MP Keeps Breaking: Tooth this time! :(

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MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Wed Sep 24, 2014 12:08 pm

You guys, I'm seriously going to get dropped from MP's insurance! :eek2: This time, one of her pre-broken top premolars has broken some more. They're both broken in the same kind of way, but this one just got worse. Every time we see the vet it's looked "OK enough" so we had been doing a wait-and-see. MP is still acting normal, although I can't imagine how it could not suck. :disturbed: :frown: I sent a picture (posted here) and the vet told me to get it seen, soon.
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Sad tooth
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I have an appointment booked for next Monday, which was the earliest I could get for either of the vets we see regularly. They said that if she goes downhill before, they should be able to get me in with a different doctor. I sure hope this is soon enough.

At the exam, we're supposed to decide if this would likely be a simple deal or a specialist deal. However, it turns out that the standard procedure is to do the x-ray right before the surgery, so they basically decide what to *really* do once they see the pictures. Meaning, it could turn out to be just the one tooth (which I'm guessing would need to be extracted; it's got a full-on vertical crack), or there could be some funky stuff elsewhere that might require a specialist's expertise. The specialist said that they're happy to look over her x-rays and provide consult/guidance if the regular vet has any questions, but I don't know if that would be super helpful if it ends up requiring some kind of special technique/equipment.

I am leaning towards a specialist (there is a bad-ass place I can bring her). I talked to a dental assistant for the specialist (who was super patient and explained everything in detail), who explained that they take multiple x-rays during the procedure to make sure they've addressed everything, and the benefit of having a bunch of other specialists around (they're a referral clinic that has tons of different specialists).

I don't know how much the regular vet costs for whatever it might take, but I'm guessing it's hundreds, not thousands. Specialist estimated it would be something around $1600-$2000 based on what I've told her, although we won't know until we get in there. Insurance would cover 100% at normal vet after deductible ($200), and 80% at specialist.

She's never had a dental because I've been (emphatically, really) talked out of it by every vet I've ever seen; her teeth and gums are supposedly extraordinarily healthy, otherwise. At least upon superficial examination. I have a big fear of "stuff underneath" and "stuff you can't see" so I've always been preemptively worried. :fie:

MP's acting and eating normally for now, but she is super stoic and there's just no way it doesn't suck. :frown: I feel pretty scared and sad because I experienced an "OMG I could very easily completely lose my mind over this pain" kind of tooth nightmare last year.

I know they do extractions all the time at the regular vet, so I'm sure MP will be totally fine there. My concern is what they'll find in the x-rays, and if they'll be able to address it the best way possible. In terms of guiding us towards a most healthful recovery (post-op pain meds, abx, etc.), I totally trust my regular vet because they know me very well and how I am. :wink:

Sorry for the rambling. :S I'd love to hear any input about your experience with dental work, etc. Of course, Acorn is probably going to be out of town (he is now) so I'd like to warn you guys that I'm likely to come here whining and scared, *again*! Sorry in advance!!! :tired:

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Re: MP Keeps Breaking: Tooth this time! :(

Postby SherriA » Wed Sep 24, 2014 12:46 pm

Oh geez MP, quit breaking!

Any chance they can take xrays BEFORE they book the surgery to help make that decision? Or is it something that requires anesthesia before, so they just do them when they're going under anyway?

I don't have much experience with tooth stuff. Jack's teeth were awful and he had plenty pulled, but they were all simple extractions, no broken teeth. Oliver got lucky and never had a dental ever, though he finally needed one when he was around 15 or 16 yrs old (at which point his kidneys made it too risky) and never had any broken teeth or anything like that.
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Re: MP Keeps Breaking: Tooth this time! :(

Postby Sabine » Wed Sep 24, 2014 1:25 pm

Poor MP. :(

Having paid far over $6K for dental surgery during Quigley's lifetime mainly due to broken teeth, personally I would pick the specialist every single time. I'm still angry over the fundamentally wrong advice I had received from the "regular" vet (a veteran with many decades of practice who is way too full of himself) who did the first surgery, which caused my dog totally unnecessary suffering for several months - even if I couldn't see it.

I also can't count the number of times anymore where I've witnessed some form of situation where people found out that their dogs had major, major dental issues even if their teeth and gums "looked ok" on visual inspection but no radiographs were ever taken. Yes, most dogs are stoic and will not show much discomfort before things get really bad, and sometimes not even then. Quigley was chewing vigorously, bones, bully sticks, etc. etc., even with a horizontally fractured tooth.

