Latest / Back In The Closet - Two Crazy Cat Ladies / The Do's and Don'ts of Dentals for Cats with Dr. Katie Kangas

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The Do's and Don'ts of Dentals for Cats with Dr. Katie Kangas · Back In The Closet - Two Crazy Cat Ladies

• 0:00
  Before we start this awesome episode, we got to give a shout
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  Yeah, and honestly, it's really an important part of their
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• 0:37
  OK, so now let's get to the podcast.
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  With wine, always with wine. I'm Jay, I'm Adrian, and
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  together we are. Those two crazy cat.
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  Ladies, I'm. Going to cut you.
• 0:50
  I think I just peed. Buckle up.
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  We're back in the closet. Welcome.
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  To another episode of the back in the closet with the 2 crazy
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  cat ladies where we are joined today yet again by the one the
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  only doctor, PD Kangas, the expert when it comes to to pet
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  dental care. I was going to say cat dental
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  care, but it's also dogs. You're actually also very, very
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  smart when it comes to dogs. But we and she is here to tell
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  us today all about the do's and the don'ts.
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  So, so pet dental health month is coming up in just a couple
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  days. So we, we wanted to kick this
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  off early with, with the expert, with the expert veterinarian in
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  pet dental health so that you guys can get all the information
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  that you need. And we can get all the
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  information we need because we have two dentals coming up
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  ourselves to, to know the questions that we need to ask
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  our vets and, and what we should be looking at and for post and
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  and pre and all the stuff and things.
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  And I have to say one more time, we are chomping at the bit for
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  this one. It's going to be so valuable.
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  And Dr. Katie Kangas is the one. It was a talk on dogs that you
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  did that changed the trajectory of my own dental health.
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  Just you, you are you are mind blowing on the information that
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  you have that all of it. So for anyone that doesn't
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  already know you, would you give a short intro?
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  Oh, thank you. Of course.
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  So, you know, Doctor Katie Kangas, I've been a veterinarian
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  for a little over 30 years, believe it or not.
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  And I did general practice for many years.
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  I actually did shelter work for many years and then found my way
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  into the holistic path, which has been my Dharma.
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  And I've been doing holistic for over 15 years.
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  And I've been through lots of different niches of training
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  with acupuncture, Chinese medicine, food therapy, herbal
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  and homeopathic as well. So I do a lot of different
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  diversity within my practice. I really kind of title myself a
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  functional medicine doctor. I kind of start there, but then
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  I add in all these other modalities to really be
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  comprehensive and complete everything.
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  But through that path, I also stumbled into a depth of
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  training in veterinary dentistry, which was kind of
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  unplanned, but it was the coolest, one of the coolest
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  things that's happened in my career.
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  And when I first opened my holistic practice a decade ago,
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  I shared space inside a dental specialty practice.
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  I leased space from them. So they had a huge building and
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  they were using it all. And I was friends with the, you
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  know, the, my colleagues, the owners, and they're like, Hey,
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  you can rent space from us. And I'm like, awesome.
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  And I move into this dental practice and boom, I meet, I
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  learned so much about dentistry and I literally, I love telling
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  my clients I am a better veterinarian because I know oral
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  health so much. And I'm also a better holistic
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  and integrative veterinarian because I know oral health so
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  much. Because as probably everybody
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  knows, but just to reiterate, well, you cannot be in good
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  whole body health if you're not living with good or if you don't
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  have good oral health. And I love that Adrian, you
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  know, even gives me any credit at all for her own health.
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  But it is so monumental that we're taking care of our mouths
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  and our pets mouths in order for us to live better and them to
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  live better and longer. I mean, longevity is definitely
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  tied to oral health, periodontal health, because it's affecting
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  everything in the body, 24/7 information and the bacterial
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  load in the mouth are shared to the bloodstream, to all the
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  organs, all the systems. And most people understand that,
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  you know, cardiac issues and kidney issues are going to be
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  worsened or driven by periodontal disease.
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  But a lot of people have don't have awareness that oral health
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  problems or periodontal disease literally drives all
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  inflammation. And so that could be arthritis,
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  it could be brain disease, neurologic disease, IBDI mean
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  everything is worsened when there's poor oral health.
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  So that's why I love to get into that as such.
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  And also you know root but connection cause of so many
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  things going on in the body. Yeah, absolutely.
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  I you know, I know they, they always say health begins in the
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  gut. And we've said that for for
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  years and years too. But then we then we learned that
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  really health begins in the mouth, right?
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  Because what? You can say both.
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  I mean, I'm all about gut as the foundation of health.
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  So well said there. But the mouth is so tied into
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  that, and it's truly part of the gastrointestinal tract, the
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  beginning of it. But the mouth is also a unique
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  reflection of what's going on in the body.
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  And interestingly, in Chinese medicine, we look very much at
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  the tongue color, the pal, the, you know, the texture that the
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  moistness. So much about the tongue gives
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  us a diagnose. We call the tongue pulse
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  diagnosis. We're checking pulses and tongue
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  to kind of figure out the pattern of what's going on in
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  the body. So that's a whole nother kind of
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  nuance, but a nice way of seeing like how much the mouth reflects
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  what's going on in the body. And so it is a big deal and it's
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  really great to focus some energy and attention on
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  investment into our pets oral health.
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  Yeah, I think our cats especially really, really suffer
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  from exactly this because they are so stoic.
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  You know, we've had a hard path understanding how important oral
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  health is for our cats. We had a cat that lost a canine
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  that rotted out and we didn't even know he was having issues.
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  Right, I'm cute and I'd love that you said that Adrian,
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  because that's a really good lead in for me to share of of,
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  you know, phrase that Dennis, you know, she on the human side
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  to that dentistry is like periodontal disease is a silent
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  killer because we don't know that it's happening sometimes
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  even in people's mouths. They don't know the level of
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  what's going on and certainly in our pets mouths where we can't
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  get a good look and also up to 60% of pathology, meaning the
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  problems in oral health are below the gum line.
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  So even when you are getting a good look, you may only be
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  seeing about 40% of what's really happening.
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  And so that's why it is such, you know, a difficult, you know,
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  or a challenge for us to really know what's going on with oral
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  health and pets. And that's why we got to be more
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  on top of it and really lean into good veterinary care for
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  oral health. And cats being so instinctively
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  hiding their pain, you know, being very quick.
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  This is. How do we know?
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  Yeah, let's. Just jump into the first
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  question, How do we know when our cats need a dental?
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  So great question. Sometimes you may not know.
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  So let's just, you know, clear that up that you there could be
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  something under the gum line and you could look in the mouth and
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  it could look normal to you and they could still need a
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  dentistry. But there are a lot of other
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  cues that you can pick up on too.
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  And that would definitely be bad breath.
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  And the medical term for that is halitosis.
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  So if you're sensing bad breath, absolutely.
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  And then other things, obviously the, the calculus or the tartar
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  is something that we can look for.
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  But more importantly actually is gingivitis.
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  And so the word gingivitis means inflammation of the gums.
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  And you know, the gum line where it meets the tooth, that's what
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  we really want to look at is that gum line.
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  And I love to, you know, educate people that looking at the gum
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  line and seeing if there's inflammation, meaning swollen,
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  you know, red, deep in red color or deep pink color or even
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  purple color. Sometimes it gets to that level
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  that is all gingivitis. And that Trump's like the
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  tartar, the calcified plaque. Yes, we want to get that off,
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  but that's really cosmetic. I mean, once plaque mineralizes
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  and calcifies into tartar, it's kind of like just a cosmetic
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  thing to get rid of it. It's not, you know, the the
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  upcoming plaque all the time with the new bacterial biofilms
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  keep stacking on there. The active bacterial biofilm is
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  not good. But people will look at even
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  veterinarians often times if they don't know dental training
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  really well is they'll look at the level of tartar and they'll
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  sort of document the level of disease by saying heavy tartar.
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  And that's all they write in the in the record.
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  Sometimes it's like, well, what are the gums look like?
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  Because sometimes I've got slides in my presentations of
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  kitties with jam packed tartar on the teeth, but the gums
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  actually look pretty good. And then you can see other pets
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  where there's very little tartar and the gums are a disaster.
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  Bad gingivitis, like really bad. And so I love helping people
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  understand that the gums tell a better story generally, unless
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  we're looking at broken teeth or something like that, but really
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  looking at the gum. So when you're asking a question
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  of if if people are seeing any gingivitis, it really is time
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  for dentistry. The other thing I would say with
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  frequency of dentistries is you don't not every cat might not
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  necessarily need a dental annually.
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  Now most veterinary dentists, I have to say, they would
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  definitely advocate for an annual dentistry And let's let's
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  face it, most humans hopefully are getting, you know, our teeth
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  cleaned at least every six months and a lot of people do it
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  every three to four months and we're crushing and flossing.
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  So an annual dentistry to a pet parent sounds like a lot because
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  you have to put them under anesthesia.
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  But when you think about oral care and dental care and you
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  think about what we're doing and annual dentistry is not very
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  much. And then the other thing that
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  Kitty parents should know is that any brachiocephalic breed.
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  So when we're talking Persians and Himalayans and exotic short
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  hairs and stuff, any brachiocephalic breed has more
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  airway problems, more dental problems because it got a
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  swished in really stinking cute face that, you know, does bring
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  more problems that cuteness going to, you know, have to have
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  a look trade off there. But yeah, so if you have a
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  brachiocephalic breed Kitty, I would definitely aim for more
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  frequent dentals because they're going to need it.
