Teeth extraction to treat aggression?

[Chapelle]

I'm COMPLETELY with the AVMA on this and think this practice is indefensible.

http://veterinarymedicine.dvm360.com/vetmed/ArticleStandard/Article/detail/663384/

How about you?

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[StartingoverVet]

Indefensible? Sorry, but sometimes unpalatable solutions are worthwhile to consider.

In this article the owner gives the choice of euthanasia or extraction. If the owner is inflexible then it is surely worth trying the extraction rather than going to straight to euthanasia. This could also buy some time to talk the owner into other strategies that are more likely to succeed.

Should a vet recommend this as a solution? Perhaps not, but that doesn't mean in a situation as presented it shouldn't be considered.

 

[VeganSoprano]

Sorry. Duplicate post.

 

[VeganSoprano]

As a profession, we consider it acceptable to amputate a cat's toes in order to protect furniture. Why not consider it an option to extract teeth as part of a treatment for aggression? The safety of humans and other animals is certainly more important than the safety of someone's furniture, and bites inflict far more serious injuries than scratches. Extraction should not be the first choice, but it has to be on the table as an option.

I once read about a shelter that found someone willing to adopt an FIV+ cat, but on the condition that his canines were extracted so he would be unlikely to transmit the virus to the other household cats. The shelter paid for the procedure. I'd do the same in a heartbeat. An elective oral surgery is a small price to pay when the alternative is death.

 

[Nechochwen]

The choice between dental extraction and euthanasia may make this procedure seem like a more viable last-option, it does worry me about having it as a choice at all. It obviously should be considered a last-option procedure after extensive attempts at fixing the root problem of the behavior; but if the public considers it an accepted option, they may be more and more inclined to asking for it with less behavior work.

De-clawing of cats follows the same logic, that de-clawed cats are less likely to end up in the shelter. (I believe that is the case, I don't know for sure) Cats are declawed without behavior training and the practice is accepted. Now I know that declawing is very different than extensive dental extraction and I'm not putting down declawing, but I wouldn't want tooth extraction to become as popular.

I guess the real problem is trying to keep the extractions as a true last resort procedure.

 

[No Imagination]

Ok... I understand the argument behind declawing vs. euthanasia, and I respect the logic (exactly the kind of argument I like to make) - but I can't bring myself to accept it.

A) I've never heard of anything more disgusting
B) I rarely make emotional decisions (and I am eager to hear other peoples ideas), but if it really comes down to Extractions or Euthanasia (ie, no behavioral modifications worked) - I'd rather see the animal put down (think its better for all involved).

Also, for some reason I am only thinking of dogs here, and aggression towards people. Haven't read the AVMA article yet (too early), but I'll get back after I look it over.

 

[breenie]

I'm sorry, but that client would have to walk down the road, because I would refuse to do the procedure.

The article didn't mention other that alternatives had been tried. Take your dog to a behaviorist. Find out why a tiny little Westie has turned into an aggressive jerk.

Removing teeth doesn't solve aggression. You're still going to have a nasty, frustrated dog who is probably going to get more aggressive because he feels like he can't defend himself. I don't think it would improve the dog's quality of life, and if the owners really wanted it, they could go somewhere else.

 

[katryn]

I think this would be an absolute last resort procedure requiring a very dedicated and determined owner. 1.) They have to have already thoroughly tried behavior modification, and had it work to some degree of making the animal controllable. 2.) Be willing to go to a dental specialist for the extractions. 3.) Understand completely that their dog will still have to be treated and handled as an aggressive dog.

Even then I don't really think it's a solution to the problem. An animal's jaw can still cause a lot of damage without teeth.

 

[twelvetigers]

I once read about a shelter that found someone willing to adopt an FIV+ cat, but on the condition that his canines were extracted so he would be unlikely to transmit the virus to the other household cats. The shelter paid for the procedure. I'd do the same in a heartbeat. An elective oral surgery is a small price to pay when the alternative is death.

