The importance of “pet-alized” dental care for older animals

Image Credit: © tsuguliev - stock.adobe.com

At Fetch Nashville, Heidi Lobprise, DVM, DAVDC, delivered a presentation titled, “They are NOT too old for dental procedures (usually).” Lobprise’s talk focused on treating older pets with periodontal disease, discussing the tailored pain management and anesthesia protocols that veterinarians should undertake to reduce treatment risks for older animals. This talk took place in Davidson Ballroom 103C in the Music City Convention Center, in Nashville, Tennessee, from 4:00 to 5:00 PM on Friday, May 30, 2025.

Why do many dogs not receive ongoing dental care throughout their lives?

Lobprise started off her presentation by addressing the main root cause for older patients being afflicted with periodontal disease. Lobprise explained that most pet owners do not routinely bring their pets to the veterinarian for routine dental checks. The result is that dental disease and chronic inflammation continues to build over time as the pet ages, and this leads to further complications once the pet enters their senior years.

“If you have cumulative changes, particularly if there hasn’t been ongoing care, that’s when you start having issues,” Lobprise said during her talk.¹

She added that pets not receiving dental care throughout their lives tend to develop comorbidities that become more pronounced with age, and it makes their care later in life much more difficult.

The objective of Lobprise’s talk was to help veterinarians better understand the systemic impact of chronic inflammation of dental disease.

Heidi Lobprise’s talk at Fetch Nashville focused on providing veterinarians with important information about pain management and anesthesia protocols for older pets with certain comorbidities. Photo Credit: Will Wetzel

What are the challenges of senior dentistry?

Senior dentistry care is often more challenging because senior pets are dealing with more ailments than younger animals. Most senior pets often have gum disease, oral tumors, comorbidities, depleted reserves for healing, and increased incidence of tooth resorption. All these factors, as well as others, influences the patient’s anesthesia risk, which can dictate their individual treatment plans.

Lobprise also talked about the stigma surrounding anesthesia. She mentioned that it isn’t only the associated risks with anesthesia that make pet owners anxious, but also the costs.

“The cost of anesthesia is always a big concern that comes up often,” Lobprise said in her talk.¹

What is inflam-aging?

The bulk of Lobprise’s talk concentrated on “inflam-aging,” which is described as chronic, low-grade inflammation.

“Inflam-aging is correlated with most age-related diseases,” Lobprise said in her talk.¹ “When we go to the doctor, we are normally told with diet and exercise that resolve our comorbidities. But inflam-aging is extremely complex. It’s more than diet and exercise. It’s a snowball effect.”

Because senior pets have one or several comorbidities, anesthesia risks are increased. As a result, Lobprise explained that preoperative evaluations are essential in assessing the risk and determining what targeted therapies can help stabilize the patient.

“When assessing a patient’s comorbidities, we have to ask: Is it moderate enough that the animal can get through anesthesia okay?” Lobprise said in her talk.¹

To determine a patient’s ability to handle anesthesia, the ASA Physical Status Scale is often used. Lobprise explained all 5 classes of this scale, mentioning that most of her patients are usually designated as Class II, with some falling in Class III.

The considerations for various diseases

In the second half of Lobprise’s talk, she provided a list of general best practices during preoperation patient care, including things to consider for pets with cardiac disease considerations, renal disease considerations, diabetes considerations, liver disease considerations, and pain management. Below are some of the highlights (this is not an exhaustive list):

1. Preoperation patient care: For medications, Lobprise explained that she refrains from prescribing ACEI, but recommends anxiolytics and most cardiac drugs. She also said in her talk that if the pet has a “history of regurgitation, I like getting them on anti-acid medication 2 to 3 days ahead of time.”¹
2. Cardiac disease considerations: Lobprise pre-oxygenates the pet if possible before the operation, recommending to also avoid routine use of anticholinergics. To support the animal further, a lower fluid rate might be needed. ACEI is also discouraged and she recommends refraining from using it in the days leading up to the operation.
3. Liver disease considerations: Glucose levels need to be monitored closely, and it is important that the patient is still eating well.
4. Pain management: Stress reduction is often critical for anesthesia procedures. As a result, pre-anesthetic anxiolytics may be recommended to help calm a patient’s anxiety leading up to the operation.

Lobprise concluded her talk by discussing best practices for during the operation and the recovery period post operation. She highlighted the importance of a good technician during the operation.

“The best monitor is a good technician,” Lobprise said in her talk.¹ “Having someone dedicated to watching the patient during anesthesia is extremely critical.”

Lobprise added that a technician can monitor a patient’s vital signs while the veterinarians and surgeon are concentrated on their specific responsibilities, alleviating their stress during this period.

For the recovery period, Lobprise discusses how patient management is very important. Mortality and morbidities become obvious during the recovery phase. It is important that fluids are watched and monitored carefully, as well as ensure that the patients do not injure themselves.

Reference

Lobprise H. They are NOT too old for dental procedures (usually). Presented at: Fetch dvm360 conference; Nashville, TN. May 30, 2025