Tooth trimming

[hln917]

Shades, my lop needs have her front tooth trimmed every 3-4 weeks and molars filed down every 3-4 months. With the molar work, she does r/c anesthesia but not with a tooth trimming. It usually only takes a couple of minutes. Since my vet is only in the office on certain days, I called another vet to check on prices and schedule. They advise thatanesthesia is requiredfor all tooth trimming performed.

Is this normal practice fora tooth trimming? I'm not comfortable with having her under anesthesia every month.

 

[elrohwen]

I know mild anethesia is normal for molar trims, I'm not sure about front tooth trims. I imagine if the rabbit is able to be restrained easily enough it would not be necessary for the front - for the molars it's hard to trim the teeth and not get the tongue in there if the bunny is moving around, but the front teeth are easily accessable.

My vet uses sort of a "twilight sleep" method for molar trims - they put the gas mask on until the bun is asleep, but not fully anesthetized. If necessary she can do this multiple times until the job is done, but it's not nearly as risky as full anesthesia because the bun is just slightly asleep. Your vet may use this technique in which case I wouldn't really worry about it every month. If it's full anesthesia, it would worry me as well.

 

[pinupchick]

I was reading up on tooth trimming the other day because Ula likely needs to get her molars trimmed very soon.

It is the norm to anesthetize for molar trims, not because it's painful, but because the bun won't sit still while his mouth is forced open (the tongue or cheeks can be cut by the tool being used) and because it's very scary to have the dremel tool shoved inside the mouth.

It's not normal to anesthetize for front teeth trims. It's painless and usually easy to do. I would be suspicious that that particular vet doesn't have much experience with rabbits, or isn't very good with teeth trimmings. The less anesthesia the better, for all animals.

 

[Pipp]

The confusion is the terminology. A rabbit only needs to be 'sedated' for molar spurs. My vet uses one drug to put them under (Domitor) and another one to bring them out of it.

I think Ketamine alone is a sedative, and combined with something else, its an anesthetic.

Also used is the above 'quick gas' method.

You want to have a bun in deep sleep for any surgery, but the teeth trimming doesn't require that. It just requires a bunny to still and unstressed for 15 minutes.


sas :bunnydance:

 

[Luvmyzoocrew]

My Sooty (RIP) had to have his teeth trimmed every 4-6 weeks. The one thing i want to stress is that the vet be a rabbit savy vet!!!! that is a must. I took Sooty to have his teeth trimmed every 4-6 weeks by my vet and at one point i did it myself , that was too nerve racking for me lol. There is always the risk of an abcess from the tooth cracking below the gum line, but in MY opinion the risk is the same with putting them under anesthesia as it is risking a tooth abcess, just MY OPINION. Like Pipp said as long as your bun is cooperative then you can get their teeth cut without anesthesia.

 

[pinupchick]

Ahh, good to know. I'll make sure they're just sedating Ula and not actually knocking her out.

Do rabbits sometimes take a while to recover from sedation? When Earl got his teeth trimmed before he died (unrelated issue!), he was groggy for several hours afterward. Would that be more in line with full anesthesia?

 

[tonyshuman]

It depends on what type of anesthesia was used and if they got the dose right. If your bunny is older than 4, I'd want them to do blood work yearly to make sure he'll respond well to the anesthesia. Sometimes older livers and kidneys don't eliminate the drugs from the system as quickly as those of a young bunny, and animals used in lab studies of drugs (to determine the right dose) are usually 6mo-18mo old.

Injectible anesthesia might not be required for a routine trim. That would include things like ketamine, benzodiazepines, etc. Usually gas anesthesia is isofluorane or sevofluorane. They go to work faster and also go away faster. I think most vets use just gas anesthesia for molar trims, and injectibles for things like a neuter. However, when a bunny's mouth is open, it can be hard to get at the nose to get them to inhale the gas anesthesia, so it may be a matter of personal preference on the part of the vet to use injectible for molar trims. In the videos I've seen of tooth procedures, gas was used, perhaps in combination with a light sedative/anxiolytic like a small dose of ketamine or valium, and they pretty much had to have a second person there holding the gas cone on the bunny's nose, and that can be a lot of hands all in one tiny space.

However, you can make the argument that small animals like hamsters and mice are pretty much only put under anesthesia with gas, and they're even smaller to work with than a bunny's mouth and nose area. I had a hammie that had to be put under to be examined because she was very squirrelly and nippy, and although she was past the life expectancy for her species, she did just fine recovering.

I'd ask the vet if they wouldn't mind just using gas anesthesia, or only a light sedative instead of something that would knock him out for the rest of the day with the gas. Also, get some blood work done to make sure liver and kidneys are good. If their function is impaired, the drug might not be cleared as quickly as the dosing calculations assume, and that might make the effects last longer.

edit: Wanted to add that front tooth trims can usually be done without any anesthesia, but molar filing usually needs something. Also, drugs that make the animal not form memories of the procedure are often used with small animals like rats, combined with gas sedation.

