1126. Dental extrraction of a 16-year-old dog






My title is M B and I came on your article about the 16y/o Pomeranian you performed extractions in c~tinuance without sedation and was wondering whether or not you might have any colleagues in the Los Angeles, CA district that might be willing to attempt the same procedure on a 9y/o Cavalier King Charles Spaniel through a grade 5/6 heart complain, mitral valve prolapse as well since lymphoma.

Her health issues make some sort of sedation impossible but she has a small in number wiggly teeth as well as couple cracked lower molars that I righteous found out are creating open sores in c~tinuance the roof of her mouth.  So it is something that really must be addressed.  Is in that place any advice/guidance you can give me to find someone that could relief us?

Thank you so much instructor,
M and T








Dec 8, 2014

I am Dr Sing Kong Yuen from Toa Payoh Vets. I put on’t know any vet in LA. You may privation to search for an experienced vet.

Isoflurane elastic fluid is needed in your case and usually this is secure place. Is your dog undergoing chemotherapy and ~ward heart medication? 

In the 16-year-antique dog, all teeth were loose traceable to aging and so were easily extracted promptly. Your dog be pleased be more energetic and have stronger mill-tooth roots. Therefore gas anaesthesia is requirement to do the extraction without the dog sarcastic or closing the mouth.

Best wishes.     



Written: 04 September, 2010

Be Kind To Pets
Veterinary Education
Project 2010-0129

Can one old vet (>50 years aged) change his mindset of not using ill-defined anaesthesia and sedation for very wise dogs so that she has a haughty probability of being alive at the end of dental work? The only chances of her perishable would be from fright (heart failure) appropriate to the stress of the dental work without general anaesthesia. Seldom are similar old dogs healthy. They usually hold heart disease and general anaesthesia kills them during the time that they are also very old.

Is it likely to perform dental extraction with ~t any general anaesthesia for such very crafty dogs with heart diseases and a mouthful of decayed and decomposed teeth as shown in the pictures of a box of a 16-year-old Pomeranian among the shades? 

dental health care scaling pain in dogs singapore toa payoh vets

dental health care scaling pain in dogs singapore toa payoh vets

16-year-old. Home cooked pabulum. Teeth encrusted with tartar but surprisingly in that place was no strong bad breath perfume.

An I/V glucose drip is weighty for aged dogs during operation. Emergency Lasix was given I/V while the dog coughed trying to unsullied her throat.

dental health care scaling pain in dogs singapore toa payoh vets

dental health care scaling pain in dogs singapore toa payoh vets

Dog goes home through no teeth left.  Vet Intern Ms Toh arranged the teeth quietly for photography. “How many teeth has ~y adult dog?” I tested Ms Toh who had eminent interest to study veterinary medicine. She shook her person. The answer is 42. 

If she survived, her peculiarity of life (no daily oral care and infection and hence able to have the advantage her food and put on weight). She would be more active and alert. She ability live to a ripe old decline of life the bacteria in her mouth had been free of.

Bacteria constantly produce toxins and disgrace her immune system.  In the in a high place case, the Pomeranian was in prosperity condition for her age. She looked like an 8-year-old dog rather than each ancient canine. She had no febrile affection and no abnormal respiratory rate. The beating pressure was lower. The dog was forward heart medication prescribed by Vet 1 toward some years.  However, she was underweight. Her voice was not smelly despite the appearance of large amounts of tartar.

The holder requested “manual scaling” as she had discovered in the internet forum that I was highly recommended in the manner that I do “manual scaling” (without vague anaesthesia). “I don’t do manual scaling,” I told her that there was a mistake in the internet forum she had researched. “How many of the hand scaling in dogs have you performed?” she asked. “None,” I reported. Ultrasonic dental scaling is the rule I use.

However, this old dog needed dental genealogy and not dental scaling. The roots of the teeth were wholly loose and infected. “Manual scaling” (without general anaesthesia) would not be in the engage of this dog as the bacteria quiet would be multiplying under the roots in time the gums. Dental scaling  would have ~ing what the lady wanted but this was not the appropriate thing to do for the dog. 

“There is a jeopard that your old dog may die from fright what is ~ to the pain of tooth lineage without general anaesthesia,” I informed the spouse. She was surprised and said, “Let me be under the necessity some time to think as to that which to do.”

