"Crab Bait" is headed to the vet today.

[ladyjane]

Originally Posted by MarkFromSea

I appreciate the links, I'll explore that route.... but...... whew...... they are all "practicing" medicine.... we're not taking this lightly or going for the cheapest route... I'd just yank his teeth myself if that was the case... so back off a bit... Thanks....

Back off? Sorry, but all I am doing is telling you that I believe your vet is putting your pup at risk (I could be wrong, but it sounds scary to me); and, if you find that offensive, I don't know what to say. You made a comment about Robyn being a tough sell, so I was trying to help give you information for her. You say your dog has some unnamed lung condition and then tell me the vet wants to do a non anesthetic dental that could cause aspiration... very scary to me but everyone does what they believe is best I guess.

I have seen that comment before from people about "practicing medicine" and all I can say is that these people I refer to are highly skilled professional people.

If not you, it may help another person reading this thread.

[MarkFromSea]

You forgot the "a bit". Gucci's health and his life itself hangs on the decision Robyn and I make. That's enough stress. I appreciate the earlier information, I'll look into it.

[Marhcarter]

Good luck, whatever you choose. I love reading about Crab Bait & how he has improved so much under your care!

[MarkFromSea]

Just got off of the phone with the other dental vet's office.

It's a $90 consult where no work is performed, just look him over and evaluate his condition. OK, maybe they stuff a thermometer up his butt, I count that as work... He hates that. $150 for blood work. IF IF IF he is in good enough shape to undergo anesthetized dental CLEANING, it's $620.... ++++++ an undetermined cost per tooth for extraction.

So here's the plan: Our current appointment for unanesthetized dental cleaning is for 21 Jan. The Dental tech/vet will FIRST evaluate Gucci/Crab Baits condition and suitability for the procedure. If he is suitable, she'll clean his teeth, $211. If he is not suitable, no charge. In addition, we'll be left with going next door to the other vet at the expected $1200 to $1800 dental cleaning and tooth extraction. If he is in good enough health.

That's about it. The Seattle area vets, and every thing else, are pretty expensive.:thum bdown

Gucci is in good shape today, heading out for a very short walk, he'll be wearing his sweater EVEN THOUGH it slows him down and shortens the walk.

[ladyjane]

The costs everywhere are close to what you were quoted (well, that is all but the non anesthetic dental that I would never want a quote for, so I cannot compare). I actually paid more for my pups dentals with extractions and did not give the vet a thumbs down at all. Her work was worth every penny. There is a huge overhead in any type of medicine...people or animals.

Your vet already said he was not suitable for anesthesia due to some unnamed lung condition. I would think that would make non anethetic dental even more of a hazard....but I am merely a lay person and at this point just repeating myself and that is of no use.

Good luck to your pup.

[mimimomo]

I don't know if this will help, but February is Pet Dental Month & participating vets give 10% off dental cleanings. My boys will be going in next month. All the Best for Crab Bait!

[ladyjane]

Another link for those who might be interested. It is from the American College of Veterinary Anesthesia and Analgesia that gives it's standpoint on anesthesia free dentistry.

http://www.acva.org/docs/Anesthesia_Free_Dentistry.pdf

[MarkFromSea]

That's great information! Makes me feel better about the direction our vet has lead us. Thank You so much! Here's the article they are referring to:

AAHA dental anesthesia mandate comes under fire
AAHA Dental Anesthesia Mandate Comes Under Fire



