Anesthetic and anesthesia free Dental Cleanings

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As part of National Pet Dental Health Month, veterinary dentist and oral surgeon, Dr. Amy Thomson joins the show to talk teeth. Wondering if your dog needs a dental cleaning? Does your dog need anesthesia for dental care? Does your pet need x-rays of their teeth? In this episode, Dr. Thomson explains why your veterinarian recommends a COHAT, comprehensive oral health assessment and treatment, to keep your pet’s mouth healthy, as well as the risks associated with cosmetic, nonanesthetic dental cleanings.

Welcome, Dr. Amy Thomson!

Dr. Amy Thomson holding her dog

Dr. Lancellotti: Welcome, everyone, to today’s episode of Your Vet Wants You To Know. I am joined, today, by board certified veterinary dentist and oral surgeon, Dr. Amy Thomson, who is going to be talking about some information that I know is important to many pet owners out there- the health of their pet’s teeth and mouth. There’s a lot of information floating around the internet. You may have gotten some information from your family veterinarian about taking care of your pet’s teeth, but Dr. Thomson is going to be explaining a lot of information that I think will be really helpful in understanding risks, benefits, and what it is that we’re trying to do when we want to take care of your pet’s mouth. I’m very excited that she’s joining me today. She was previously on an episode all about toothbrushing, so you can go back and listen to that, if you want to help take care of your pet’s teeth, as well. Thank you very much for joining us, today, Dr. Thomson.

[00:01:57] Dr. Thomson: Thank you so much for having me. I’m so excited to be back. These are two of my favorite topics to talk about, so I’m really thrilled to get to delve into this one with you.

[00:02:07] Dr. Lancellotti: Yeah! Last time you were here, you gave us so much good information. I know that there have been people that have listened to that episode who have incorporated those tips into brushing their pet’s teeth. So, thank you so much for sharing your time there and for agreeing to come back again. Can you tell the listeners a little bit about your background and what it is that you’re passionate about?

[00:02:27] Dr. Thomson: Absolutely. They call me Toothy Thomson. That started many years ago when I was a family veterinarian. The more I learned about dentistry and oral care, the more I realized I needed to learn, and the more I implemented those practices the more that I saw the benefit and the changes for positive. So, we weren’t always seeing the negatives of oral disease, but we were definitely seeing the improvements with the positives. After a few years, I decided that teeth and mouths were “it” for me- that’s all I wanted to do, so it was a bittersweet transition out of family practice into doing a residency. Now, I exclusively do dentistry and oral surgery, focusing on mouths. Since completing my residency, I have (for almost three years) been working side by side with family veterinarians, offering advanced care for their pet patients and providing education on all things teeth.

[00:03:31] Dr. Lancellotti: Yeah. Your education is absolutely invaluable. You have an amazing social media site where you teach veterinary professionals about all aspects of dental care, and you’re an active participant in VetHive, which is a veterinary support community for veterinarians and technicians. And I love learning from you because you have so much information about how to care for teeth and the mouth, in general. I’m so thankful for you coming on and sharing that knowledge, today.

[00:04:01] Dr. Thomson: Oh, thank you so much. Dentistry and oral care is truly a passion. The education portion of it, mostly targeted towards veterinary professionals in those teams (but definitely out there for owners, as well), has really been my purpose. I, too, have been in this situation where I’m meeting with pet owners and knowing that there’s just so much. It’s just a vast amount of knowledge that we expect our family veterinarians to have, so I want to be able to arm them with this information, to be helpful and get that out to their pet parents.

What is a COHAT? Is it the same as a dental for my pet?

[00:04:35] Dr. Lancellotti: Let’s talk a little bit about today’s topic. There’s some confusion around basic terminology. When we first started brainstorming this, we wanted to talk about a term called COHAT (which I’ll let you go into a little bit more), but most owners might be familiar with the term “dental.” So, I want to give you the opportunity to explain the difference between a COHAT and a dental, establishing some terms for pet owners to understand before we talk a little bit more.

