I’m looking for comments/suggestions on how to approach this type of case.
Auburn is a 14 YO FS Labrador (68#). She has DJD and is managed with Previcox and nutraceuticals. We have been seeing her since she was 10 weeks old.
In 2008 we first noted 104 was discolored. In 2012 the owner noted drooling but we were not sure if dental or anxiety related. There was no weight loss. They declined a dental until May 2014 when she had her first dental. This was about 6 months prior to me getting dental xray. They declined extractions of 104 (and I had also recommended 108) as they didn’t feel she was uncomfortable. I extracted 105 but that was it. She had lots of furcation exposure and very heavy calculus. I recommended referral for dental xrays at that time.
Fast forward to this August. She presented for check mouth. I could smell her before walking in the room. She had lost 4# in 1 month…Her mouth stunk! Preanesthetic bloodwork was good for her age, so we did a cohat…..
I took xrays, then planned to extract 108, 106, 205, possible 206. I was also concerned about both mandibular canines, but I’m not comfortable extracting those. After discussing with owner, I started with 108….It was the worst extraction I have ever done. It took 1 ½ hr to get it out…I fractured both the distal root (I have never fractured that one before!), and the vestibular root. By the time I finished, she had been under over 2 hours, and I was so flustered I stopped, and told owners she should be evaluated by a dentist for the rest of the extractions.
So my questions are:
1. Can you see anything on 108 that would have indicated it would be so difficult? Maybe I just had a bad day?
2. How would you approach this mouth with a 14 YO dog…Certainly we are not looking for perfection…just comfort.
3. Her mouth smelled so bad we were gagging at the dental…I was surprised not to find a necrotic mass in her mouth…can you see anything in particular that could be blamed for the smell? Her extraction site has healed well, but she is already getting halitosis, and I feel uncomfortable on oral exam still. I’m not sure the owners will pursue further treatment at her age…and I feel bad I didn’t do her justice.