By Ken Niedziela Veterinary Practice News

Posted: September 30, 2013, 3:00 p.m. EDT






19




Dental cleanings done without general anesthesia are safe and effective in many cases, according to a pilot study that challenges a new American Animal Hospital Association mandate requiring anesthesia and intubation for all dental patients.
The rule, part of the updated 2013 AAHA Dental Care Guidelines for Dogs and Cats, has a few veterinary hospitals contemplating abandonment of their AAHA accreditation. Many who oppose the mandate have been using anesthesia-free dentistry in their practices for years without problems.
"I totally oppose the policy,” said Kristy Lund, DVM, co-owner of Lund Animal Hospital in Boca Raton, Fla., which has been accredited for more than 25 years. "I’m up for renewal in November and I’m not renewing.”
Dr. Lund has offered non-anesthetic dentistry for seven years.
The study, published in the fall issue of Integrative Veterinary Care Journal, looked at Professional Outpatient Preventive Dentistry (POPD), an anesthesia-free service performed by trained technicians who are qualified by examination by the American Society of Veterinary Dental Technicians and work under a veterinarian’s supervision.
Pet Dental Services (PDS) of Costa Mesa, Calif., and West Palm Beach, Fla., which helped fund the research, carries out 15,000 POPD cleanings a year at veterinary clinics in 11 states.
PDS is one of only a handful of companies that perform anesthesia-free dentistry on veterinarians’ premises and under their guidance. This distinguishes it from lay people who "clean” pets’ teeth in grooming shops, pet stores, boarding facilities and house calls.
The study of 12 cats and 12 dogs found that all the animals tolerated the cleanings without complications.

In the study, the animals’ teeth were cleaned by a trained Pet Dental Services technician and subsequently examined under general anesthesia by a board-certified veterinary dentist.
"The examination consisted of inspection for any remaining subgingival calculus using compressed air, exposed full mouth radiographs and a complete oral exam,” the study reported.
After the POPD was completed, according to the study, the board-certified veterinary dentist found no residual plaque or calculus on any of the dogs or cats. In addition, all the patients for which the technician recommended anesthetic dental treatment were found to have radiographic findings in the specialist’s examination.
"In summary, the POPD was able to perform a complete prophylaxis, scaling supra- and subgingivally thoroughly and safely on all subjects,” the authors reported.
The study was peer reviewed by W. Jean Dodds, DVM, founder of the HemoPet blood bank and diagnostic laboratory in Garden Grove, Calif., and a board member with the American Holistic Veterinary Medical Association.
AAHA President Kate Knutson, DVM, criticized the findings and the study’s credibility, pointing to the "very small” sample size and other statistical and technical aspects.
Dr. Knutson would not rule out relaxation of the AAHA guidelines over time.
"AAHA welcomes more rigorous studies that do a deeper dive into non-anesthetic dentistry,” she said. "In the meantime, we need to consider what is best for the patient.”
Taking part in the study were Stephanie Sur, DVM, of The Whole Pet Vet Hospital and Wellness Center in Los Gatos, Calif., Nova Southeastern University researcher and statistician Patrick Hardigan, Ph.D., and three doctors of dental medicine. With the exception of Hardigan, all are directors of the National Pet Dental Association, a group that promotes non-anesthetic veterinary dentistry.
The research team noted that anesthesia-free dental work using body restraints and behavior management is not appropriate for all cats and dogs.
"It is intended to be a preventive treatment for young patients or as a therapeutic treatment for patients with Stage 1 and 2 periodontal disease,” the study reported. Neither is it intended "to replace anesthetic dentistry but to support it, meaning that it is up to the doctor to decide when and for what patients the service is appropriate,” the authors wrote.

