Round Rock Animal Hospital 404 Chisholm Valley Dr. Round Rock, TX 78661

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1 Round Rock Animal Hospital 404 Chisholm Valley Dr. Round Rock, TX D.M. Sundbeck, DVM Phone: D.A. Hocher, DVM Fax: R. Bohmfalk, DVM L. Mendelzon, DVM Our examination has revealed that your pet has Periodontal Disease. While this can be a serious problem, it does respond well in most cases to proper treatment. Periodontal disease is an inflammation and infection of the tissues surrounding the teeth. In order to deal with this problem, a thorough teeth cleaning is needed. The following discussion has been prepared to answer your questions concerning the problem and needed procedure. HOW DID MY PET GET PERIODONTAL DISEASE? At the point where the tooth meets the gum a narrow groove is formed. This groove creates a channel that easily becomes filled with soft food material. When such food material becomes mixed with saliva and mouth bacteria, it accumulates within the channel and sticks to the surface of the tooth. This accumulation is called plaque. As the bacteria in the plaque multiply, they putrefy the food material in the plaque and cause the gums to become inflamed. Solutions of chalk-like minerals seep from these inflamed gums into the plaque to form a hard substance known as calculus. As the build-up of plaque and calculus (together called tartar) continues, dead bacteria and white blood cells accumulate to form a pocket of pus along the root of the tooth. This pocket further separates the gum from the tooth. Into this space more food debris is trapped and the cycle continuously repeats itself. In advanced cases, this accumulating debris becomes so toxic that it actually kills the tissues around the tooth and begins to erode the bone that holds the tooth in place. Once this bone becomes eroded, the tooth becomes loose and painful. The effects of advanced periodontal disease are not limited to the mouth, but can also result in severe systemic illness. Chronic throat and stomach infections are commonly associated with this condition. In some cases, the bacterial infection in the mouth can get into the blood stream and affect vital organs such as the kidneys and heart. Dealing with periodontal disease is of vital importance to the overall health and comfort of your pet. HOW IS TEETH CLEANING PERFORMED? Tartar must be completely removed from the teeth to return the gums to a healthy state. This is accomplished using manual and ultrasonic scalers in the same way your dentist cleans your teeth. After cleaning, the teeth are polished to provide a smooth tooth surface thus retarding the accumulation of new deposits. Since this procedure is uncomfortable, we must use general anesthesia to do the job properly. If loose or diseased teeth are found during the cleaning, they are extracted. While some diseased teeth can be saved using techniques such as crowns or root canals, we do not perform these techniques. If you would prefer one of these techniques rather than extraction, please let us know and we will refer you to a veterinary dental specialist.

2 WHAT RISKS ARE INVOLVED? Anytime an animal is placed under general anesthesia there is always a chance of complications, however, the risk involved is quite small and is far out-weighed by the benefits gained by getting periodontal disease under control. Even though we use the safest anesthetic agents available, we do recommend blood tests be performed prior to the procedure to screen for underlying problems that may cause complications. In addition, to pre-anesthetic testing the doctors recommend the placement of an IV catheter for the administration of fluids and electrolytes during the surgery or dental procedure. These fluids can help prevent the lowering of blood pressure during anesthesia and can help flush out bacteria that may enter the blood stream during the plaque removal phase of dental cleaning. The catheter also allows easy administration of emergency medications, should this unlikely need arise. The catheter is optional for routine procedures, but may be required by the doctor should they feel it is important. It is highly recommended for pets over 8 years of age. WHAT IS THE COST? The cost for the anesthesia, cleaning, polishing and antibiotics ranges from $ , depending on the size of animal and anesthetic agent used. These fees do not include the cost of pre-operative blood work, I.V. Fluids, or extractions, which may be needed. HOW LONG WILL MY PET HAVE TO STAY IN THE HOSPITAL? Because we use gas anesthesia, the recovery time is quite rapid and the patient can be dismissed the same day. We prefer to have patients brought in by 9:00 AM and picked up anytime between 4:00 PM and closing. HOW DO I GO ABOUT SETTING UP AN APPOINTMENT? We perform dental procedures any day that we are open except Saturday. Simply call the office and choose a day that will be convenient. Since we do like to put patients on oral antibiotics prior to the procedure, you will need to pick those up at least three days before the day of the procedure. WHAT ABOUT HOME DENTAL CARE? Once we have cleaned and polished your pet s teeth, it is important to continue dental care at home in order to slow down the accumulation of new tartar and aid in the prevention of tooth and gum disease. While feeding dry food and/or providing hard biscuit treats are helpful, additional dental care is often needed to prevent problems. Such dental care options include brushing the teeth, using the Clenz-a-dent Rinse, or providing Dentahex chews. We also carry the Hill s Prescription diet t/d, which is specifically formulated to control plaque and tartar. We will be happy to discuss each of these products with you and the proper technique to use with each. We hope this information has helped you to understand the importance of proper dental care for your pet. If you have any additional questions, please don t hesitate to ask.

