Conscious Dentals - Some Thoughts

[abbymarysmokey]

Great post Vikki

What vets are you training at?

 

[abbymarysmokey]

Also wanted to say that we have 12 dental buns here at the sanctuary atm. They range from needing minor work done a few times per year...to those with major problems including lots of missing teeth or a mouthful of totally wonky teeth which means they need dental work doing at least once a month.

We usually have at least 4 molar dentals done every month (sometimes more), which would equate to £260 per month just on regular dentals if my vet insisted on full GA every time (approx £65 per full GA dental at my vets). This would mean we would have to stop taking in rabbits....and unfortunately this would mean the rabbits dying or being PTS because we take rabbits that nobody else will take

 

[honeybunny]

I personally think it would be helpful if a distinction could be made on this thread between:
Conscious dentals for incisor trimming, and conscious dentals for molar trimming and reshaping.

I have no problem with conscious dentals for incisor burring if the rabbit isn't too flighty, but there is no way on god's earth I would ever agree to any rabbit of mine having molar work done consciously. I personally don't feel the benefits outweigh the risks having read the opinion of both exotic vets on this forum and that of David Crossley a leading vet dentist.

but have you ever seen a conscious done?
how many threads have we seen on here where a rabbit is lost due to reaction to a ga?..how many have you seen where a bun was lost to a conscious?
I've seen many, many rabbit have conscious dentals..none have been any more stressed than with any other procedure such as a mouth exam or vaccination..and all have been normally eating, drinking and binkying within minutes

 

[prettylupin]

but have you ever seen a conscious done?
how many threads have we seen on here where a rabbit is lost due to reaction to a ga?..how many have you seen where a bun was lost to a conscious?
I've seen many, many rabbit have conscious dentals..none have been any more stressed than with any other procedure such as a mouth exam or vaccination..and all have been normally eating, drinking and binkying within minutes

I have not seen a conscious dental done other than on incisor teeth and would not wish to. I don't need to see a conscious dental done to understand the risks behind them. I have a medical training and understand the risks without the need to see it.

 

[abbymarysmokey]

For those who don't believe in rabbits having conscious dentals...what are your thoughts about horse dentals, which are pretty much always done conscious?

 

[honeybunny]

I have not seen a conscious dental done other than on incisor teeth and would not wish to. I don't need to see a conscious dental done to understand the risks behind them. I have a medical training and understand the risks without the need to see it.

Well I respect your opinion, but having known of numerous rabbits have conscious dentals over 5 years ..without a single problem ..I will continue to support them..

 

[prettylupin]

Well I respect your opinion, but having known of numerous rabbits have conscious dentals over 5 years ..without a single problem ..I will continue to support them..

I never said you shouldn't We are all entitled to our own opinion, i'm glad it works for you and your bunnies. As you can see from this thread I am not alone in my views either

ETA I do think it is an interesting thread and appreciate Vikki's professional and first hand insight/experience in to the matter. It doesn't change my view but it is interesting to read and does clear up some questions for me personally.
For me there is definitely a distinction between incisor and molar work without GA.

 

[Fluffers]

I think this thread has really helped those with little or no experience of conscious dentals, consider all the options. Only then can people make an informed choice for their animals

I understand the risks associated with GA's & so my take on it is:

Assuming the rabbit is calm enough (i.e. will remain still & is not stressed) and the vet experienced, competent & confident, a conscious dental is less risky (over all) than one carried out under GA, not least because of the rabbits willingness to eat soon afterwards which can in itself be a real issue.

If a combination of the above factors cannot be ensured then I (personally) would consider a GA less risky (overall) & therefore the better option.

I don't know if the make up of a rabbits mouth is similar to that of a horse re. nerve endings etc? I know they share many similarities but I don't know if this is one. Teeth "rasping" in equines is generally an annual requirement but as horses get older this frequency increases. I have never heard of horses having to have teeth rasping done whilst under GA (as a routine thing). Occasionally sedation is used but even that (in my experience) is rare. My rescue pony Peggy is completely terrified of the vet but practically nods off whilst having her teeth rasped! :lol:

 

[rodneyvet]

I know this is a bit of an RU "can of worms" but I just thought I would share some of my experiences and see what people think.

Prior to having seen any conscious dental work in rabbits, I was of the opinion that all dental work should be done under GA or at least heavy sedation due to a) the risk of damage to the rabbit should it move during the procedure, and the difficulties in treating such problems in a conscious patient, b) the rabbit's perception of fear, discomfort, pain etc when conscious and c) the inability to visualise the all teeth and perform a complete dental procedure on a conscious rabbit.

Now that I have seen quite a number of conscious and unconscious dental procedures in different breeds, ages of rabbits with varying problems, and discussing them with the vets involved, I have made the following observations:

1. For the majority of rabbits undergoing conscious dental work there was little or no apparent pain, discomfort or fear reactions, beyond that expected in an animal being gently restrained and examined. The animals were very well held and the vets and nurses involved have had specialist training and are very experienced. Immediately after the procedure all the rabbits bar one (who was very neglected and not used to being handled at all) acted completely normally - moved their mouths around, were inquisitive about their surroundings, moved around the table, washed etc, and ate and drank normally within minutes.

2. With use of an appropriate dental gag applied correctly, visualisation of the molar teeth is actually quite good and they can be manually rasped very effectively.