I expected the woman of refinement to go home on this sunny Sunday afternoon of May 3, 2009. I had my hands replete on this busy Sunday. However, she returned and unwavering to take the risk.

An I/V grape-sugar drip was given to help to greaten the blood pressure as the beating was weak. Into the drip plant, I gave Baytril antibiotic to extent the dog immediately to kill the bacteria.

The dog was quite docile and so there was not a great quantity worry.  Two front incisor teeth were extracted. The dog started coughing during the time that if to clear phlegm in her faux.  This indicated that the vocal heart medication given to the dog was not efficacious to remove the fluid in the lungs (pulmonic edema).  What now? Cease operation?

Going back to the basic of veterinary pharmacology, I needed a deaden with narcotics to clear the water from the lungs immediately. I broke a vial of Lasix and injected it into the IV  fall in drops. The drug would take away liquid and gaseous from clogging the airways by infectious it into the blood-stream. I waited 5 minutes   in front of continuing dental extraction.

One or sum of ~ units teeth were extracted at 1-2-tiny intervals. The teeth were so unbind that most of them could just be pulled out easily. There was narrow bleeding. Tissues were used to superintendence the bleeding. When the bleeding had stopped, the other teeth were extracted.

The dog had not even coughed throughout the process of dental extraction. He was apprehensive.  Suddenly the dog shifted and the IV catheter came out. Intern Ms Toh had informed me that there was a skin swelling above the catheter. 3 Elastoplasts strips and a fold-around bandaged had been used to place the catheter in place but we had anticipated that this would come to pass. The dog had around 100 ml of grape-sugar and that would be sufficient. Since the catheter had popped audibly of the vein, the rest of the liquid and gaseous was given subcutaneously. Caution would exist the key and there was rest in between each dental extraction, dragging the measure to over one hour. Prevention of spirit failure due to fright was superior. After all, the owner wanted ~y effective veterinarian who would produce a live dog at the end of the set time, not an efficient one with a dead material part .    

The dog had 23 unsewed and rotten teeth extracted with slender pain and little bleeding. The woman of distinction’s eyes brightened when she returned later and was told that her dog was OK. 

The dog was alert and her worthy of great praise coat shone golden in the going down of the sun rays of the evening sun while I took her photograph. As the dog was not vaccinated, I did not lack the dog to be hanging right and left the Surgery. The lady put the dog in her car at the same time that she paid the bill. Well, the dog peed interior her car, but she was not upset. Her good in the highest degree friend was alive and that was the sort of mattered to her.  

This is the alone case of me doing dental drudge without general anaesthesia in my 2 decades of minute animal practice. I record this in depict to share my unusual experiences by other veterinarians. If the dog had kicked the bucket, the owner would be very unhappy as she had 14 years of society with this old friend after acceptance from the SPCA as a 2-year-sensible.

It was fortunate that the sensible Pomeranian did not die of fright in successi~ the operating table.  I dress in’t want to do any to a greater degree such cases as this will incite the God Of Death. This was not a uncombined case as the dog was coughing. If the coughing continued, the dog was exist stressed out and die of fortitude failure. Therefore, the vet must discern what to do when things slip on’t proceed smoothly. Of course, the with most propriety way is not to accept in the same state a high-risk case as deaths of consort animals on the operating table are never forgiven or forgotten by the holder and her family.      

It would exist wise for dog owners to fall the dog’s teeth check every year and get dental scaling bestowed when the dog is young and fit. Continue with tooth brushing after dental scaling.

The dog lived to a mellow old age and passed away in April 2010. The put in the mail-operation feedback from the owner indicated that the dog had verbal pain and low blood sugar.       

E-send by post to Dr Sing dated Sep 2, 2010



Dear Judy, 

I adage the case study on the in a high place website. 

I am the owner of this dog. Her name is She. She passed let us go. this year 11 April. It was a Sunday spring-time. 

Please send my regards to Dr Sing. 

On the particular occurrence study, I would also like to update you the sort of happened after I got home.  

The surgery was a success as my dog was indeed alive and well. Just like any other beings, they extremity rest after surgery.

However dogs be inclined always attempt to walk or mark out as its part of their mood, not knowing itÂ’s exhausting.

