Thursday, December 22, 2011
Equine Dentistry: Sedation or No? Written by Marsha Wyatt
Written by Marsha Wyatt
Teeth floating is a part of nearly everyone’s scheduled treatments for their horses. The rule of thumb for how often to schedule floating is at least every two years, more frequently if specific problems exist. Inherent to the floating procedure is the decision of whether to opt for sedation. Both sides of the sedation issue have pertinent, valid points. Where do you stand?Dr. Suzan Seelye, DVM of Yelm, WA has been in practice for 28 years and her business is almost entirely equines. She specializes in holistic medicine and carefully considers the possibility of any negative effects before administering drugs to her patients. During her lengthy career Dr. Seelye has observed, “Horses allowed to live more naturally on pasture with a variety of plants and grasses to graze on, typically maintain a better mouth than horses kept stalled or fed predominately hay -- ground feeding being an important aspect of allowing the horse to eat, chew, swallow and digest correctly. However,” she adds, "genetics do play a role in the overall health of the dental condition.”
Dr. Seelye approaches sedation on a case-by-case basis. “The demeanor of the practitioner is of utmost importance to the success of the floating,” she says. We know that an assured, calm approach helps our horses in any situation, health procedures being no different. Her experience is that many horses will accept the procedure fairly quietly, especially if the work needed is minor or the horse has had previous positive experiences. She suggests that you prepare your horse by setting him up for success. Arranging for the horse to be floated in a familiar place will help. Do not ask him to go to a strange area or stall for the treatment. Do not separate him from his herd or buddy prior to floating. Avoid adrenalin rushes at all costs; isolation in an unfamiliar environment can build anxiety in the horse quickly. Seelye always evaluates her patient’s mouth to determine the extent of the work needed prior to considering sedation. “After the first few swipes of the hand tools,” she offers, “most horses will accept the feeling and sound and settle down.” In cases where the horse cannot accept the procedure, or if extensive work or extractions are needed, Dr. Seelye will opt for sedation. She wants to provide the most effective treatment with the best outcome for the horse.
PROCEED WITH CAUTION
While recognizing that drugs are occasionally necessary, Seelye has numerous concerns associated with sedation. She cautions, “There is always the possibility of death, seizures or injury from falling during the procedure, while waking up or during hauling afterwards.” Additionally, the GI tract slows down from the drugs and colic is possible during the first 24–48 hours. Choke is also a side effect if the horse is allowed to eat before he’s fully awake. A sedated horse should not be fed for 2–4 hours after the procedure. Seelye explains, “Flaccid muscles produced by sedation can allow the skeleton to move unnaturally and the horse can be compromised physically. Sedation also affects blood flow, organ function and neurology. I recommend having some type of balancing bodywork done on your horse after any procedure requiring sedation.” As a holistic practitioner Dr. Seelye has found, “Floating without sedation prevents many serious problems and I choose that option whenever possible. Unfortunately, some situations do require sedation to adequately address existing problems.”
THE DOWNSIDE OF NOT SEDATING
An equine dentist from the south [anonymity requested because he operates in a state where it is currently illegal for equine dentists to practice without the supervision of a veterinarian] works from this perspective: “Unless a horse is extremely quiet or needs very little work, in most cases sedation is preferable.” He does his evaluation before sedation and is willing to accommodate a client requesting he not use drugs. However, based on his experience he states, “Without sedatives, horses tend to bunch up in a corner with tensed muscles causing an improper head position and jaw misalignment. The result is a less than adequate treatment and muscle soreness for days afterwards.”
This dentist primarily uses power tools for floating because he feels it expedites the process and allows him to create a balanced mouth with less trauma for the horse and the dentist. “The use of power tools always requires sedation,” he feels. “It is not safe for the horse otherwise.” He does not use stocks or any special restraints. The horse wears a halter and speculum, but is allowed to hold its head in a more natural, down position. The use of the speculum is necessary to be able to see/feel to the very back of the horse’s mouth, but should be released often to give the horse’s jaws a rest. “Without sedation,” this dentist claims, “most horses are claustrophobic and anxious about this device.” For sedating, he prefers Dormosedan, which is administered in small dosages and acts very quickly to bring the horse to a state of tranquilization without total anesthesia. Additionally, horses are able to keep their feet under them and usually begin to wake up in about 30 minutes. He adds, “To date, I have had no negative experiences with side effects associated with sedation.”
