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Macrodontia

LunksandMinipli

New Born Pup
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Location
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Hi all,

Just looking for some advice around my minipli. She’s 4 years 2 months. She’s been in reasonably well health since I took her home 4 years ago.

She had non-functional ovarian cysts last year and she was spayed in November. Other than that she’s been in good shape.

We found her on the 28th august covered in diarrhoea. We syringe fed her at home, gave fibreplex, supplemented vit C, all the usual things. She went to the vets on the 1st September having lost a fair bit of weight (she weighed 800g at this point).

She had bloods, X-rays, faecal analysis for parasites and her teeth were examined, the (very well respected) exotic vet found nothing. We took her home and monitored her. She lost more weight despite feeding and dropped to 735g. The drop was really sudden in the last couple of days. She gained and then maintained in the week beforehand.

She went back to the vet 13/9 and she was admitted for monitoring. Given IV fluids as a precaution. The vet called and thought she may have dental issues that required surgery and suggested PTS. My partner was at work so I asked to think. The vet then suggested we did dental X-rays. The dental X-rays found macrodontic teeth on both sides of her mouth. Her molars were also slightly overgrown and these were corrected whilst under GA.

The vet advised she required 2 surgeries at around £600 per surgery to remove the teeth and she likely wouldn’t survive.

When I took her in, she was incredibly bright, just losing weight but I agreed to PTS if we could say goodbye. They were very busy so I didn’t hear much the next day other than that she was doing well. They asked to keep her 2 more days, which I agreed to.

The next morning I called back and asked to see her and I decided to take her home as I was confused about her prognosis if she needed to be PTS and why she was still at the vet.

She’s been home since Friday and really bright. She’s having metacam twice a day and I’ve been topping her up with critical care.

During her time at the vets she ate 2 dandelion leaves herself and that’s all. Since being home she has gained 36g and managed to maintain that. Yesterday she had only 20ml of critical care.

I usually feed them haybox hay but she’s finding that a bit coarse I think so I have given her a softer hay which she’s coping with well.

I will continue to syringe feed her and hopefully put more weight on her. I wanted to see how she coped whilst eating herself but I will top her up a bit more now I know she’s eating. She has an appointment with the the cat and rabbit clinic but my vet wouldn’t send her history over as he said conscious dentals are cruel. The only option in his eyes are PTS or 2 surgeries at about £600 each.

In the last 2 weeks I’ve already spent £1.5k on her but if she needs the surgery and it is fair to do it I will make sure she gets it.

I’m just confused as I respect my current vet a lot but I have heard amazing things about the cat and rabbit clinic.

Could anyone advise about the process of the conscious dentals and what to expect? Whether my vet is right or maybe the process has moved on recently and is more fair? Are they given pain relief or local blocks?

Essentially am I doing the right thing for her? She is as bright as anything, running, wheeking, eating veg and hay and small amounts of pellets. She lives with 2 other sows, one of which has lymphoma so I’m terrified to lose 2 out of 3 in quick succession as I love them so much.

In terms of her usual husbandry they have unlimited haybox hay, an appropriate amount of burgess pellets, oxbow vit C treats as extras daily, fresh water in bottles (and now bowls in case she has difficulty). Pepper daily and an assortment of other veg and herbs making up about 10-15% of their diet.

I’ve spread some forage throughout to encourage her to eat and I’ve also had her out of the cage to ensure she definitely is getting the hay into her mouth (she is!). I feel like it’s my fault and I’ve done something wrong and I’m worried I’m not being fair to her.

I completely respect my vet and I know she’s on metacam at the moment otherwise I wouldn’t have taken her home but it feels so wrong to put her to sleep when she’s doing so well. I’m also aware that she might not be well for long and I need to make a decision.
 
It's definitely worth a chat with Kim and Simon at the Cat and Rabbit Care Clinic before making any decisions.
It a a good sign she has perked up again and is eating and putting on weight!
You're doing a great job for her and certainly have nothing to feel guilty about; you've done more than many people would.
We had one pig in at the rescue who had a conscious dental with Kim. We could be in the room with him but he was literally starving to death before hand. Desperately hungry but just couldn't eat.
When we went in to the room to see him after he was bright as a button munching on some spinach like nothing had happened! He went on to live a long happy life in his new home.
I really hope Simon and Kim can help your piggy like they helped Duke; if anyone can, it's them!
Best of luck for your appointment x
 
Hi all,

Just looking for some advice around my minipli. She’s 4 years 2 months. She’s been in reasonably well health since I took her home 4 years ago.