I don't agree with the agression based reasoning, but the FIV thing mentioned by VS intrigues me. My mom has a FIV+ cat that she let's intermingle with the other cats, and he's a male so he probably does still fight. It drives me nuts. He's eleven now, and doing well healthwise still. If I could have taken his canines out at age 3 and decreased the chances of passing on the disease, that would have been a consideration at least. Add to this equation the cost of vaccinating probably... 25 or so? cats for FIV. Some that were still pretty feral.

It's so odd to think that my family was (is?) THAT family, lol. I'm making progress, but it's tough.

Like I said though, for aggressive dogs, taking out teeth will decrease the severity of the wounds but will NOT stop (or even alter) the behavior.

 

[Pigsfoot]

I haven't read the article yet, but this just makes me think of when major dental extractions are done for health's sake, often times a pet ends up with few to no teeth by the time they are old. (my 13 y.o. cat has 3 teeth left in his head, and after this upcoming dental i'll be glad if he has 2 left!) I dont think the pet suffers at all without teeth as long as they're able to get their nutritional requirements by eating the proper food.

however-i agree, it doesnt solve the aggression. i've been gummed by many angry toothless animals, and that sure didn't make it any more pleasant.

 

[Bill59]

I have a hard time imagining a case where full mouth extraction is a good idea to "treat" aggression.

-It doesn't treat the problem at all. Most dogs bite because of anxiety and by not addressing the underlying anxiety you aren't fixing the problem. The dog is still suffering from the anxiety.

- Ever been bit by a toothless dog? It still hurts. A large dog could still break fingers and seriously injure someone, especially a child. What is your liability when this dog injures someone after you've removed the teeth to "treat" the problem?

- Millions of healthy, non aggressive dogs are euthanized every year. What's so bad about euthanizing a dog that's a danger to people and other animals to make room for another dog to have a home?

 

[VeganSoprano]

I opted to extract my cat's 2 reasonably healthy teeth last year when she needed all the rest extracted due to FORLs. (I should clarify that her canines needed to be extracted and we did leave the few incisors she had left.) My reasoning was that 2 teeth weren't going to be of any use to her but were very likely to develop FORLs down the line. It seemed silly to set her up for another anesthetized procedure, and myself for another significant expense, when we could permanently eliminate the problem without causing her any additional discomfort. I would have reconsidered if she hadn't been handling the anesthesia well, but she was doing great so the teeth came out. So my now-8-year-old cat has exactly one lower incisor. She's quite the little hillbilly. I've had a total of 3 full mouth extractions on my animals, so I admit that I'm a little biased toward regarding it as no big deal.

 

[Tco87]

I feel like it's hard to really weigh in on this without more information.

Personally, if the owner hadn't consulted with a veterinary behaviorist and tried EVERYTHING they recommended, I would refuse to euthanize or do a dental procedure until they did.
If the owner had tried everything conceivable and the dog was still being aggressive, I would most likely recommend euthanasia. This would depend on the specific details of the case, like how aggressive the dog really was, who the dog was aggressive towards, etc. A dog who's constantly aggressive to everyone, even his owners, is probably living a miserable life and puts a lot of people in danger.
I agree with the sentiments that taking out an animal's teeth doesn't prevent that animal from causing serious damage when they bite, so if the owners really were concerned about their safety, then I think the only answer is to treat the core behavior issue, or if it's untreatable, humanely euthanize.

 

[su_grad2007]

I really don't think that removing the teeth will really do much. There are multiple causes of aggression and the underlying cause of the behavior would need to be treated and treatable. I wouldn't consider doing the surgery or euthanizing the animal without knowning that the owner was working with either a veterinary behaviorist or a certified applied animal behaviorist (CAAB) and I would want to consult with the specialist myself before coming to any conclusions.

I just don't think pulling the teeth will really solve the problem. The dog will still be aggressive.

 

[cowgirla]

Personally, if the owner hadn't consulted with a veterinary behaviorist and tried EVERYTHING they recommended, I would refuse to euthanize

This sentence jumped out at me. You don't think that aggression is a valid reason for euthanasia? What if the owners can't afford a specialist? IMO, by saying that, you're punishing the dog even more so than you are the owners. It's not always black and white, and honestly, I would rather see the dog euthed than live a miserable aggressive life with owners who are either unable or unwilling to pursue different options. What if you decline to euth, and they DONT go elsewhere? What if they just lock the dog in a crate and proceed to neglect him because "they didn't want him anymore, anyway." Or they put an ad on craigslist, and send him home with first unsuspecting person. That person can't handle him, and rehomes again, and again, and again. Who loses? the dog.

