The Dentist Will See You Now, or Why I am Not a Veterinarian

I’m usually pretty good at keeping track of all things medical—when my kids were vaccinated, when I need my mammograms and PAP smears, when the girl dogs come into season and when the horses need to see the dentist.  So when Norman the Lipizzaner arrived home from the boarding stable underweight, and two weeks later when he didn’t seem to be eating all of his hay, my thoughts turned to his teeth.  Unlike humans, domesticated horses’ teeth grow throughout their lives, and when people refer to an aged horse as being a bit “long in the tooth,” they aren’t kidding.  Lacking the need to forage 24/7, our stabled companions need the regular attention of a horsey dentist who will come in and do what is euphemistically called “floating the teeth.”  Think of the drill your dentist uses and multiply its surface area and sound by 100, and you’ll get the idea.  Reaching into twenty four year old Norman’s mouth, I felt sharp “points” on the molars, and realized why he wasn’t gaining weight.  I checked my records and realized that he and his buddy Dash were six months overdue.

If you’ve ever taken your three year old for his first dental appointment, you have an idea of how hard a tiny body can struggle.  Same with horses, only they are a lot bigger than we are.  None of them willingly open their mouths wide and allow insertion of a drill—the mere sound of it is terrifying.  So they must be anesthetized.  And just like with elderly humans, the trick with an old horse is to give them enough anesthesia that they tolerate having a vice put into their mouths and cranked open, yet not enough to kill them.  This, apparently is not an exact science.  The first shot directly into Norman’s jugular vein did exactly nothing.  Although he was restrained, the whites of both wide eyes were showing as he chomped down on the dental device.  The second shot seemed to have a light sedative effect.  But the THIRD shot—well, that was the one that did the trick.  Same thing with good old Dash.

Now here’s the thing—I was SUPPOSED to go to work after the dental appointment.  Our machine was down for maintenance, and I had a lot of paperwork to catch up on.   After the requisite 45 minutes, I released their halters, tied to the bars in their stalls. They both tried to fall down.  How do you leave when you’ve got two horses staggering around their stalls like drunken sailors?  You don’t.  With Norm, the younger of the two, the drug seemed to wear off quickly.  But with Dash, I spent the next two hours hanging on to his lead rope and elbowing him when the head got too low and the front knees threatened to buckle.  Finally he too came around, and I left them munching grass in the pasture, a full three hours later than I had planned to be at work.

Sometimes our head and neck cancer patients are really claustrophobic in their immobilization masks, much like my horses getting dental work.  I usually prescribe a light sedative, and then if that doesn’t work, I tell them to take another.  Sometimes, the family gets into the act with great enthusiasm and has the patient take a third, unbeknownst to me.  So far, I’ve been lucky.  I’ve heard a few snores, but no one has aspirated or fallen off the table from what we used to call “the neurosurgery height.” But watching those old horses yesterday, I realized once again that there’s a fine line between “not enough” and “too much.”  Come to think of it, that probably applies to radiation therapy and chemotherapy too, along with a whole lot of other things in life!