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Re: MP Keeps Breaking: Tooth this time! :(

Postby UpwardDog » Wed Sep 24, 2014 1:30 pm

That sucks. :cussing:

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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Wed Sep 24, 2014 1:46 pm

Thanks, guys! Sabine, I totally remember your ordeal with Q-man—one of the reasons I'm thinking specialist! :(

Sherri, from talking to both the regular clinic and the specialist one, it seemed like x-ray + surgery was a pair deal, because they have to sedate to take the x-ray, and I suppose it's better to do it just once than twice.

I'm gonnu have to get a real REAL job! :tired:

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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Wed Sep 24, 2014 2:27 pm

So, since I'm pretty sure that there is no way that she isn't in pain, I asked the clinic if it'd be wise to give her some Tramadol in the meantime. They didn't have a vet available to answer at the moment, but a few techs thought it would be OK. They said they'll call me back once a doctor frees up to answer and she thinks it would *not* be OK. What do you guys think?

***They called me back already to tell me that it *is* OK. I gave her one for now.***

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Re: MP Keeps Breaking: Tooth this time! :(

Postby JudyL » Wed Sep 24, 2014 2:57 pm

That is exactly the type of fracture Dixie had a couple of years ago on one of her molars, or might have been a pre-molar, I can't remember now. I found it while cleaning her teeth and one-half of the tooth was wiggling back and forth from the other half, and she acted like nothing was wrong and didn't react to it at all. There was no inflammation around the tooth so I must have caught it really early. I thought that was pretty strange. She was a strong chewer but only ever got bully sticks, never any bones.

My current vet also takes x-rays immediately before any dental procedure, and they also take x-ray after any extraction to make sure they've solved the entire problem. Their dentals do cost more because of that and the additional monitoring during the procedure and in recovery. Also, each dog in recovery has a tech assigned to stay with the patient. I haven't ever used a specialist, but I understand Sabine's viewpoint too. Cinnabon had her upper incisors and one canine removed 2 years ago, and then this Spring she had to have lots of teeth removed. I wonder now if there was infection brewing elsewhere that was either missed or so small that it didn't show on the x-rays, or that maybe a specialist would have caught it. I'll never know, but I do wonder. Her teeth were very pretty and clean looking too. :(

Sorry, that all doesn't help you decide. I don't have insurance for any of my dogs, but if you can afford the out-of-pocket charge of the specialist, I'd probably go that route.

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Re: MP Keeps Breaking: Tooth this time! :(

Postby Riddick » Wed Sep 24, 2014 3:38 pm

Yeah, dental X-rays are definitely a under anesthesia procedure. The dental X-ray machine is very different from a normal X-Ray. It is a tube shaped thing that literally has to be like a 1/2 inch away from the tooth. I actually just assisted on a broken molar extraction last week. We took X-rays before to make sure that the tooth hadn't abscessd or started resorbing. We extracted the entire tooth, and then retook X-rays to make sure we didn't miss any pieces of the root before stitching the gum up. We use metacam injectable and oral as a pain medication, seems to do a little better job with pain management than Tramadol. If your regular vet does dental cleanings and extractions on a regular basis and has the dental X-ray, I don't see why a specialist would be needed. Usually we only send people to a specialist if we suspect the tooth has abcessed or started to resorb, and with that there is usually some external evidence of that and we don't even waste time or money taking X-rays, we just say go straight to the specialist. You seemed to have caught it early enough because the tooth is not discolored or dead looking, so as long as your regular vet doesn't see any evidence of bigger problems on examination, he should be able to perform the extraction just fine. Hope that helps a little.
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Re: MP Keeps Breaking: Tooth this time! :(

Postby emmas_mom » Wed Sep 24, 2014 5:02 pm

I know nothing about dental stuff - by the time I get most of my dogs, they either have hardly any teeth left or they need most of them pulled. :frown: But I just wanted to say: MP, Quit Breaking!!!!
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Re: MP Keeps Breaking: Tooth this time! :(

Postby QBert » Wed Sep 24, 2014 6:32 pm

good grief, MP, it's not a contest!
See if you can schedule her for October 3rd, The Rabbit will be going under for a dental that day and we can fret and fuss together!

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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Thu Sep 25, 2014 3:53 pm

Thanks for the good thoughts and knowledge, guys!

So, the tooth is now almost like Judy's description of Dixie's—the front (towards the nose) part of the crack is not quite wiggling back and forth, but definitely separated from the other half because I can kind of move it. :( She's also acting normal but there is just no way it doesn't hurt, so I gave her 2 Tramadols just now. God I hope this is sufficient. I nearly cut my head off from dental pain this past year so I'm super scared that she is secretly dying inside. According to all the vets who have had to do things that suck to her (e.g., suturing, stapling, joint injections, dry needling, etc.), she is an insanely stoic and pain-tolerant dog, so all the more I'm worried. :S

Anyway, since the tooth appears to be wiggling and extra anxiety about the weekend (no e-vet, please!), I moved up the Monday appointment to tomorrow afternoon with a new doctor at the regular clinic. I don't think it would really matter who sees her tomorrow because it's supposed to be more a "look-over and discuss options" kind of thing. I just needed to get this over with to determine whether to pursue the specialist or not, and get their input on pain meds (if Tramadol is going to cut it until the surgery, etc.). If I have to go with the regular vet for the procedure, our regular vet who we were going to see Monday would do it.