She had non-functional ovarian cysts last year and she was spayed in November. Other than that she’s been in good shape.

We found her on the 28th august covered in diarrhoea. We syringe fed her at home, gave fibreplex, supplemented vit C, all the usual things. She went to the vets on the 1st September having lost a fair bit of weight (she weighed 800g at this point).

She had bloods, X-rays, faecal analysis for parasites and her teeth were examined, the (very well respected) exotic vet found nothing. We took her home and monitored her. She lost more weight despite feeding and dropped to 735g. The drop was really sudden in the last couple of days. She gained and then maintained in the week beforehand.

She went back to the vet 13/9 and she was admitted for monitoring. Given IV fluids as a precaution. The vet called and thought she may have dental issues that required surgery and suggested PTS. My partner was at work so I asked to think. The vet then suggested we did dental X-rays. The dental X-rays found macrodontic teeth on both sides of her mouth. Her molars were also slightly overgrown and these were corrected whilst under GA.

The vet advised she required 2 surgeries at around £600 per surgery to remove the teeth and she likely wouldn’t survive.

When I took her in, she was incredibly bright, just losing weight but I agreed to PTS if we could say goodbye. They were very busy so I didn’t hear much the next day other than that she was doing well. They asked to keep her 2 more days, which I agreed to.

The next morning I called back and asked to see her and I decided to take her home as I was confused about her prognosis if she needed to be PTS and why she was still at the vet.

She’s been home since Friday and really bright. She’s having metacam twice a day and I’ve been topping her up with critical care.

During her time at the vets she ate 2 dandelion leaves herself and that’s all. Since being home she has gained 36g and managed to maintain that. Yesterday she had only 20ml of critical care.

I usually feed them haybox hay but she’s finding that a bit coarse I think so I have given her a softer hay which she’s coping with well.

I will continue to syringe feed her and hopefully put more weight on her. I wanted to see how she coped whilst eating herself but I will top her up a bit more now I know she’s eating. She has an appointment with the the cat and rabbit clinic but my vet wouldn’t send her history over as he said conscious dentals are cruel. The only option in his eyes are PTS or 2 surgeries at about £600 each.

In the last 2 weeks I’ve already spent £1.5k on her but if she needs the surgery and it is fair to do it I will make sure she gets it.

I’m just confused as I respect my current vet a lot but I have heard amazing things about the cat and rabbit clinic.

Could anyone advise about the process of the conscious dentals and what to expect? Whether my vet is right or maybe the process has moved on recently and is more fair? Are they given pain relief or local blocks?

Essentially am I doing the right thing for her? She is as bright as anything, running, wheeking, eating veg and hay and small amounts of pellets. She lives with 2 other sows, one of which has lymphoma so I’m terrified to lose 2 out of 3 in quick succession as I love them so much.

In terms of her usual husbandry they have unlimited haybox hay, an appropriate amount of burgess pellets, oxbow vit C treats as extras daily, fresh water in bottles (and now bowls in case she has difficulty). Pepper daily and an assortment of other veg and herbs making up about 10-15% of their diet.

I’ve spread some forage throughout to encourage her to eat and I’ve also had her out of the cage to ensure she definitely is getting the hay into her mouth (she is!). I feel like it’s my fault and I’ve done something wrong and I’m worried I’m not being fair to her.

I completely respect my vet and I know she’s on metacam at the moment otherwise I wouldn’t have taken her home but it feels so wrong to put her to sleep when she’s doing so well. I’m also aware that she might not be well for long and I need to make a decision.

