I recently went to a dental lecture where the Veterinary Dentist referred to a dog with a complete mouth of diseased teeth that needed to be removed as “toothanasia.” On the ride home from the lecture, my wife asked me if I have ever had to do that and I told her about Princess the Maltese.
Princess was not a princess. She was one of the only Maltese that I have ever had to muzzle so an oral exam was not going to happen and dental home care was also out of the picture. One day the owner brought in a video of Princess eating. She would go over to the food bowl and pick out a piece of kibble and chew it then spit it out. Then she would pick it up with the other side of the mouth and chew some more and then eventually swallow it. The time to finish the entire meal took her hours and she would frequently walk away without finishing. When the owner gave her a soft meal or canned food she would swallow it whole. I told them that it sounds like she is having dental pain and unfortunately I have to recommend a dental procedure without actually being able to look at the teeth. They were concerned about how many teeth would need to be extracted but were excited that the breath would be better and she would not be in pain anymore.
The owners were nervous about Princess and I told them if they wanted to stay for the induction of anesthesia and actually see her teeth before I x-rayed them then that would be fine. Her pre-surgical bloodwork was fine and I placed an IV catheter and gave her the sedative. From there we put in the endotracheal tube and was able to see a mouth of green and black teeth. The closer we looked the more the smell of the mouth hit us. We keep a jar of Vicks vapor rub that we can put a dab under our nostrils if the smell is that bad and for Princess it was. I decided to bring Mom and Dad in to see. I showed them that 85 percent of the teeth were actually loose in the mouth. When I took my probe to the molars her jaw would tremble. Under anesthesia, she should not be feeling any discomfort but a metal probe to the tooth root is uncomfortable. I let them stay in the other room while I took the x-rays and every tooth except the four canines was either abscessed or did not have enough bone coverage to make the tooth sturdy and solid.
Mom was upset and dad was concerned that if we took out all of the teeth minus the four canines how she would eat. I reminded them that the reason we got to this point is that they brought in a video showing that Princess could not eat pain-free and at home dental brushings were not possible. Not that the whole episode needed more drama, but when I was probing one of the premolars with my dental probe the tooth actually fell out. Mom looked at me and was mortified. She wanted to see the tooth and when she brought it close to her face the smell hit her. She was wondering why Vicks was on the table and now understood. So we all agreed based on x-ray we were going to perform the necessary extractions.
The surgery went well and Princess was sent home with a week of antibiotics, pain medications, and recommendations of soft food. I asked to see her a week later and mom said that she couldn’t make it, but she was doing well with the soft food. I eventually examined her one month later and could not believe the change. She was eating her hard food again. The owners were totally fine with the canned food but caught her eating a dog biscuit and enjoying it. They gave her the hard kibble and seemed to gum it and be more satisfied with eating it compared to the canned food. They put her on my examination table and without hesitation opened her mouth for me to see and it looked great. No teeth but for the first time I was able to look at her mouth without a muzzle. I felt a little lucky so I approached Princess to look a little closer and the growling started. I had to remember that Princess was no princess.
Glenn Kalick, DVM is a veterinarian at Brookside Animal Hospital. Visit Brooksidevet.com.