In discussing my dental options with the rehab vet during our appointment today, she suggested that I could get a neck MRI at the specialist if we go that route, since she'll be under anyway. If insurance would pay some of it and if I can go make some extra change to cover the cost (= sing and dance on the corner of my street), it might be another reason to go with specialist. It's *really* getting up there at this point, though. :( I really hate complaining about money because the lack of it feels like it's my own damn fault (I don't think this at all about others), but it kills me to say that it is definitely not a good time. :tired:

Thanks for letting me poop out all these thoughts. You guys are the best.

And QBert, October 3rd is MP's fake birthday!! I'm hoping to have this thing done and gone by then, but we'll see! Either way, I'll fuss-n-fret with you anyway. ;)

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Re: MP Keeps Breaking: Tooth this time! :(

Postby UpwardDog » Thu Sep 25, 2014 7:35 pm

I have had the super bad dental pain with an abscessed tooth, but a month ago I had a big chunk off tooth fall out of a tooth that had had a huge filling. Basically I bit into something and 1/4 of the tooth broke off. It was annoying and a bit sore but nothing compared to the pain of an abscess.

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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Fri Sep 26, 2014 2:27 pm

Thanks, Heather!

I was able to see our regular vet (the one who will do the dental), and he allayed my fears with a thorough walk-through of the procedure, telling me how common/frequently he does these, and that he really didn't see any elevated risk factors or a need for a specialist. I do trust my vet and they have all the monitoring and anesthesia protocols that sounded good (according to the list I brought), so I think I will try to save $ and do it there. The specialist would be no-excuses, but it'll be quite a bit of difference in cost, and this way, I could use the savings to continue her owie rehab and stuff instead. (Or get a damn dental *myself*!!) I did ask for whole mouth x-ray instead of just the one FUBAR tooth, just in case. The rehab vet also asked for better x-rays while she's sedated (apparently the first ones were kind of not great), hoping that they'd be better if she's out. They'll also take off a couple bumps on her face: the eyebrow one is getting bigger and likely will bother her later, and the cheek one bleeds when she wears head halters (not often anymore, but if it's not a big deal, it is better gone than not). They'll also aspirate a couple bumps, just in case. I'm wondering if this is too much x-raying. :tired: (She had shoulder ones done in Jan, torso region in July, *twice*, after the phantom growth scare.) If so, I can forego the shoulder and neck x-rays for the rehab vet.

QBert, she's scheduled for 10/2!!! It was the soonest I could get my vet. They said it's OK to wait that long, so I sure hope so. They gave me Rimadyl for the night before the surgery, and also if she is in pain in the meantime.

I hope this is a fine choice. Thanks for listening, everyone!

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Re: MP Keeps Breaking: Tooth this time! :(

Postby Sabine » Fri Sep 26, 2014 5:01 pm

Looks like you've got a solid plan going. :) Best of luck!
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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Sat Sep 27, 2014 7:59 am

Thanks so much, Sabine! Nervous nonetheless, but hoping for the best. I have a few more days to drive myself crazy with self-doubt and what-ifs! ;)

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Re: MP Keeps Breaking: Tooth this time! :(

Postby QBert » Sat Sep 27, 2014 10:49 am

I could have scheduled The Rabbit fort he 2nd but that's her obedience class night - she's not likely to feel well enough to work just a few hours after anesthesia, and she'd be SO ANGRY with me if I made her miss class on top of the insult of the dental...

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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Wed Oct 01, 2014 7:57 pm

Tomorrow's the day, MP's Internet aunties!! I bring her in at 7:45 am. Wah!!!

It turns out that there's an option to get an Oravet treatment and a take home kit. I read that the take home kit is a PIA and not so great so I'll pass on that. Should I ask for the application? She's apparently getting a cleaning at the same time and it somehow helps protect the teeth afterwards . (Although they said it should be easy and light bc she has super clean teeth.) I'd love any input—thank you!!!

