How do plaque and tartar form, and what do they do?

Plaque is a gummy substance that forms on the teeth within a few hours after a meal. Within 24 hours, plaque begins to harden by combining with salts that are present in the saliva. As the plaque continues to accumulate and mineralize, it eventually forms tartar. Tartar, also called calculus, is rough and porous and can develop above and below the gum line.

There are two ways that tartar harms the teeth and gums:

First, tartar forms a rough surface serving as a place for bacteria to grow and multiply in the mouth. Bacteria can cause inflammation of the gums (gingivitis), which often results in painful bleeding. Gingivitis often progresses to periodontal disease, which leads to further inflammation, pain, and tooth loss. As tartar builds along the gum line, it pushes the gums away from the roots of the teeth. As the gums recede, they expose the sensitive, enamel-free part of the tooth, which causes sensitivity and pain.

Second, the bacteria on the tartar can be absorbed into the bloodstream and deposited in various organs, including the heart, liver, and kidneys, causing infection.

How can I prevent plaque and tartar formation on my pet’s teeth?

After your pet’s teeth have been professionally cleaned and polished by your veterinarian, home dental care is needed to help reduce plaque and tartar buildup. You can decrease plaque accumulation by:

• Feeding your pet Veterinary Health Oral Council (VOHC) accepted dental diet which slows plaque and tartar accumulation by mechanical or chemical means. By limiting plaque as it forms, tartar development is greatly reduced.
• Brushing or wiping your dog’s teeth daily. This is the most effective way to remove plaque before it turns into tartar. Do not use human toothpaste as it contains ingredients that can cause an upset stomach when swallowed.
• Using a VOHC accepted water additive to reduce the bacterial count in the mouth, resulting in improved breath.
• Offering your pet chew toys and dental treats that are specifically designed to help reduce or remove mild tartar. Never let pets chew on toys that may break their teeth (bones, antlers, even ice cubes). Any acceptable chew toy should yield with thumb pressure as this indicates that it is not too hard for your pet’s mouth. Also, tennis balls are very abrasive and can wear down teeth.
• Having your veterinarian perform dental cleaning under general anesthesia as needed. Regular dental cleaning is important in pets as it is in people and will go a long way to prevent irreversible damage to the gums and roots.

How do I know if the product I’m using to prevent tartar is actually working?

The Veterinary Oral Health Council only accepts dental products that are safe and proven to reduce the accumulation of plaque and tartar based on strict scientific studies. A list of accepted products can be viewed at www.VOHC.org.

What does pre-anesthetic bloodwork assess?

While the exact biochemical parameters measured in pre-anesthetic bloodwork vary, depending on the particular bloodwork panel your veterinarian recommends, pre-anesthetic bloodwork typically involves two primary components. These components are the CBC (Complete Blood Count) and serum biochemistry. These tests provide valuable information about your pet’s internal health status.

CBC (Complete Blood Count):

A complete blood count assesses the cells that are present in your pet’s blood. Abnormalities in your pet’s cell counts may indicate an underlying disease and affect your pet’s surgical/anesthetic risks and recovery.

A complete blood count specifically looks at three types of cells that are found in the blood:

• Red blood cells: these cells carry oxygen through the blood to your pet’s tissues. A CBC assesses the quantity, shape, and hemoglobin content of your pet’s red blood cells. These tests detect a number of diseases, including anemia (low red blood cells) and polycythemia (elevated red blood cells).
• White blood cells: these cells typically respond to inflammation and infection. A CBC not only measures your pet’s overall white blood cell count but also provides separate counts for each unique type of white blood cell. Elevated white blood cell counts often indicate infection or inflammation; the specific white blood cell type that is abnormally elevated can often provide additional information about a possible diagnosis. Abnormally low white blood cells counts may indicate a more serious infection or possible immunodeficiency. Less commonly, dramatic white blood cell count abnormalities may indicate cancer.
• Platelets: platelets are responsible for blood clotting. A low platelet count suggests that your pet may be at greater risk of excessive blood loss during surgery.

Serum biochemistry:

The serum biochemistry examines levels of a number of chemicals in the blood associated with organ function. The exact parameters that are checked in a blood panel will vary depending on the particular panel your veterinarian recommends; young, healthy pets may receive a smaller biochemistry panel than seniors. In general, serum biochemistry will include values that assess your pet’s liver, kidneys, blood glucose, serum proteins, and possibly other parameters.

• Liver function: is assessed through a number of values on the serum biochemistry. These values include alkaline phosphatase (ALP), alanine transferase (ALT) and can include others (i.e. AST, GGT, total bilirubin). Elevations in these values may suggest an increased risk of liver disease in your pet.
• Kidney function: is assessed by measuring the blood urea nitrogen (BUN) and creatinine. Both of these substances are normally cleared by the kidney. Increased levels of BUN and creatinine suggest that they are not being effectively cleared by the kidney due to dehydration or kidney disease.
• Glucose: is a measure of the sugar in the blood. Dramatically elevated blood glucose levels may indicate diabetes.
• Serum proteins: include albumin (ALB), globulin (GLOB), and total protein (TP). Low protein levels are associated with a number of medical conditions. Pets with low protein levels may experience delayed post-surgical healing. Elevated serum protein levels may indicate dehydration.
• Electrolytes: such as potassium (K), sodium (Na), and chloride (Cl) may be tested and may become increased or decreased with various disease states that may affect surgical healing or suitability for anesthesia.

