs when I was grooming him with the brush and that the skin might be sore or since my dog doesn't like people looking in his mouth that not letting anyone near his legs might just be temperament.

He lets me rub his legs and never whelped so I think he's OK but will do the xray just in case to be sure.

Is it common for small breeds to have somewhat weak backs? If it turns out to be a malformation or arthritis what happens next for treatment and are those conditions common in small breeds?

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Thank you so much. You have no idea what sharing your knowledge and expert opinion has meant to me. I truly appreciate it.

I'll update when we go in again.

[Jennifer Mathis, D.V.M.]

Both the elevated globulins and slight enlarged nodes may (easily the reason) or may not be related to dental issues.  8 wks should be fine to have it checked.  Please have them do a CBC (complete blood count) with the Globulin test (part of a chemistry panel) to help interpret the Globulin significance.  
Bloodwork is just a snapshot in time, like a race.  The person winning the race at the beginning, may not be the person that wins at the end.  Take a picture later (ie repeat bloodwork) will help determine what's happening in the body/race.

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Is the slightly elevated globulin anything to worry about? My other vet said that his lynph nodes seems a bit swollen and she too said it's prob. the teeth.

Yet the other vet never mentioned the lymphs. What do you think?

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Called and found out he did indeed get the subgingival. That's what I figured.

I inquired about the xrays and was told they don't have xray machines for dental xrays but they have digital regular xrays, but should be getting the dental xray machine in about a year. You were right as I expected. Thanks for that.

I don't know if I mentioned this before but my dogs globulin was a slightly elevated. I was told it's probably because of the inflammation and dental disease. I was thinking of getting him retested in about 8 weeks does that sound good?

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I just read that there are two types of cleanings. One to make them look 'pretty' and a subgingival. I hope he got the subgingival one.

[Jennifer Mathis, D.V.M.]

not more teeth, but less teeth that have infection remain.
ie without xrays he likely has painful infections that remain.  I hope to save teeth, but usually they need to be lost by the time it's severe - trying to save teeth keeps infection in the mouth.

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Thanks so much. Do you feel that without xrays he was subjected to having more teeth pulled? I hope non could have been saved etc.
Thanks so much again for your expert opinion

[Jennifer Mathis, D.V.M.]

Give it 2-8 wks for the gums that have had changes to heal, then put him under again just for xrays, as it will likely be for xrays and further treatment, but best medicine with the healthiest the mouth can be - ie after healing before any problem that was missed has worsened....

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Thanks for your responses they are very informative. Do you think waiting until the next dental would be to long to go without xrays? I'll obviously take him to the specialist at this point for them. I wanted xrays to begin with in order to know everything going on and it's frustrating to know all of this.

Do you think it's a bad idea to put him under again just for x-rays? If not how long do you feel I should wait?
Thank You

[Jennifer Mathis, D.V.M.]

I have a feeling he said your dog didn't need xrays because they didn't have dental xray equipment.  I learned there were things I couldn't evaluate in a mouth without xrays, so got xray equipment 1.5 yrs ago.  2/3 of the tooth is actually under the gum line.  85% of the teeth with mild concerns we find out with xray that they are much worse than we knew.

Please find a veterinarian with dental xray capability.  Given that information, it is likely xrays will reveal that the teeth in which doxirobe was used will likely not be enough and as seen on xray, there is more damage and further extractions are likely needed.  Again, though that doesn't sound appealing, taking out a problem tooth is much better than leaving it and the infection that is likely at the root gets removed, too.

I've taken xrays of a hairline crack that turned out to be an abscess under the gum line and had damaged the adjacent tooth.
I've found cysts in the jaw that if not found would have fractured the jaw.
I've found cavities under the gum line and broken roots (root=nerve=pain).
I've found damaged teeth with retained roots that continue causing problems.
I've found a loose tooth and the three in front of it had not yet loosened, but had infection around the roots caused from the single initial problem tooth.
I could go on, but these problems would not have been caught/treated without xray capability.

Basically, if you don't look you won't find and pain may still be present.

It is not wrong to do dentistry without xrays, but it is likely things have been missed.  Often I like the major problems to begin to heal, then go back and repeat xrays and take any further damaged teeth after the major tartar has been cleared so that the gum line can heal better during the procedure 2-4 wks later.

ie your veterinarian hasn't done anything wrong, but your furbaby is likely not clear of problems.  The only way to know is to have dental xrays under anesthesia.

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The vet I brought him to to do the dental this week is the same vet who neutered him etc. I then moved a few years ago and found another vet close by in my new town. I brought my dog to the vet close to me ever since for his yearly checkups and shots.