[00:05:10] Dr. Thomson: Absolutely. I was initially taught and trained to talk about dentals, and I just find that term to be inappropriate. It’s not all encompassing of what we want to be using when we’re talking to pet parents and making the recommendations. The term COHAT is a bit of a mouthful- it stands for comprehensive oral health assessment and treatments. Obviously, it’s not something that you want to be using regularly. COHAT’s a lot nicer, but the problem is that a lot of pet parents and even some veterinary professionals aren’t familiar with that term. The reason we use COHAT instead of “dental” is because there’s so much involved in this procedure and we’re making sure that we’re really being comprehensive. We’re taking that opportunity to get a deep look at all of the oral tissues, not just the teeth. Part of that is dental radiography because we can only see half of the tooth. And unlike you and I, we can’t ask our patients, “Is it tender here? Does it hurt here? Is there a certain area that’s bothering you?” So we have to use our diagnostics. A COHAT is truly a tooth-by-tooth exam with full mouth x-rays, cleaning, and then making a treatment plan based on what we’re finding in that mouth.

[00:06:36] Dr. Lancellotti: Yeah. There’s a lot more that goes into a COHAT than just a dental cleaning. I think it’s a great opportunity for us to explain a little bit more the value in this procedure, in taking care of the animal’s mouth.

Does my pet need anesthesia for a dental cleaning?

Dr. Lancellotti: I know that you have worked with tons of patients over the years and you have lots of different stories. Do you have one in particular that comes to your mind when you think about just how important COHATs are?

[00:07:03] Dr. Thomson: Yeah. So I have many stories, as you might imagine, after over a 10-year career focusing on oral health. The one that really comes to mind is both recent and really highlights what we’re trying to focus on and educate on in this podcast episode. So, I saw Zoe a couple months ago and she was not coming to see me for a COHAT. She was actually coming to see me for a fractured tooth, which is always quite sad. And unfortunately, I see these all too commonly because there are a lot of toys and treats out there that are too hard and cause damage. But that’s a completely different episode. So, she was coming to see me for this fractured tooth, and after discussing with the owner and examining the mouth and then following up with a full COHAT, that tooth was not a good candidate for root canal treatment to preserve the function of this tooth, so we did need to extract it. However, what was the most enlightening (and for me, heartbreaking) was to come to the realization that Zoe was not coming to see me for a COHAT because she’d had a cosmetic cleaning just a month or two ago. And it was after that cleaning that the tooth fracture happened. And during my full assessment, I actually found 9 teeth that were diseased enough that they actually required extraction, in addition to the fractured tooth. So, we had to remove the fractured tooth, as well as these 9 other significantly diseased teeth.

[00:08:31] Dr. Lancellotti: Wow. This highlights the fact that she had received (what the owner thought was) dental care, but when you really looked at everything that was involved, including taking those x-rays while she was under anesthesia, there were a lot more problems that you couldn’t see at the surface.

[00:08:51]Dr. Thomson: Absolutely. Yes.

Should my pet have an anesthesia-free dental cleaning?

[00:08:53] Dr. Lancellotti: I think that fear of risks of anesthesia are a major reason why pet owners will avoid having a COHAT performed. I talk a lot about risk versus benefit on this show, because I think that’s how we make a lot of our decisions in veterinary medicine. What is the benefit that this procedure or treatment may provide? A lot of pet owners may be considering doing a non anesthetic dental cleaning because of either the risk of anesthesia or the cost of a full dental assessment with cleaning and treatment. Tell me a little bit about the non anesthetic options that are available.

[00:09:29] Dr. Thomson: Absolutely. If I’m speaking quite frankly, I am upset and heartbroken that the fear that owners have with anesthesia (I truly believe) is being capitalized on, by offering something that is truly cosmetic and has zero health benefit as an alternative to something that is truly going to benefit their pet’s health. It really upsets me. I get all of these different companies that have been developed (I see them popping up everywhere- all over the internet and social media) about these cleanings, showing “before and afters” and talking about how great the breath smells. And while that’s all fine and well, there’s no health benefit. It’s just upsetting because anesthesia is absolutely not a benign therapy. There are risks. However, I feel that we need to explore those risks. I can honestly say that the risk of anesthesia has only outweighed the benefit of a complete COHAT in less than a handful of my patients in a 10-year career.

