Tooth Be Told: Older Dogs Face Higher Anesthesia Risks!

Risk factors associated with increased mortality within 14 days of general anesthesia in specialty veterinary dentistry and oral surgery practices

Spaar Weiss MR, Hutt JP, Stewart SD, Volker MK.

Background
Anesthesia-related morbidity and mortality in dogs undergoing dental or oral surgical procedures is a concern for veterinarians and owners. Specialty veterinary dentistry and oral surgery practices routinely employ general anesthesia for advanced imaging and procedures. While prior studies have examined anesthetic risk in broader clinical contexts, this study specifically aimed to quantify the mortality rate and identify risk factors for death within 14 days of anesthesia in dogs treated at such specialty practices.

Methods
A retrospective cohort study was conducted using electronic medical records from four specialty veterinary dental clinics over a two-year period (June 2021–May 2023). Data were collected for 3210 dogs undergoing anesthesia for dental imaging or surgery. Variables included patient demographics, ASA physical status classification, anesthesia duration, and 14-day mortality outcomes. Statistical analysis involved univariate testing followed by multivariate logistic regression to identify independent risk factors.

Results
The overall 14-day post-anesthesia mortality rate was 0.37% (12/3210 dogs). Univariate analysis revealed that dogs who died were older, had higher ASA classifications, and experienced longer anesthesia durations compared to those who survived. Multivariate analysis, however, identified only age as a statistically significant independent risk factor, with increasing age associated with higher odds of death (odds ratio 1.338). ASA status, anesthesia duration, and body weight were not statistically significant in the multivariate model.

Limitations
Limitations include the retrospective nature of the study and potential inconsistencies in ASA status assignment across veterinarians and clinics. The small number of deaths limited statistical power. No post-mortem examinations were conducted, leading to reliance on presumed causes of death. Dogs with higher ASA status may have been underrepresented due to selection bias, and variations in anesthetic protocols across clinics may have influenced outcomes.

Conclusions
Mortality following anesthesia in specialty veterinary dentistry and oral surgery practices is low and comparable to rates in other referral settings. Advanced age was the only significant independent predictor of mortality. These findings underscore the importance of age-related risk discussions with owners considering anesthesia for older dogs.

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