Vet360 Vol 3 Issue 04 August 2016 - Page 4

DENTISTRY Article reprinted with the permission of DVM360, MARCH 2016, DVM360 Magazine is a copyrighted publication of Advanstar. Communications inc. All rights reserved. The ABC's of Veterinary Dentistry: A to C Mar 14, 2016 By Jan Bellows, DVM, DAVDC, DABVP, FAVD DVM360 MAGAZINE Our alphabet of 26 letters forms the foundation for billions of words. I’ve narrowed the list down to a mere 26 related to dental care in pets. I hope you enjoy this series of articles starting with A for dental anaesthesia and ending with Z for dental zebras (I’m still searching for a good Y dental concept if you have one please email me at dentalvet@aol.com). Each letter holds major importance in our quest to do the best for our veterinary patients. A is for Anaesthesia Most people recline in the dental chair, open their mouths and are OK with a suction tube placed under their tongues, probes placed into their sulci and radiograph sensors placed next to their teeth. But dogs and cats will not tolerate this without a fight — and who wants to fight? General anaesthesia is needed to thoroughly clean, polish and examine the teeth and oral cavities in our patients (Fig 1). Figure 1. A peek inside All Pets Dental, Dr. Bellow’s veterinary practice in Weston, Florida. (Photos courtesy of Dr. Jan Bellows) Unfortunately many of our clients are so worried about anaesthetising their dogs and cats that proper care is declined. How can you allay your clients’ fears? Share with them the efforts you take to make anaesthesia as safe as possible by choosing the right patient for anaesthesia through preoperative testing, tailoring the anaesthetic protocol, and monitoring the effects of anaesthesia before and after the procedure. Monitoring. Close patient monitoring is paramount during and after anaesthesia. (All photos courtesy of Dr. Jan Bellows) The American College of Veterinary Anesthesiologists (ACVA) recommends monitoring for: 1. Circulation — Ensure that blood flow to tissues is adequate; measured via blood pressure. 2. Oxygenation — Ensure adequate oxygen concentration in the patient’s arterial blood; measured via pulse oximetry. 3. Ventilation — Ensure that the patient’s ventilation is adequately maintained; measured via capnography (Fig 2A). 4. Temperature — Avoid hypothermia, which is common in anaesthetised dental patients and a source of trouble for perfusion and ventilation. The ACVA recommends having a trained veterinary technician at the patient’s side. The technician can respond to feedback from the electronic monitoring Figure 2A. An in-line capnograph. system, use his or her hands-on clinical expertise to manage the patient’s proper anaesthetic depth, and maintain an anaesthetic record of significant events and trends in monitored parameters. In our procedures, the technician relays information to the veterinarian, who is appraised of the patient’s condition at least every five minutes throughout the procedure (Figure 2B). How to monitor. Monitoring is accomplished through subjective methods (e.g. clinical appearance) and objective methods (e.g. electronic systems). During anaesthesia, the patient should have minimal jaw tone and no palpebral reflex. The femoral pulse should be palpable, and the perfusion time should be two sec- Issue 04 | AUGUST 2016 | 4 VET360 AUGUST 2016 working.indd 4 2016/07/25 11:04 PM