One the elementary night after the surgery, my dog collapsed unexpectedly and started to whine. I picked her up and gave her a massage, what one. she was able to stand ~ward her feet soon after. This happened as far as concerns another 2 times in a epoch. 

I realized it may have existence trauma and shock, and maybe unmanly glucose level. She is also not erosive well. Where is she going to obtain the “energy”?

She was even now on long term medication for spirit, plus after surgery medicine. I was not prepared with regard to more medication for my little 16+ yr aged. 

I brought her to TCM. I ween this doctor is the only learned man in SG who provides acupuncture on this account that dogs. He is (Name given). I asked this learned man to also do treatment for her appetite, her heart, and other senses of the like kind as hearing and sight. She responded exceedingly well after the first treatment. She was likewise beginning to eat! And best sub-division is she and I had vigilance contact, it shows that sheÂ’s acquisition more alert.  

She continued the method of treating for about 1 month, about 5 consultations. She recovered actual well. Soon after she starts to rend all people who attempt to pertain to her, including myself. I think itÂ’s the surgery trauma and ancient age crankiness. But I also have an opinion that if she bites it mode she is alert to her surroundings. I see it as something over-confident, sometimes, funny.

Because, no teeth stop want to bite people?

No besides bad breathe and no more toothache. I was not worried encircling bacteria possibly worsening her heart condition anymore.

Without teeth, her tongue eternally sticks out! Amazingly she looked calm younger and cuter!  

I wrote this to you for as fate has it, Dr Sing has indeed changed the nobility of her life.  

But he is also right, itÂ’s very risky. What allowing that the owner did not take providence AFTER the surgery? 

I be in possession of attached 4 pictures. 1 taken in May 2009, 1 in Sep 2009 and 1 not so much than a month before she left in 2010. 

16-year-old Pomeranian after dental work looks much younger and active. Toa Payoh Vets, Singapore

16-year-old Pomeranian after dental work looks much younger and active. Toa Payoh Vets, Singapore

16-year-old Pomeranian after dental work looks much younger and active. Toa Payoh Vets, Singapore

She was surpassingly lucky, to have met the as it should be people. 

Thank you.  

Best Regards,

E-defensive covering from Dr Sing dated Sep 4, 2010


I am Dr Sing and got your dutiful news of your dog living to a consummate old age.  Thank you concerning your email and important feedback situation-operation as I seldom get some feedback. Most likely it was moo blood sugar as you diagnosed. It could have ~ing the post-dental extraction pain.  Your pictures are large. Pl give permission to post the pictures.  I sense of possible fulfilment all are well with you.

E-put in the ~ to Dr Sing dated Sep 4, 2010


Hi Dr Sing,

Great to have an account from you! 

Sorry I would like to rephrase, I meant her reverence and anxiety on the surgery level would definitely caused that “weakness” that makes her faintish.

Yes, I should frame as low blood sugar. ItÂ’s a erect after-surgery process. I remember feeding her sweeten/glucose water. 

I am well, express gratitude you. I guess this is single thing all dog owners have to walk thru. 

Until yesterday, I could not at all have imagined how hard you guys drudge over the metal table, while I was stoning in your clinic.

It was a real detailed re-enactment. Thank you beneficial to sharing. It was heartwarming for me. 

I reliance my feedback could help you and your furry patients.

Please be wrought up free to use the pictures, itÂ’s my desire.

Best Regards

Singapore flowers, Toa Payoh VetsTIPS FOR VETS:
I did not bestow the dog pre-op NSAID torture-killer nor after the dental parentage as I would do for a younger dog. This is because this dog’s kidneys would not have ~ing as good as a younger dog to withstand any adverse reactions on the kidneys from NSAID drugs.

NSAID drugs are not to exist given to dogs with kidney disorders and nevertheless no blood tests to ascertain renal province were taken, I expected the kidneys and livers of a 16-year-ancient dog not to be as vertical as to metabolise NSAID drugs in the absence of dying of side effects and by that means distressing the lady owner. As towards post-operation sugar paste, this would exist given for old dogs. In surpassingly old dogs, it is very risky to employment injectable anaesthesia. In this case, isoflurane aeriform fluid would be safer but it was not used while the owner

Nick Wright and colleagues at the Wellcome Trust Centre on this account that Neuroimaging at UCL carried out a order of tests using seventeen pairs of female* volunteers who had previously never met.

Recent Comments