They noted that "if this [had not been] a research setting, the technician would have stopped the POPD after the exam in 62.5 percent of the patients, all of which were [later] found to have radiographic findings, and discussed the findings with the veterinarian.”
AAHA’s new guidelines state that general anesthesia and intubation are necessary in all dental cases to ensure proper assessment and treatment.
The guidelines say that intubation is essential to prevent the aspiration of water and debris during dental procedures. They also state that anesthesia ensures patient health and safety by permitting "immobilization without discomfort, periodontal probing, intraoral radiology, and the removal of plaque and tartar above and below the gum line.”
The mandate has the support of the American Veterinary Dental College.
"Dental experts agree with and endorse AAHA’s new mandatory standard regarding anesthesia and dentistry,” said AVDC President Jan Bellows, DVM, Dipl. AVDC, Dipl. ABVP.
Dr. Bellows helped design and participated in the study’s early stages before stepping aside.
"Once I felt the study was fatally flawed in design and their initial conclusions, I declined any further contribution,” he said.
Bellows did not dispute the finding that the animals he examined under anesthesia after the POPD had no residual plaque or calculus supra- or sub-gingivally.
His objection was to "their conclusions that thorough diagnostics, including tooth-by-tooth probing and cleaning, can be done without general anesthesia. The fact that they missed many areas that we found either through the under-anesthesia, tooth-by-tooth exam leans to the uselessness of non-anesthetic dentistry.”
Patrick Hardigan, Ph.D., counters Bellows’ take. Hardigan is executive director of Health Professions Division Research at Nova Southeastern University in Fort Lauderdale, Fla., and was the statistician on the pilot study.
"The researchers were able to identify all areas of pathology, and confirmed their findings with radiography. Therefore, their research supports the conclusion that a probing and cleaning can be done without general anesthesia.”
Starting Nov. 1, all 3,200 AAHA-affiliated practices seeking reaccreditation must comply with the standard by the time of their evaluation.
Another veterinarian reconsidering AAHA status is James Davis, DVM, who owns accredited hospitals in Jupiter, Fla., and Marietta, Ga. About 12 patients a month at Harmony Animal Hospital in Jupiter get anesthesia-free cleanings through Pet Dental Services, Dr. Davis said.
"We’ve seen the benefits these procedures have for patients,” he said. "Because of the lower cost involved, they are able to get their teeth cleaned a lot more often.
"Bottom line, we clearly have better dental health in our patient base with the non-anesthetic service.”
Anesthesia carries inherent risks, Davis said, using the example of a 7-year-old Cavalier King Charles spaniel, a breed known for elevated odds of heart and dental disease.
"Heart disease can be so severe that there’s no way you’re going to do anesthesia on that dog,” Davis said. "AAHA is telling us that we can do nothing to that dog to clean its teeth, that it’s unethical and that it’s below the standard of care. And that’s unacceptable for us.”
AAHA’s president countered that anesthesia remains the better choice.
"If you have a dog that is not a good candidate for anesthesia, one option is to send it to a facility that does high-risk procedures,” Knutson said. "People need to understand that having severe periodontal disease or an abscessed tooth can be an equal, if not bigger, threat to a pet’s health than a broken leg, for example. If the dog’s leg was broken or it had a bladder stone, most veterinary professionals would still take it to surgery. The same commitment needs to be made to dentistry, either by using anesthesia during the procedure or by partnering with a practice that does.
"Thanks to AAHA anesthesia standards, the risk of adverse anesthesia-related events is minimized,” she added.
Davis emailed both Knutson and his AAHA representative to register his objections to the policy change.

[MarkFromSea]

article cont:
"Basically [AAHA] is telling us that we’re not doing a good job,” Davis said. "The staff is taking it hard. We’re dedicated, well-educated, disciplined professionals who want to do the right thing. But we feel that the change in this policy is clearly going to hinder our dental health program.”
He suggested that AAHA develop guidelines "based on patient selection and how to make this work rather than just pulling the plug on it.”
Knutson stood by the mandate.
"At this time, there are no studies to show that non-anesthetic dentals work as well as charting, cleaning and taking full-mouth X-rays when a patient is intubated,” she said. "As a medical professional, you need to be able to give your client a correct diagnosis.
"It is also a welfare issue,” she added. "We have no idea what stress hormones are released in a pet who is having an awake non-anesthetic dental procedure performed on them. Further research on non-anesthetic dentals is needed before any guidelines by any organization could be developed.”
Davis is considering following Dr. Lund and giving up his AAHA accreditation.
"We haven’t made a final decision, but we are leaning that way,” he said.
AAHA acknowledged that some members may cut ties.
"Whenever we pass new standards there will be members who won’t [abide] and won’t be able to receive accreditation,” communications manager Kate Spencer said. "It won’t necessarily surprise us if not everyone complies.
"The vast majority of what we’ve heard is positive.”

[ladyjane]

To each his own. I will stick with AAHA recommendations.

As I said, I wish your pup well.

[kjc]

Sorry to hear this news.... my 2 cents, lol: Getting a dental vs not getting a dental is a double edged sword. Yes the anesthesia could kill him, but with no dental, bacteria can very easily enter the bloodstream and he will become septic and could die just as easily. Both very bad things to have happen.

I've been there... the first option I call 'Death by Dental' (as in pulling a gun on the police is Death by Cop). Sorry for the sick humor.... it's how I deal with the hard stuff.

