My pet has bad breath – does this mean they are in pain?

Bad breath is very common in dogs and cats, but it is definitely NOT normal! What you are smelling is infection and pus. Plaque bacteria on the teeth causes gingivitis, resulting in painful, red, swollen, ulcerated or bleeding gums. Left untreated, the bone surrounding the teeth also gets destroyed, leading to abscesses, loose teeth and even jaw fractures if nothing is done. Infection also spreads through the bloodstream to the vital organs, including the liver, heart and kidneys.

My vet told me my pet has dental disease but he/she is eating fine- could he/she really be in pain?

Most pets are brave, and do not show obvious signs of pain until it is excruciating. They will continue to eat despite significant discomfort. When you think about it, they really have no other option. They may start to chew on one side, or prefer softer foods, but in many cases the signs are quite subtle and easily missed, even by a diligent owner. Pets with dental disease will not stop eating until the pain is so severe that starving slowly is an easier option. This can take months or years of disease to happen. Please don’t wait for this to happen.

Your vet may refer you to see Dr Christine…

Your vet may refer you to see Dr Christine – this is our preferred method of seeing patients as we can then work with your vet, access previous medical records (blood tests, treatments, previous anaesthetic details etc). This also minimises the risk of unexpected non-dental issues being discovered at your dental consultation, which may then need to be dealt with at your own vet prior to dental treatment.

We can also see your pet without referral if you are concerned about their dental health, especially in the case of an emergency. However, in the majority of cases, your regular vet is the best place to start.

Where can my pet see Dr Christine?

Dr Christine sees patients at the following centres:

• Sydney Veterinary Emergency and Specialists
• Veterinary Specialist & Emergency Centre, North Shore

Please note the Willoughby North contact address is a post office box, and she is not allowed to perform surgery in the post office.

What days does she operate?

Surgery days are Tuesdays and Thursdays. In some emergency cases, Dr Christine can arrange to see your pet on other days if necessary (including weekends), this may incur an extra fee. You can contact her here

Can surgery be done the same day as the initial consultation?

Most surgeries can be performed on the same day as the consultation, if your pet has been fasted appropriately and there are no other health issues that need to be addressed first. This saves you time, and your pet the stress of an extra visit to the hospital. You can also choose to schedule surgery for a later date if you prefer.

Sometimes it is preferable to schedule surgery at a later date, if extra precautions or preparations are required prior to anaesthesia (such as a course of medication, or a longer period of preoperative intravenous fluids). Dr Christine will keep you fully informed of the reasons for this if necessary.

How do I make a booking?

Bookings can be made directly through the appropriate hospitals:

• Sydney Veterinary Emergency and Specialists 
• North Shore Veterinary Hospital 

Should I fast my pet before our visit?

If you would like the option of your pet having surgery on the same visit as your consultation, fasting is recommended. We recommend no food after midnight on the night prior to your arrival. Water should be available until you come to the hospital, especially in warmer weather. This is particularly important for patients with health issues such as kidney disease or diabetes.

If your pet is very young, has a medical condition such as diabetes, or takes medications that need to be given with food, please ask for advice on fasting when you book your appointment.

Do I need to do anything to prepare for my visit?

Aside from fasting your pet as above, please also let us know if your pet has health issues prior to your appointment. This can be done by your referring vet.

How much does it cost to see Dr Christine?

An initial consultation with Dr Christine is $240. This generally takes about 30 minutes, and includes a thorough oral examination, detailed discussion of the options available, and formulation of a treatment plan.

Dr Christine also offers a free recheck appointment 10-14 days after surgery, to check that everything is healing well. You will be given details for this when your pet is discharged from hospital.

How much does dental treatment cost?

This is a common question, which is completely understandable! While Dr Christine can sometimes give a very rough guide in advance for fairly ‘standard’ procedures such as root canal treatment, the costs can vary depending on the individual problem, the size of your pet, and other medical issues affecting the anaesthetic. Once she has examined your pet, a more accurate estimate can be given based on all of these factors.

You can click here for further information on pricing.

How do I find the hospital?

Click here for directions to Sydney Veterinary Emergency and Specialists and you can call reception on (02) 9197 5800 if you get lost.

Click here for directions to the Veterinary Specialist & Emergency Centre, North Shore and if you get lost call reception on (02) 9436 4884.

What happens during the initial consultation?