Hi and welcome

Please ask your treating vets whether they would be willing to have your piggy and its file referred to the Cat&Rabbit Care Clinic in Northampton. They are doing about 25 piggy dentals in a week and have the best experience in the whole UK. Because of the high demand, they only take on new customers from vets who are unable to do cope with providing the dental care themselves.
They do include any minor conscious dentals in their normal consultation fee plus any medication needed but you need to be aware that most dentals cannot be addressed in just a single treatment and that problems often require several until the teeth have fully normalised. But
The Cat and Rabbit Clinic, Northampton - Referrals for guinea pigs with dental issues

Please switch to syringe feeding support and weighing daily at the same time on your kitchen scales immediately. Three quarters of what guinea pigs eat in a day is hay, the intake of which you cannot measure by eye but need to replace to keep your piggies going and fit enough for any treatment. It is the silica in the grass/hay fibre that keeps the grinding back teeth abraded and against which the growth rate in guinea pigs has evolved. Your home care and feeding support for as long as needed is as important as any dentals, as is your overall normal diet. Many people overfeed on pellets and soft foods, which take away from the crucial hay.
This comprehensive guide with pictures and videos addresses all possible aspects of support care in practical detail, including emergency support: All About Syringe Feeding and Medicating Guinea Pigs with Videos and Pictures
I hope that this helps you. Please take the time to read the links; you will find them very helpful and informative.

All the best!
 
Hi
Please ask your treating vets whether they would be willing to have your piggy referred to the Cat&Rabbit Care Clinic in Northampton. They are doing about 25 piggy dentals in a week and have the best experience in the whole UK. Because of the high demand, they only take on new customers from vets who are unable to do cope with providing the dental care themselves.
The Cat and Rabbit Clinic, Northampton - Referrals for guinea pigs with dental issues
Please switch to syringe feeding support and weighing daily at the same time on your kitchen scales immediately. Three quarters of what guinea pigs eat in a day is hay, the intake of which you cannot measure by eye but need to replace to keep your piggies going and fit enough for any treatment. It is the silica in the grass/hay fibre that keeps the grinding back teeth abraded and against which the growth rate in guinea pigs has evolved. Your home care and feeding support for as long as needed is as important as any dentals.
This comprehensive guide with pictures and videos addresses all possible aspects of support care in practical detail, including emergency support: All About Syringe Feeding and Medicating Guinea Pigs with Videos and Pictures
Hi,
Thanks so much for your reply.

She has an appointment with the cat and rabbit clinic already :) but my current vet won’t condone conscious dentals and therefore won’t send her clinical history.

She’s gaining with the amount I’ve fed her and I plan to increase how much I give her. Of course I want her to eat on her own also so I am finding the balance but she has been steadily gaining or maintaining. No loss since she came home
 
It's definitely worth a chat with Kim and Simon at the Cat and Rabbit Care Clinic before making any decisions.
It a a good sign she has perked up again and is eating and putting on weight!
You're doing a great job for her and certainly have nothing to feel guilty about; you've done more than many people would.
We had one pig in at the rescue who had a conscious dental with Kim. We could be in the room with him but he was literally starving to death before hand. Desperately hungry but just couldn't eat.
When we went in to the room to see him after he was bright as a button munching on some spinach like nothing had happened! He went on to live a long happy life in his new home.
I really hope Simon and Kim can help your piggy like they helped Duke; if anyone can, it's them!
Best of luck for your appointment x
Thank you, that’s great to hear!
I am concerned my current vet was so against conscious dentals. They’re an experienced exotics vet and they’re on the approved lists on here. I definitely trust them so I am concerned about analgesia (or lack of?) for the conscious procedure.

I’ve had piggies my whole life and somehow managed to avoid a pig with dental issues.
 
Thank you, that’s great to hear!
I am concerned my current vet was so against conscious dentals. They’re an experienced exotics vet and they’re on the approved lists on here. I definitely trust them so I am concerned about analgesia (or lack of?) for the conscious procedure.

I’ve had piggies my whole life and somehow managed to avoid a pig with dental issues.

The Cat & Rabbit Care Clinic are proper vets who specialise in seeing cats, rabbits, guinea pigs and other small rodents only; they are NOT rodentologists whose conscious dentals can and have caused permanent harm, which is why many exotics refuse to consider conscious dentals.

The C&R will use anaesthesia where needed but provide conscious dentals where possible. It is the flexible approach that has proven key to success in treating dentals. If you wait until the teeth have overgrown again for filing/burring under full GA, then you always start back in square one; piggies are also often much more reluctant to start eating on their own again.
If you provide conscious follow-up dentals in gradually longer intervals as soon as the teeth start overgrowing again, then you give them a chance to normalise for the longer term and the impact on the piggy is not as large as a regukar full GA. It all depends on the nature of the problem and on how bad things are, of course.