[00:10:43] Dr. Lancellotti: Yeah. There’s a risk, but we do things to minimize risks associated with anesthesia. These non anesthetic dentals are cosmetic, so it makes the teeth look better, but the disease is still there, and then you wind up with animals that get fractured teeth, severe disease, oral pain, etc. There’s a lot more that’s going on underneath the surface that can only be assessed when the animal is under anesthesia and when we’re doing those dental radiographs.

What should I ask my veterinarian about an anesthetic dental cleaning for my pet?

[00:11:11] Dr. Thomson: Absolutely. If we just talk briefly about statistics- it’s one in 10,000 pets will have an adverse reaction (and possibly a cardiac arrest). And while I know if your pet is that one, it doesn’t matter about the other 9,999. However, with that said, as long as we can have open communication with our family veterinarian, or if your pet has an increased risk (kidney disease or heart disease), there are options to see a specialist, like myself. Oftentimes, I’m going to be quicker, so we can have a shorter anesthetic, and we can often work with both a cardiologist and anesthesiologist to alter the treatment plan and be ‘on the ready’ to help if there are any issues. In my career, I’ve only had two cardiac arrests and only one patient that we did not recover. That patient was not coming to see me for a COHAT. That patient had sustained significant maxillofacial trauma. It still haunts me. I never want to lose a patient. I just want to be very forthcoming that anesthesia is not benign, but there are a lot of things that can be done (both before, during, and after anesthesia) to make that a safe procedure.

[00:12:37] Dr. Lancellotti: Yeah. I think what you mentioned before is really important- having a relationship with your family veterinarian, where you feel comfortable having that conversation, “You know my pet. What are the risks of anesthesia in my pet’s particular situation? What is the benefit that I’m going to get out of doing this procedure?” and talking to them about ways to minimize the risk. Those may include things like doing some bloodwork, taking chest x-rays (to see how the heart and lungs are looking, making sure that they’re healthy enough to undergo the extra workload that anesthesia places on those organs), or even reaching out to a cardiologist for further assessment of the animal’s heart function. So, just opening the door to that conversation is going to go a long way towards making you feel more comfortable with the decision to do this procedure.

[00:13:29] Dr. Thomson: Absolutely. I work very closely with many cardiologists. At least (maybe) 40% of my patients do have cardiac disease, so they’re being referred to me (maybe for the complexity of their pet’s oral health, but more often than not) because of their comorbidities (other diseases that they have that may make them at higher risk for anesthesia). There is a lot that can be done, as far as the medications we use to sedate during the procedure, to make it a much lower risk and still get the benefits. They’re getting an actual health benefit from a COHAT, versus just cleaning up the surface, not really treating any disease or putting your pet in better oral health with these anesthetic-free or (in Ontario, they have to be called) “cosmetic” cleanings.

[00:14:23] Dr. Lancellotti: Oh, I love that they made them do that terminology. It should really explain to people that they’re not getting anything except something that looks pretty.

[00:14:32] Dr. Thomson: Yeah. I think there’s still some room for education and knowledge. There was a Supreme Court ruling after a wide bulk of evidence showed (not just the lack of health benefit, but) the risks associated with having instruments in their mouths while awake. A lot of trauma and (unfortunately) injuries have occurred.

[00:14:56] Dr. Lancellotti: Yeah. When these animals are awake, they get stressed out. As a fear-free veterinary professional, it’s really important to me to make sure that my animals have as minimal fear, anxiety, and stress as possible. I just can’t imagine how anxious and afraid these animals are when they’re having their teeth cleaned while they’re wide awake. It certainly adds a layer of health risk to it because the stress can create adverse reactions in the body, as well.

