I believe that things happen for a reason, the effort to get Elliott's cleaning & extractions done as planned, might be delayed for the 3rd time. The good news is that I would be choosing to cancel this week's appt in order to have more time to weigh the various general anesthesia & sedation/pain mgmt options, to have my questions & concerns addressed with confidence & cooperation by the vet. I also want to share that the short 1 month that I've been a part of HA has been very instrumental in shifting my mind-set to understand how essential & important it is to dedicate the time & energy to acquire the knowledge necessary to become an active participant with these types of potentially quality-of-life altering decisions. I came across this very educational article while looking for a printable canine dental chart that I would use for my observations to use as a starting point with the vet who was scheduled to do the cleaning - at previous office visits she was not comfortable looking deep in the mouth or to touch front loose teeth in order to give me a ball-park amt for extractions & I also wanted to create an actual dental condition check-list for my reference. Here is the link Increasing Clients’—and Your Own—Dental Awareness From the Exam Room to the Dental Suite | Today's Veterinary Nurse It's intended to actually teach vets on how to effectively present comprehensive pet dental care to their patient's owners & in my current 1-1/2 year odyssey to get Elliott's mouth safely tended to it served as a very important & useful checklist & guide as to the types of questions to ask. Despite many years of having canine dentals done, I had never requested a written estimate, detailing exactly what the procedure would entail & what types of meds would be used. It has only been 10 yrs or so since I even began asking about the type of anesthesia & that was only because while I was living in Mexico I was told that gas/inhalation types were easier to detox compared to IV delivery & for many years I postponed procedures for those occasions when a vet visiting fm the USA would bring inhalation equipment i.e. for spay/neuter clinic. I'd gone through several procedures when sodium pentathol or ketamine was used & the dogs seemed to really suffer & I was in charge of monitoring the recovery because where I was living, the vet office closes down & everyone leaves for a 2 hour lunch, all animals go home awake or not. I hadn't seen this article a month ago, when I scheduled the firav appt for cleaning, but I did decide it was best for Elliott to have a pre-op visit even though the vet had said the most recent Feb 4 visit would suffice, I felt I needed a calm opportunity to point out other things that might be dealt with during the anesth & to point out some of the problem teeth to get a clearer picture of the cost. I also took the opportunity to ask for a written estimate w/details & am I glad that I did, because despite the vet & I discussing scheduling a cleaning since our 1st meeting back in November, I made the mistake of assuming that the procedure would be done using basic pre-anesth sedative injection & gas anesthesia. I'd made peace with using inject. antibiotic. In all of the previous cleanings which sometimes included multiple extractions involving "big" teeth w/deep roots, extra pain meds, a drug to revive/wake-up, & antibiotic injections had never been used, things were very basic. The 1 recent written estimate which a previous had vet prepared without my requesting only showed Gen'l Anesth/Isoflurane, Pain Med/Carprofen injection & Antibiotic/Penicillin & I'd assumed each quote would be similar except for cost. Dr. E wasn't able to give me the estimate while I was in the ofc, I'd been anticipating a relatively short list of planned procedure meds & was very happy to see the all-inclusive items i.e. Catheter, EKG monitoring, BP monitoring, x-rays, what I wasn't prepared for was the list of 8 various anesthetic/sedative/pain-relief drugs. I had neglected to inquire directly about the Gen'l Anesth being inhalation or IV presuming that would be described. What is prompting this inquiry specifically about the ins & outs of Anesth procedures is that Dr. E isn't as forthcoming with an explanation so that I could perhaps request a reduction in the quantity of drugs to be used. I had thought she totally understood my desire to keep the drug/toxic load & reliance on meds to a bare minimum to get the job done. I hv complete respect for the vet's comfort zone that they need to work with whatever protocol that they have the most experience & confidence using, I am concerned about going through with the cleaning without getting further input on the wisdom of exposing a 9 yr old dog to such a vast array of drugs when I've witnessed bare-bones procedures & 2 other local USA vets seem to employ much fewer narcotic/opioid/local anesth. I also plan to ask Dr. H for a comprehensive written estimate on Mon to accurately compare his approach, it is a shame that this has come up just 5 days prior to the scheduled cleaning, & I am also glad for this eye-opening experience before any potent drugs are administered. I've spent several hours researching the various drugs listed on Dr. E's estimate, it has made a huge difference to at least to hv a basic grasp of the gen'l purpose of each item. I am still waiting for clarification of the actual Gen'l Anesthetic drug, Propofol was listed & I'd concluded that she was using it as the gen'l