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  And a lot of those kiddos probably need extractions, you
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  know, along the way, definitely by the time they're older, often
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  times so. So would you say so, so many of
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  us as cat parents like we, we don't necessarily, we can't
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  necessarily or our cats, not all of our cats at least will
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  necessarily. Let us look.
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  Oh, look at that. My teacup.
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  I love that teacup. Representing the felines.
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  OK. All right, go ahead.
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  We can't necessarily work as some, some cats won't let you
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  really lift their lips and really look at their gums
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  ourselves. So would you say that it would
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  be beneficial for us to at least bring them into the vet and have
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  the vet look at those things first?
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  And and, or as you say, you can't really see everything with
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  the naked eye really then, then would, would we want to do these
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  dentals proactively? Yes, and so truly, I I mean in
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  an ideal situation, proactively annually, annually, definitely
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  if you have a break use of valid breathe, maybe you could do
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  every other year, especially in the, you know, the first half
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  ish of life or whatever. But yes, proactively is so good
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  because again, even a veterinarian getting a
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  potentially a better view than a pet parent could get, we're
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  still, we're still not able to see everything.
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  That said, we have a more educated eye where we would be
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  finding stuff more than, you know, an average pet owner
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  would. And so that's really helpful.
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  And kitties, of course, get some specific sort of syndromes that
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  aren't as common in dogs. And the resortive lesions that
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  cats get, sometimes you can actually see those, sometimes
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  you can't. But the Sentinel tooth is this
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  mandibular third premolar. Actually right up here, they
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  call it the Sentinel tooth because usually if there's going
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  to be a resortive lesion, that's the tooth that usually starts on
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  and then other teeth can become involved.
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  And So what we often see is a little like a little divot,
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  sometimes even in the gum line, like it just looks like it's
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  sinking in a little bit and it's inflamed right in a little focal
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  spot. And sometimes you can see it, we
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  call like a neck lesion because it's sort of in the neck of the
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  tooth where the where the tooth, you know, meets the gum line and
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  then the root obviously is below that.
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  But sometimes you can see a little divot in the tooth of
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  actually a resorptive lesion there or starting, or sometimes
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  you just get an indication that it's there because you see a
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  very focal point of gingivitis right there and almost looks
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  like the gingiv is dipping a little bit and you're like,
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  that's probably a resorptive lesion.
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  So point being is, yes, an educated eye can pick up things
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  that you might not be able to see.
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  So the more frequently or the more routinely you can get your
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  Kitty evaluated, their mouth evaluated, the better.
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  But it's not until they're under anesthesia and we can take a
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  periodontal probe and probe in literally 6 spots around every
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  tooth to see if the probe sinks in deep anywhere, cuz that's
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  abnormal and pathological, not good.
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  And then any place that there's a pocket or a suspect lesion or
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  problem that that deserves an X-ray.
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  And so dental X-rays are imperative, important to provide
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  good care. And so that's one of my
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  qualifiers for people in finding a general practice veterinarian
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  that does good dentistry is make sure at least one baseline tip
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  for people to see if it's a good place to take your Kitty for a
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  dentistry is if they have dental X-ray.
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  And if they don't have dental X-ray, I definitely wouldn't do
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  a dentistry there. Just because they have dental
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  X-ray doesn't mean they're exceedingly trained in dent.
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  But if they don't have dental X-ray, just cross it off the
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  list right there. So.
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  They're blind, I mean, and that's what we used to do.
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  I mean, I hate to say, I mean, 30 years ago, dental X-rays and
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  pets were, you know, not not standard.
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  And now they're digital. I mean, we used to have little
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  films that you had to dip and you know, all the stuff like
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  human and you, I mean, everybody, anybody goes to a
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  human dentist. You're like, my gosh, the
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  technology and dentistry these days knocks your socks off
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  digital pen and they map your mouth and they can do your night
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  guard and produce it right there for you.
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  I mean, it's insane. But point being is we want to be
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  able to see under the gum line so that we know what that pet
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  needs because otherwise we have no clue what's going on under
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  the gum line. And that tooth may be need to be
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  extracted. It may be able to be saved.
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  You know, we need that, that visual, that information, but we
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  find it with the physical exam of probing and looking.
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  And you can't do all that unfortunately, without
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  anesthesia. And that's teeth cleaning
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  happens. So we can talk about the
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  difference between, you know, what is a dentistry versus what
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  is a teeth cleaning because most people think they're taking
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  their pet in for a teeth cleaning and it is, but it's not
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  just a teeth cleaning. So I love to clarify that for
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  everybody. Is that a dentistry, a
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  professional anesthetic? Dentistry is not synonymous with
• 16:48
  a teeth cleaning. Yeah, yeah.
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  One of the main objectives is to clean the teeth clearly.
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  So we get that health value out of it.
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  But cleaning the teeth is not just scaling and polishing
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  scaler like a, you know, Yeah, so cleaning the teeth with, you
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  know, like a scraper, I guess what I was going to say, a
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  scaler. So scaling the teeth either with
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  ultrasonic or a hand scaler is scraping off that tartar, that
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  hardened plaque, and then you follow it with a polisher.
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  We need to smooth out that enamel because if we leave
• 17:20
  scratches in the enamel plaque, it's like a heyday for plaque.
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  The next line of plaque that comes in, it's like, now we can
• 17:27
  really attach. We're good.
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  This is a better structure even than it was before.
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  So it's got to be smoothed out again to be a little more
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  resilient to plaque. But the problem is with, for
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  instance, not that many cats go for free cleanings because not,
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  you know, most cats would not tolerate that.
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  But, and I love to clarify that for people that non anesthetic
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  cleanings, you're literally just scraping and polishing the
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  crown, the part of the tooth you can see, but the sub gingival
• 17:57
  space with the root and any little space under the gingiva.
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  If that's not getting cleaned and investigated, then you're
• 18:04
  leaving disease in the mouth and you're just then the pet ends up
• 18:07
  with cleaner looking teeth. But the medical value isn't
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  there because what's going on under the gum line is still
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  proceeding into disease. So back to explaining.
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  A teeth cleaning is literally cleaning, scaling and polishing
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  the teeth, but getting sub gingerly with a sub gingival
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  curette, anything that's happening under the gum line.
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  And then also a full exam through the mouth with the
• 18:31
  periodontal probe with visual. You know, sometimes masses are
• 18:34
  in the mouth or you know, gingival masses, tumors, polyps,
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  I mean there's all kinds of things that can be found.
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  So a dentistry is much more than just.
• 18:45
  A cleaning, OK. So, so you would say because we
• 18:48
  have a question here that like a regular dental cleaning is not
• 18:51
  going to affect gingivitis or it it's not going to help with any
• 18:56
  of these period? Yeah.
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  If it's not done well, like if it's done under anesthesia where
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  they're doing all that, then definitely it will help.
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  If it's just a rudimentary, you know, and again, I don't think
• 19:11
  that many cats are going for non anaesthetics.
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  But you know, if it was literally just like a quick
• 19:15
  scale and Polish, which is what happens with non anaesthetic
• 19:19
  dentistry, then there's little to no health value in that.
• 19:23
  And it's a cosmetic service only.
• 19:25
  But in a proper anaesthetic dentistry, you know, and
• 19:29
  obviously we can tell people again, how to find skilled and I
• 19:33
  would I would always advocate to see a board certified dentist if
• 19:36
  possible. That's where you're going to get
• 19:39
  the highest level of care. But that said, there's still a
• 19:44
  lot of primary veterinarians that have really good dental
• 19:47
  training. So not to, you know, under score
• 19:50
  that option too. But definitely, if there's a lot
• 19:54
  of problems in the mouth, if they need a lot of extractions,
• 19:57
  if there's a lot going on or there's other health issues with
• 20:01
  the Kitty, if people can go to a board certified dentist, that's
• 20:05
  absolutely ideal. They're going to get yeah.
• 20:09
  OK. Into the next question then,
• 20:10
  because I think this is where a lot of the fear comes from is
• 20:13
  the fact that we're putting our kitties under anesthesia and
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  there's it's, it's a fear for us, not just.
• 20:21
  Like it brings all of us to tears.
• 20:23
  We just, you know, every time we all cry.
• 20:26
  And when they're going under because it's like surgery,
• 20:28
  right? It's like, no, they're going
• 20:30
  under anesthesia. Are they going to come back?
• 20:32
  Right, so let's talk a little bit about what needs to be done
• 20:35
  before they go under anesthesia. What kind of workup do you
• 20:38
  recommend? What, what kind of questions do
• 20:40
  do we need to be asking? How do we know if our cat is
• 20:43
  healthy enough? What should we do?
• 20:44
  And then what? Yeah.
• 20:45
  And then what should we ask? That was like 15 questions.
• 20:50
  It's all perfect and it's so spot on with what people really
• 20:54
  need to know because that is, I think one of the biggest
• 20:56
  obstacles, both that and money, you know, it's the fear of
• 21:00
  anesthesia and the cost. I mean, those are the two things
• 21:02
  that, you know, are the obstacles for people to get this
• 21:05
  done. And you know, what we really
• 21:08
  want to make sure is that, you know, usually dentistry is still
• 21:12
  called an elective procedure. Like, you know, it's not an
• 21:15
  emergency. They don't, you know, usually
• 21:17
  need it like today, unless you know, their jaws broken or
• 21:19
  something like that. But normally it's an elective
• 21:22
  procedure. So before any elective
• 21:23
  procedure, you want to do your due diligence in doing a pre op
• 21:28
  workup with blood work, maybe even a chest X-ray.