What happens during a comprehensive oral health assessment and treatment (also known as pet dental)?

I want to shift back to what we’re doing when the animal is under anesthesia. The American Animal Hospital Association describes the essential steps of dental cleaning and therapy. Can you briefly go through some of those steps and how a veterinary team performs them when a pet is under anesthesia?

[00:15:49] Dr. Thomson: Absolutely. Once we have your pet under anesthesia, we have an IV catheter. So if they run into trouble, we can give medications immediately. We’re also giving them intravenous fluids to support blood pressure, monitoring that blood pressure, monitoring their heart rate, their respiratory rate, oxygen levels, blood pressure, etc. Then, they have a breathing tube that is going to secure their airways, providing them with oxygen and anesthetic to keep them sleeping. Given that they are sleeping and perfectly still, we can do a cleaning, removing all of the plaque and calculus on the crowns (surfaces) of the teeth. Then, we can do a tooth-by-tooth exam. So, just like you and I, when we go to the dentist, we want to probe and feel for any abnormal pockets, potential tooth resorption, or decay on the crowns of the teeth. Removing all that plaque and calculus first allows us to get a really good look. Even though we can see the crowns of the teeth when they’re awake, we can’t get a great look because they’re moving, we don’t have magnification, and we can’t probe around the teeth. Then, we’ll do full mouth x-rays, pairing them together with the tooth-by-tooth exam. Each pet, whether it’s a cat (30) or a dog (42), has tiny little patients. Each patient in that mouth is going to get a treatment plan based on what I can see on both the oral exam and the x-rays. Then, at that point we can talk to the owner about it.”Okay, it is the teeth we were worried about,” or more often than not, “Wow. I found these other things. This is what we need to do.” Then, we need to get consent for that. The great thing is that we can move straight from diagnostics into treatment.

Does my pet need teeth pulled?

[00:17:37] Dr. Lancellotti: It’s important for owners to really make sure they know when their veterinarian is going to be reaching out to them, so that they’re available to talk to the vet while the animal’s under anesthesia and give the “okay” to move forward with the treatment plan. And as far as cost, it may be very different once you get in there and see exactly how bad the disease is.

[00:18:01] Dr. Thomson: Correct. An awake oral assessment is really important and can help us focus on where we think the problems are, but a lot of studies have shown (whether it’s a pet owner, a family veterinarian, or someone who has a specialty and has been doing it for 30 years) that our awake oral assessment is only about 60-70 % accurate with what we’ll truly find. And there’s lots of literature to say that in over 80% of cats and dogs, we’ll find that the disease is either worse than we’d thought, or we’ll find another tooth or teeth that is or are diseased, that we couldn’t have appreciated while they were awake. More often than not, we’re finding more disease, but it can also go the other way because periodontal disease is really dependent on how our pets respond to plaque and calculus. Some pets will have a lot of plaque calculus and not a lot of progression of disease or bone loss, whereas other pets will have minimal plaque and calculus (seemingly not too bad on the surface), but because their body responds differently, they can have pretty significant disease. This is why the tooth-by-tooth exam and full mouth x-rays are so critical.

How often should my pet have their teeth cleaned?

[00:19:09] Dr. Lancellotti: What would you recommend, in terms of frequency for this particular procedure, in regards to cats, dogs, big dogs, little dogs, etc? Is there an overall average, as far as how often you would recommend that a COHAT be performed? Or is it variable between each pet?

