June 2021

Can you use spring loaded mouth gags in veterinary medicine? (No.)

In this VETgirl online veterinary continuing education blog, we remind you not to use spring loaded mouth gags – especially in cats! That’s because rare post-anesthesia blindness has been seen when these spring loaded mouth gags are used in cats during dental procedures. If you have these spring-loaded feline mouth gags in your clinic, consider accidentally throwing them in the recycling bin. That’s because they have been associated with blindness secondary to presumptive reduce maxillary artery blood floor when cats’ mouths are opened really wide during dental procedures.

Please help minimize the risk of post-anesthesia blindness by using custom-made plastic gags instead of spring-loaded mouth gags or even the “modified” needle cap technique! Keep in mind a standard 42 mm needle cap also may be too long and should be shortened – ideally in half! If the needle cap is 20 mm (half the size of a standard needle cap), it still allows the mouth to be open enough to do most dental procedures.

So, the ideal mouth gag is HALF of a standard needle cap shown in this first photo:

20 mm syringe mouth gag in a cat; Photos courtesy of Dr. Alexander Reiter

Even though the 30 mm needle cap may allow you to see a bit more of the inside of the mouth, it actually is less helpful than a 20 mm needle cap in terms of retraction of lips and cheeks to expose the teeth and gums for dental procedures. You can see what a 30 mm syringe mouth gag looks like here:

30 mm syring mouth gag in a cat

30 mm syringe mouth gag in a cat; Photos courtesy of Dr. Alexander Reiter

This standard sized syringe cap at 42 mm should NOT be used, as it can contribute potentially contribute to post-anesthesia blindness:

42 mm syringe mouth gag in a cat; Photos courtesy of Dr. Alexander Reiter

42 mm syringe mouth gag in a cat; Photos courtesy of Dr. Alexander Reiter

When in doubt, help minimize these rare anesthetic complications!

Photos courtesy of Dr. Alexander Reiter, Dipl. Tzt., Dr. med. vet., Dipl. AVDC, Dipl. EVDC
© Alexander Reiter

Mouth gags

Download the article on why you shouldn’t use spring loaded mouth gags in cats HERE!

  4. Ann Presler says:

    This blog provides good information. However, there are some spelling errors that make it seem less credible. I love the idea of using needle caps! Great idea!

    • Justine Lee says:

      You’re welcome to email us directly or below and we’ll get them corrected, as we don’t see any.

      Best,

      Justine

  5. Kalley Cline says:

    That is great information, my clinic has been using mouth gags for as long as I have worked here……. I am definitely going to share this information with the owner of the practice.

  6. Jessika Bowden says:

    For some reason I never considered using the cap, I’ve just cut down a 1ml syringe to the appropriate size. But this was a great easy to read article.

  9. Trisha Ljungberg says:

    The last sentence of the first paragraph has some errors, but I love the needle cap idea!

  10. Chelsea Lautner says:

    Great info! At this point I think I just have gotten in the habit of not using anything to hold the mouth open consistently.

  15. Anne Hudson says:

    I’ve never really used anything to hold the mouth open, even back in the day when spring-loaded mouth gags were widely used. To me, it’s just one more thing in the mouth that gets in my way during cleaning, so I just use my fingers. Do people use syringe caps, etc. more often for extractions?

  18. Caroline Garcia says:

    Thankfully, I can say I’ve never used a mouth gag in a cat, and I don’t use them in dogs either. Glad to see they are going the way of the dodo.

  22. Cynthia Bascom says:

    Have been using just my own hands, and in a pinch, a cut down needle cap for years. Thanks for the documentation to support!

  24. Heather Baum says:

    I rarely ever used a mouth gag in any animal but when necessary I tie the spring down to suitable position as to remove the load of the spring on the patient or wrap tape along the slide to do the same thing. I knew about trimming syringe barrels but needle caps are very handy too.

  34. Brittany Zimmerman says:

    I did not know this. At my GP hospital we use old ET tubes but to different sizes. The spring loaded gags tend to rust easily anyway.

  35. sarah cross says:

    although i rarely deal with dental, as i only work emergency/ trauma, this is something i never would have known and is something i will now keep in mind for any sedated oral exams / facial trauma patients.

  39. Katherine Pierron says:

    Spring-loaded mouth gags are one of those things you see people do a hundred times and it’s not a problem until it’s a huge problem. Not worth the risk to the patient or your practice. Great reminder!

  45. Tammy Chamness says:

    Very interesting. I work in an ICU of a specialty clinic, so we do not do dentals. Never even heard of blindness in cats due to mouth gags.

  51. Calla Fisher says:

    I’m so happy I learned this, my previous practice still uses spring gags daily. What an eye opener for me. We will be adjusting our protocols to increase safety for the patient.

  55. Diane Vermillion says:

    I stopped using these over 10 years ago after seeing a patient have jaw issues. Couldn’t imagine one going blind. I don’t use anything and can do the cleaning and evaluation just fine. Great info.

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