Normally, I opt for having the dental, bc if they survive, it will improve their health for their remaining years and will give them more time.

If a dental is definitely out, then you just do the best you can for as long as they're around. Antibiotics, special food, home dental hygiene, etc, whatever the vet recommends.

Many Yorkies have crappy teeth. This is a fact of life and we must be prepared for their care. If one of mine needs a high risk procedure, I turn them over to my vet and God, as it's in His Hands overall. That's about all I can do, and Pray.

And just a warning (this next part is kind of yucky) A family member never had dentals done on their dog, he did well and must have had good teeth, till he became ancient, and he started pulling his own teeth out. I get a call: What do we do? Well considering something is wrong that would make him do this, I told them to get a dental ASAP, if not he could bleed to death or die of infection, depending what was going on with him. They said he's too old, a dental would kill him. I said yes, you're probably right, but you can't not do anything, you have to try to help him, either by cleaning his mouth up and restoring him to a state of health, or he could die on the table, and be out of his misery. They opted for the dental. Spent a few days saying goodbye and spending special time with him. Then I took him to the vet for his dental. He did survive it, and lived a year or two longer to our surprise.

I'll be praying for a good outcome, and Peace in your hearts for you and your wife as you make a very difficult decision.

[MarkFromSea]

Hey KJC... you missed something.. that's ok though, there's a lot up there now. LOL
So here's the plan: Our current appointment for unanesthetized dental cleaning is for 21 Jan. The Dental tech/vet will FIRST evaluate Gucci/Crab Baits condition and suitability for the procedure. If he is suitable, she'll clean his teeth, $211. If he is not suitable, no charge and we have to figure out a different route.

So we'll know more on the 21st,,, We're still ok! He's not in any noticeable pain, he's a pretty happy spoiled old dog.

[kjc]

That falls under 'Whatever your vet recommends...'. I'm definitely curious about the 'noisy lungs'... if that clears up that would be better for anesthesia and maybe a go for the Dental w/anesthesia? (I think those are best, but I have no problem with the anesthesia free ones done in between.)

Praying for the best for CB! I know you both have a lot of love going on for this little guy!

[MarkFromSea]

Robyn found out some additional information earlier this evening about Gucci's past. About a year before we got Crab Bait he was fished out of the bottom of a pool with a net. That's in addition to the heat stroke that we already knew about, before we got him. Might be the lung issue.

He's got quite a resume' now. Puppy mill stud, rescued, drowned and cooked. Might explain why he never chews on anything other than food. On the rare occasion he barks, it's barely audible from the next room. He doesn't play with toys. He plays the "food" game with me and the "go to bed" game with Robyn. He sleeps most of the time and in our bed, looks pretty darn comfortable too. He watches us a lot when he's awake from his bed or the floor. He's not a spry pup but he knows he's an old stud. When he is awake, he is very alert. He isn't lethargic in his movements or facial expression, he just doesn't move fast... He moves with purpose. At times, on our off leash walks, when he walks in front, he moves with this bounce bounce bounce keeping pace in front of me. He looks pretty cool when he's moving that fast.

[ladyjane]

Originally Posted by MarkFromSea

Robyn found out some additional information earlier this evening about Gucci's past. About a year before we got Crab Bait he was fished out of the bottom of a pool with a net. That's in addition to the heat stroke that we already knew about, before we got him. Might be the lung issue.

He's got quite a resume' now. Puppy mill stud, rescued, drowned and cooked. Might explain why he never chews on anything other than food. On the rare occasion he barks, it's barely audible from the next room. He doesn't play with toys. He plays the "food" game with me and the "go to bed" game with Robyn. He sleeps most of the time and in our bed, looks pretty darn comfortable too. He watches us a lot when he's awake from his bed or the floor. He's not a spry pup but he knows he's an old stud. When he is awake, he is very alert. He isn't lethargic in his movements or facial expression, he just doesn't move fast... He moves with purpose. At times, on our off leash walks, when he walks in front, he moves with this bounce bounce bounce keeping pace in front of me. He looks pretty cool when he's moving that fast.

OK I will bite yet again...what IS this lung issue? Diagnosis??