• 21:32
  Certainly if it's a Kitty breed that either has a high, you
• 21:38
  know, propensity for heart issues or if there's any history
• 21:42
  of cardiovascular heart murmur, anything like that, then most
• 21:47
  vets and certainly that Dennis really like to have chest X-rays
• 21:50
  before surgery as well, just to make sure that nothing looks,
• 21:55
  you know, significant enough that that needs to be
• 21:57
  investigated before anesthesia. But standardly it's always like
• 22:02
  a full blood panel, which would be ACBC and chemistry.
• 22:05
  I would always opt for a urinalysis as well, because U as
• 22:08
  are so important for everyone's health, but especially cat
• 22:11
  health. We get a lot of information out
• 22:13
  of those. So keep that in like the, you
• 22:15
  know, comprehensive lab ticket there.
• 22:18
  But ACBC in a chemistry panel is considered, you know, pretty
• 22:23
  required. You know, that's like the
• 22:24
  baseline requirement to check out, you know, their red blood
• 22:28
  cell, white blood cell count, platelets in the CDC, and then
• 22:32
  the kidney and liver values and electrolytes and blood glucose
• 22:35
  and all that kind of stuff in the chemistry panel.
• 22:38
  And even if there are some lab values that are, you know, not
• 22:44
  optimal, if something's, you know, elevated in the labs
• 22:48
  doesn't mean that the Kitty can't have a dentistry.
• 22:50
  But depending on what's going on that dentist dentistry made, he
• 22:54
  postponed and say, hey, we just found something that we didn't
• 22:56
  know about. Let's figure this out.
• 22:59
  Let's address this. We're going to wait on the
• 23:01
  dentist, you know, the the dentistry for a minute and
• 23:04
  figure this out and support the cat to better health before we
• 23:07
  go ahead and plan that anesthesia.
• 23:09
  So it gives you that ability to be the best advocate for the
• 23:14
  Kitty and figuring out where their health is at so that
• 23:17
  things can be planned accordingly.
• 23:19
  That said, there are kiddies that have kidney disease, you
• 23:23
  know, kidney CKD and chronic kidney disease and they can
• 23:26
  still, you know, go. So it doesn't necessarily if
• 23:28
  you're in end stage disease, if you're in like, you know,
• 23:31
  cardiac failure, I mean, obviously that's a different
• 23:33
  story. But there are pets that go under
• 23:36
  very successfully all the time with certain conditions and even
• 23:41
  heart murmurs and things like that.
• 23:42
  It's just we really need to know what's going on so that we can
• 23:45
  plan anaesthesia better. Certain anaesthetics can be
• 23:48
  used, certain strategies can be used.
• 23:53
  And the other thing that veterinary dentists do a lot is
• 23:56
  that if there's a lot of work to be done in the mouth, they may
• 24:00
  stage it into two different procedures and not allow that
• 24:04
  pet to be under anaesthesia for too long and wake them up and
• 24:08
  get them back in a month or two to finish the rest of the work.
• 24:12
  So absolutely. And I love that you asked that
• 24:16
  because I will speak to that in that most people intuitively, we
• 24:20
  would all intuitively think that the last times our pet or
• 24:24
  ourselves go under anesthesia, the better.
• 24:27
  So people want to do everything. And if they're after primary
• 24:29
  that they're like, oh, can you take that lump off and do the
• 24:31
  dentistry? And you don't do this and do all
• 24:33
  these things at the same time. And what we don't know with all
• 24:38
  the, you know, data that's out and all the board certified
• 24:41
  anesthesiologist and veterinary medicine are like short,
• 24:45
  multiple short anesthetics are actually safer than one long
• 24:48
  anesthetic. The longer the body is under
• 24:51
  anesthesia, the more ramifications that can occur
• 24:55
  from that and especially kidney perfusion.
• 24:58
  So which is in that lead us into why IV catheters are important
• 25:03
  and things like that. So when we do put them under
• 25:07
  anesthesia. So this will this will kind of
• 25:10
  tie into your question of, of the fear of anesthesia is we can
• 25:14
  have a lot less fear about it if we know that it's being done
• 25:18
  well with top notch, you know, current today's standards IV
• 25:23
  catheter, monitoring their EKG and monitoring their pulse ox
• 25:28
  and all that kind of stuff when they're under.
• 25:29
  So those are things that you want to make sure that the
• 25:31
  veterinarian is doing and that would price the dental a little
• 25:35
  more. So I always tell people, you
• 25:36
  know, if you're checking in the prices of dentals and somebody's
• 25:39
  dental price is a lot lower than somebody else's, it may be
• 25:43
  because they're not doing all that so it cost them less.
• 25:46
  So those are things that are really important for the safety
• 25:49
  bells and whistles that we want to make sure are happening.
• 25:53
  And if they're under for a long, long period, you know, more than
• 26:00
  whatever it's two hours or 90 minutes or whatever, you know, I
• 26:03
  don't do the surgery. They make their cut off, but
• 26:06
  it's very important to to plan that timing appropriately so
• 26:13
  that we don't lose good perfusion to the kidneys so that
• 26:16
  the kidneys are at full strength, you know, after the
• 26:18
  procedure. And that's why IV fluids are
• 26:21
  important too. It keeps the blood pressure
• 26:23
  normalized. It keeps the, you know,
• 26:25
  vasculature sending, you know, good, you know, good flow
• 26:29
  through the kidneys, etcetera. And the other thing that's very
• 26:33
  important in the the perioperative care when they're
• 26:37
  in the procedure is a warm air blanket.
• 26:41
  So I'm back in the day, you know, I've been a vet for 32
• 26:44
  years or whatever. I mean, we have a heating pad
• 26:46
  like, you know, old school. And now I don't know if you know
• 26:49
  the humans. I mean, we get this too.
• 26:51
  If they're operating on your leg and not your abdomen, you're
• 26:54
  like in this nice warm air blanket when you wake up because
• 26:57
  when you go under anesthesia, your body temperature drops.
• 27:00
  The longer you're under, the more, you know, hypothermic you
• 27:04
  can get. And when you are on for
• 27:08
  dentistry, pets go at the surgery tables like what we call
• 27:11
  wet table. So because you got ultrasonic
• 27:14
  stuff with water, you know, go in and it's cool and you're, you
• 27:17
  know, water in the mouth and they have the tree in the
• 27:19
  endotracheal tubin. So that's breathing for them and
• 27:22
  getting them their oxygen and their anesthesia.
• 27:24
  So the good thing is the airway is protected.
• 27:26
  They're not inhaling all that junk that's flying around with
• 27:29
  all the plaque and bacteria that's being buzzed off and all
• 27:32
  that and the water. So their Airways being
• 27:34
  protected, but that water, their mouth open, they're, you know,
• 27:39
  there for a while, the body cools down.
• 27:42
  And so with that warm air blanket they called a bear hug
• 27:45
  or whatever. And the warm air is so cozy.
• 27:47
  It's so amazing. And that keeps the body nice and
• 27:52
  warm, which helps perfusion. And when you wake up, when the
• 27:56
  patient wakes up, recovery is so much better.
• 28:00
  If hypothermia was not experienced, they wake up
• 28:03
  better, the body responds better, you recover better, the
• 28:07
  body's working better, all of that.
• 28:09
  So those are things that literally back in the day, I
• 28:12
  mean, like, you know, it's like one side of your body's warm and
• 28:16
  now it's like you're wrapped up in this nice little cozy air
• 28:19
  blanket. It's awesome.
• 28:21
  So also I actually never, I never, I've never asked that
• 28:24
  question. I've never known if there is
• 28:26
  that. I've never.
• 28:27
  I've never even heard that until now.
• 28:28
  So what's a good way to ask that though?
• 28:30
  So if we know, if we feel comfortable with our maybe it is
• 28:33
  even our primary vet and, and we want to go ahead and do this pre
• 28:37
  anesthesia work up what's in what's a, is there an easy way
• 28:41
  or do they know is their vet speak for Hey, we want the
• 28:44
  catheter, we want the EKG and the blood pressure and we want
• 28:47
  the blood ox. We want the warm blanket, you
• 28:50
  know? Yeah.
• 28:51
  And I would say, you know what are, what are all the, you know,
• 28:57
  what are, let's see, what are all the, the pieces of what you
• 29:02
  do around, you know, the perioperative care.
• 29:05
  I guess I would just ask what the perioperative care is and,
• 29:08
  and let you know, say those things.
• 29:10
  I mean you can label them off. I would definitely say an IV
• 29:13
  catheter, cardiac monitoring, which would be an EKG and pulse
• 29:17
  ox and things like that. And then I would specifically
• 29:20
  ask about how do you keep them warm?
• 29:23
  Do you have that warm air blanket?
• 29:25
  Are you very focused on, you know, making sure that they're
• 29:27
  that they're, that they don't lose body heat?
• 29:29
  Yeah, we need to ask that question.
• 29:30
  How do you keep them warm? Because yeah, that's that's
• 29:33
  that's important. And I never knew that.
• 29:34
  Also, it's interesting because I don't remember which bed it was,
• 29:38
  but I know that we went, we were out of bed and I don't know if
• 29:40
  it was for a dental, but our cat was going under anesthesia and
• 29:44
  there was a form that I had to fill out and it asked and we had
• 29:48
  to check it if we wanted an IV. So that's not a normal.