The initial consultation is 30 minutes. Dr Christine will discuss your pet’s medical and dental history with you while your pet explores the room and gets settled. She will then perform a thorough oral examination (as thorough as your pet will allow!) and then describe her findings with you. You can then go through all the treatment options, including the prognosis and costs, before making a treatment plan that suits you and your pet.

If your pet is staying for same-day surgery, they will be admitted to hospital for treatment. Otherwise you can take time to make any decisions, and schedule surgery for a later date.

What happens to my pet when they are admitted to hospital for treatment?

Your pet will be settled into a comfortable bed, and prepared for their surgery in the afternoon. An intravenous line (drip) will be placed to make sure they are not dehydrated, and to support their blood pressure throughout the procedure. Any blood samples that are required can be taken at the same time. Sedatives and pain relief may be administered to keep your pet calm, comfortable and happy until surgery.

After surgery, your pet will recover from their anaesthetic under close observation. Dr Christine or one of her team members will call you to let you know how things have gone, and confirm a time for you to be reunited with your pet when they are awake enough to return home.

Will my pet need to stay in hospital overnight?

It depends on the procedure performed, and the overall health of your pet. Most patients are discharged the same evening, but sometimes a sleepover in the ICU (Intensive Care Unit) is required. Extensive surgery may mean your pet needs stronger pain relief than can be dispensed for home use. Some patients may require extra intravenous fluid support and nursing care in the ICU until they are back on their feet and ready to eat and rest at home. Dr Christine will keep you informed if your pet needs this extra care. The hospital has a dedicated 24/7 ICU team of vets and nurses so your pet is in safe hands around the clock.

Does my pet need to be put under anaesthesia for treatment?

Almost every dental procedure requires a general anaesthetic, for several reasons. Firstly, although Dr Christine has many tricks for getting a good look in your pet’s mouth, it is not possible to thoroughly examine and clean all surfaces of all teeth (including the backs and insides of all of those back teeth), check and clean below the gumline, and take xrays unless your pet is asleep. Secondly, dental cleaning and treatment can be uncomfortable and scary for your pet, especially if there are inflamed gums or damaged teeth. The instruments Dr Christine uses are very sharp (they have to be!), and the power equipment is noisy and sprays water. Your pet can be seriously injured if they move, or inhale bacteria or water during the procedure (cats and dogs don’t rinse and spit like humans do!). Anaesthesia allows us to do a thorough job safely without your pet feeling pain and fear.

How is the anaesthetic risk managed to keep my pet as safe as possible?

Managed well, general anaesthesia these days is generally very safe for most patients. Dr Christine minimises the risk by knowing your pet’s health status through their medical history, physical examination, and, if needed, supplementary tests (such as blood tests, chest xrays). She tailors the anaesthetic protocol to their individual requirements, and will discuss any special considerations arising from other health issues with the Critical Care and Medicine teams as needed. Your pet is continuously monitored throughout the procedure, to keep them at a safe level. Local nerve blocks allow her to keep the level of anaesthesia as light as possible. Finally, the hospital is a fully equipped emergency facility so the Dental team has the backing of the Critical Care and Medicine teams should any potential issues arise.

Is anaesthesia-free dental treatment a better option for my pet?

In a nutshell, the only way to do dental work without an anaesthetic is to not do it properly. Sadly, it is common for pets that have had anaesthesia-free dental cleanings for several years to come in requiring multiple extractions that may have been avoided had a thorough dental procedure been performed under anaesthesia instead.

While we would love to be able to perform dental assessment and treatment on your pet without anaesthesia, we do not offer this service as it does not allow proper diagnosis or treatment. Dr Christine’s aim is to find and alleviate all sources of infection and pain in your pet’s mouth. This means examining every tooth, above and below the gum margin, and being able to clean and treat all areas. While Christine has repeatedly asked for xray vision every Christmas and birthday, she is yet to receive it, and (like all other humans) can only see the tip of the iceberg when she looks in your pet’s mouth.

Most people find dental treatment unpleasant and uncomfortable – your pet is no different. A well-managed anaesthetic is far safer and more humane than attempting to use sharp instruments and power equipment in a mobile patient without a protected airway.

My pet is elderly – should I even consider putting them under anaesthesia?

Every owner of an elderly pet shares this same concern. Dental disease increases with age, so a large proportion of our patients are in fact elderly! Most dental conditions cause discomfort or pain, and almost all involve infection that can enter the bloodstream and affect the rest of the body. Dental disease is just as painful for older pets as it is for younger ones, and older pets absolutely deserve to be happy and pain free. We have treated many, many elderly cats and dogs with great success, relieving their pain and infection and giving them back their quality of life. Modern anaesthetics give us many options to make the anaesthetic as smooth and safe as possible so we can achieve this. Christine’s surgical experience also means procedures can be done quickly to minimise the time under anaesthesia.