The C&R has certainly saved many a forum piggy's life over the years, including some of my own; if in the majority of cases not necessarily for dental problems. They are my closest with guinea pig experience. I hope that they can help you.

Unfortunately, it is sadly still more of an ideological divide rather than a practical one. :(
 
The Cat & Rabbit Care Clinic are proper vets who specialise in seeing cats, rabbits, guinea pigs and other small rodents only; they are NOT rodentologists whose conscious dentals can and have caused permanent harm, which is why many exotics refuse to consider conscious dentals.

The C&R will use anaesthesia where needed but provide conscious dentals where possible. It is the flexible approach that has proven key to success in treating dentals. If you wait until the teeth have overgrown again for filing/burring under full GA, then you always start back in square one; piggies are also often much more reluctant to start eating on their own again.
If you provide conscious follow-up dentals in gradually longer intervals as soon as the teeth start overgrowing again, then you give them a chance to normalise for the longer term and the impact on the piggy is not as large as a regukar full GA. It all depends on the nature of the problem and on how bad things are, of course.

The C&R has certainly saved many a forum piggy's life over the years, including some of my own; if in the majority of cases not necessarily for dental problems. They are my closest with guinea pig experience. I hope that they can help you.

Unfortunately, it is sadly still more of an ideological divide rather than a practical one. :(
Thank you! I completely understand they are real vets and my current vet was aware of the practice but still not willing to refer.

He said they tip them on their backs which I’m pretty sure isn’t the case. He also explained how painful it would be to have someone file an already painful tooth. I completely understand this but wasn’t sure whether local analgesia was provided. I plan to keep the appointment with C&R and make a decision after seeing them. They seemed quite confident on the phone.

If C&R said PTS was the only option we would go for it, or alternatively consider the surgery to remove the teeth but it seems like recovery will be tough.

I trust my current vet so I think they’re trying to do the best for my girl but I also want to keep her for longer and avoid PTS if I can. I imagine that the procedure is different to when they last read about it. I also feel bad about ‘going behind the back’ of my current vet.

I have seen GA dentals many times but never been in a practice that offers conscious dentals so I’ve never seen the process myself. I have heard amazing things though.

I’m also aware that if she has the teeth removed she will require further dentals which current vet would do under GA so it won’t cure the issue. She’s had 2 GAs in less than 2 weeks too so I’m keen to avoid more considering perioperative death for piggies is around 3.8%

Having read all the literature I can find around macrodontia and conscious dentals (rodent dental textbooks) it all seems to have a negative outlook but a lot of it is outdated. I can’t find anything inpractice articles or other veterinary texts to make an informed decision on it and I was wondering if anyone else had dealt with macrodontia in piggies and if they went for removal or conscious dentals.

I know PTS is never a welfare issue and it would never be cruel to make that choice but it feels so wrong for me to let her go when usually I am confident that I am making the kindest decision to PTS.
 
Sorry I meant I wasn’t sure whether *local anaesthesia and analgesia was provided. To be honest, I just don’t know enough about the process
 
Thank you! I completely understand they are real vets and my current vet was aware of the practice but still not willing to refer.

He said they tip them on their backs which I’m pretty sure isn’t the case. He also explained how painful it would be to have someone file an already painful tooth. I completely understand this but wasn’t sure whether local analgesia was provided. I plan to keep the appointment with C&R and make a decision after seeing them. They seemed quite confident on the phone.

If C&R said PTS was the only option we would go for it, or alternatively consider the surgery to remove the teeth but it seems like recovery will be tough.

I trust my current vet so I think they’re trying to do the best for my girl but I also want to keep her for longer and avoid PTS if I can. I imagine that the procedure is different to when they last read about it. I also feel bad about ‘going behind the back’ of my current vet.

I have seen GA dentals many times but never been in a practice that offers conscious dentals so I’ve never seen the process myself. I have heard amazing things though.

I’m also aware that if she has the teeth removed she will require further dentals which current vet would do under GA so it won’t cure the issue. She’s had 2 GAs in less than 2 weeks too so I’m keen to avoid more considering perioperative death for piggies is around 3.8%

Having read all the literature I can find around macrodontia and conscious dentals (rodent dental textbooks) it all seems to have a negative outlook but a lot of it is outdated. I can’t find anything inpractice articles or other veterinary texts to make an informed decision on it and I was wondering if anyone else had dealt with macrodontia in piggies and if they went for removal or conscious dentals.