• 29:51
  Thing that everything like some that and it depends on the
• 29:55
  practice and things are changing, you know, things are
• 29:57
  always getting, you know, progressively, you know, like
• 30:00
  standards are changing, but you know, many years ago that was it
• 30:06
  wasn't standard and then it was probably, you know, in some
• 30:08
  practices optional, it's safer and but they're trying to keep
• 30:13
  costs down for people, so they'll do it, you know, and so
• 30:16
  but a lot of hospitals would not even give you the option.
• 30:19
  They're like, we're just doing it.
• 30:20
  That's it because we don't want to be responsible for your Kitty
• 30:24
  not doing well under anesthesia. I mean, that's, you know, it's a
• 30:28
  big deal. And so back to that fear
• 30:32
  question around anesthesia is what I like to tell people is if
• 30:35
  anesthesia is done well, because there are different standards
• 30:38
  that can be used. And if we're using good quality
• 30:42
  standards, the periodontal disease, the risk of that pet
• 30:49
  keeping periodontal disease in their body far outweighs the
• 30:52
  risk of the anesthesia. The anesthesia should be safer
• 30:55
  using today's standards, especially if you've done your
• 30:57
  pre op workup, you've checked everything to make sure that
• 31:00
  there are no glaring things that we need to, you know, be
• 31:03
  concerned about with them going under.
• 31:05
  If we've checked all those boxes, letting them live with
• 31:09
  periodontal disease will take more off of their life than the
• 31:12
  anaesthetic. Proceed.
• 31:13
  Like I, I had actually somebody in a podcast actually asked me
• 31:16
  recently and I hadn't heard this statistic and who knows where it
• 31:19
  came from, but she's like, I heard that every time someone
• 31:22
  goes under anesthesia that takes like 7 or maybe it was a pet.
• 31:25
  I don't know if she meant pets or humans takes like seven
• 31:27
  months off their life or a year off their life.
• 31:29
  What do you think of that? And I'm like, well, if it's done
• 31:33
  well, I said, I've never seen that.
• 31:36
  I can't, you know, say. But what I can tell you for sure
• 31:40
  is that if you're living with periodontal disease, you are
• 31:44
  definitely going to have early mortality.
• 31:45
  Like it's linked to early mortality.
• 31:47
  And obviously that depends on how severe your, your
• 31:50
  periodontal disease is. But, you know, if you want to
• 31:53
  compare to, you know, a shortened lifespan, I mean,
• 31:56
  periodontal disease is way up there with that.
• 31:58
  Wow, wow. So it's finding a good
• 32:02
  veterinarian, doing the your due diligence with the preoperative
• 32:06
  work up and you know, we can get to post op recovery and things
• 32:11
  we can do for them there too. Yeah, real quick, when it comes
• 32:14
  to the pre op 2, is there anything that you would suggest
• 32:17
  that we do at home? Not even just ask our vets, but
• 32:20
  anything like a supplement or certain foods or anything that
• 32:23
  we do at home pre, you know, like I, I know they're like
• 32:29
  certain supplements that they'll say, you know, double up on this
• 32:31
  like a milk Thistle or a spirulina or something like
• 32:34
  that. Like double up on this before a
• 32:36
  surgery and after surgery. Is there anything that you think
• 32:39
  that? That's such a great question
• 32:41
  because the thing, the little bit of a rub with the pre op
• 32:44
  piece is that some anesthesiologists or a lot of
• 32:49
  anesthesiologists get a little nervous or cautious about
• 32:54
  supplements because a, either some of them maybe have had some
• 32:59
  studies or clinical data that there might be a little issue
• 33:02
  with it. But a lot of them there's just
• 33:03
  no clinical data. Like we don't know.
• 33:06
  And like even people get worried about fish oils because Omega
• 33:09
  threes will potentially increase bleeding, you know, and diminish
• 33:14
  clotting a little bit depending on how you know much you're
• 33:17
  taking or whatever. So anesthesiologist like don't
• 33:20
  take any fish oils for like a week before surgery.
• 33:22
  We don't want you to bleed more, you know, etcetera, etcetera.
• 33:24
  So I usually tell people that you know, most supplements
• 33:29
  should be should be fine, but just to be on the air of
• 33:32
  caution. Often times I tell people stop
• 33:35
  supplements 3 to 5 days before anesthesia just to be on the
• 33:39
  safe side. And so I prefer to do a little
• 33:42
  more after the anesthesia and there's no no right or wrong.
• 33:46
  There might be other veterinarians that love to do
• 33:48
  some pre op stuff, but just on the side of caution, I usually
• 33:52
  focus a little bit more on the post op when we don't have to
• 33:55
  worry about that. And then we're like, yes, we can
• 33:57
  come in and support them with the liver support and that you
• 34:00
  know all the good anti-inflammatory.
• 34:02
  Now that said though, I came out with my doctor Katie's remedies
• 34:06
  line of course last year and today most of my products are
• 34:10
  homeopathy and then I have my 1:00 dental product, which is
• 34:13
  not homeopathy. It's the coconut oil base and we
• 34:15
  can talk about that. But point being is homeopathy is
• 34:19
  amazing and that is one of the, you know, tools in the toolbox
• 34:25
  that I would have no qualms using pre op.
• 34:27
  So herbs probably safe, but you know, there might be somewhere
• 34:32
  there's, you know, a discussion there, the fish oils, you know,
• 34:35
  some other things, but homeopathy is not going to
• 34:38
  interfere. So that is such a safe tool to
• 34:42
  dip into pre post whenever and so we can talk about.
• 34:48
  But I've got some great, you know, remedies that could help
• 34:51
  with post op care. But one that I would say from my
• 34:55
  line or something similar, you know, that's out there that you
• 34:58
  could do for pre op is I actually have my immune blend.
• 35:03
  So and my immune blend has, you know, the echinacea and it's
• 35:09
  also going to have the silica and the gallium for lymphatic
• 35:13
  drainage and that sort of thing. But I've actually had some
• 35:17
  patients of kitties with upper respiratory that were, you know,
• 35:21
  chronic symptoms and they were doing some other good, you know,
• 35:24
  herbs and other good supplements and put the immune blend in and
• 35:27
  they're like, Oh my God, the symptoms are gone.
• 35:29
  So, you know, even if the Kitty doesn't have a history of upper
• 35:32
  respiratory, it's always a nice thing to support the immune
• 35:36
  system to be stronger heading into surgery.
• 35:39
  So, you know, something like that where we're supporting the
• 35:42
  immune system. But just to be, you know, a
• 35:45
  little bit cautious around some of the, you know, some herbs and
• 35:49
  supplements. Just immediate post op or I'm
• 35:51
  sorry, immediate pre op? OK, awesome, awesome.
• 35:55
  If Jessica is here, if you could drop that link in the comments,
• 35:57
  that would be awesome because I feel like we all need to get
• 36:01
  that right. Can we take it?
• 36:04
  Yeah. We especially because we have
• 36:06
  two dentals coming up for Jack and Madison in in the coming
• 36:10
  months. So.
• 36:10
  One more question about pre anesthesia when when they're
• 36:14
  under is it? Is it usually, is it something
• 36:17
  that you would recommend being done is having?
• 36:20
  I think there's a distinction between just regular X-rays and
• 36:23
  dental films. What is that something that we
• 36:25
  should expect? So that's another thing I want
• 36:29
  to say is that regular X-rays and most, you know, most or at
• 36:34
  least many primary veterinarians now have dental X-ray.
• 36:39
  But I just it's nice for people to know that regular X-rays and
• 36:42
  dental X-rays are completely different.
• 36:44
  So it's not like a regular X-ray where they're just laying the
• 36:47
  kiddies head on an X-ray plate and taking a picture of the
• 36:49
  whole jaw. Dental X-rays where they're
• 36:52
  literally putting that digital, you know, that digital film now
• 36:55
  inside, you know, behind the tooth, just like they do for us
• 36:58
  from taking dental X-rays for us.
• 37:00
  You get a very high, what I want to say like high clarity picture
• 37:08
  of exactly what's going on. And that's, that's really an
• 37:12
  important part of, you know, having good dental care.
• 37:15
  Yeah, OK. OK so let's move on to post op
• 37:19
  then because that's when we all are.
• 37:22
  Like, it's fine if they're a little derpy when they come
• 37:24
  home, but we're just so relieved that the demo is over, right?
• 37:30
  So they made it through. So we're coming home with our
• 37:33
  little. I know they usually wait.
• 37:35
  How long should that wait before they release the cash after
• 37:38
  anesthesia? Because we're always like, oh,
• 37:41
  well, you're done at 2:00. I'll come pick them up.
• 37:43
  Yeah. So such a good question in that
• 37:47
  different hospitals are going to have different protocols.
• 37:51
  But I will tell you some of the board certified dentists that
• 37:54
  I've worked with, and one of the reasons I love recommending
• 37:57
  people to go there, not only their high caliber of care, but
• 38:01
  the way you know, their whole protocols of how they do things
• 38:06
  are so much better not only for the pet, but for the pet parent
• 38:09
  to be less stressful. So some veterinary dental, you
• 38:13
  know, veterinary dental specials and I haven't seen many primary,
• 38:16
  not to, not to bag on primary vets, but most primary vets you
• 38:19
  bring the way that their structure goes in the hospital
• 38:22
  is you drop your pet off in the morning and you pick them up
• 38:24
  late in the day. The veterinary dental specialty
• 38:28
  center that I worked inside of, they literally would have a 2
• 38:32
  hour block for each patient. Just like when you go to your
• 38:35
  dentist like that, they're only with you.