Dr Christine can help you determine if your pet’s mouth is infected or painful, and how beneficial treatment is likely to be. The anaesthesia risk can then be weighed up and managed to give your pet the very best chance of regaining comfort in its old age. Indeed, it is common to find pets act many years younger once they have had good dental care!

Click here to view our page on anaesthesia management.

Every owner of an elderly pet shares this same concern. Dental disease increases with age, so a large proportion of our patients are in fact elderly! Most dental conditions cause discomfort or pain, and almost all involve infection that can enter the bloodstream and affect the rest of the body. Dental disease is just as painful for older pets as it is for younger ones, and older pets absolutely deserve to be happy and pain free. We have treated many, many elderly cats and dogs with great success, relieving their pain and infection and giving them back their quality of life. Modern anaesthetics give us many options to make the anaesthetic as smooth and safe as possible so we can achieve this. Christine’s surgical experience also means procedures can be done quickly to minimise the time under anaesthesia.

Dr Christine can help you determine if your pet’s mouth is infected or painful, and how beneficial treatment is likely to be. The anaesthesia risk can then be weighed up and managed to give your pet the very best chance of regaining comfort in its old age. Indeed, it is common to find pets act many years younger once they have had good dental care!

Click here to view our page on anaesthesia management.

My pet has an increased anaesthetic risk due to concurrent illness (eg heart, kidneys, liver) – what should I do?

Pets with serious illnesses can also have serious dental issues that impact on their quality of life, as well as their overall health. Many of Dr Christine’s patients have multiple illnesses, yet if dental treatment is required, this can almost always be achieved through careful anaesthetic management and keeping the procedure as short as possible (this is where her surgical experience comes in). The backing of a referral hospital with intensive care and medicine teams, if needed, gives extra peace of mind.

Will I need to feed my pet a special diet?

This depends on the procedure performed. In the evening after surgery, a small soft meal is usually appreciated, as your pet will still be under the effects of the anaesthetic. If extractions have been performed, a soft diet is usually recommended for several days – this may include soaked kibble, small chunks of meat or chicken, or tinned food (small chunks are better than gravy-type foods). Dr Christine will provide all the details when your pet is discharged from hospital.

How will I give any medications required?

After surgery it is best to avoid handling your pet’s mouth in most cases. Where possible, medications are supplied as liquids that can be gently syringed into the side of your pet’s mouth or put in their dinner. Occasionally long acting injections or pain patches may also be used. Tablets are only used if necessary, and can generally be hidden in food.

Will I need to take time off work while my animal recovers?

It is rare that you will need to take time off to nurse your pet (that’s our job!). With good surgical technique and the use of pain medication, most patients are up and eating several hours after surgery. If surgery has been extensive, your pet will generally be kept in hospital until they can eat and manage themselves well – this allows them to receive strong pain relief, intravenous fluid support and loads of TLC until they find their feet again.

Will my pet be able to eat if teeth are extracted?

This is a common and valid concern. The great news is that pet cats and dogs do absolutely fine without teeth, even if they have to have them all removed! Pets need their teeth for hunting and chewing through carcases, so as long as you continue to feed your pet so they don’t have to hunt, they will do well. In fact, many pets with no teeth at all will still eat biscuits, and some will even continue to hunt if allowed.

Dr Christine only removes teeth where it is the best option for your pet – this means that, in fact, most eat far better without the pain and infection, despite having fewer teeth.

Do I need to make a follow-up appointment? How much will this cost?

It depends on the treatment performed. For many surgeries a follow-up appointment is recommended – Dr Christine will let you know. This is so she can check that the mouth is healing well and answer any questions you may have. She uses dissolving sutures so you won’t need to have these removed.

The great news is that this post-surgery check is free (it’s all part of the service). Just book through Reception.

I live a long way from the hospital – do I need to see Dr Christine or can I see my regular vet?

While Dr Christine always loves to see her patients, you don’t have to see her for the post-surgery check if this is inconvenient for you due to distance, scheduling, or life in general. She will send a report to your own vet following surgery so they are up to date with your pet’s treatment, and can take over their care again once you are home. If your vet is concerned or has any questions, they can contact Christine for further advice.