Staged Dental Procedures for Pets in Melbourne
Are Two Shorter Anaesthetics Safer Than One Long Anaesthetic?
This question is increasingly topical in veterinary medicine. There is no single approach that suits every patient and there are conflicting views in the profession. However, staging dental procedures is now common practice in the United Kingdom and is increasingly adopted by veterinary hospitals in Australia, particularly for older pets or those with underlying health conditions. At our Hawthorn East vet clinic, we often find that two shorter procedures may represent the safer option in selected cases.
Why the Length of Anaesthesia Matters
Veterinary medicine does not receive the same research funding as human medicine, and the available body of literature is comparatively limited. Nevertheless, both veterinary and human studies suggest that the duration of general anaesthesia is an important factor in patient safety.
In human medicine, a large study examining whether the length of anaesthesia or the frequency of anaesthetic events in dental patients predicted adverse outcomes found that longer anaesthetic durations were linked to a higher rate of complications. In contrast, the number of separate anaesthetics a patient received was not directly linked to an increased risk.¹ In practical terms, this suggests that one prolonged anaesthetic may carry greater risk than two shorter anaesthetics, even where the cumulative time under anaesthesia is similar.
Veterinary studies demonstrate similar findings. A study published in the Journal of the American Veterinary Medical Association assessing intra-anaesthetic complications in dogs undergoing general anaesthesia found that for every 30-minute increase in anaesthetic duration, the odds of an intra-anaesthetic complication increased by approximately 0.6%.² While this percentage may appear small, it is statistically significant and clinically relevant, particularly when it relates to patient safety.
In the absence of large volumes of controlled veterinary studies, expert opinion and clinical experience remain important. Many veterinary anaesthetic specialists, including my former specialist mentors, advocate for staged dental procedures because shorter anaesthetic times typically allow for better control of a patient’s temperature and blood pressure - two critical factors in patient safety that impact wound healing and kidney perfusion. From a practical perspective, these physiological parameters are generally easier to maintain within normal ranges during shorter procedures, particularly in geriatric patients or those with other medical conditions.
An additional advantage of staging is diagnostic precision. The first anaesthetic allows for full-mouth dental radiography and comprehensive assessment of severity. Treatment planning can then be performed accurately before proceeding with extractions or advanced dental procedures under a subsequent, shorter anaesthetic.
Cost Considerations and Our Approach
A common concern regarding staged dental procedures is increased cost. At Tooronga Vet Hospital in Hawthorn East, Melbourne, we aim to ensure that financial considerations do not compromise patient safety. For this reason, we apply a maximum cost cap to staged dental procedures, provided the second procedure is performed within one month of the first.
Is Staging Right for Every Pet?
Staging dental procedures is not appropriate for every patient. Decisions must always be made on an individual basis following clinical examination and diagnostic assessment. Instead, the decision should be guided by how the patient is responding under anaesthesia - including the stability of their vital parameters such as blood pressure, heart rate, oxygenation, ventilation and body temperature - as well as their overall health status and procedural requirements.
However, for many pets - particularly older dogs and cats, or those with underlying medical conditions - two shorter anaesthetics may offer a safer alternative to one prolonged procedure.
If you have any questions or concerns about dental disease or anaesthetic safety, our caring Melbourne veterinary team is always here to help. We’re more than happy to take the time to talk through your pet’s individual needs and guide you through the safest, most appropriate options.
Dr Andrew Nicholls DVM
References
1. Keith B Hyder et al, ‘Does Anaesthesia Duration or Number of Cases per Patient Predict Safety Events?’ (2019) 131(2) Anesthesia & Analgesia 444.
2. Kenneth J Wotman et al, ‘Intraoperative Complications Associated with Duration of Anaesthesia in Dogs Undergoing Elective Procedures’ (2018) 253(3) Journal of the American Veterinary Medical Association 301.