Dental Handout 1: Surgery Discharge Form
Your Animal Hospital, 123 Plain Street, Anytown 12345; 555.123.4567
Dental Surgery Discharge for Petname
Your pet received a dental surgery procedure including:
a dental prophylaxis
dental radiograph(s)
extraction(s) or crownectomy
gingivectomy
other:
perioceutical treatment
crown restoration
root canal
gingival flap
Dental Prophylaxis
Ultrasonic scaling above and below the gumline was
performed to remove tartar. This debris often goes
unnoticed and is a primary element of periodontal
disease.
Polishing to smooth your pet’s teeth was completed to
help make teeth more resistant to plaque buildup.
BEFORE
AFTER
Dental Radiographs
Dental radiographs can reveal hidden problems within
the tooth and below the gum line. It can help identify
bone loss and root regression due to periodontal
disease and help identify teeth that need to be extracted.
Results of dental radiographs:
________________
_
________________
Dental Surgical Procedures
Procedures performed:
Explanation:
BEFORE
AFTER
Instructions for the Care of your Pet Following Dental Surgery
Please read the following plan for your pet’s recovery. If you have any questions or concerns regarding this
plan, please bring them up with the doctor or technician at the time your pet is discharged from the hospital.
Today and Tonight:
 Until tomorrow, keep your pet quiet and confined in a warm environment, off furniture, and off high places where he
or she could potentially fall.
 Normal activity may be resumed upon arriving home.
 After surgery, your pet may be inclined to drink and eat excessively, which will likely result in vomiting. To avoid
this, do not offer food or water until __________________. You may resume normal feeding tomorrow.
 Begin giving prescribed medications ___________, and continue as directed.
Incision/Wound Care
Check the extraction site(s) daily and notify us if you see any swelling, redness, or drainage. If you are unable to
see the extraction site, you may be able to tell if there is a problem if your pet shows a lack of appetite or
reluctance to eat, and/or is pawing or rubbing the face.
Diet
 Feed softened or canned food for the next _______ days to allow your pet’s mouth to heal.
 Feed ____________________________ for _________ days.
 A permanent diet change to _____________________________ is necessary. In order for this diet to be effective,
it is imperative that you feed only this food. No table scraps or non-prescription treats are allowed.
Appointments
 We need to see your pet back for a recheck examination in _____ days, with __________. Please schedule this at
the front desk.
Monitor
 A decrease in activity or appetite for one to 2 days may be observed, and patients may not have a bowel movement
for 24 to 36 hours after surgery. This is normal. However, if your pet exhibits any of the following symptoms,
please notify the hospital: (1) loss of appetite for over 2 days, (2) refusal to drink water over one day, (3)
weakness, (4) depression, (5) vomiting, or (6) diarrhea.
Special Instructions