Why is Preanesthetic Bloodwork Recommended?

Preanesthetic bloodwork is typically recommended for most animals that are undergoing anesthesia. This allows your veterinarian to assess your pet’s overall health, ensuring that your pet is a good candidate for anesthesia. If pre-anesthetic bloodwork shows any abnormalities, these can be addressed by making any necessary adjustments to your pet’s treatment plan.

For geriatric or ill pets, additional blood tests, electrocardiograms, or x-rays may be recommended before surgery as well. If serious problems are detected, surgery can be postponed until the problem is corrected.

Along with the bloodwork, we perform a thorough physical exam on your pet before administering anesthetics. This is to ensure that a fever or other illness won’t be a problem. We also adjust the amount and type of anesthetic used depending on the age and health of your pet. We have advanced anesthesia monitoring equipment and will make surgery as safe and efficient as possible.

How might the test results affect my pet’s treatment?

If your veterinarian finds abnormalities in your pet’s pre-anesthetic bloodwork, there are several potential outcomes.

Some abnormalities are mild and unlikely to be clinically relevant. For example, a white blood cell count that is just marginally above the normal range, in the absence of clinical signs, may be an indication of stress and not of any underlying disease.

Marginally elevated blood glucose without other abnormalities may also be seen with stress. If your pet has a very mild elevation, your veterinarian may proceed with anesthesia without any further testing or interventions. In some cases, your veterinarian may recommend rechecking the value in the future to ensure that more significant abnormalities do not develop, even if the elevation does not appear to be significant at the time of testing.

In some cases, pre-anesthetic bloodwork detects abnormalities that can be corrected prior to anesthesia. For example, if your pet’s pre-anesthetic bloodwork indicates mild dehydration, your veterinarian may administer intravenous fluids prior to anesthesia. This allows your pet to be as medically stable as possible prior to undergoing anesthesia.

In other cases, however, more significant abnormalities might be detected on pre-anesthetic bloodwork. In these cases, your veterinarian may recommend postponing surgery until additional testing or treatment can be performed. Examples of situations where this may occur include anemia, elevated liver or kidney values, or diabetes. In the case of significant bloodwork abnormalities, postponing surgery until the pet’s condition can be thoroughly diagnosed and addressed helps maximize the chances of a safe anesthetic procedure and smooth recovery.

Preparing For Surgery

At Sequist Animal Hospital, the health and well-being of your pet is our highest priority. For that reason, we require that a full examination be performed by one of our veterinarians within six months of your animal’s surgical procedure. We also strongly recommend (and sometimes require) pre-anesthetic blood screening.

The examination and the bloodwork complement each other to have the best overall picture of the health of your pet – from the inside out! The reason this is so important is that this can change or even postpone a surgical procedure depending on the outcome of the examination and testing.

A Few Days Before Surgery

Our team works diligently to generate an anesthetic and surgical plan for your pet. Upon arrival, we will ask you important questions related to your pet’s health that will be important information for surgery. Please be prepared to tell us any medications, supplements, or preventatives that your pet is currently taking (including over-the-counter products) as this may change the plan for anesthesia and for medication that may be needed after the surgical procedure.

When those questions are being asked, we will also inquire as to what other procedures you may want that day – including nail trim, vaccines, microchip implantation, etc.

We will also review any medical conditions that your pet has as they may affect our anesthetic protocol for the procedure.

We will also have an automated message to remind you of your surgical appointment one day before the scheduled time. (this gives you information on fasting before the procedure as well as confirming the time of admittance).

It is essential that if you cannot keep the appointed time for surgery that you contact the hospital immediately.

The Night Before Surgery

Please do not allow your pet to eat after midnight on the night before the scheduled surgical procedure. Water is okay to leave down through the morning.

If your pet takes medication at night, it is okay to give that medication.

If your pet takes medication in the morning, it is generally okay to give this (if needed, you can give a tiny amount of food around the medication). Please contact the hospital to confirm whether this is correct for your specific animal.

Please contact the hospital if you are unsure if and when you should be giving any medications, supplements, or preventatives prior to the surgical procedure.

The Day Of Surgery

Please be prepared to arrive at the scheduled time (note for dog owners: please give your pet some extra time to eliminate before they enter the hospital).

We will need to go over the following:

• Estimate/Consent to Surgery form
• Surgery Admission Form
• Verify phone numbers that will be the best point of contact for the day
• Meet with admitting technician to answer any further questions and collect any remaining information

After you have dropped off your pet, a veterinary technician will perform a cursory examination to ensure that no parameters have changed. They will then discuss the surgery with the veterinarian performing surgery, and the surgical team will then finalize the treatment protocol for your pet.

