Allie is an 18 year old Labrador Cross from Las Vegas pictured here with Dr. Niemiec’s Danish Resident Camilla. She had two major surgeries on her right mandible (lower jaw) for a malignant cancer several years ago. These were successful in curing the cancer; however the treatment changed the way her jaw functioned on that side leading to an increase in periodontal disease. For the last few years she had suffered with severe periodontal disease as well as oral pain, but the local veterinarians were concerned about treating her dental disease. First, because she had had major surgery on her jaw, it was weaker and abnormal, which would complicate the cleaning as well as any oral surgery. Since extractions were likely to be necessary, the jaw integrity would be further compromised, possibly leading to a fracture. Further, her advanced age and history of cancer made anesthesia a higher risk.
She was referred to Las Vegas Veterinary Dentistry and Oral Surgery. Based on the fact that she was in severe pain and had significant infection, the benefit of proper care was great. Her lab tests were normal as was her physical exam (other than being thin). Based on these findings, it was elected to proceed with the necessary dental work.
She was carefully placed under general anesthesia and a complete oral exam was performed. This confirmed the severe periodontal disease, but also revealed a large ulcer on the inside of her cheek from the severe plaque and tartar.
The fact that she had so much of her jaw and soft tissue in the area removed, created significant pressure from the tender cheek against the rough tartar. Full mouth dental radiographs were exposed, which also confirmed the advanced periodontal disease (red arrows).
Intraoral dental radiographs of the mandibular left (2,3) mandibular right (4), maxillary left (5-7), and maxillary right (8,9). These images confirm the advanced bone loss and infection throughout the mouth. The white line represents where the bone should be, dashed red line shows the current level of bone.
Allie was treated with numerous extractions as well as debridement of the ulcer. Because there was concern about the possibility of the recurrence of cancer, a biopsy was taken. Luckily, the biopsy came back as benign inflammation. Allie’s owner reported that she was a “a whole new dog” the very next day.
Allie is a classic example of a pet that suffers for an extended period due to baseless anesthesia concerns. Age and size have very little to do with anesthetic risk. Properly performed anesthesia is very safe, and clients should be encouraged to seek out a veterinary dental specialist for care if the primary care veterinarian is uncomfortable.