I'm certainly not a supporter of "convenience euthanasias" of perfectly healthy and sane animals, but this is a whole different ballgame.

 

[rileydog]

I'm sorry, but that client would have to walk down the road, because I would refuse to do the procedure.

The article didn't mention other that alternatives had been tried. Take your dog to a behaviorist. Find out why a tiny little Westie has turned into an aggressive jerk.

Removing teeth doesn't solve aggression. You're still going to have a nasty, frustrated dog who is probably going to get more aggressive because he feels like he can't defend himself. I don't think it would improve the dog's quality of life, and if the owners really wanted it, they could go somewhere else.

Completely agree. I have added this to my list of elective procedures -declawing, convenience euthanasia, ear crops and tail docks - that I will not do. Definitely do not want to start an argument on the pros and cons of these procedures. This is a personal decision that I have made to not perform these procedures. In this case, I would refer the dog to another vet and/or a behavior specialist. I don't know the specifics but agree that if the aggression is fear based, removing the teeth will not do anything. The dog will still be afraid and will probably become more creative in acting out its aggression/fear. And what happens to the dog when the aggression is not cured? It gets euthanized a little further down the road after going through a painful, and at this point, unnecessary surgery?

 

[WhtsThFrequency]

A dog that is still aggressive after all the behavioral modification attempts, training, drugs, etc does not need teeth extraction. It needs to be euthanized. Period.

Maybe that is a harsh way of looking at things, but a dog that is a danger to people and other animals, and is refractory to behavior modification, and cannot be managed, needs to be put down, just like any other dangerous animal. And this is coming for someone who has spent years working with her own fear/dog-aggressive dog, making tiny steps at a time. If Ginny, as much as I loved her, had not improved, I know what I would have had to do.

Taking teeth out does nothing to solve anything except keep the dog alive for a few more months until the owner gets sick of the dog's inability to change its aggressive behavior, even if its bites hurt less, and euthanizes it anyway.

The case mentioned in the article does sound quite fishy though. I would like to know more background. I agree with rileydog and would refer such an owner to a behaviorist if such a thing had not been already tried with no results

 

[Tco87]

This sentence jumped out at me. You don't think that aggression is a valid reason for euthanasia? What if the owners can't afford a specialist? IMO, by saying that, you're punishing the dog even more so than you are the owners. It's not always black and white, and honestly, I would rather see the dog euthed than live a miserable aggressive life with owners who are either unable or unwilling to pursue different options. What if you decline to euth, and they DONT go elsewhere? What if they just lock the dog in a crate and proceed to neglect him because "they didn't want him anymore, anyway." Or they put an ad on craigslist, and send him home with first unsuspecting person. That person can't handle him, and rehomes again, and again, and again. Who loses? the dog.

I'm certainly not a supporter of "convenience euthanasias" of perfectly healthy and sane animals, but this is a whole different ballgame.

If someone couldn't afford to see a specialist and wanted a clearly aggressive animal euthanized, I would support that. I agree with you, it's not fair to the animal to keep them in that situation if I know the owner's not going to seek treatment. But the fact that this owner was willing to pay for multiple extractions indicates that they have money to spend on a behavior specialist. My statement was purely directed at the scenario that an owner wanted their dogs teeth extracted or to have the dog euthanized. If an owner came in and just said "My dog's aggressive, I want him/her put down" then my approach would be completely different.

 

[StealthDog]

A dog that is still aggressive after all the behavioral modification attempts, training, drugs, etc does not need teeth extraction. It needs to be euthanized. Period.

Yes, yes, yes. There is no consideration for the pet's quality of life when tooth extraction is used to "treat" aggression- the underlying motivation for the aggression is still there, and I think a life of constant anxiety and frustration is a form of suffering.

 

[WhtsThFrequency]

I think a life of constant anxiety and frustration is a form of suffering.