3. Many animals that had regular dental work could be examined and work done in under 10 minutes and so didn't require admission to the hospital etc

So...I have to admit that my opinions on conscious dental work has changed. I still believe that a GA gives the best visualisation of molar teeth and is more appropriate for extensive or complicated work. It is also still safer with respect to potential damage to teeth and surrounding structures, particularly in nervous or fractious animals. But conscious dental work would seem appropriate when done by experienced vets (i.e. newer graduates etc should be well practiced at GA dentals before attempting any conscious work) and with experienced and knowledgeable nurses, particularly for trimming incisors. I still think power tooths e.g. burrs etc do a better, cleaner, more thorough job than manual clipping or rasping and that such power tools should NOT be used in conscious animals due to their higher risk use, BUT regular manual work, if this allows the animal to be seen more often and keeps the costs down (which is a necessary consideration in the vast majority of cases) is an adequate alternative.

Thats really interesting...
So could you tell me the plasma cortisol levels of the rabbits from blood taken at the time, That will give me an idea of how stressed they are. A study on "Hypnotised" rabbits foung their cortisol levels were through the roof, indicating severe stress despite looking relaxed (I suppose its the same in animals that play dead). Im more than happy to pm the reference or you could contact Anna Meridth, she will have the reference. Tell her you do concious dentals at the same time if you like. Funny really as reading this has raised my plasma cortisol somewhat. This will be my first and only post on this topic as my feelings are clear and will never change. But all I will add is that Im interviewing for positions at the moment and you need not apply.

 

[abbymarysmokey]

rodneyvet...what are your opinions on conscious dentals for horses? :wave:

 

[honeybunny]

Rodneyvet ..which practive do you own/work at?

also do you give a ga when examining a rabbits teeth?..or ears?..or rear end?..and do you test plasma cortisol levels when carrying out all these exams?
as having seen conscious dentals..I have, on occassion, seen rabbits more stressed by routine examinations

 

[abbymarysmokey]

Thats really interesting...
So could you tell me the plasma cortisol levels of the rabbits from blood taken at the time, That will give me an idea of how stressed they are. A study on "Hypnotised" rabbits foung their cortisol levels were through the roof, indicating severe stress despite looking relaxed (I suppose its the same in animals that play dead). Im more than happy to pm the reference or you could contact Anna Meridth, she will have the reference. Tell her you do concious dentals at the same time if you like. Funny really as reading this has raised my plasma cortisol somewhat. This will be my first and only post on this topic as my feelings are clear and will never change. But all I will add is that Im interviewing for positions at the moment and you need not apply.

That's bit rude to Vikki rodneyvet. Can you tell us which vets you work at if they are so far superior to the surgery Vikkivet is training at? People in your area might be interested to know that they have such a rabbit savvy vet nearby. (I'm presuming that you don't work with Anna Meredith seeing as you can't spell her name correctly?)

 

[Jack's-Jane]

rodneyvet is one of the best Rabbit Vets in the UK

First Vet on here

http://www.trinityvetcentre.co.uk/

 

[Fluffers]

Thats really interesting...
So could you tell me the plasma cortisol levels of the rabbits from blood taken at the time, That will give me an idea of how stressed they are. A study on "Hypnotised" rabbits foung their cortisol levels were through the roof, indicating severe stress despite looking relaxed (I suppose its the same in animals that play dead). Im more than happy to pm the reference or you could contact Anna Meridth, she will have the reference. Tell her you do concious dentals at the same time if you like. Funny really as reading this has raised my plasma cortisol somewhat. This will be my first and only post on this topic as my feelings are clear and will never change. But all I will add is that Im interviewing for positions at the moment and you need not apply.

:shock: How rude and completely unnecessary.

It's a shame I'm not recruiting for a condesending and patronising **** because you'd get the job hands down.

I get the distinct impression that you suffer from "not invented here" syndrome... :roll:

 

[abbymarysmokey]

rodneyvet is one of the best Rabbit Vets in the UK

First Vet on here

http://www.trinityvetcentre.co.uk/

Can we have more info? I've done a search on Mark Rowland, but everything minus one article on skin diseases seems to be related to reptiles. This could just be my home PC having limited access to scholarly journals. I can't do a proper search until I'm at work tomorrow

 

[Jack's-Jane]

Can we have more info? I've done a search on Mark Rowland, but everything minus one article on skin diseases seems to be related to reptiles. This could just be my home PC having limited access to scholarly journals. I can't do a proper search until I'm at work tomorrow

Why not PM him :wave:

This thread'll get locked if it continues to be 'personal'

 

[abbymarysmokey]

Why not PM him :wave:

This thread'll get locked if it continues to be 'personal'

Already have done, but I'm just looking for stuff he's written on rabbits and can't really find anything?

Nothing personal at all, just wondering why he was so rude to Vikki

 

[Hunnybunny2007]

Tilley had 3 conscious dentals on her molars, she came home and ate straight away, no side effects or anything, she had one under GA and died

 

[Suzanne]

I would choose a conscious dental over a GA the majority of the time and if the vet won't do it I would fine one that would. In his short time with us (18 months) Willow had about 12 or more conscious molar dentals. There was no way I would have put him through a GA every time. He was in and out of the vets in 20 mins and back home eating within half an hour. On the two times where he had a GA it was a few days for a full recovery. You may argue that he was stressed during the procedure but no more stressed than when having his teeth examined or going in for a GA. I was always with him during the procedure and was taught by the nurse how to hold him. This meant that I was there with him instead of some one unknown.

Whilst they may not be suitable for every bun I would request them without hesitiation.

 

[Tamsin]

Please keep it polite and not personal, even if you disagree!