I know PTS is never a welfare issue and it would never be cruel to make that choice but it feels so wrong for me to let her go when usually I am confident that I am making the kindest decision to PTS.

The dentals happen behind the scenes. But both Simon and Kim are well aware of all aspects in terms of pain or bodily distress, including any potential strain on the heart; putting a piggy on the back is not something they do for that reason. As mentioned, they are not home DIY rodentologists.
They have got all the practical experience as to how to approach and deal best and most safely with the various issues and aspects, seeing more dental piggies in a week than most exotic vets in a year and most general vets in their whole career, and having done so for many years now.

I have experienced the sensitivity and care they take first-hand when looking after a friend's old and increasingly frailer piggy with a painful dental issue (thickened incisor not wearing down properly and causing pain in the jawbone as well as infection in the surrounding tissue) on top of several underlying age related problems and in challenging weather this summer; especially the moment when he became too frail (showing the first warning sign of bodily distress) for a continuation of the ongoing conscious dental and it was immediately stopped.

But you will have to find that out for yourself; you are the owner and any decisions lie with you, and only you. At the very best you'll have a piggy able to go on for a goodly while longer; at the very worst you'll have the reassurance that you have truly done all you possibly could.
 
T
The dentals happen behind the scenes. But both Simon and Kim are well aware of all aspects in terms of pain or bodily distress, including any potential strain on the heart. As mentioned, they are not rodentologists. They have got all the practical experience as to how to approach and deal best with the various issues and aspects, seeing more dental piggies in a week than most expotic vets in a year and most general vets in their whole career, and having done so for many years now.

I have experienced the sensitivity and care they take first-hand when looking after a friend's old and increasingly frailer piggy with a painful dental issue on top of several underlying age related problems and in challenging weather this summer; especially the moment when he became too frail (showing the first warning sign of bodily distress) for a continuation of the ongoing conscious dental and it was immediately stopped.

But you will have to find that out for yourself; you are the owner and any decisions lie with you, and only you. At the very best you'll have a piggy able to go on for a goodly while longer; at the very worst you'll have the reassurance that you have truly done all you possibly could.
Thank you again!

You’re absolutely right. It’s just difficult 2 vets that I know are both amazing at what they do having such polar opposite views.

I was hoping C&R had given someone an in-depth run down. I did see the guinea pig vet had reservations, saw the technique, and then adopted it herself after coaching from Simon so that is a good sign:

My partner has actually contacted C&R directly for more information to help put our minds at ease ahead of our appointment.
 
Hi, C&R do not put piggies on their backs to carry out dentals. They are securely wrapped in a small towel and stood on a table in a normal standing position and held by a nurse. The vet then sits face to face with piggy.
As piggies teeth continually grow and ware down they don't have roots in the way we do, so filing/burring of overgrown teeth should not usually be painful, unless a root is infected or something. I am sure Simon and Kim will be happy to discuss whether or not pain relief is required in your case and if a conscious dental is the best option or not.
I think some vets, understandably, are concerned about how stressful the procedure might be but anaesthatising a piggy is also stressful and carries its own risks. It is a case of balancing what is best for each individual.
 
Hi, C&R do not put piggies on their backs to carry out dentals. They are securely wrapped in a small towel and stood on a table in a normal standing position and held by a nurse. The vet then sits face to face with piggy.
As piggies teeth continually grow and ware down they don't have roots in the way we do, so filing/burring of overgrown teeth should not usually be painful, unless a root is infected or something. I am sure Simon and Kim will be happy to discuss whether or not pain relief is required in your case and if a conscious dental is the best option or not.
I think some vets, understandably, are concerned about how stressful the procedure might be but anaesthatising a piggy is also stressful and carries its own risks. It is a case of balancing what is best for each individual.
Thanks so much for your reply!

Simon actually called me pretty promptly after my partner emailed and explained the process in depth over the phone and highlighted common misconceptions.

I feel much more reassured that exploring this option is the right thing for her. I will know that if nothing can be done we at least tried our best.

The care demonstrated by calling further increased my confidence in the practice and they can’t be faulted in any way by me thus far.
 