3 Help us keep your pet healthy with pre-anesthetic testing. To ensure your pet can properly process and eliminate an anesthetic, we run tests to confirm that your pet s organs are functioning properly and to find hidden health conditions that could put your pet at risk. The top FOUR reasons to test your pet before anesthesia: 1. Enjoy peace of mind. Testing can significantly reduce medical risk. 2. Detect hidden illness. Healthy-looking pets may be hiding symptoms of a disease or ailment. Testing helps detect this kind of illness so we can avoid problems with anesthesia. 3. Reduce risks and consequences. If the pre-anesthetic testing results are normal, we can proceed with confidence. If not, we can alter the anesthetic procedure or take other precautions to safeguard your pet s health. 4. Protect your pet s future health. These tests become part of your pet s medical record, providing a baseline for future reference. To help ensure safe anesthesia for your pet, we will run a combination of the following tests. Hematology Complete Blood Count (CBC) A CBC provides detailed information about red blood cells, white blood cells and platelets. The total white blood cell count, along with individual leukocyte counts, can help identify underlying stress, inflammation, an inability to fight infection and potentially, leukemia. Low platelet numbers can indicate a potential bleeding problem. We might advise that surgery be delayed if anemia, inflammation or especially a low platelet count is present because these conditions could cause serious surgical complications. Blood Chemistry Alkaline Phosphatase (ALKP) An enzyme present in multiple tissues, including liver and bone. Elevated levels can indicate liver disease, Cushing s syndrome or steroid therapy. Total Protein (TP) The level of TP can indicate a variety of conditions, including dehydration, inflammation and diseases of the liver, kidney or intestine. Blood Urea Nitrogen (BUN) BUN is produced by the liver and excreted by the kidneys. Abnormally high levels can indicate kidney disease or dehydration, and low levels can be associated with liver disease. Alanine Aminotransferase (ALT) An enzyme that becomes elevated with liver cell injury. Creatinine (CREA) Creatinine is a byproduct of muscle metabolism and is excreted by the kidneys. Elevated levels can indicate kidney disease, urinary tract obstruction or dehydration.

4 Blood Glucose (GLU) High levels can indicate diabetes. In cats, high levels can also indicate stress, which can be a result of the trip to the veterinary hospital. Low levels can indicate liver disease, infection or certain tumors. Albumin (ALB) A protein that is produced by the liver. Reduced levels of this protein can point to chronic liver, kidney, inflammatory or intestinal disease. Cholesterol (CHOL) Elevated levels of cholesterol are seen in a variety of disorders, including hypothyroidism and liver or kidney disease. Total Bilirubin (TBIL) Bilirubin is a breakdown product of hemoglobin, as well as a component of bile. Blood bilirubin levels are useful in indicating liver disease and may help identify certain types of anemia. Amylase (AMYL) An enzyme produced by the pancreas. The pancreas secretes amylase to aid in digestion. Elevated levels in the blood can indicate pancreatic disease. Phosphorus (PHOS) Elevated phosphorus can be an indicator of kidney disease. Calcium (Ca+) Increased levels can be seen with diseases of the parathyroid gland and kidneys, or as an indicator of certain types of tumors. Electrolytes Sodium, Potassium, Chloride (Na+, K+, Cl-) The balance of these electrolytes is vital to your pet s health. Abnormal levels can be life-threatening. Electrolyte tests are important when evaluating vomiting, diarrhea, dehydration and cardiac (heart) symptoms. Suggested Pre-anesthetic Testing Guidelines Youth (<1 year) Healthy Adult (1 7 years) Healthy Senior (+7 years) Sick all ages * We will administer a sedative if your pet is too anxious or overactive for this procedure.