because Isofluorane did not appear. I am hoping that Dr. E will explain her drug choices so that maybe I can logically decline things like Buprenex & Marcaine - Wouldn't it be true that Arnica & Hypericum could accomplish the same purpose of post procedure pain-relief without potential unexpected reactions? I hv a definite sense that younger, more recently trained vets believe in the pain-awareness models & it has a direct impact on their preferred protocols. I feel nervous about so many chemicals interacting all at once, especially w/preservatives & additives, I believe my dog 3 yrs ago had a reaction of paralysis flwg a therapeutic aqua-puncture injection of a cocktail of Adequan & Vit B-12, that there was a reaction to the Sodium Benzoate in the B-12. Would it be possible to get your feedback on the proposed meds & basic protocol? 1. Inhaled vs IV Gen'l Anesth - I seem to recall reason it was safer is because by giving O2 could purge out more quickly & I also understand newer products like Propofol are metabolized in an entirely dif. manner. It's interesting to me that 2 local vets clearly indicated that ISO is their preference plus from 2008 there was 1 vet who opened a super modern practice who used Iso & I was able to observe several anesth procedures. I am waiting for clarification on whether Midazolam inj., Torbugesic inj., Dexdomitor Desmedesed are pre-op sedatives or something else. I've ID'd Buprenex inj. & Marcaine inj. as local anesth, I wonder if a local during the procedure is needed if Elliott is 100% unconscious, & hopefully post-procedure Hypericum will resolve extraction pain, I feel Arnica would also help, especially with sore mouth & face muscles being manipulated. Dr. E plans to use Clindamycin inj. instead of Penicillin, it was interesting to learn why it is probably a better choice for this procedure. Dr. E also plans to use Antisedan inj., would this offer a clue to the planned Gen'l Anesth, I don't recall a "wake-up" drug being used for previous work? I am also going to look into using CBD oil after using Arnica/Hypericum during immediate post-procedure period. Does anyone have any personal experience using CBD for this type of pain management + is it best to stop homeopathy before using CBD or are they compatible together? Also, I've been applying PurO3 brand ozonated sunflower oil to previously inflammed spots on gums for about 1 week & I plan to use topically after any extractions. It is supposed to be soothing & promote healing, it is my first time working with this type of treatment & I think Elliott felt relief, it diminished the signs of blood & he reacts as though it feels good. It can be used directly on surgical incisions, the oil acts as a carrier for the ozone. Before I purchased from Amazon I spoke with one of the PurO3 founders, we had a great conversation, he was very informative, PurO3 is very pleased & surprised that the article mentioning ozonated oil has resulted in many people trying out the product specifically for their pet's mouths. Dr. Jeff & Dr. Christina, I know this is very long, I thank you in advance for any input you can provide, I don't want to proceed w/scheduled appt. if there are reasonable, practical ways to reduce the toxic load of this much needed dental procedure. This has been a very intensive learning experience, that I hope others may find useful.
because Isofluorane did not appear. I am hoping that Dr. E will explain her drug choices so that maybe I can logically decline things like Buprenex & Marcaine - Wouldn't it be true that Arnica & Hypericum could accomplish the same purpose of post procedure pain-relief without potential unexpected reactions? I hv a definite sense that younger, more recently trained vets believe in the pain-awareness models & it has a direct impact on their preferred protocols. I feel nervous about so many chemicals interacting all at once, especially w/preservatives & additives, I believe my dog 3 yrs ago had a reaction of paralysis flwg a therapeutic aqua-puncture injection of a cocktail of Adequan & Vit B-12, that there was a reaction to the Sodium Benzoate in the B-12. Would it be possible to get your feedback on the proposed meds & basic protocol? 1. Inhaled vs IV Gen'l Anesth - I seem to recall reason it was safer is because by giving O2 could purge out more quickly & I also understand newer products like Propofol are metabolized in an entirely dif. manner. It's interesting to me that 2 local vets clearly indicated that ISO is their preference plus from 2008 there was 1 vet who opened a super modern practice who used Iso & I was able to observe several anesth procedures. I am waiting for clarification on whether Midazolam inj., Torbugesic inj., Dexdomitor Desmedesed are pre-op sedatives or something else. I've ID'd Buprenex inj. & Marcaine inj. as local anesth, I wonder if a local during the procedure is needed if Elliott is 100% unconscious, & hopefully post-procedure Hypericum will resolve extraction pain, I feel Arnica would also help, especially with sore mouth & face muscles being manipulated. Dr. E plans to use Clindamycin inj. instead of Penicillin, it was interesting to learn why it is probably a better choice for this procedure. Dr. E also plans to use Antisedan inj., would this offer a clue to the planned Gen'l Anesth, I don't recall a "wake-up" drug being used for previous work? I am also going to look into using CBD oil after using Arnica/Hypericum during immediate post-procedure period. Does anyone have any personal experience using CBD for this type of pain management + is it best to stop homeopathy before using CBD or are they compatible together? Also, I've been applying PurO3 brand ozonated sunflower oil to previously inflammed spots on gums for about 1 week & I plan to use topically after any extractions. It is supposed to be soothing & promote healing, it is my first time working with this type of treatment & I think Elliott felt relief, it diminished the signs of blood & he reacts as though it feels good. It can be used directly on surgical incisions, the oil acts as a carrier for the ozone. Before I purchased from Amazon I spoke with one of the PurO3 founders, we had a great conversation, he was very informative, PurO3 is very pleased & surprised that the article mentioning ozonated oil has resulted in many people trying out the product specifically for their pet's mouths. Dr. Jeff & Dr. Christina, I know this is very long, I thank you in advance for any input you can provide, I don't want to proceed w/scheduled appt. if there are reasonable, practical ways to reduce the toxic load of this much needed dental procedure. This has been a very intensive learning experience, that I hope others may find useful.