👍 Exactly. I was referring both to the safety of the owner and/or other animals as well as the aggressive animal's quality of life. You're very right. It would be a constant life of misery for the animal, perhaps even worse for fear aggressive animals because their only form of attack/defense has been removed.

 

[WhtsThFrequency]

But the fact that this owner was willing to pay for multiple extractions indicates that they have money to spend on a behavior specialist..

They may have already spent money, and perhaps a lot of it, going that route. We just don't know fromt he story

If an owner came in and just said "My dog's aggressive, I want him/her put down" then my approach would be completely different.

True - that's where owner counseling comes in, referring, etc.

But even if a ******ed owner came in, refused all referrals, refused everything, just wanted the dog put down...I would have to say that honestly I would do it because a) I want to make sure it is done right, and not at a chop shop down the road, b) if i don't the dog may up in a shelter and gassed or worse, c) the animal may linger for months or years being shut up in basements, tied up in the yard, no human contact, slowly going insane.....sometimes as much as you hate the fact that people are stupid and just want the darn thing dead....you have to do the right thing for the DOG'S sake. Sad 🙁 but true.

 

[WhtsThFrequency]

T What if you decline to euth, and they DONT go elsewhere? What if they just lock the dog in a crate and proceed to neglect him because "they didn't want him anymore, anyway." Or they put an ad on craigslist, and send him home with first unsuspecting person. That person can't handle him, and rehomes again, and again, and again. Who loses? the dog.

I'm certainly not a supporter of "convenience euthanasias" of perfectly healthy and sane animals, but this is a whole different ballgame.

Cowgirla, my sentiments exactly, I typed before I fully read your post 👍

 

[jpeterman13]

But even if a ******ed owner came in, refused all referrals, refused everything, just wanted the dog put down...I would have to say that honestly I would do it because a) I want to make sure it is done right, and not at a chop shop down the road, b) if i don't the dog may up in a shelter and gassed or worse, c) the animal may linger for months or years being shut up in basements, tied up in the yard, no human contact, slowly going insane.....sometimes as much as you hate the fact that people are stupid and just want the darn thing dead....you have to do the right thing for the DOG'S sake. Sad 🙁 but true.

That's kind of what I was thinking...because who's to say that after you refuse, they wouldn't let the dog go on the freeway and drive off, or do something else that's simply terrible. It is very sad--but very, very true.

 

[milkmaid]

If a healthy dog is aggressive enough that the owner is considering something as intensive as removing all the dog's teeth... that dog should be put down. Period. It's for the safety of the family and general population.

After all, the typical owner doesn't come up with suggestions like removing all a dog's teeth without reason. It's likely that the dog doesn't just growl at the mailman, but has bitten someone (and seriously!) at least once and probably over more than just a food dish.

I've spent more time in small animal clinics than large animal clinics, done a lot of breeding/training/showing dogs, but the small-animal-owner mentality is one of the main reasons I refuse to be a small animal vet. Hats off to those of you who don't mind working with those clients.

 

[Tco87]

If a healthy dog is aggressive enough that the owner is considering something as intensive as removing all the dog's teeth... that dog should be put down. Period. It's for the safety of the family and general population.

After all, the typical owner doesn't come up with suggestions like removing all a dog's teeth without reason. It's likely that the dog doesn't just growl at the mailman, but has bitten someone (and seriously!) at least once and probably over more than just a food dish.

No, the typical owner wouldn't want a dog's teeth pulled unless the aggression issues were very serious, but you can't assume that this person is "typical". For all we know, they're claiming that the dog is psychotically aggressive, but the real issue is it's chewing the furniture. However, they know better than to expect a vet to extract teeth over furniture destruction. I believe that most pet owners are great and well-intentioned, but I've met people who would seriously euthanize or request tooth extraction over something like furniture destruction.

Looking at it another way, maybe this dog is only dog aggressive, and not people aggressive. Yes, he still poses a risk if he redirects his anger at another dog towards his owner, but in my opinion (and I don't have much experience with this so I could be wrong) that's much more manageable.
Essentially, what I'm trying to say is that I don't trust the lay person's ability to assess their dog's aggression and decide what treatment it needs. There are probably a lot of people out there who don't realize that certain forms of aggression in their pets can be treated. Also, the fact that these people think that removing their dogs teeth will fix the problem makes me question their reasoning.

