pokes r us.
I am sorry to hear that this happened to you. In my experience, such events are very rare and becoming less and less frequent as technology allow us (veterinarians) to determine which patients are higher risk for anesthesia and to monitor patients closely while they are under. Just like in human medicine, there is always risk involved with any anesthetic procedure, but there are things that can be done to reduce that risk to a very low level.
The next 3 paragraphs were posted, by me, in another thread on this board.
IMO, in general, most dogs/cats should have a professional dental cleaning annually after about age 3. Some of my patients need it as early as 1.5 years of age. Some of my patients never look like they need it. If your dog has tartar accumulating on teeth or if the gumline is red and inflamed, he/she needs a professional dental cleaning. Not only do I think it will lead to better overall health, but it will prevent future pain when eating/chewing, as well as future tooth loss.
Patients must be anesthetized in order to do a good job. Some vets might cut corners when it comes to anesthesia, and that is something to watch out for. In my office, clients do not get a choice when it comes to anesthesia. Every patient has pre-surgical labwork, a pre-surgical EKG, and IV fluids before, during and after the procedure (Helps maintain blood pressure, which promotes good blood flow to the vital organs. Also gives easy access to the circulatory system if the patient needs meds to stimulate breathing, heart rate, etc). Some clients are afraid to anesthetize older patients, but the risk is no greater than that of a 3 year old patient as long as the older patient has normal physical exam, bloodwork and EKG.
Once anesthetized, careful monitoring of BP, Temperature, Heart rate, SpO2, and breathing is of key importance. Basically, you want your vet that sticks to the same level of care that you would get if you were to undergo surgery in a hospital.
All dogs should have 42 adult teeth. Therefore brachycephalic (short nosed) breeds, like the pug, have the same number of teeth as a Jack Russell Terrier, but they are crammed into a much smaller space. This causes crowding, which leads to Plaque accumulation, which leads to infection around the teeth. The infection eats away at the bone around the teeth and allows bacteria to get to other parts of the body as well. Tooth crowding is why smaller dogs tend to have more dental problems than larger dogs. And short nosed dogs have more problems than longer nosed dogs.
I don't know your vet, and have no knowledge of anything that happened to your dog, so I can't tell you what happened. Hopefully he/she took all of the precautions that I outlined above. However, even if all of that happened, it does not wholly eliminate the possibility of anesthetic death. When it comes to anything in medicine, there can never be a 100% guarantee.
I can tell you that, speaking from experience, your veterinarian probably feels absolutely awful about losing your precious pug. In situations like that, the feelings of guilt and the second guessing can be overwhelming. I have had occasions where I have been unable to put such events out of my mind, and where it has kept me from sleeping for multiple nights in a row. I know that probably doesn't make it any easier for you and your wife. I am sorry that you have to go through this.