[00:19:29] Dr. Thomson: It’s definitely going to depend on each individual pet. I always compare it to us. We brush a couple times per day and we go to see our dentist every 6-12 months, so ideally, from an oral health standpoint, it would be once a year. Dogs and/or cats that have specific conditions or a more exaggerated response to plaque and calculus, I will see sooner. Some patients who have specific diseases, I might see every 4-6 months. Like you mentioned, larger breed dogs. Sometimes we’ll push that out to 18 months because we don’t get as much tissue breakdown or if we get a bit of tissue breakdown, it isn’t what I call catastrophic. So a millimeter of bone loss in a large lab is concerning because it is disease, but it’s not going to put us in a spot where we need to extract that tooth. But a millimeter of bone loss in a little chihuahua, that’s going to be an issue. So while some owners will go, “Whoa! Every year! That’s a huge expense!” And I appreciate that. But my focus is to keep your pet as healthy as possible, and I would like to see them (and I know that your family veterinarian would like to see them) when we don’t need to extract teeth- when the treatment is the cleaning of both the crown that we can see, but more importantly, underneath the gum line. The goal is to find that sweet spot, where we can see them at stage 1 out of 4. Nerd alert! I think this is incredibly cool because it’s the only disease stage that we can actually reverse the problem with a COHAT. I think that’s pretty darn cool.

[00:21:08] Dr. Lancellotti: That’s awesome! And that’s something that can potentially save the owner money in the long run, if they’re providing more of that prophylactic or preventative care, rather than reactionary- when the pet’s teeth get really bad and all of a sudden, you’re having to remove multiple teeth from the animal’s mouth.

Anesthetic dental cleanings can reverse disease!

[00:21:26] Dr. Thomson: Yeah. Absolutely. Prophylactic care is something we use very commonly. I tend not to use that term for the reason that stage 1 periodontal disease is once we have plaque and calculus that has led to gingivitis or inflammation of the gums. So it’s important to communicate with owners and that owners understand that we don’t need to see mobile teeth, deep pocketing, or root exposure to have disease. As soon as those gums are inflamed, that’s considered disease. Doing a cleaning is actually not preventing the disease. It’s treating it before it gets worse. And the great thing about catching it in this stage 1 is that we can reverse it. Which again, I just think that’s so cool! Rarely, do we get to reverse disease. We manage it or slow it down, but here’s an opportunity we have to truly reverse it- to do that deep cleaning, remove the gingivitis or gum inflammation, and basically, reset to zero. It gets me really excited, as you can tell!

[00:22:30] Dr. Lancellotti: That’s awesome. I love how enthusiastic you are about this topic. It just makes me so happy. 

What are some common questions about pet dental cleanings?

Dr. Lancellotti: I know you talk about this all day, every day, to all of the pet owners that come to see you. What are some of the most common questions that you get in regards to this procedure?

[00:22:46] Dr. Thomson: A lot of the questions I get regard anesthesia. And I am pretty honest that, “What I do and what your family veterinarian does as part of a COHAT cannot be done in an awake patient. Just think of the idea of going to get x-rays, yourself, and you have to hold that in your mouth. There is no way! Even the most behaved cat or dog is not going to sit with that in there. And we don’t want them to! Like you said, we don’t want this to be a fearful experience. We’re doing things that they don’t have in their day-to-day life, so they’re going to be stressed. So we can’t take X-rays. We can’t probe 4-8 spots around the tooth. We can’t clean below the gum line effectively. And it’s dangerous because these instruments are sharp. I definitely appreciate and understand where pet parents are coming from. Every time my little Raisin Nose (who’s no longer with us) would get COHATs every 6-9 months, I was anxious. And I anesthetized probably 4 patients a day! It’s different when it’s your pet. It’s stressful, and I understand that, and I know that the benefit she’s going to get from actually treating that early-stage disease is going to be off the charts as far as, comparing to the risk of anesthesia. So, that’s a big question that I certainly got when I was in general practice. “Can we just do it without the x-rays?” Everything adds up, and I want to fully acknowledge that this is not an inexpensive treatment. However, it is very much worth it. For me, it’s a non-negotiable because if we’re not taking those X-rays, we’re not doing comprehensive care. We’re missing. In most patients, we’re going to miss something.

[00:24:35] Dr. Lancellotti: Any other common questions that people will ask regarding the COHAT procedure?

Dr. Thomson: I find those are the big ones. It’s definitely not an inexpensive procedure, so the best way to reduce the cost is to reduce the amount of time under anesthesia, which also alleviates the stress for a lot of owners. So that, for me, is why it’s so important.