 

[VeganSoprano]

Hey, again vets declaw to spare the furniture, often without a second thought.

I think my main issue is with the concept of extraction as a "treatment" for aggression. It's not. A dog who is seriously aggressive is probably a genuinely unhappy animal and that needs to be taken into account. Extraction is just a tool to mitigate the potential damage. This may be something that is done in order to safely give behavior modification +/- medical management time to work, or it may be a strategy for a very narrow problem that has been refractory to other types of management, such as resource guarding in a home with an intellectually disabled or autistic child who cannot be taught to leave the dog alone in these circumstances. And the potential for extraction to actually mitigate damage must also be considered. An aggressive Presa Canario can do serious damage with or without teeth. A Westie's jaw is not likely to leave anything more serious than a bruise.

To use another example unrelated to aggression: I know a relatively young cat who was recently euthanized for obsessive-compulsive fabric chewing that was refractory to medical management. Despite his family's best efforts, he was a master at exploiting any opportunity such as a dresser drawer left slightly ajar. He averaged one foreign body surgery every 6 months and had multiple partial obstructions that resolved with some combination of fluid therapy, w/d, and barium. Eventually his family made the heartbreaking but completely reasonable decision to euthanize rather than go through with yet another surgery. I think extraction of the teeth, or at least the premolars, would have to be a very reasonable option to consider in cases like this. It wouldn't treat the underlying pathology but at least he could gum fabric to his heart's content without posing any danger to himself.

I think that in general, if a particular body part is posing a threat to that individual's survival *and* good QOL is possible without that body part, then its removal has to at least be an option. After all, it's an option as part of a treatment plan when a spleen is necrosing after a GDV or a femur is riddled with osteosarcoma or a tail is mangled in an accident. I think the same basic standards need to apply here. It's better to live a *good* life without something than to die with it.

 

[Chapelle]

Hey, again vets declaw to spare the furniture, often without a second thought.

I don't agree with that either. I used to work at a hospital where declaws were offered along with sterilization of kittens - like a package deal of routine elective surgeries. It made me sick because these animals were not even given a chance at keeping their toes and because declaws were treated as on par with S/N.

I do think that teeth extraction is on a whole other level of 😡 though because of the reasons previously discussed (it does not treat the problem and will not improve an aggressive animal's terrible quality of life). Maybe there are super special cases like the furniture chewing cat but I don't think full mouth extraction should be a procedure the public even knows is an option - if there is a super special case like that cat, the vet can propose it as part of his/her secret arsenal of creative solutions (assuming the cat doesn't start just swallowing things whole).

 

[WhtsThFrequency]

I used to work at a hospital where declaws were offered along with sterilization of kittens - like a package deal of routine elective surgeries.

I probly know which hospital that was....

 

[Packen]

I think my main issue is with the concept of extraction as a "treatment" for aggression. It's not. A dog who is seriously aggressive is probably a genuinely unhappy animal and that needs to be taken into account. Extraction is just a tool to mitigate the potential damage. This may be something that is done in order to safely give behavior modification +/- medical management time to work, or it may be a strategy for a very narrow problem that has been refractory to other types of management, such as resource guarding in a home with an intellectually disabled or autistic child who cannot be taught to leave the dog alone in these circumstances. And the potential for extraction to actually mitigate damage must also be considered. An aggressive Presa Canario can do serious damage with or without teeth. A Westie's jaw is not likely to leave anything more serious than a bruise.

I could not agree more with this statement or with the AVMA's stance on the subject. I feel that just extracting teeth for aggression is going against one of the main objectives of being a vet - to treat an animal's affliction, not just address a symptom. Why not just install permanent urinary catheters and collection systems for cats that mark in the house?

Behavioral problems should be addressed just like any other medical problem, IMHO. The general vet should do everything in their power to treat the problem and then if they cannot adequately help the animal, refer it to a specialist. I know that many clients cannot afford to go to a specialist, whether it be a behaviorist or a cardiologist. At that time then I think the vet and owners would need to assess the animal's quality of life and take the next steps accordingly.