5 Round Rock Animal Hospital Pre-Dental Blood Work Form Owner s Name: Pet s Name: Date: Please Read Carefully and Sign. Your pet is scheduled for anesthesia/dental. Please remember your pet should have no food after 10PM the night before the scheduled procedure. Your pet can drink water-freechoice. We need to have your pet here the morning of the procedure by 8AM unless other arrangements have been made in advance. We recommend a blood profile to ensure that your pet is in a low risk category prior to anesthesia. The latest technology has enabled us to run safe and accurate blood chemistries minutes before anesthetic induction. These tests are similar to those your own physician would run were you to undergo anesthesia. In addition, the results of these tests will serve as reference values for future use should your pet become ill. The cost for these tests is in addition to the cost of the dental. Profile #1 Cost = $23.62 Includes PCV (assesses anemia) Profile #2 Cost = $36.67 Includes Complete blood count (assesses anemia, infection) Profile #3 Cost = $60.15 Includes Complete blood count BUN (kidney) ALT (liver) Electrolytes Profile #4 Cost = $90.37 Includes all the tests in Profile #3 Plus: Glucose (sugar) Creatine (kidney) Albumin (protein) ALK (liver) Phosphorous (kidney) Calcium (certain cancer) Cholesterol Bilirubin (liver) Amylase (pancreas) Globulin (immune status) Though you may choose any of the profiles regardless of your pet s age, we generally recommend the more extensive profiles for the older pets. Please check one: Profile #1 Profile #2 I do not want any tests performed Profile #3 Profile #4 I would like I.V. catheter placement and fluid therapy for my pet during surgery. $38.00 I would like the Oravet dental treatment for my dog. I do not want the Oravet dental treatment for my dog. Dentistry release and Authorization I hereby authorize the doctors at Round Rock Animal Hospital to perform dentistry on my animal. I understand that this procedure necessitates the use of general anesthesia and that there is some inherent risk involved. Signature of Owner Date

6 Round Rock Animal Hospital 404 Chisholm Valley Dr Round Rock, TX Dennis Sundbeck, DVM Phone: David Hocher, DVM Fax: Regina Bohmfalk, DVM Lauri Mendelzon, DVM Now that your pet s teeth have been cleaned and polished, it is important to continue dental care at home in order to slow down the accumulation of new tartar and aid in the prevention of tooth and gum disease. While feeding dry food is helpful, additional dental care is often needed to prevent problems. Such dental care options are: 1) Brushing the Teeth Daily: Not every pet will tolerate brushing, but most will and it is the most effective way to prevent tartar buildup. 2) Using one or more items from our Clenz-A-Dent Oral Hygiene product line: Easy: Clenz-A-Dent wax: An innovative solution with clinically proven efficacy on plaque. Just apply the wax to your dog s teeth and you re done. Easier: Clenz-A-Dent Mouth Rinse: A palatable and convenient solution to extend your pet s oral health. Apply directly to teeth with spray nozzle, helps keep teeth clean and freshens their breath at the same time. Clenz-A-Dent Dental sticks: Just give these chews as a treat and it will clean their teeth as they chew Dogs just love them. Easiest: Clenz-A-Dent Food Additive: Not much time to spare, just sprinkle this powder on your pet s food daily and it will clean teeth and freshen breath at the same time. Clenz-A-Dent Water Additive: To be used in the daily drinking water for immediate breath freshening effect and a continuous action all day long 3) Providing Dentahex Chews: The antibacterial activity of Chlorhexidine provides plaque removal, tartar control, and up to 24 hours of sustained antimicrobial action. 4) Feeding Hill s Prescription Diet t/d: This diet is specially formulated to effectively control plaque and tartar. We have each of these products available to you. Please ask us about them!