Toothbrushing is important for your pet!

Dr. Thomson: The other topic I like to talk about is home care; toothbrushing and reducing that plaque and calculus buildup. It is that biofilm that our body or our pets’ bodies are reacting and having an inflammatory response to. So if owners can do plaque control 364 days a year, I can do the 1 day a year.

[00:25:20] Dr. Lancellotti: I’m going to direct pet owners to listen to episode 30 on Toothbrushing. You did a great job of explaining how owners can do this in a really easy way and the benefits of toothbrushing. So I would encourage everyone who’s listening to go back and listen to episode 30 so that you can help to provide your pet with good oral healthcare at home, in between these dental procedures.

Add Your Heading Text Here

Dr. Lancellotti: I want to give you the opportunity to touch on some of those big takeaway points. What do you think is most important for pet owners to take away?

[00:25:51] Dr. Thomson: I want pet owners to know that there’s no shame in exploring these anesthesia-free (or in Ontario) “cosmetic” cleanings, because I know that every pet owner I’ve met wants the best for their pet. That’s never in question. And one thing I often will share with owners is that I’m a dentist. I focus on the mouths. I leave all the other hard stuff to other specialists like yourself and family veterinarians. However, I know that my patients are not just walking mouths, so if they’re running into issues under anesthesia, we can stop the anesthetic and regroup about what can be done differently, in the future. I hope that this will give you the comfort to know that having this dialogue with your family veterinarian and talking about a full COHAT is something that’s going to be really helpful. I don’t know a single veterinarian that wouldn’t want to work with you. Maybe it’s not in the cards right now, but let’s focus on saving for that and making that a priority. And the great thing is- once they have a COHAT, if we do a thorough assessment and treatment and we remove all of the disease, then we can start at zero. Then, we can implement toothbrushing and other things, so that in the future, we’re not dealing with such a large expense and such a large time under anesthesia.

[00:27:12] Dr. Lancellotti: Yeah. Those are great tips. I think that’s a great conversation starter for pet owners with their family veterinarian. Many family veterinarians are comfortable managing pets with dental disease, but a link to find a veterinary dentist near you will be posted on the website under the resources tab, if you’d like to consult with a specialist. We also have a Facebook group, Your Vet Wants You To Know. You can join there if you have experience with anesthetic versus non anesthetic dentals, and that would be a great resource for you, as far as talking to other pet owners in the community. Dr. Thomson, if pet owners want to get some more information from you, where is a good place for them to find you?

[00:28:02] Dr. Thomson: Thank you! I am @toothy.thomson on Instagram. I share a lot of content guided towards veterinary professionals (veterinarians, technicians, and assistants), however, I’m very transparent. So, while it may not be specifically directed towards pet parents, it is information that I want pet parents to know about. So you’re more than welcome to check me out there. And soon, my website will have a lot more owner handouts and there’ll be a section for owners. Right now, it’s guided towards family veterinarians.

[00:28:33] Dr. Lancellotti: I love your website. I think it’s absolutely adorable. I can’t wait to see more resources coming there because you just have such good information for the veterinary professionals, and I think pet owners are going to benefit from all of your knowledge, as well. Thank you very much for making that a priority in your professional career.

[00:28:49] Dr. Thomson: Absolutely. Like I said, while I’m a veterinary dentist, I’m also a pet parent, myself. Some family veterinarians may not discourage against anesthetic-free cleanings because something’s better than nothing, but I’m very confident in saying, “I would rather you do nothing than do something that gives us a false sense of health. Let’s focus on saving up towards doing something that’s truly going to impact the health and comfort of our pets.”

Scratching the Itch

Dr. Lancellotti: I like to end each episode with a segment that I call Scratching The Itch. It’s designed to highlight something, whether it’s a human interest story, a product, or website. Essentially, it’s anything that provides relief or just makes you feel good. Dr. Thomson, do you have a ‘scratching the itch’ for our listeners today?

