17-Year-Old Italian Greyhound Needs 17 Teeth Removed!
Antonio was a 17-year-old grey and white epileptic Italian Greyhound. He walked into my office with the right half of his face so swollen, he looked like he tried to swallow a sausage and it got stuck lengthwise in his mouth! His big brown eyes looked miserable.
“I know what it is,” announced his mom, “I know I should have had his teeth looked at years ago, but I was afraid because he’s so old and he’s on 2 kinds of medicine for epilepsy.”
Indeed, Antonio needed emergency dental surgery. The infection from at least one tooth root abscess had caused the side of his face just below his left eye to swell painfully. He could barely eat; he did not want to drink any water. In fact, Antonio had started to generate a fever. He was on his way to becoming septic and possibly dying from the tooth abscess!
As his doctor, I know that with proper pre-anesthesia laboratory testing, monitoring heart rate, blood pressure, carbon dioxide, electrocardiogram, temperature, pulses, and Antonio’s general status under anesthesia, he was likely to do just fine and make a full recovery. An elderly patient like Antonio has several increased risks of anesthesia compared to younger, healthier pets. For one, he was very skinny; he was an Italian Greyhound, after all! The lack of body fat made him prone the hypothermia, or a low body temperature under anesthesia. He also took phenobarbital and Potassium Bromide to control epileptic seizures, which he still had about twice a year. While his liver bile acids showed good hepatic function a few months before at a routine check-up, a healthy liver is essential to a good anesthetic outcome. These issues can be dealt with by proper pre-anesthesia checking and proper monitoring.
The other, by far the hugest, anesthetic risk, was the deep periodontal dental disease itself! By waiting 3 years since his last dental cleaning under anesthesia, his mom had allowed harmful bacteria to establish huge colonies in his gums and around his tooth roots. This chronic disease process causes untold pain, immunosuppression, and subtle, often immeasurable damage to the whole body.
Antonio’s pre-anesthesia work-up looked perfect. Anesthetics were chosen in combination with each other to minimize pain, smooth his anesthetic experience, and be as gentle as possible on his liver and kidneys. Antonio’s vital signs were perfect throughout his dental surgery…which turned out to be 3 hours!
First, the technician obtained a full-mouth set of digital dental radiographs (X-rays), then cleaned the teeth with an ultrasonic scaler and subgingival hand tools. Then I examined the radiographs and Antonio’s oral cavity. He had 17 teeth that were loose and infected! 17!!! I called his mom to let her know the work that needed to be done. Luckily, I have developed my dental medical practice over the years to the point where I can take care of nearly anything without waking the pet up and having them go to the dental specialist. Antonio needed exodontia (full teeth extractions) for the 17 teeth, treatment of the alveolar sockets left behind, and careful gingival surgery to prevent “dry socket” and to help Antonio heal quickly.
“Antonio’s mom? Well, the good news is, I can fix him. The bad news is, Antonio needs to loose 17 teeth.”
“How will he eat?” (Everybody’s first question.)
“Fine. Much better than he’s eating now, that’s for sure!”
“How many teeth will he have left?” (Everybody’s second question, sort of irrelevant to Antonio, but humans like these sorts of numbers.)
“Oh my G*d!” (At this point, most people forget to ask how much it will cost, and if I would chicken out and not bring it up, they would have mini-parental heart attacks when they collect their pet to go home. Just imagine, three hours of advanced surgery!)
“It is ____ dollars worth of work.”
“Well, if we have to, we have to; he needs it.” (The third thing everybody says.)
Antonio did well. He woke up just great. His eyes looked bright and happy right away. He went home a few hours later.
Three days later he came for his post-op recheck. His face looked perfect! His mom reported, “He’s eating more than he has in years!”
A healthy mouth makes for a happy pet at any age!