Contents of Today's Veterinary Practice - JAN-FEB 2012

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

Page 40 of 83

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Safe dental care for seniors Are your preanesthetic protocols up-to-date?
Seniors: Higher risk for dental disease Dental diseases, including periodontal and associated diseases of the oral cavity, are perhaps the most common ailments affecting feline and canine patients of all ages. As pets age, however, the incidence and severity of dental disease greatly increases. Furthermore, senior and geriatric pets frequently have concurrent but unrelated age-associated diseases that may be clinical or subclinical. These include endocrinopathies, such as hypothyroidism, hyperthyroidism or Cushing's syndrome, or metabolic diseases, such as chronic hepatobiliary and renal disease. Older animals often have less competent immune systems and may be more susceptible to a variety of inflammatory and infectious diseases.
Healthy baseline values help flag deviations Baseline laboratory values and individualized reference interval limits early in the lives of healthy veterinary patients allows you to detect disease early, even before values creep outside the reference interval. A subtle deviation from established baseline laboratory values may indicate serious systemic disease. The minimum recommended wellness screen for the senior patient is a complete blood count (CBC), chemistry panel (including electrolytes and lipase), T4 and a complete urinalysis.
Dental disease is preventable and treatable Periodontal disease (periodontitis) is defined as destruction of the periodontal ligament and supportive tissues of the teeth by infection and inflammation. Periodontal disease is often accompanied by gum recessation, tooth root abcessation, loose teeth and ultimately tooth loss, often resulting from years of neglect with respect to dental health and preventative care. Unfortunately, dental-associated disease is a constant source of pain and discomfort for senior pets and the resultant halitosis that typically accompanies significant dental disease often has a negative impact on the human-animal bond.
Severe dental disease is preventable and treatable in most patients. In otherwise well- cared-for pets, neglect of oral health and lack of preventative dental care, including regularly scheduled cleanings, is often due
Tucker's teeth before cleaning
Re-evaluate any mild changes identified on the preanesthetic blood work in 3–4 weeks. In many cases, these changes, such as a mild increase in the ALT or globulin on the chemistry panel or mild inflammatory changes on the CBC, improve after the dental procedure.
Tucker's teeth after cleaning
to an overestimation of the risks associated with general anesthesia by the pet owner and even the veterinarian. Also, many animals are resistant to oral examination. Daily brushing, diets and a variety of chew toys and treats may help prevent but rarely improve established dental disease.
Minimizing anesthetic risks Today, routine anesthetic agents are far safer than those used even a few years ago. Additionally, most veterinarians understand that they can greatly reduce the risk of complications secondary to general anesthesia in both sick and well patients. They do so by performing a thorough preanesthetic evaluation, including preanesthetic blood work and adjusting the anesthetic protocol, postponing anesthesia and pursuing further diagnostics based on any changes detected and every patient should be closely monitored during and after the anesthetic procedure.
The minimal preanesthetic senior screening tests recommended for senior wellness screens include a complete CBC, full chemistry panel (including electrolytes and lipase), T4 and a urinalysis. Perform laboratory tests the day of the anesthetic procedure to minimize risk as values can change quickly and may be undetectable clinically.
This information has not been peer-reviewed and does not necessarily reflect the opinions of nor constitute or imply endorsement or SFDPNNFOEBUJPO CZ UIF 1VCMJTIFS PS &EJUPSJBM; #PBSE 5IF 1VCMJTIFS JT OPU SFTQPOTJCMF GPS BOZ EBUB PQJOJPOT PS TUBUFNFOUT QSPWJEFE IFSFJO Ï
Improving quality of life for senior pets .VMUJQMF TUVEJFT JO IVNBO NFEJDJOF IBWF demonstrated a clear relationship between periodontal disease and severe systemic diseases, such as cardiovascular and pulmonary disease. Although there has been no established link between specific systemic disease and dental disease in veterinary patients, more studies are needed. What is clear is that veterinary patients with significant dental disease often have significant pain and EJTDPNGPSU .BOZ PXOFST PG TFOJPS QFUT SFQPSU that their pets have increased activity levels, improved appetites and general quality of life after the dental procedure.
Clients' decisions are often based on trust. Sharing the results of the preanesthetic evaluation with pet owners when they pick up their pets increases that trust and creates instant value. Clients who understand the value of preanesthetic testing for their pet's safety will be more likely to agree with your recommendations and more satisfied with their overall experience at your clinic.
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preanesthetic testing Consistent preanesthetic testing protocols help ensure patient safety before, during and after anesthesia.
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Take a look at your preanesthetic protocols and make sure your practice is ready for you senior patients.
Visit www.idexx.com/prean3 to learn more.
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