• 38:37
  And so you don't drop them off. The pet parent can stay there
• 38:40
  the whole time and hang out in the lounge and they admit the
• 38:45
  patient they put them under, they asked the pet parent to
• 38:48
  come back into the operatory, into the you know, OR and they
• 38:53
  actually show you the X-rays. They show you the pets mouth.
• 38:55
  They're like, this is what we found.
• 38:56
  Look at the probe sinking in like they tell you everything
• 39:00
  and then revise the estimate if they need to, to tell you how
• 39:03
  much it's going to be to do the work, tell you, oh, there's a
• 39:05
  lot going on. We might need multiple
• 39:07
  extractions. We might only do half of it
• 39:08
  today. You know, all that discussion
• 39:10
  that needs to be had let you go back out to the lounge, do the
• 39:15
  work. And as soon as the pet wakes up,
• 39:17
  they go home. And their philosophy is they
• 39:19
  don't want any pets to have to be in a cage or a kennel because
• 39:23
  it's just stressful. And so they literally come in
• 39:25
  with the pet parent and a couple hours later they go out.
• 39:28
  So they wake up road and they watch, you know, I mean, it
• 39:31
  takes a little bit of time to wake up from anesthesia, but
• 39:33
  it's not hours and hours. And so they watch them until
• 39:36
  they're, you know, awake and send them home.
• 39:39
  They might be just, you know, a little bit groggy, but you know,
• 39:41
  they're awake and, and ready to go.
• 39:43
  And one of the things that makes it easier for them to be awake
• 39:48
  and ready to go is when, if they did need any extractions that
• 39:55
  that local blocks what we call, you know, the, the, the local
• 39:59
  anesthesia with the injection in your mouth.
• 40:02
  Nerve blocks, they call them. If nerve blocks are done
• 40:05
  appropriately, then you don't have to use such a deep level of
• 40:10
  anesthesia because those nerves are numbed.
• 40:13
  And when the patient wakes up, it's a way more pleasant
• 40:16
  experience because I would say back in the day, I mean, it's
• 40:19
  going to make you shudder, But back in the day when I first
• 40:22
  became a veterinarian, it was not standard to use nerve blocks
• 40:25
  at all. And so when pets wake up from
• 40:29
  anesthesia and they had extractions, they went from like
• 40:32
  zero to 60, they went from like 0 pain because they were under
• 40:35
  and they wake up. And it's like, so we know when
• 40:40
  we go to a dentist and we get that, you know, injection, the
• 40:43
  novocaine injection or what they're using today, you pivot
• 40:46
  cane or whatever it is, is that it wears off gradually and
• 40:50
  slowly so that by the time it wears off your body, you know,
• 40:54
  you don't get slammed with like, you know, pain.
• 40:59
  You know, that's, that's tough. So point being is that when
• 41:02
  nerve blocks are done, anesthesia can sort of be kept
• 41:07
  at a little lower. You don't have to have them so
• 41:08
  deep under anesthetic. And that's always nice for the
• 41:13
  body period, but also for the recovery being quicker and
• 41:16
  smoother. Wow, wow it.
• 41:20
  Is OK then if if they're if our kiddies awake then we can take
• 41:23
  them home. Yeah, so.
• 41:26
  I really wonder how much that it would be for a dental specialist
• 41:29
  because it is like it is so all of us cat parents, we know how
• 41:32
  expensive a dental is even at your primary vet.
• 41:37
  So I wonder like what the how far up that goes if we were able
• 41:41
  to afford a. Dental specialist, you mentioned
• 41:44
  it's the fear and it's the finances.
• 41:46
  Can you get a general financial expectation for this level of
• 41:50
  care versus primary? Yeah.
• 41:53
  So I mean, I think in my experience in granite that can
• 41:57
  change with people's, you know, region around the country.
• 42:00
  But you know, in Southern California area, I mean, I would
• 42:05
  say even a primary veterinarian that's doing a good job a
• 42:09
  dentistry often times is going to be at least, you know, 800 to
• 42:13
  $1200 and maybe more depending on what's going on.
• 42:18
  And I would say probably the lowest with a board certified
• 42:24
  dentist is going to be 1500, but it might, you know, be 17102
• 42:29
  thousand 2500. And like if the cat's getting
• 42:31
  full mouth extractions because of super yucky stomatitis or
• 42:35
  something like that, I mean, obviously that could be a lot if
• 42:38
  there's a lot of resorptive lesions and there's a lot of
• 42:40
  extractions, etcetera. So you know, it can it can go up
• 42:45
  there. A lot of pet parents do have
• 42:48
  health and, you know, pet insurance that covers dentistry
• 42:52
  goodness and that can be, you know, a huge make or break for
• 42:57
  whether people are able to do this level of care.
• 43:00
  So I don't want to talk people out of doing things if you
• 43:03
  can't, you know, afford a board certified dentist.
• 43:05
  But it's nice for people to know the options and just do the
• 43:09
  absolute best you can and be informed as you are getting
• 43:13
  today with being able to select the best option that you can do.
• 43:19
  So that's available, yeah. OK, so we made the bill, our
• 43:24
  baby is home. Let's talk about post op care.
• 43:27
  What do you or how do we kind of keep track of their recovery?
• 43:31
  You know if they have that? I think the majority of us Co
• 43:34
  parents have come home with extractions being done of some.
• 43:38
  Kind. OK, OK, So yeah, so if that's,
• 43:41
  you know, a common place thing, then we want to think about, you
• 43:44
  know, their pain levels, their comfort levels.
• 43:47
  Also, you know, when you when they come home, depending on
• 43:50
  your household environment, you know, if there's a lot of other
• 43:52
  pets, whether it's other kitties, other dogs, whatever
• 43:55
  kids running around, noise, whatever, be thinking about
• 43:59
  their comfort with recovery and providing them a nice quiet
• 44:04
  space at least for that night until the next day, whether or
• 44:08
  not bothered by too much stimuli and you wake up from anesthesia
• 44:12
  and you got all this stimulus going on.
• 44:13
  It's like, so you know, give them some quiet time for the
• 44:17
  body to really recover in a more peaceful state.
• 44:20
  That will really help. And you know, often times they
• 44:24
  may not with depending on when you bring them home.
• 44:28
  If you did feed them that night, I would definitely feed them a
• 44:31
  small, you know, very small meal.
• 44:34
  Avoid dry food. Clearly, if there's been, I
• 44:37
  mean, I would essentially, I mean, we always want to avoid
• 44:39
  kibble if possible, but you know, freeze dried soft food,
• 44:45
  you know, that's really, you know, mushy, crumbly, that kind
• 44:48
  of thing. But wet food definitely would be
• 44:50
  the best and small amount that night, if at all.
• 44:54
  You know, if they're still groggy and they're not
• 44:55
  interested in eating, don't push it and let them go till, you
• 44:58
  know, the next morning they got fluids through the day, you
• 45:00
  know, they're hydrated, that sort of thing.
• 45:04
  Yeah, but anything. And you can even puree their
• 45:05
  food. I mean, whatever it takes, you
• 45:07
  know, depending on the, you know, texture of what they
• 45:10
  normally need or whatever you can, you know, puree it and give
• 45:12
  them something, you know, really nice and small amounts that
• 45:16
  night and pain relief, you know, if they need it, often times
• 45:22
  they may have been given something, you know, an
• 45:24
  injectable pain or whatever, but it's going to, you know, wear
• 45:27
  off. So that that's a that's a
• 45:30
  question that we that we get a lot as far as pain meds and how
• 45:33
  important are the pain meds or are there any alternatives that
• 45:36
  I can use and are? My pain meds better than other
• 45:39
  pain meds right? Is there is there a certain pain
• 45:42
  Med we should ask for for a kid? Or that we should stay away
• 45:45
  from, right? Yeah, so often times what what
• 45:48
  they may do is 1 injection of meloxicam is considered, you
• 45:53
  know, safe for cats, but we cannot do repeated NSAID's for
• 45:57
  kitties. It is not safe for their
• 45:58
  kidneys. So we can't keep doing it like
• 46:00
  we do for dogs. There is ansior which is labeled
• 46:04
  up to three days for cats for pain.
• 46:08
  And so that may or may not be sent home.
• 46:10
  Gabapentin's really hit the scene as a pain, you know,
• 46:13
  medication with mixed success. You know, some people think it
• 46:18
  works. Some people are like me, you
• 46:20
  know and so certainly not the end all be all for working well
• 46:24
  for everybody and sometimes can have some side effects.
• 46:27
  So if you can, if you can just use natural tools after what was
• 46:34
  provided for them in the surgery with the nerve blocks and
• 46:38
  whatever injection or pain that they may have given.
• 46:41
  If we can get enough comfort level with just natural products
• 46:46
  after that, that would be, you know, obviously my goal and I
• 46:49
  would definitely dip into CBD and cannabinoids for that.
• 46:53
  And I know you guys have some, you know, a couple of options on
• 46:56
  your website. I think with the CBD cat and or
• 47:00
  buddy got both great choices there.