In Fayetteville, AR, Dr. Paul Turchi, DVM, has been practicing equine veterinary medicine for 22 years. He predominantly sees float cases in his clinic where stocks, a speculum and a halter to position the horse’s head are used. Most of his patients are sedated after a pre-exam for dental issues. “In the early days of my practice, all floating was performed with hand tools,” Dr. Turchi explains, “Those tools were not ideal and more than a little difficult to work with.” For the last 10 or 12 years he has used power tools for floating and believes they are safe, easier on the horse and practitioner and much more effective for a thorough treatment. The size difference between hand tools and power tool blades make the smaller power tools easier to manipulate in the horse’s mouth. Dr. Turchi also explains, “The speculum is a necessary tool to open the mouth sufficiently to address the teeth all the way to the back of the jaw. Without sedation, most horses will resist and become anxious about the speculum being opened wide enough to be effective.” He is cognizant of the possible side effects from sedatives, but feels the positive aspects outweigh the negative. His choice for sedation is Dormosedan mixed with Xylazine. If a horse is still quite groggy at the end of the procedure, he uses Yohimbine as a reversal drug to wake the horse up. This is a safety measure for horses being hauled after floating.
Turchi feels that in the stocks of his exam room, a horse is relatively safe from injury and he would be able to assist immediately if the horse were to experience a negative reaction. Having said that, he will respect any request by a client to withhold sedation during floating. When asked what might be the benefits of non-sedation, he says, “The absence of drug reaction would be the only clear benefit.”
Steve Sampson has been an equine dentist for nearly 40 years, currently practicing near Palm Springs, CA. His practice keeps him on the road traveling from California to Canada and back for most of the year. He uses hand tools exclusively and 99.9% of his patients are floated without sedation. Sampson believes, “It is important for a horse to have input during floating to help me find the really sore areas, which could indicate deep infection or a cracked tooth. When under sedation, a horse cannot contribute to the process and I can only guess at the pain level/severity of a dental issue.”
Dr. Sampson is confident that his assured, knowledgeable approach is the key to cooperation from his patients. He works at being “correct” in his heart and mind to encourage the horses to trust him. Sampson says horses are frightened by fear, aggression and anxiety. If someone enters the barn harboring any of those emotions, the horses will know immediately and “He should just go home for the day.”
Sampson works alone with a halter, a speculum and his tools. His floating procedure takes about 25-30 minutes, the same time frame for a sedated horse. He generally prefers that the horse owner stay clear of the procedure so as not to inject anxiety into the situation. A common part of his dental work is extractions. In most cases, he is able to perform extractions without sedation and without undue upset on behalf of the horse. On occasion, a tooth problem is just entirely too painful for the animal and Sampson will opt for sedation. He uses Dormosedan for the small volume required and the immediate, deep sedation.
Sampson says, “I was taught my craft by an ‘old cowboy’ who developed his horsemanship during a time when men devoted their entire lives to understanding horses and becoming true horsemen.” He declined to clarify the cowboy's identity stating he “doesn’t like to drop names.” His belief is that quality horsemanship ultimately allows him to perform procedures on and for the horse which would otherwise require sedation.
Each dentist designs his or her floating protocol based on individual experience, training and knowledge. As horse owners, we must make our decisions regarding sedation based on the same criteria.
DO YOUR DENTISTRY HOMEWORK!
When searching for a qualified dentist, begin with asking people you know and trust. Word of mouth is usually a good source. Do not be shy about calling and interviewing prospective dentists.
- Where was the dentist trained?
- How long has he/she been in practice?
- What type of facility does he/she have?
- Do they do farm calls?
- Do they use power tools?
- Do they use sedation?
- Will they abstain from sedation if asked?
- Have there been any deaths, injuries or accidents associated with their practice?
- Whom can you call as a reference?
Any respectable practitioner will be more than happy to share information about their practice and details about their treatment methods.
If you’re planning a trip to the equine dentist, make sure the haul is as uneventful as possible. Your horse should be confident with trailering alone; if not, take a buddy horse to help keep him relaxed. Consider extreme temperatures and make allowances respectively. If your horse has ever had a reaction to sedation, is compromised by cardiac problems, respiratory problems, age or any health issue which might affect the sedation outcome, call and talk to your practitioner BEFORE your appointment.
Marsha Wyatt is a lifelong horsewoman whose horsemanship has evolved dramatically during the last ten years. Natural horsemanship paired with alternative equine medicine is now her focus. She currently offers lessons and training in Fayetteville, AR and is particularly interested in helping women with fear and confidence issues associated with horses. She can be contacted at email@example.com
Dr. Suzan Seelye DVM, CVM, CVT – Yelm, WA - Holistic Animal Practice firstname.lastname@example.org or www.quantumvet.com
Steve Sampson, Equine Dentist – Palm Springs, CA – email@example.com
Dr. Paul Turchi, DVM – Northwest Equine Hospital - Fayetteville, AR – (479) 521-5558
International Association of Equine Dentists – www.iaedonline.com
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