Two weeks ago when I noticed the bad teeth they told me that he didn't need pre dental antibiotics and that one of the machines I inquired about probably wouldn't be used to monitor him during the procedure. They also cut me off when I was asking questions so I decided not to go there since basically none of my questions were being answered.

I then took my dog back to our original vet because he's great. And that's where my dog got the dental.

I would have taken him to a specialist in Vet. dentistry but I never had that vet in the past and wasn't comfortable taking him someplace that I was unsure of (even though I'm sure they are great) I just felt since he was neutered by this vet and the vet did a great job with the anesthesia etc. that it was less risky.

The other issue with seeing a specialist is there is only 1 in my state and since I never used them in the past I was weary especially considering my experience with the local vet that he will now never go back to.

Forgot to ask:  Do all vets do sutures and flaps after a dental? Do the sutures dissolve?

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Hi,
My vet said that my dog didn't need xrays of the mouth at all. He said this after he looked into his mouth at the loose teeth etc. I asked two times before the procedure and was told he didn't need them.

The next dental I'm not sure if there are going to be xrays taken.

I was wondering why he didn't need them and thought it was strange. Is this bad he didn't have them?

[Jennifer Mathis, D.V.M.]

Please clarify.  Did your vet say your dog didn't need xrays of the mouth at all? or not again after the procedure until next dental (6-12 months depending on pet/mouth)?

ie were xrays ever taken?

If not, there is likely still a problem present in your baby's mouth.

I'll wait for your reply to let me know what xrays were taken/when to clarify my answer as there are lots of reason xrays may or may not be needed at different times depending on what is happening in a pet's mouth.

It is needed at least at the first procedure, though - -MINIMALLY.
Dr. Jen

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My furbaby is doing well today. Just a quick question for you. I asked our vet after the initial consultation about his teeth if my dog needed x-rays and was told no. I'm just wondering why? The vet said after the procedure that they got all the roots etc. but I just wanted to know why some vets do some and why some don't? Is it because of my dogs accessed condition and our vet figured it wasn't necessary because some of the teeth were already loose? Or is it because they got all the roots so didn't need to x-ray because they had all the roots? Should I get him some x-rays? Or is he OK?

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I hope it works too. Maybe the vet thinks they can be salvaged? Or maybe he didn't want to pull too many at once?

I'm feeding him his hard food but letting it soak for an hour in water then feeding it. Is that OK? I'm also wondering how long is too long to leave the soaked food out? I usually get rid of the soaked food within 4-6 hours and start a new bowl of soaked food. I was thinking of getting him some cans but not sure if I should introduce new food(don't want to upset tummy)

I'm blaming myself. Mainly because I was recently diagnosed hypothyroid and have felt 100% better lately. But last year was hell. I was so tired all the time and many other symptoms. I can't help but think if I wasn't so tired all the time then he would have more teeth than he does because I would have been on top of things more.

I will think about the vaccine. The vet said the lowers look good though so maybe we can save those at least.

Thank you so much again

[Jennifer Mathis, D.V.M.]

Hopefully Doxirobe works, but if several pockets are present, they usually lead to teeth loss.  Again it's much better off without a tooth than a painful tooth.  Dogs and cats WITHOUT ANY teeth can still eat hard food.  If no teeth are present, it's better to feed soft food or moistened dry food as having more moisture is better for the body.  Soft food tends to have more fat which is not good for the waist/joints. Soft food will damage teeth faster, so hard is better when teeth remain.

20% of small dogs get sore at the injection site with the porphormonas vaccine.  My own little dog (12 lbs) with tooth loss (fractured and damaged and finally removed) was sore, but improved within 3 days, and was less sore with the booster given 4 wks later.  Given the pockets you've reported it may not be beneficial to give the vaccine as it helps prevent problems that may already be present and the vaccine is not 100%.  It becomes a personal choice.

All dogs have essentially the same number of teeth (unless they didn't come in from birth).  IT IS BETTER OFF WITHOUT A TOOTH THAN A PAINFUL TOOTH. You cannot change the past.  They can still eat hard food.  They are no longer painful without the tooth -- ie don't worry about the # of teeth extracted - only very few teeth are important for function, but function is still fine without ANY teeth.  A toothless dog has a better quality of life than a dog with few teeth with pockets and recurring pain.

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Hi,

Just an update on my Pom. He had his dental yesterday everything went well with the anesthesia etc. So that was a relief. He needed 10 extractions mostly from the upper arcade in the back. I nearly fainted when I was told that. I was expecting 5-6 when I was told 10 I felt terrible and still feel like I let him down. I didn't know then what I know now. :( I picked him up that same night and brought him home.
He moaned a few times throughout the night I stayed with him and cuddled him which helped. He's eating fine and going to the bathroom fine.