Your pet will be placed in a comfortable environment to await surgery. They will receive an injectable sedative which will help them become drowsy. An intravenous catheter will be placed for most procedures (this helps to ensure access to administer medications and fluids), and your pet will be completely anesthetized, prepared for surgery, and then the surgery will take place.

During Surgery Procedure

During surgery, the veterinary surgeon will perform the procedure with the aid of one veterinary technician and one veterinary assistant. The supporting staff will monitor your pet during the entire procedure and also assist the doctor during that time.

Immediately After Surgery

Directly after surgery, your pet will continue to be monitored closely as they recover. You will be contacted about how your pet is doing, how the procedure went, and how to care for your pet at home during the recovery period.

Send Home

Your pet will be sent home the same day that the procedure is performed. The pick-up time will be dependent on multiple factors, including how your pet recovers from anesthesia and your schedule.

Helpful Steps To Prepare For When Your Pet Comes Home From Surgery

• Your pet has had general anesthesia and will still not be back to “normal.” It is best if they can go straight home to a warm and darkened environment that is quiet. This is generally the best way to allow them to continue to wake up slowly and comfortably from anesthesia. Continue to monitor your pet during this process.
• If you have other pets in the household, it is best to keep them separate for the evening and then can be reintroduced, with supervision, the next day. Sometimes when the pet comes home, they smell different and are acting differently, which is sometimes challenging for other pets to see.
• Your dog or cat may need to be on a leash when outdoors during the recovery period for incisional healing. If they are not used to being on a leash or wearing a collar or harness, it may be helpful to work with them prior to the procedure. Your surgical team will make recommendations as to how long using the leash should be necessary. For cats, it may be recommended to keep them strictly indoors.
• Since your pet may need to be kept from running/jumping and playing for a period of time, you may want to have a kennel or crate set up as a place for your pet to rest. It is very important for your pet to be comfortable with this environment before you use it for post-surgery purposes.
• Your pet will need to have a somewhat restricted diet when they come home from surgery. Generally, you can offer small amounts of water and also about 1/4 of the normal amount of food IF your pet seems interested. If they are not interested, then wait until the morning and try to offer food and water normally. If your pet needs to have exercise restriction for more than one week, we recommend reducing the food by 25% to help prevent weight gain while your pet is recovering from surgery.
• There may be medications that your pet receives. Instructions on how to administer as well as when to start the medication will be discussed as well as printed on the medication labels. Please be prepared to hide the medication in something your pet will be interested in or ask our staff about ways in which to hide or administer medication if need be.
• In general, pets will need to wear an e-collar/cone after their surgical procedure. Please click here to learn how to prepare your pet for an e-collar, as well as our recommendations for when your pet should wear the collar. There are alternate options to the e-collar, which must be discussed and purchased well in advance of the procedure.
• It is normal for pets to vocalize some when they are recovering from anesthesia. Again, keeping them in a quiet and darkened environment can help them sleep off the remainder of their anesthesia. Some pets take comfort in being with their owners, so you can prepare to sit quietly with them. For some pets, this makes them vocalize more, so you may want to be prepared to give them some alone time if that seems best.
• Your pet may be a bit unsteady on their feet. We do not recommend having them go up or down stairs without assistance (either holding onto their collar/leash/harness or carrying them up or down). We also do not recommend that they jump on or off couches, beds, or into or out of vehicles.
• Please remember that although your pet has undergone what is likely a major surgery, they will not act like it! Do not give in to them wanting to play and run before they have healed. They are not the best judge of their activity level!

Important Reminders

When you arrive at the admission appointment, expect to:

• Make sure your pet has had ample time to urinate and defecate. This is very important to a more comfortable experience for them for the day.
• If your pet already has an e-collar (aka cone, lampshade), please bring it with you at their morning admission appointment. We want to ensure proper fit, and they may need to wear it immediately after surgery.
• It is a good idea to have your pet groomed before surgery as they may not have another opportunity to be groomed for 2-10 weeks (depending on the procedure and recovery time)

Please have an idea of any medication or product refills you may need for any of your pets at the time of admittance so that we can have them prepared at the time of pick-up.

Does My Pet Have To Come Back? If So, When?

For most routine procedures, your pet will not have to return at any specific time. Exceptions include:

• For many surgeries, we use absorbable sutures underneath the skin. These will dissolve on their own and do not need to be removed later. In very specific cases where staples or skin sutures have been placed, the pet will need to return. If this is the case, we will alert you to this and when you will need to return. There is generally no charge for this second appointment.
• If booster vaccines or additional testing are needed. Again, we will guide you on whether this applies to your pet.
• Most dogs and cats do not lick excessively, paw, and/or chew at the incision area, but if you have any concerns about the healing process of the incision, please contact the hospital. We sometimes will recommend emailing a picture for review, but an appointment may be necessary.

Please be aware that if you have any additional questions either before, during, or after surgery that we are always available to help. Please call 802-888-7776 if you need assistance or if you need to schedule your pet’s surgery.

As always, we are available after hours and on weekends if needed.

Thank you!

The veterinarians and staff at Sequist Animal Hospital