[00:29:34] Dr. Thomson: I do! I live in my toothy world, so I have to say that this is a conversation I had with a pet parent not too long ago, after I’d seen both of their kitty cats. Two young cats, Tiger and Chadwick, were referred to me because they had very significant gingivitis, and there was concern that they might have a condition called Stomatitis (needing all of their teeth removed). Fortunately, that wasn’t the case, but they had very significant gingivitis, which is (at least) stage 1 of periodontal disease. So, they came in to see me and unfortunately, once we got in there, we found (even at a young age of only about a year and a half) they both needed quite a few extractions, because the disease was actually more like stages 3 and 4 out of 4. So we treated them up, they went home, and I saw them back for the recheck (as I always like eto see how everyone’s doing) and the owner was like, “You are not going to believe this…” Poor Tiger- they’ve always thought he was timid and shy, and since he had his COHAT with extractions, he is prancing through the house, coming to see visitors when they come to the house. He is not being bossed around by his little brother and he is holding his own at the food dish. It was just such an amazing realization. Kitty cats, specifically (and definitely dogs too), are way more stoic and tougher than we are, so it’s a very common experience that pet owners have. They rarely see oral pain signs. When they do, it’s significant, but it’s when we remove the disease that we can really see such a positive change. That just really melted my heart, and it’s probably why I’ve ended up where I am. I was hearing that story over and over again as a family veterinarian focusing on dentistry, and it just makes me so happy that we’re able to provide that comfort.

[00:31:30] Dr. Lancellotti: Yeah. I love that so much- when you treat an animal’s condition and then the owner actually sees their true personality come through. So much of that pain and discomfort is hidden because they don’t know what else to do with it. They’ll hide their discomfort. And when they finally feel better, they can think, “Okay. I can be myself again.” And I just love that it changed their life. I think that’s fantastic. It really makes us feel good about doing our jobs.

[00:31:58] Dr. Thomson: Oh, absolutely. It’s so reassuring. And it’s just one of those things. The owner felt bad and I was like, “Whoa whoa, whoa! This is not about you feeling bad. Your cat wasn’t showing you when they were in discomfort.” A lot of pet parents think, “Oh, if their mouth is painful, they’ll stop eating.” And our job, as veterinarians, is to advocate for pets and say, “No, no, no. We don’t always see them stop eating.” Sometimes, we will. But I always relate it back to when I had a toothache and I complained to anyone who would listen. I still ate and drank, went to work, and I still used the potty. So I relate that back to kitty cats. They can’t tell us that they’re painful, and if they stop eating, then they have a sore mouth AND they’re hungry. That’s our job, as veterinarians, to make sure that we can communicate with pet parents. The other thing that I want pet parents to know is that when you take your pet in for a COHAT, and we find more disease than what you thought, you should not feel guilty because you have your pet there and we’re treating it now. I just want to remind pet parents that we’re doing the best (with the information) that we can, and that’s why I’m here, and that’s why you’re running this podcast- to give them more information so that we can make the best decisions for our pets.

[00:33:09] Dr. Lancellotti: Absolutely. Dr. Thomson, thank you so much for coming on and sharing all this information. I hope pet owners feel a little bit more comfortable with talking to their family veterinarians about a COHAT and doing this regular dental maintenance to keep the animal as healthy as possible.

[00:33:25] Dr. Thomson: Absolutely. Thank you so much for having me. It’s been a great time and I’m glad to be able to share this information with pet parents.

[00:33:32] Dr. Lancellotti: And for everyone out there listening, I look forward to your next visit with Your Vet Wants You To Know.


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  3. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in cats. Am J Vet Res. 1998 Jun;59(6):692-5. 
  4. Bauer AE, Stella J, Lemmons M, Croney CC. Evaluating the validity and reliability of a visual dental scale for detection of periodontal disease (PD) in non-anesthetized dogs (Canis familiaris). PLoS One. 2018 Sep 26;13(9)

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