2. "Manual scaling" a 16-year-old Pom

"I don't do manual scaling," I said to the lady owner of the 16-year-old Pomeranian that had a mouthful of tartar-covered loose and rotten teeth Somebody in an internet forum had highly recommended me to her.

I elaborated, "Manual scaling refers to the removal of tartar and plaque from the dog's teeth by without the use of general anaesthesia. Some pet shop operators in Singapore provide such a service as the dog owner is worried that the dog may die under general anaesthesia (GA)."

I use ultrasonic dental scaling rather than manual scaling to remove tartar and plaques from the teeth but I did not educate this fair lady in her 30s on the difference between ultrasonic and manual dental scaling.

I knew what she wanted. She wanted her dog to have dental work without GA as the internet forums mentioned deaths of dogs during surgeries and dental work at veterinary practices. This Pomeranian had lived to a ripe old age of 16 years and GA would likely kill her as she had heart disease previously diagnosed by Vet 1 and confirmed by me.

"How many cases of dental scaling without GA have you performed in old dogs?" the lady asked.

No owner had asked me that question in my over 2 decades of small animal practice.

"None," I replied. "I use isoflurane gas anaesthesia for dental scaling in old dogs for the past years as I find it to be much safer a method than injectable anaesthetics. The dog wakes up immediately rather than be groggy for some hours."

The use of sedation and GA is to remove the pain in dental work, but it does not guarantee that the dog will not die of heart failure under GA. Many owners just do not do dental work to avoid this death on the operating table. Bacterial infections of the gums lower the immune system of the dog as the bacteria produces toxins daily and spread them over the body and internal organs. The dog becomes thinner as he eats less and less. This 16-year-old Pom was fed home-cooked food but he was thin. Either he did not get sufficient calories or he had oral pain and ate less. However, he looked much younger than his 16 years. He looked like a 10-year-old dog.

"I have kept this Pom for 14 years," the slim lady had adopted the spayed Pomeranian from the SPCA as a 2-year-old.

Sunday was a very busy day for me. So I did not have time to ask why she did not get the dog's teeth checked during her younger years. But I could understand that this owner wanted her dog to live for more years. To do that she needed the dog's bad teeth to be scaled. But not under GA.

This dog was an extremely high anaesthetic risk. Was there such an option as dental work without GA? Was this cruelty to dogs? The status quo would be for the dog to live in perpetual oral pain and bacterial infection killing her in time to come.

"Assuming no GA and that you are aware that your dog would suffer some pain during dental work," I cautioned the owner. "Your Pom could still die of fright and stress during such dental work (without GA). It would not be scaling but extraction of the rotten teeth," I had checked the dog. She had no fever and her respiratory rate was normal. However her pulse was weak.

The lady had not thought of this real possibility. "Let me have time to think about the whole process," she said. Men with heart disease do die under stress. So do dogs. I thought she would go home as I handled a surgery to remove a patch of necrotic patch 1x1 cm above the neck of the Shih Tzu whose body was full of rashes.