He's on metacam and clavamox(started the clavamox a day before the dental)

He will not let me near his mouth to look in and the aftercare instructions say to look in. I've even had to put his metacam on a small amount of food(he ate it all) because he won't let me squirt the syringe in his mouth for obvious reasons.

Is it OK to squirt the metacam on his food, so as long as he eats it all in one sitting?
The clavamox is taken separately from the metacam, hours apart and I've need to squirt this on his food. Is that OK to do?
I'm going to call the office as well to be sure.

Doxirobe gel was placed on several teeth into the pockets. I really hope he doesn't lose anymore teeth. Now I'm concerned that he will only be able to eat moist foods because of how many teeth he had out. Is that what happens?

Also I was looking to get him the porphyromonal dental vaccine, as recommended by my vet. once he's through all this. But I've read that small toy breeds tend not to take to it well and have reactions, get really sick etc.?

Can anyone tell me how many teeth a 5.6 pound Pomeranian has? Is it the same as larger dogs? I'm really concerned about the amount of teeth extracted. While I understand it was for the better I feel it's a lot and that can't obviously be good for the future.

[Jennifer Mathis, D.V.M.]

Don't beat yourself up.  I think I stated I don't brush my dog's teeth.  I do do other comprehensive preventatives though as well as regular anesthetic dental cleanings.  I've even had to do extractions on my own dog - better that have body problems/pain.

If you mean baby or deciduous teeth by "milk" teeth, it's a common issue that is unrelated to what you are likely seeing now.
The warning of bad teeth to come is the size of the pet. 85% of all pets have dental disease by age 3.  It higher % and earlier in pets under 25#.  ie any pet under 25# will have dental problems - it is a known fact that is often under emphasized by many veterinarians.

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Thank you!  I have faith in my vet I just really need to relax...can you tell? lol My baby seems to be doing better because I've been soaking his food with water for an hour then mashing it up. His energy is much better than it was a few days ago. I can't wait to get this all taken care of. I hate knowing he's in pain.I wanted to get him some canned foods but I'm afraid of changing his diet especially since he is having his dental on Mon. I'm def. going to get some prescription diet as the vet suggested while I'm there. Once this is over and done he will get brushings daily and I will never again let him run the show as far as tooth brushing goes. He's always disliked anyone touching his mouth. I remember bringing him home and struggling to brush his teeth, giving up trying again for years. I sure wish I laid down the law better now. Regrets.

When he was neutered I also had 4 milk teeth removed that had been growing on top of his adult teeth, they were in double rows. Could this have been a sign/warning of bad teeth to come? I just thought of this now.

[Jennifer Mathis, D.V.M.]

The second article by Fraser Hale about dental truths states that once there's a problem tooth - almost always the only options are extraction or root canal.  They can actually eat hard food well without any teeth, if the teeth are removed correctly and no retained pieces nor hiding teeth remain.  A dog has 42 teeth and really only 10 could do the same function.  Often it is better to loose a tooth than have that unimportant tooth continue decay and damage an important tooth.  If what I think is happening in your baby's mouth is really going on (xrays under anesthesia will tell), it is best to extract teeth and not try to save them.  All too often a borderline tooth is much worse than we think and damages other teeth and the body. Again, remove any damaged tooth.

Bio glass - I think you are referring to a product called Consil.  If consil gets placed in a socket where much bacteria are or if the socket has so much damage it communicates with the sinuses, problems can result.  It's not so much the bacteria as the body's reaction causing tissue irritation.  ie don't over use it.  There are non specialists that have this material.  If it's a case of the remaining bone of the lower jaw may fracture once the damaged tooth has been removed, consil or the like is a good choice.  You  may need to see a specialist on that one, or your DVM may have it.  Please let your veterinarian make the choice.  Consil, when it works, improves the jaw bone by about 10% over nothing but the blood clot - ie it is often not needed.  If you really want to have something there, see a specialist that uses an osteoallograft or OraMend -- the new much safer products than the bio glass that don't cause the irritation that sterile glass shards can cause.

ie let your veterinarian make the choices for the best health of your pet.  I do use the OraMend graft and have Consil, but rarely is it needed - ie your baby will likely have the same outcome either way unless the jaw is destabilized.

Best of luck!

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Is perioglass/bio glass usually used during extractions routinely? Or is that something I'd have to request? Also if any of the teeth could be potentially saved what are my options for my baby if any and will my vet be able to use the perioglass and possibly save teeth? Or is that a veterinarian dental specialist type of thing?

Thank You