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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog
Satisfied Customers: 19752
Experience:  DVM, Emergency Veterinarian; BS (Physiology) Michigan State Univ
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I am a dentist who will be cleaning my Tibetan Terriers teeth

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I am a dentist who will be cleaning my Tibetan Terrier's teeth in the next few days. He has significant perio problems, I will be extracting the lower central incisors due to a severe labial bony defect. I do not have the $$ to have this done by a vet (horrid divorce, gave this beautiful dog to the family that bought my house, but want to clean up his mouth before I move out of the area). Please, will some one help me with twilight sedation info? I have Rimadyl for pain management , and Valium. I have scaled this dogs teeth for years, he is very manageable for me to work on 1 quadrant at a time, I will have 2 hygienists to assist with scaling and high volume suction to allow us to clean his entire mouth. I need to know Valium dose in mg/kg body weight. Trust me, I take this very seriously, but I see this as my best option.
Hello, I'm Dr Gary. I've been practicing veterinary medicine since 2007. I look forward to helping with your questions/ concerns.

This is a tough situation indeed. I understand that you want to help the dog, but I worry about how well this will go. We really try to discourage awake dental procedures in dogs. You just can't clean well under the gum line and you can't polish the teeth after scaling. This ends up leaving scratches in the enamel and these turn into breeding grounds for more bacteria.

If you are going to try to extract a couple teeth, you may be able to just grab them and pull them out if the alveolar bone and the peri-odontal ligament is damaged. If there is still intact alveolar bone, you won't be able to make flaps and drill out that bone in an awake dog.

As far as a valium dose, the dose we use is 0.5 mg/kg in dogs. It's preferred to give it IV, but a Sub-cutaneous dose can be used. Using IV Propofol or a Ketamine/ Diazepam mixture would be more appropriate. When using Ket/ Val, we use 1 mL of the mixture per 20 lb body weight. When using Propofol, we use 3-5 mg/kg IV and then titrated to effect.

I hope this helps, let me know if you have any other questions.
Customer: replied 4 years ago.

I will be extracting the incisors with a piece of gauze - they are that loose!

I will not be using an IV, only oral Valium. Again, this is an extremely manageable animal/relationship. I am his alpha. Seriously, I have done root scaling on him before multiple times, a quadrant at a time, and polished his teeth at my office. He certainly doesn't enjoy it, but is reasonably compliant. Again, I am between a rock and a hard place to get this done,family taking him on doesn't have the resources to pay for this. Any further thoughts/suggestions would be highly appreciated. He's hung in with me through a really rough year, and I want to serve his needs as best I can in this situation. Then I kiss him goodbye and turn him over to his new family, as I leave town next week.

If they're that loose, then pulling them is pretty easy. I would try to grab them with some hand extractors to make it as painless as possible. They usually pluck out pretty quickly.

I would give the valium 30-40 minutes before you start and then follow up with Rimadyl at 1 mg/lb twice daily for a few days. A course of antibiotics- Clindamycin or Clavamox (Augmentin) would also be helpful. I usually have owners start antibiotics 2-3 days before the dental and then another 3-4 days after.
Customer: replied 4 years ago.

I can't thank you enough for this clinical information.

What is the dosage of antibiotics for a 30# XXXXX? Is either antibiotic preferred over the other in a dog with significant periodontal propensities?

Is the Valium dose of 0.5mg/kg body weight true for oral dosing as well?

You've been a great help, and I will exercise caution at every step of the process.

Thanks again - Dr. Suzanne Hall

In a 30 lb dog, I'd give Clindamycin- 150 mg twice daily. It's better for oral bugs.

If you went with Clavamox/ Augmentin, I would go 250 mg twice daily.

The Valium dose orally would be a bit lower, I'd go with 5 mg orally.
Customer: replied 4 years ago.

You are the best - thank you for all of your help.

You're very welcome.
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