• Fluid therapy Fluid therapy
• Anesthesia General anesthesia: overview
• Anesthetic induction Anesthetic induction: overview.
• Drug administration Therapeutics: antimicrobial drug Analgesia: overview
• Blood sampling Jugular venipuncture.
• Euthanasia.

• Easily accessible, large size vein
• Easily performed in the conscious animal with simple restraint.
• Length of forearm allows simple secure fixing of catheter for semi-permanence.
• Bilateral sites available, ie both forelimbs.

• The cephalic vein can have a tortuous course in the brachicephalic breeds making location and fixation of the vein for catheterization difficult.
• The site is easily accessible for interference by the patient - catheter must be secured adequately and interference prevented, eg using an Elizabethan collar or muzzle.

Criteria for choosing test

• The primary objective in treating periodontal disease Peridontal disease is to achieve a mouth free from pain and infection. Extraction of teeth ispreferable to leaving teeth in a diseased state.
• Is the disease localised or generalised? Generalised disease carries a poor prognosis for long-term success than localised disease.
• Are there any uncontrollable systemic factors that may negatively affect outcome? Is there furcational involvement? This makes treatment and homecare much more challenging.
• Consider tooth functionally. Preservation of a mandibular canine is a higher priority than a first pre-molor.
• Do you have adequate equipment and training to carry out the procedure effectively?

Materials required

Minimum equipment

• Periosteal elevators in several sizes.
• Ultrasonic scaler plus tips suitable for sub-gingival use.
• Hand scaler
• Gracey curettes, eg #11-12, 13-14.
• Scalpel handle.
• Periodontal probe.
• Sharp explorer probe
• Adson tissue forceps
• Needle holders.
• Tungsten carbide and round diamond burs
• Tissue retractor

Minimum consumables

• No. 15 scapel blade
• Suture material, ideally absorbable monofilament, eg pologlecaprone 25 Suture materials.

Pre-medication

• Consider multi-modal and pre-emptive analgesic protocols as gold standard.
• Dietary preparation
• Fast patient for 12 hours prior to general anesthesia to prevent reflux esophagitis.
• Site preparation
• Ensure a cuffed endotracheal tube us used, and a retrievable throat pack placed.
• Flush the mouth with 0.12% chlorhexidine solution Chlorhexidine.
• Perform supragingival scaling and polishing Dental scaling.
• Regional anesthesia (nerve blocks Local anesthesia: intraoral ) are strongly recommended.
• Full mouth probing and charting is mandatory.
• Radiography Dental adiography: overview required for any treatment areas. Full mouth radiography can be justified
• Proper lighting and magnification if helpful.

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Beckman B(2003) Mandibular incisor apically repositioned flap in the dog. J Vet Dent 20(4), 245-240 PubMed

Other sources of information

• Newman M G, Takeu H H, Klollevold P R, Carranza F R (2012) Carranza's Clinical Periodontology.St Louis: Elsevier Saunders.
• Holmstrom S E, Frost Fitch P, Eisher E R (2004) Veterinary Dental techniques for the Small Animal Practitioner. Philadepiphia:Saunders.
• Wiggs R B, Lobprise H B (1997) Veterinary Dentistry Principles and Practice. Philadelphia: Lippincott-Raven.