I used to take my Boy Ted for several years to the C&R for conscious dentals and the conscious dental procedure is the piggie stands on all four feet on the bench and is held around the back end by the vet nurse while Simon gently files the spur down using tiny files. The piggie wears a dental brace and cheek separator, It takes about 5 minutes in total with regular breaks if the piggie needs it. Simon and Kim are amazing and gave my Ted an extra 2.5 years of happy and healthy life after our local vets (a very well respected group in Cornwall) told me to have him PTS. You are the customer here and you pay the bills and your vet should send over the notes if this is your wishes. Otherwise give the C&R a call yourself. Simon and Kim probably don’t need them anyway, they will assess the teeth there and then and do any work needed

When it comes to dental issues Simon and Kim are the go to vets in the UK

Good luck
 
I run a guinea pig charity that specialises in offering sanctuary places to guinea pigs with ongoing health issues, primarily dental problems. We are only able to do what we do, because of the amazing skill of Simon and Kim Maddock, at the Cat and Rabbit Care Clinic. I've lost count of the amount of guinea pigs, who have come to us, after being given a death sentence, by other vets and in 11 years of running TEAS, we have only had three piggies, who haven't done well, long term!
You are definitely doing the right thing to get your piggy seen by Simon! xx
 
Thank you both!

My girl is doing really well. There’s still another week until her appointment with C&R but she’s gaining steadily without much help from me at all. Still on metacam but she’s up 120g since she came home from the vets on the 16th so I’m pretty happy with that. Eating hay and pellets herself and honestly only getting a small amount of critical care from us.
 
That’s great news. I remember Ted eating hay for the first time in 2 months after his first dental and we hadn’t even left the vets. We owe Simon and Debbie @furryfriends (TEAS) for helping us with Ted 😊
How amazing! I’m hoping C&R can help and she will be able to continue to gain and then maintain without any help from us at all (in between dentals).

But so far she’s doing really well. Her normal weight is closer to a kg so she still has a little way to go.

It’s been so stressful these last few weeks and having another sow with lymphoma I just want to enjoy them for a little while
 
How amazing! I’m hoping C&R can help and she will be able to continue to gain and then maintain without any help from us at all (in between dentals).

But so far she’s doing really well. Her normal weight is closer to a kg so she still has a little way to go.

It’s been so stressful these last few weeks and having another sow with lymphoma I just want to enjoy them for a little while
Aw, yes it’s been extremely stressful for you, you are giving her the very best chance with Simon. I hope you have many, many happy times with both your piggies 😊
 
I had a similar situation to you.i visited a very competent exotic vet with a male piggie who had spurs on one of his teeth.H
e had been admitted for bloat at the exotic vet.He pulled through.But he was chewing like he had a piece of glass in his mouth.
I was still fairly new in my piggie journey.i had my piggie seen at the cat and rabbit clinic for his teeth and he improved rapidly.unfortunatley the Maddocks were on annual leave.Jerry had bloat again,but when my exotic vet became aware i had taken Jerry to the Cat and Rabbit vet.The vet expressed deep concerns with the methods of unconcious dentals,he disagreed and refused to treat Jerry.unfortunatley Jerry did not survive this further episode of bloat.
Ive been on the difficult receiving end of this.Now any piggie with dental problems i always use the cat and Rabbit clinic,as they are the best.i hope you have a fruitful outcome with you piggie.
 
I had a similar situation to you.i visited a very competent exotic vet with a male piggie who had spurs on one of his teeth.H
e had been admitted for bloat at the exotic vet.He pulled through.But he was chewing like he had a piece of glass in his mouth.
I was still fairly new in my piggie journey.i had my piggie seen at the cat and rabbit clinic for his teeth and he improved rapidly.unfortunatley the Maddocks were on annual leave.Jerry had bloat again,but when my exotic vet became aware i had taken Jerry to the Cat and Rabbit vet.The vet expressed deep concerns with the methods of unconcious dentals,he disagreed and refused to treat Jerry.unfortunatley Jerry did not survive this further episode of bloat.
Ive been on the difficult receiving end of this.Now any piggie with dental problems i always use the cat and Rabbit clinic,as they are the best.i hope you have a fruitful outcome with you piggie.
So sorry you lost Jerry 😞 I really don’t understand these vets that think conscious dentals are cruel. My Ted had both GA and conscious. The GA dentals were both poor, not done by Simon and he suffered for months because of them. Simon always says it’s a matter of doing a dental well and that’s what is important
 
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