 

[Pipp]

tonyshuman wrote:

I think most vets use just gas anesthesia for molar trims, and injectibles for things like a neuter.

Okay, we're sort of saying opposite things.

I'm saying the trend is to use an injectable *sedative* for trims. Gas is traditionally an anesthetic for serious surgery. And of course you can have an injectable anesthetic. (And just to further confuse things, they are also combined with analgesics, or pain killers).

But they often use a sedative in addition to the gas anesthetic for surgeries. I remember reading that sometimes a stressed rabbit will silently 'scream' expelling air when hit with the gas, and it will also hold its breath when it smells the gas. That causes problems getting the right levels or mixes or something, and its stressful for the rabbit.

Thus they will put the rabbit into a light sleep with a sedative and then administer a gas anesthetic for major surgeries.

But with molar trims, they don't have to be overly concerned about a patient getting semi-conscious, its not like they have an open incision, so I'm sure some will just use a whiff of gas for a short period requiring low maintenance.

My vet was using Domitor for molar trims, a short acting sedative. Its been getting great safety and recovery results, but its a newer drug, the longer term effects are still being researched.


sas :bunnydance:

 

[tonyshuman]

I would think, though, that gas would be a lighter anesthetic because it is eliminated from the body much quicker than injectibles. Unless your vet is using an injectible with a reversal drug, also injected?

 

[Pipp]

tonyshuman wrote:

I would think, though, that gas would be a lighter anesthetic because it is eliminated from the body much quicker than injectibles. Unless your vet is using an injectible with a reversal drug, also injected?

Yup, there is a reversal drug, I forget the name.

I suspect that gas alone is lighter, but possibly stressful and not as reliable in terms of keeping them under. I think both have their upsides and downsides.

I'm waiting for the long term effects studies, they should be getting enough data by now.


sas :bunnydance:

 

[hln917]

Thanks everyone for your response. Shades is usually very good at the vet for her front tooth trimming. She'll stay still for the couple of minutes it take to clip them. I, on the other hand gets all skeevy and turn away b/c I can't watch.:cry2 I didn't understand why a vet would administer anesthesia for a simple procedure.

Now a new cause for concern, I know the vet administer isofluorane when both Baci and Shades gets their molars filed down.Baci just turned 2 and Shades is 1 1/2. Should I be concern re: the effect of gas anesthesia as oppose to injection?

 

[Flashy]

I'm really sorry, I can't answer your question about the different types.

Just wanted to add to the debate about the anaesthetics, is that as some of you may know we have a clutch of dental bunnies here. They have it injected IV (in the ear). They all come back with baldy bits on their ears, which is the clue. Prior to that they had it injected IM in the hip (but I only learnt that after they started coming back with baldy ears and I asked why). They also seem to use IV for the stuff like x-rays too, which is also only needing a light sedation. So, just wanted to say that my vets, at least, seem to do as Pipp says with regards to what they use.

 

[tonyshuman]

Usually gas is better tolerated too, because it goes out of the body so quickly. However, it's really hard to determine the dose of--you have to do it in liters per minute, so timing and the amount that the canister is open matter, and it's hard to tell how much of the gas that goes out the cone will go into the lungs. And it wears off quickly, and you can't really tell if it's wearing off until they start waking up, and that can be stressful. Some bunnies don't like the nose cone either and have to be put into a box to get them started, which I can imagine is quite scary.

I wouldn't worry about bunnies that age, Helen.

I've seen bunnies get blood drawn from the front paw too, so that could be another place to inject IV, although the rabbit ear vein is supposedly easy to inject into as well.

I just would ask your vet what options they have and if they're comfortable doing a lighter anesthesia for more routine procedures. I'm a firm believer that bunnies over age 4 should have annual blood work whether they're routinely getting sedated or not, so that's also something I'd want done. Doing the blood work and a full annual exam (listening to the heart, lungs, feeling the organs) should help determine how the bunny will respond to the anesthesia to prevent there from being big problems in how they react to it.

 

[tonyshuman]

Here's some info on anesthetics:
http://www.medirabbit.com/Safe_medication/Anesthesia/Safe_Anesthesia.htm

 

[pinupchick]

Okay, so I asked my vet tech what type of anesthetic they use for tooth trimmings and they do a full injectable with some gas.

I booked Ula an appointment for Friday because she's still making teeth crunching/flicking noises despite eating normally. I'm worried though as she's close to 5 years old now. She had a physical last week and is in good health other than her potential molar spurs. The vet wanted to do anesthesia to explore her mouth thoroughly and then trim if it's necessary.

So... should I let her go through with it? It's bad in the long run to not treat spurs or overgrown teeth right? Is it worth the anesthetic risk to ensure that her teeth are okay?

Thanks for your help! I'm really nervous now. :nerves1

 

[tonyshuman]

I think it is worth the risk but have the vet listen to her heart and lungs first, and maybe get a full blood panel done to check liver and kidney values.

 

[Saffy]

My vet clipped Mookie's front teeth whilst she was in my arms ... She said she would only need to be put under if she had her back teeth done.