• 47:02
  And so CBD or cannabinoids for cats, so you know, such in the
• 47:08
  safe bracket of something to do and you know, good for analgesia
• 47:12
  and pain, but also good for inflammation and good for immune
• 47:15
  support. I mean, it's such a win, win,
• 47:17
  win and relaxation and stress. I mean, So what a great plant
• 47:21
  medicine to dip into because it checks a lot of boxes of, you
• 47:24
  know, versatility of what it's providing.
• 47:27
  And then the other thing that I would do or something similar is
• 47:31
  I do have out my leg try to fix with my lighting, but my nerve
• 47:36
  blend of the homeopathy and I can tell people how this comes.
• 47:41
  A lot of times homeopathy will come in tinctures or in pellets.
• 47:44
  The way that I develop mine is that there are pellets in the
• 47:48
  bottle and we add water. The consumer, the pet parent
• 47:52
  adds water when you get it and then hydrates it.
• 47:55
  And so the pellets will dissolve and then it's ready to go.
• 47:58
  But because it's based in water and not alcohol, it tastes fine.
• 48:02
  It tastes like water. And so cats don't mind it and
• 48:05
  it's, it's very palatable, which is great.
• 48:07
  So it could be put in food or can just be drizzled directly in
• 48:11
  the mouth or just inside the lip or whatever, you know, you can
• 48:15
  do with the least amount of stress for your Kitty.
• 48:17
  But this nerve blend is awesome for post dental.
• 48:21
  And The funny thing is it's actually made-up here in my
• 48:23
  house because I used it recently because I had some dental work
• 48:27
  and I had to have some crowns replaced and stuff.
• 48:29
  And you know, it's a big deal and a lot of stuff going on in
• 48:32
  there and this nerve and I actually have a holistic dentist
• 48:35
  and she's like like take some arnica and take some hypericum,
• 48:38
  which is comes from Saint John's Ware, etcetera.
• 48:40
  And I was like, oh, that's in my nerve remedy.
• 48:42
  I'm going to take that. So so this is a great formula
• 48:47
  for any nerve pain, nerve related pain or nerve really
• 48:52
  supportive, any kind of nervous system support, but definitely
• 48:55
  post op dental and extraction. So again, I would lean into
• 48:58
  homeopathy because it's so safe and but I love layering, you
• 49:03
  know, the typically, you know, sensible, not too many things,
• 49:06
  especially with cats, but layering in a few things is
• 49:10
  really, really helpful. So the CBD, the you know, arnica
• 49:14
  and there's josemium and the hypericum in here, something
• 49:19
  like that. And then you we could add other
• 49:22
  pain herbs if you know, if we need to comfort plus with poppy
• 49:26
  and skull cap and stuff is something I've used that sort of
• 49:30
  thing. And so yeah, for, you know,
• 49:34
  layering and some some good comfort supporting tools.
• 49:37
  I love that because we know that, you know, pain management
• 49:40
  is so important. We don't want our cats to be in
• 49:42
  pain. Right, and they are.
• 49:44
  To know when they are. So that's why you know, people
• 49:46
  come to us and we're like, well, there are other options.
• 49:48
  And we always say arnica and CBD as the as the options of, you
• 49:53
  know, things that you can use. I didn't know that this nerve
• 49:55
  thing, I mean it's usually a different surgery that we're
• 49:58
  asked about, but that this is great with like the dental, I
• 50:01
  think we have it. So we are the the nerve one.
• 50:04
  I think we need to use that for our dentals.
• 50:07
  So I'm excited about that. Quickly too, on the on the more
• 50:11
  conventional medications, Nancy was asking can you address the
• 50:14
  use of synth. I think it's systemic or do they
• 50:18
  make a synthetic gabapentin versus oral syringe of
• 50:23
  buprenorphine? I think that's.
• 50:26
  OK, so yeah, so buprenorphine, that's a that's a great
• 50:28
  question. And it's just been a while since
• 50:31
  I've prescribed things, so I'm just thinking about how to.
• 50:34
  So buprenorphine was super popular to use for cats
• 50:39
  apparently, you know, still is it's still being used.
• 50:42
  The the issue with buprenorphine is it doesn't last very long.
• 50:47
  I think it's, you know, it's duration of action might be more
• 50:50
  like 6 hours, four to six hours. So you have to give it and it's
• 50:54
  probably recommended to be dosed 3 times a day rather than four
• 50:58
  times a day, but it has to be dosed pretty frequently.
• 51:01
  But it is on the safer end of things for cats with, you know,
• 51:06
  pain relief and it's definitely been used pretty standardly for
• 51:10
  cats for a long time. So that's always nice.
• 51:12
  As far as like a safety track record, it's not new on the
• 51:15
  block and I would, I would expect with the clinical
• 51:21
  knowledge that I have that I I would think buprenorphine is
• 51:25
  probably doing a better job than gabapentin, but it just has to
• 51:30
  be dosed more frequently. Yeah.
• 51:33
  OK. And it's liquid.
• 51:35
  And, you know, gabapentin could be compounded in a liquid.
• 51:37
  But the nice thing about buprenorphine is probably easier
• 51:40
  to give, you know? Yeah.
• 51:42
  OK. Good to know.
• 51:44
  Yeah. And I like that there's, you
• 51:45
  know, there's history behind it because gabapentin is fairly new
• 51:48
  to the market really too. Yeah, it's it's, you know, it's
• 51:51
  the new kid on the block for, you know, it used to be for, for
• 51:54
  like back pain and nerve, you know, spinal stuff.
• 51:57
  And now they're just using it for everything and sedation and
• 52:00
  they're sending cats with it for sedating them.
• 52:02
  And so now it's kind of blanketly used for a lot of
• 52:04
  stuff with, like I said, mixed, you know, mixed reviews on that.
• 52:08
  Speaking of things blanketly used Anthea, I'm probably saying
• 52:12
  your name wrong asks are antibiotics necessary prior to
• 52:17
  dental? That's a great question.
• 52:19
  That's so good. Pretty much, no.
• 52:22
  So, yeah. And so that's, you know, and,
• 52:25
  and you know, in the in the past, historically, a lot of
• 52:30
  human dentists and veterinary dentists, if somebody had a
• 52:32
  heart murmur, it was like, oh, you know, get your antibiotics
• 52:35
  going, you know, before, beforehand, all that kind of
• 52:38
  stuff that's really going on at Vogue.
• 52:40
  And fortunately, what's also going out is that, you know, to
• 52:44
  use to use antibiotics automatically for a dentistry.
• 52:49
  And what dentists are, this is kind of the fun phrase, joking
• 52:53
  phrase that a lot of dentists would use is that there's
• 52:56
  bacteria showering from the mouth to the bloodstream all day
• 53:00
  long, every day, 24/7. They come in for a teeth and
• 53:03
  we're actually getting it out of there.
• 53:04
  Like why are we going to use antibiotics?
• 53:05
  Now? The body's been exposed to this
• 53:08
  bacteria for, you know, Now that said, if there's like an Abscess
• 53:13
  that's full of pus and draining and stuff, that's different.
• 53:16
  Like if there's a dental Abscess, they may recommend
• 53:18
  antibiotics. But if you just have yucky
• 53:21
  periodontal disease, antibiotics are not considered necessary.
• 53:25
  And as hopefully most people you know viewing this would know is
• 53:30
  we really want to be judicious about antibiotic use because
• 53:33
  every single time we use systemic antibiotics, we're
• 53:36
  affecting the microbiome, we're affecting the immune system.
• 53:39
  And so we want to be really sensible and most or I think all
• 53:44
  veterinary dentists are very judicious with antibiotic use,
• 53:47
  even more than general practitioners.
• 53:49
  Like you might be more likely to receive antibiotics from AGP
• 53:53
  primary that and a board certified dentist because
• 53:56
  they're very at the high level of, you know, training of where
• 54:00
  things are now. And we're really scaling back on
• 54:03
  over prescribing antibiotics. Yeah, we always say don't use an
• 54:06
  antibiotic as a preventative. An antibiotic is not a
• 54:09
  preventative is right. And most, most cases you're not
• 54:13
  even going to get handed one post op so that you're it's rare
• 54:18
  that you're going to go home with antibiotics, but there are
• 54:20
  cases that that might be indicated.
• 54:22
  So if a veterinarian is saying, hey, let's do some antibiotics
• 54:25
  before, before we do the dental, you can ask, oh, do they have an
• 54:28
  Abscess? And if not, then.
• 54:31
  Or is there some infection right?
• 54:33
  Yeah. And, and I don't know, I think
• 54:36
  dental abscesses are more common in dogs than cats.
• 54:40
  But, you know, I'm sure it occurs in cats, but, you know,
• 54:43
  we see dental abscesses in dogs all the time.
• 54:47
  And so, yeah, that would be something to ask if they're
• 54:50
  recommending antibiotics, like what is that being used for?
• 54:53
  Is there a known Abscess or. Yeah.
• 54:56
  OK, two more quick things on. The, I will say quickly that I
• 55:00
  had to, or a vet fired me actually, because I asked the
• 55:04
  question when, like when she was recommending an antibiotic, it
• 55:09
  was actually for our cat that was constipated and he had a, he
• 55:11
  had a turd stuck in his butt hole.
• 55:13
  And she, she put her finger in there and got it out and it was
• 55:17
  fine. And then she, and then she said,
• 55:20
  so I'm going to send you home with some antibiotics.
• 55:22
  And I said, why does he have an infection?
• 55:24
  And she was like, well, no, but you want I was like, no, then I
• 55:27
  don't want an antibiotic if if he doesn't have an infection.
• 55:30
  And she was like, blacklist that girl.