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Re: MP Keeps Breaking: Tooth this time! :(

Postby Moemer » Wed Oct 01, 2014 8:50 pm

Not sure about the kit thing, but good luck tomorrow!!!
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Re: MP Keeps Breaking: Tooth this time! :(

Postby maxs_mommy » Wed Oct 01, 2014 9:23 pm

We had the option of Oravet too with Max's last dental. I didn't because his teeth (The good ones) were fairly clean with his regular RMBs and chewys. The dental was more for the extractions and x-rays than tartar buildup. It was one more thing I didn't need to add to the bill, especially after 2 surgical and 2 non-surgical extractions and the extra anesthesia/pain meds.
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Re: MP Keeps Breaking: Tooth this time! :(

Postby JudyL » Wed Oct 01, 2014 9:42 pm

Good luck tomorrow.

I got that Oravet kit one time, and one time only. My dogs are all good about me fooling with their mouths and teeth, but the stuff in the kit is a PIA to get it to stay on the teeth. It comes with little foam applicators like come with cheap eye shadows, and the stuff doesn't want to stick to the teeth. I only tried to apply it a couple of times and finally gave up on it. I felt like I wasted my money on it. I saw a video of one person putting it on with their finger. I'd asked for the vet to apply it during the cleaning and they forgot but sent me home with the kit anyway! I can't answer about whether or not the product applied by the vet really works since my vet forgot and I was never really able to get it on the teeth. Also, if the kit says to apply it every week, then does what the vet applies also last only one week?

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Re: MP Keeps Breaking: Tooth this time! :(

Postby JudyL » Wed Oct 01, 2014 9:45 pm

More about that kit. The stuff is supposed to be applied over clean teeth anyway. After 8 weeks even with brushing, what are you putting it on top of or sealing under it? Really a mute point since the stuff hardly sticks anyway, but just more of my rambling ranting thoughts about this product.

Keep doing what you are doing for MPs teeth. They looked pretty clean in the picture.

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Re: MP Keeps Breaking: Tooth this time! :(

Postby SherriA » Thu Oct 02, 2014 5:32 am

Sending good tooth vibes for MP and stay calm vibes for you, Nana!
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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Thu Oct 02, 2014 6:58 am

Thanks for your input and good thoughts, everyone! I ended up just telling them to let the vet decide if he thinks it's necessary to do the Oravet. :) I dropped her off about an hour ago without incident (i.e., I didn't poop my pants). What was kind of funny was that Acorn was up *all night* from worry, even though he had been getting super annoyed about me being wonked out over it all week! :smirk: Hoping all goes well and the dumb bumps come off OK and that she doesn't give the vets and assistants too much trouble. I'll probably freak out again until the anesthesia wears off, but for now, I'm going to eat a bunch of onions and raisins and chocolate and leave them out on the counter. :grin:

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Re: MP Keeps Breaking: Tooth this time! :(

Postby emmas_mom » Thu Oct 02, 2014 1:50 pm

MP's Canadian Internet auntie has all her fingers and toes crossed, even if that does make it hard to get much done today. I hope all goes well!
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Re: MP Keeps Breaking: Tooth this time! :(

Postby SherriA » Fri Oct 03, 2014 5:48 am

Nana, how is MP this morning? And how are you, worried mama?
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Re: MP Keeps Breaking: Tooth this time! :(

Postby QBert » Fri Oct 03, 2014 6:49 am

C'mon, I need a Pancake update while I'm waiting for the clock to hit "head to vet with The Rabbit time"!

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Re: MP Keeps Breaking: Tooth this time! :(

Postby MaisyPancakes » Sat Oct 04, 2014 12:37 pm

Urgh, you guys, I did not see these posts for some reason (am supposed to get email alerts!!)—we survived the dental and she is recovering very well! The tooth in front of the PM4 was abscessed (!!!!) so they got rid of that one, too. She was under for quite a while—it said 3 hrs on my invoice. :S She got a couple of OK-but-bothersome bumps off of her face, a few x-rays done for her gimpy shoulder, and some aqua puncture and laser to help her recover more quickly. :) She was very alert when I picked her up, and was able to walk home (we live on the same block as the vet clinic!). She's not physically unsteady, but is still a little on the subdued side (fine with me!) and a bit like when I don't get enough sleep. We've been taking it easy and hoping that all the mouth and bump removal stitches stay in place. Her poops have been super soft and pretty bad, but they said it'll likely be weird for a few days. She's been given easy foods so far, in smaller amounts. She's getting the usual, like the probiotics, slippery elm, milk thistle, and collagens. I'm stopping the other joint supplements and anti-inflammatories for a few days because a lot of them had potential to cause bleeding issues. I think something like turmeric would be helpful now, though.

Last night, Acorn pulled a Acorn and left out a half-finished pilonchillo and it was gone when we came home from an errand. (I was SO MAD.) Luckily, it was super soft so I'm guessing she just kind of crumble-swallowed it. So, even though some parts of her are still getting over it, I think her countersurfing skills have been restored. ;)


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