Thursday, January 9, 2020

CERTIFIED ORAL PAIN FREE-The Senior Oral Pain Patient-#42

Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry

Image result for Picture of an older dog in pain

Certified Oral Pain Free
Caring for Oral Pain in the Aged Pet
The Touch of the Master's Hand-
CORET~Comprehensive Oral Radiologist Evaluation and Treatment 

The Old Violin

The Touch of the Masters Hand

'Twas battered and scarred,
And the auctioneer thought it
hardly worth his while
To waste his time on the old violin,
but he held it up with a smile.
"What am I bid, good people", he cried,
"Who starts the bidding for me?"
"One dollar, one dollar, Do I hear two?"
"Two dollars, who makes it three?"
"Three dollars once, three dollars twice, going for three,"
But, No,
From the room far back a gray bearded man
Came forward and picked up the bow,
Then wiping the dust from the old violin
And tightening up the strings,
He played a melody, pure and sweet
As sweet as the angel sings.
The music ceased and the auctioneer
With a voice that was quiet and low,
Said "What now am I bid for this old violin?"
As he held it aloft with its' bow.
"One thousand, one thousand, Do I hear two?"
"Two thousand, Who makes it three?"
"Three thousand once, three thousand twice,
Going and gone", said he.
The audience cheered,
But some of them cried,
"We just don't understand."
"What changed its' worth?"
Swift came the reply.
"The Touch of the Masters Hand."
"And many a man with life out of tune
All battered and bruised with hardship
Is auctioned cheap to a thoughtless crowd
Much like that old violin
A mess of pottage, a glass of wine,
A game and he travels on.
He is going once, he is going twice,
He is going and almost gone.
But the Master comes,
And the foolish crowd never can quite understand,
The worth of a soul and the change that is wrought
By the Touch of the Masters' Hand.
- Myra Brooks Welch

The Aged Pet is lost in a New Millennium of social media; electronics; and Google.
As oral health advocates, we must never dismiss the affects of pain on the aged pet.  There are two Stages of Life that need the most veterinary help.  They are the very young and the very old Stages of Life.
It is common as pets age............. for co-morbities to occur!
Common Co-Morbidities in Aged Pets:
1]  Liver pathology
2]  Kidney Pathology
3]  Osteoarthritis
4]  Obesity
5]  Pancreatitis
6]  Hear Disease
7]  Lung Disease
8]  Cancer
9]  Diabetes;Thyroid Disease; and other endocrine diseases

10] ORAL PATHOLOGY resulting in PAIN
Pets as they age become battered and scarred!
The triad of doctor; pet advocate; and patient must be strong to face all of the co-morbidities of aging and attack these problems in a proactive way! Removing pain and restoring a quality of life is the key!  
Reactive is the wrong road.  These patients are presented in severe pain and require major medical and surgical attention to reverse the pathology that is present.
Being Proactive in the care of the Geriatric Pet is the KEY with CORET- [Comprehensive Oral Radiology Evaluation and Treatment]
Common Oral Problems in the Geriatric Dog and Cat

  • Advanced Gingivitis-totally reversible
  • Advanced Septic Periodontitis-Advanced Gum Disease-controllable
  • Dog Stomatitis-A very painful whole mouth oral pathology
  • Broken teeth with painful open pulp canals
  • Worn teeth with tooth root abscesses or pulpitis
  • Cysts or Masses in the Mouth
  • In Cats-Multiple Resorptive Lesions [caries or cavities] into the pulp canal
  • Cat Stomatitis-the most painful oral pathology in cats
How to Become Certified Oral Pain Free

  1. Speak to your veterinarian about CORET
  2. Ask for an out-patient physical exam and non-definitive oral exam by your LDVM prior to pre-anesthesia testing for dental x-rays and treatment under general anesthesia. [Dental X-rays can only be taken under general inhalation anesthesia to avoid misdiagnosis with the slightest patient movement]  
  3. Come to this appointment with a series of questions.  Your LDVM will discuss safety in gas inhalation anesthesia at this time and the importance of pre-anesthesia testing.
  4. Ask for your doctor to perform CORET under general inhalation anesthesia~Comprehensive Oral Radiology Evaluation and Treatment
  5. Treatment follows consent after your doctor describes dental x-ray findings.  After the oral x-rays are completed, with Informed Consent, your LDVM in a consultation review will ask permission for the treatment of the pathology present or refer you to an animal dentist 
  6. CORET is only completed under General Gas Inhalation Anesthesia.  
  7. Non-sedation dentistry is ineffective and can cause pathology. 
  8. With non-sedation dentistry, if the patient moves even the slightest during root planing........ the pet can be put into a pain state.  [See AVDC white paper on non-sedation dentistry in pets]
  9. Ask for your doctor to have your digital dental x-rays evaluated by an animal dentist or radiologist prior to treatment in aged pets with abnormal dental x-rays.  [One such service is E-Vet Diagnostics]
  10. Ask questions!  Become thoroughly informed!  Never be hesitant to ask you LDVM for a Referral to an Animal Dentist in cases where the oral problems in your pet are classified as Advanced or MAJOR!
  11. Never ignore oral problems in the aged pet.  These loyal friends and family members have provided unconditional love for years.....NOW it is our time to step up to the plate...... as pet advocate; nurse; and doctor to diagnose oral pain centers and remove these areas of discomfort permanently.

Contact Dr. DeForge at

1 comment:

  1. Great information Thank you for sharing
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