• 55:33
  You're like, OK, well, thank you for, you know, letting me know
• 55:36
  that I should be moving on. Correct.
• 55:39
  That made us feel very negligent about that.
• 55:42
  So a Jenkins, great question. Would acupuncture following
• 55:46
  anesthesia help with recovery do you think?
• 55:50
  Yes. And you know what else is a
• 55:52
  great modality post anesthesia is chiropractic.
• 55:55
  So, but acupuncture is amazing if you're Kitty, you know, a lot
• 55:59
  of kitties will tolerate acupuncture, but you know,
• 56:01
  sometimes they won't or sometimes, especially if you
• 56:04
  have a mobile veterinarian that can come do the acupuncture so
• 56:08
  you don't have to trip your Kitty out somewhere.
• 56:10
  Because I always tell people weigh out the stress benefit
• 56:13
  ratio. You know, even if your cat likes
• 56:15
  ACU, if you have to drive them, they hate the car and they're
• 56:17
  super stressed out, they go get an ACU and it's like supposed to
• 56:19
  be zenful for their body and then they're freaking out on the
• 56:21
  way home. Like, you know, let's weigh out
• 56:23
  what the value is for them. But in theory, of course,
• 56:28
  depending on the stress level of the Kitty and the acceptance,
• 56:30
  acupuncture is amazing. You know, I mean, it's helping
• 56:34
  energetically connect the body, the meridians to, you know,
• 56:38
  lymphatics, you know, shedding, supporting the immune system,
• 56:42
  you know, supporting liver. I mean, there's so many things
• 56:44
  you can do with acupuncture that would be a huge asset.
• 56:48
  But also chiropractic therapy, which I don't think I have my
• 56:51
  activator sitting right here, but I do VOM veterinarian
• 56:54
  orthopedic manipulation with the handheld activator tool that
• 56:57
  just go click, click, click that we essentially move down the
• 57:00
  spine. But you can do extremities as
• 57:02
  well. The activator is very gentle.
• 57:05
  It's an amazing technique for cats.
• 57:07
  Most cats act like they like it, like they like, they don't just
• 57:11
  tolerate it like they're like, oh, that feels good.
• 57:14
  A lot of them. And it chiropractic after any
• 57:18
  procedure, but especially a dental procedure is really nice
• 57:21
  because not only are you adjusting the body and helping
• 57:25
  to resolve subluxations of, you know, the spine of things that
• 57:30
  are out of alignment, but your neck when you're under
• 57:34
  anesthesia for dentistry, remember they're putting a
• 57:38
  little mouth gag in to keep mouth open.
• 57:39
  You know, like we have when sometimes when you have
• 57:42
  procedures and they're moving and they're, you know, being
• 57:45
  gentle when they move the pet and everything, but you know,
• 57:47
  they're moving the head, they're innovating, they're doing all
• 57:49
  this stuff. And when you wake up, you know,
• 57:53
  when there's been any procedures in here, your TMJ may be sore,
• 57:56
  your neck may be out, you know, all these things.
• 57:58
  So a lot of humans that have had big dental procedures, they go
• 58:01
  to their chiropractor after that, they're like, OK, I need
• 58:03
  an adjustment. And so adjusting helps the body
• 58:07
  recover on a lot of different levels, but it gets that nervous
• 58:10
  system back in alignment, the blood flow, the lymphatics, It's
• 58:13
  a beautiful way to help the body recover.
• 58:16
  So, and even if you went, you know, for humans a lot of times,
• 58:20
  and we'll even do the activator on the TMJ and sometimes, you
• 58:25
  know, along the areas here and you know, sometimes sinus and
• 58:28
  stuff like that. But anyway, that is a great post
• 58:31
  op care. And then we can also talk about
• 58:36
  detoxing from anesthesia or the medications that were used.
• 58:39
  And again, multiple ways that we can do that.
• 58:42
  I would always, you know, put the put the recommendation in
• 58:46
  for using homeopathy there too. And I actually do have a remedy
• 58:51
  that actually, I didn't grab it, but it's called detox and detox.
• 58:58
  We, I named it detox for vaccine detox.
• 59:00
  But it's more than just vaccine detox.
• 59:02
  It's general detox. So from chemicals, you know,
• 59:05
  after chemical exposure, you know, glyphosate vaccine or
• 59:09
  sorry, flea meds, you know, etcetera, but anesthesia as well
• 59:13
  or medications. And there is Thuya and silica in
• 59:18
  there and also gallium for lymphatic drainage.
• 59:23
  So that is a very nice thing to take after anesthesia to help,
• 59:28
  you know, drain all of that out and remove, you know, things
• 59:32
  from the body after the procedure.
• 59:34
  So tying that in. But then also the herbals, you
• 59:38
  know, we know liver support is awesome always, but especially
• 59:42
  after anesthesia and kidney support too.
• 59:44
  And so something like milk Thistle and dandelion, you know,
• 59:48
  just a lovely tandem, they're both good for, you know, liver
• 59:52
  and, and kidney and a gentle diuretic again, just helping
• 59:56
  things move out of the body and get excreted and all that good
• 1:00:00
  stuff. So I love to tell people to do
• 1:00:02
  some sort of liver support. And you know, there's other
• 1:00:06
  things that we could combine in like, you know, burdock root and
• 1:00:08
  berberine and you know, all that, but do some sort of liver
• 1:00:13
  support. I I would do it a minimum of two
• 1:00:16
  weeks after surgery and I like to do 30 days.
• 1:00:18
  So you know, like 30 days of liver, liver, kidney in an
• 1:00:22
  herbal form. And then my the homeopathic I
• 1:00:26
  usually just use for seven days, like 7 days and you can start it
• 1:00:29
  right away, but like the next day post op or two days post op
• 1:00:33
  whenever you feel like they're ready.
• 1:00:35
  Yeah, I love that. I can't believe.
• 1:00:38
  We're already at an hour. I know, I know.
• 1:00:41
  Like we can listen to you forever.
• 1:00:43
  One more question. Feels like it's been 15 minutes.
• 1:00:45
  Five more questions. One more question.
• 1:00:48
  So you were mentioning the diet and it's so important obviously
• 1:00:50
  that our babies are eating after, you know, maybe not
• 1:00:53
  necessarily the day of the operation, but certainly the
• 1:00:55
  next morning to get food back in their belly.
• 1:00:57
  And you said obviously wet food, wet soft food is going to be
• 1:01:00
  best, especially if we've had extractions.
• 1:01:02
  What about raw food for us raw feeders?
• 1:01:06
  If they've had an extraction, would you recommend taking them
• 1:01:09
  off the raw? Thank you, Amber, for that
• 1:01:11
  question. And it's soft, you know, there's
• 1:01:14
  nothing there's so depending on I guess like the texture of the
• 1:01:18
  raw, but I, I mean, most raw foods that are fat are very
• 1:01:21
  mushable and malleable and that kind of thing.
• 1:01:23
  So if that's it and they're not getting like a whole raw thing
• 1:01:26
  where they really have to crank on bones or something like that,
• 1:01:29
  you know, if they've had extractions, I wouldn't give
• 1:01:31
  them like a a wing or something like that.
• 1:01:33
  But if it's, you know, sort of, you know, the texture is like
• 1:01:38
  Pate. Yeah, ground.
• 1:01:40
  Thank you. That's that's the word I wanted.
• 1:01:41
  If it's ground, absolutely fine. There's no reason that they
• 1:01:47
  shouldn't be able to have RAW as far as their immune system after
• 1:01:50
  that. Perfect.
• 1:01:52
  I love that there has been so. Much great information.
• 1:01:55
  And everybody's saying that too, that this is so informative and
• 1:01:58
  helpful. You are just like such a
• 1:02:00
  delight. Every time we learn new things
• 1:02:03
  from you, we get inspired, we get excited.
• 1:02:07
  We love having you on the podcast.
• 1:02:09
  And most of all, you empower us, especially.
• 1:02:12
  We've got dentals right around the corner.
• 1:02:14
  And I can just tell from the, the tone of these comments that
• 1:02:17
  there's a lot, there's a feeling of empowerment, almost relief.
• 1:02:21
  You know, it feels, it feels really good to have had some
• 1:02:24
  time to learn from you. So thank you.
• 1:02:27
  So glad, I hope everything was super useful for everybody.
• 1:02:30
  And then just a quick, quick comment to let everybody know
• 1:02:34
  there's great stuff on your guys website, the teeth, you know,
• 1:02:37
  some other things that they can use for just ongoing dental
• 1:02:40
  health. Now everybody's very equipped
• 1:02:44
  with, you know, some information about how to support your pet
• 1:02:47
  through a dentistry planning for it post op.
• 1:02:50
  But just kind of that ongoing care too with, you know, any
• 1:02:55
  oral care that your Kitty will allow you to do with either
• 1:02:58
  gingival rubs or a little finger brush or whatever if they'll
• 1:03:01
  allow it. But teeth as a prebiotic, there
• 1:03:06
  are some probiotic and enzyme sprays.
• 1:03:08
  I have a probiotic one too that I carry that I really like.
• 1:03:12
  And you know, just the, the oral care continuing beyond just the
• 1:03:18
  dentistry to really be as proactive as possible.
• 1:03:20
  Yeah, because that really is, I'm glad you brought that up
• 1:03:23
  because that really is like the most important, right?
• 1:03:25
  Like would you say that like the people that the cat parents and
• 1:03:29
  there's few of us, but cat parents by us, I mean few of
• 1:03:32
  them that brush their cat's teeth on a daily basis or, you
• 1:03:36
  know, twice a day, the rock star cat parents, right?
• 1:03:39
  That that that are able to do all that all that with their
• 1:03:42
  cats. Would you say that they have
• 1:03:45
  less likely or that they're able to get a dentistry less often
• 1:03:51
  or? They should be.
• 1:03:53
  I mean, absolutely that's what we would expect.
• 1:03:56
  And there's always, you know, outliers where they don't, you
• 1:03:58
  know, follow what the rules should be.
• 1:04:01
  But in general, absolutely. And some of the just quick tips
• 1:04:05
  of things that are so helpful, like we didn't bring up Omega.
• 1:04:08
  We talked about Omega freeze as far as bleeding, but Omega
• 1:04:10
  freeze are phenomenal for dental health as overall health.
• 1:04:14
  I mean, they're so good for inflammation and healing.
• 1:04:17
  So we want good omega-3 levels. I didn't bring up mushrooms and
• 1:04:21
  we were talking about supplements pre op.
• 1:04:24
  There's no need to stop mushrooms, but the mushrooms are
• 1:04:26
  food. So if you've got your Kitty on a
• 1:04:29
  awesome mushroom supplement, you don't have to stop that.
• 1:04:32
  You know, like prior to anesthesia or anything.
• 1:04:34
  But again, mushrooms are great immune modulators.
• 1:04:37
  They're good for the gut, for the Biome.
• 1:04:38
  I mean, there's so many good things and things like that.
• 1:04:41
  And then on your product line, the catalase and the oxycat,
• 1:04:48
  those are things that support immune and dental and no need to
• 1:04:52
  stop those before anesthesia. Do it like there's just nothing
• 1:04:55
  they're going to interfere with. It's just, you know, some herbs
• 1:04:58
  and you know, stuff like that. But there's those tools and the
• 1:05:02
  homeopathic tools are stuff that there would be no concern of
• 1:05:05
  interference. Yeah, I love that you brought up
• 1:05:07
  the Omega threes because it's so good, because we've learned so
• 1:05:10
  much. So we, we've been huge fans of
• 1:05:12
  Omega threes for years and years, but we have learned so
• 1:05:15
  much more about recently, like over the past couple years,
• 1:05:19
  we've learned so much more about Omega threes helping dental
• 1:05:21
  health, helping kidney health, helping great.
• 1:05:24
  And like so many things. So yeah, I'm, I'm glad Like it's
• 1:05:29
  a one and it's like a A1 and all supplement or something.
• 1:05:32
  The Jack of all trades. Test by the way, I think you
• 1:05:35
  guys know that, but I mean, I, I test Omega freeze in all my
• 1:05:39
  dobie and Kitty patients and that is such a a good investment
• 1:05:44
  to, you know, track whether or not their diet and supplement
• 1:05:49
  regimen is getting in them where they should be.
• 1:05:50
  Because that alone, the omega-3 level being low and the vitamin
• 1:05:54
  D level 2 huge for them to recover.
• 1:05:58
  I mean, so might as well just say that real quick is, but if
• 1:06:00
  you can get vitamin D levels done on your Kitty before, you
• 1:06:04
  know, surgery, not like right before, but you know, sometimes
• 1:06:06
  if you're planning on doing that, that's also a beautiful
• 1:06:09
  thing to do Because if their vitamin D levels are low, we're
• 1:06:12
  more susceptible to infection, we're more susceptible to
• 1:06:15
  inflammation, recovery won't be as easy, etcetera.
• 1:06:18
  So getting levels checked on nutrients like vitamin D and
• 1:06:22
  omega-3, such, such a good, good money spent there.
• 1:06:27
  Is that something that a primary vet can do?
• 1:06:29
  Can they run those tests or is this something that?
• 1:06:33
  So, yeah, and, you know, I do carry the test kits.
• 1:06:36
  Some other, you know, holistic vets, you know, carry test kits
• 1:06:39
  too, that you can just, you know, buy them online.
• 1:06:43
  And do what? You can take them to your.
• 1:06:46
  Yeah, good question. You can take them to your
• 1:06:48
  primary veterinarian because they want.
• 1:06:50
  People can ask, but you know, 99% of primary veterinarians are
• 1:06:53
  not going to carry that. It's more in the holistic,
• 1:06:55
  integrative space to date. But that's going to change.
• 1:06:59
  I, you know, mark my word, I mean, vitamin D testing will get
• 1:07:02
  common space, but it's not yet. So now we have the kits from VDI
• 1:07:07
  and Omega Quant and people and we send them, you know, when
• 1:07:10
  people order them from me, we send them and say take them to
• 1:07:13
  your primary vet. 99% of primary vets are cooperative, even if
• 1:07:16
  they've never seen. And they're like, OK, you know,
• 1:07:18
  we'll help. We'll draw the blood and, you
• 1:07:20
  know, put it in the kit and send it out.
• 1:07:22
  But you don't have that conversation with them.
• 1:07:25
  And we'd really love to get these levels tracked.
• 1:07:28
  We got this from, you know, our integrated vet or an integrated,
• 1:07:31
  you know, vet or got them directly and we'd like to get
• 1:07:34
  these tracked. And if people want to lean into
• 1:07:37
  me to do any interpretation, I'm happy to, you know, do that
• 1:07:41
  through, you know, my clinic and greater veterinary care, my
• 1:07:43
  telemedicine. But the reports are, you know,
• 1:07:48
  pretty user friendly where you can see what's going on and what
• 1:07:50
  your pet needs. But you know, there is there is
• 1:07:54
  some nice guidance to get along the way with what products, how
• 1:07:57
  to dose them, etcetera. So vitamin D, we do need to be
• 1:08:00
  very aware of proper dosing. We don't want to overdose
• 1:08:05
  vitamin D. So vitamin B's, vitamin C's, you
• 1:08:08
  know, the body excretes it out. Not a big deal, but it's worth
• 1:08:11
  telling everyone that we don't go gonzo with vitamin D, but we
• 1:08:15
  definitely want to pay attention to vitamin D because it's super
• 1:08:18
  important. So.
• 1:08:23
  I know that we've we're already holding you way over, but
• 1:08:25
  there's just so much great information out there about MCT
• 1:08:28
  oils, our MCT oils. What is your feeling on?
• 1:08:31
  That yeah, we so and a good thank you for asking because MCT
• 1:08:36
  oil alone and coconut oil alone phenomenal for the mouth and you
• 1:08:42
  know the lauric acid and other components in coconut oil are
• 1:08:46
  anti-inflammatory and naturally antimicrobial and coconut oil
• 1:08:50
  tastes good and Oh my gosh, it's super nutritious.
• 1:08:53
  I mean it's so good for the body.
• 1:08:54
  So there's a lot of great things about coconut oil and rubbing it
• 1:08:58
  on the gums is excellent. You could also use it on a
• 1:09:01
  toothbrush or a finger brush if your kidney allows.
• 1:09:03
  But even if you just get a little on their gums or put it
• 1:09:05
  in their food and let them lick it, there are little dental
• 1:09:10
  toys. We're even aware.
• 1:09:11
  I mean, Jessica can drop the link of a toy that I actually
• 1:09:15
  saw at Super Zoo. And it's like a fish fishing
• 1:09:21
  line or fishing pole with a little rubber with, you know,
• 1:09:25
  soft enough that it's not going to damage the gum, but little
• 1:09:27
  projectile pieces on it. And it entices the Kitty to chew
• 1:09:30
  it, which will massage the gums. And you could put something on
• 1:09:34
  it, like either an enzymatic juice base, coconut oil, catnip,
• 1:09:40
  I mean, anything that will get them to chew on it.
• 1:09:43
  And so that's kind of like some active, you know, chewing.
• 1:09:45
  And, you know, there's other cat toys like the Sissel ropes and
• 1:09:48
  all that. But coconut oil, yes, is a huge
• 1:09:51
  supportive tool for the mouth and my dental remedy, which
• 1:09:56
  might be, you know, more widely accepted by dogs, but some cats
• 1:09:59
  don't mind this. The essential oils are very, you
• 1:10:03
  know, minimal in here to where the flavor is subtle, but there
• 1:10:07
  is some a little bit of peppermint oil, just, you know,
• 1:10:10
  that's very small amount in this bottle and Mer.
• 1:10:13
  And then it's mostly the coconut oil, which is the cocoa therapy,
• 1:10:18
  which retains the lauric, the lauric acid portion and then
• 1:10:21
  also trace minerals so to help keep the teeth and the enamel
• 1:10:25
  strong and mineralized. So just coconut oil by itself or
• 1:10:29
  MCT oil, you know, great. I need to get that.
• 1:10:33
  I need to get the the the name of that toy from you.
• 1:10:36
  Shout out to Jessica for giving all these links and I think she
• 1:10:38
  even the the links for the test kits.
• 1:10:41
  This just really invaluable, empowering information.
• 1:10:45
  Yeah. Everyone for staying with us for
• 1:10:49
  the full time. I hope I hope you know us going
• 1:10:52
  over was was super worth it for everybody.
• 1:10:53
  So you guys are the best. I love being with the time.
• 1:10:57
  It goes by like 10 minutes because you're so fun to be with
• 1:11:01
  that. It feels like no time at all.
• 1:11:04
  But my hopes are that that super useful information for
• 1:11:07
  everybody.