First Street Veterinary Hospital Newsletter - February 2008

Dental Health Care for Pets

Periodontal disease is the number one disease of pets today. It is a diagnosis common to all pets, in all age groups, becoming more advanced as pets get older. This disease affects 85 percent of adult dogs and cats, but can strike young pets too. Yet it is very preventable. Factors that influence the development of oral disease include genetics, diet and home care.

Veterinarians believe that periodic professional dental cleanings coupled with home dental care is a critical element of total healthcare for our pets. Periodontitis, inflammation of the tissues, and structures surrounding the teeth, not only causes “doggy breath” but also pain, discomfort and potential tooth loss. It is not normal for your pet’s mouth to have a severe odor. The by-product of bacteria produces this foul odor. Dental disease generally begins with inflammation of the gums and accumulation of plaque on the teeth. Plaque is formed when bacteria combine with salivary debris. Tooth loss, gum bleeding, and pus between the teeth or at the gum line are indicators of advanced periodontal disease. A pet with periodontitis can send a bacterial shower into the blood-stream every time it chews. In turn, these bacteria can affect the heart valves, lungs, liver, and kidneys.

A thorough oral exam is one of the most important parts of our comprehensive exam. Many of our clients are surprised when we point out dental disease in their pets. Clinical signs of disease may include bad breath, excessive salivation, appetite changes, facial swelling, weight loss, pawing at the mouth, and behavioral shifts. Invariably, we suggest home dental care and perhaps professional dental care for your pets, depending on severity. Home dental care is a classic example of preventative medicine.

We can’t change the genetic code of your pet, but we can significantly slow the progression of dental disease through home care. We educate all puppy and kitten owners on basic teeth brushing techniques as part of routine grooming and training. Daily teeth brushing is ideal. It takes 6 to 8 hours for bacteria to attach to the tooth’s surface. The bacteria then absorb calcium from saliva and become mineralized, forming tartar or calculus. This is why brushing is recommended daily, to continually break this cycle. While brushing a few times a week is helpful, brushing weekly does not significantly inhibit the formation of calculus. Do not use human toothpaste when brushing your pet’s teeth. The toothpaste may cause tummy upset and the fluoride levels can be toxic to their kidneys. We recommend and sell CET enzymatic toothpaste, in chicken and mint flavor.

Though there is no substitute for brushing, as it mechanically breaks up the plaque film, there are other home care options when brushing simply is not possible. These include wiping the teeth with medicated wipes, rinsing the mouth with an antiseptic prescription rinse and lastly using chews, such as CET Chews and Greenies. While calculus is reduced by chewing on hard crunchy foods and treats, real bones, rocks, and even ice can cause fractures of the teeth, and are best avoided. We can assume that dental disease causes pets significant chronic pain, just as it does in people. After dental care, it is thrilling to see the dramatic improvements in pets we have treated for advanced dental disease. Their activity levels, appetite, and energy levels often improve significantly.

We would be glad to discuss specific recommendations for your pet, in both the professional and home care realm. We can determine upon exam the need for a prophylactic cleaning (to prevent disease) or periodontal therapy (treatment of current disease) and provide an estimate accordingly. As a rule, smaller breed dogs and cats are more prone to periodontal disease than large breed dogs. The interval between professional cleanings varies based on the same factors that influence development of disease. Some dogs and cats need annual cleanings while some may go a lifetime without the need for this procedure. An adult cat has 30 teeth; and an adult dog has 42. One of our wellness goals is to educate owners to care for each of these teeth over the lifetime of their pet. Dental care isn’t costly, but dental disease is.

February is Dental Month 15% off Dentals!

Clients often wonder just what happens when we do a dental prophy on their dog or cat. We get lots of questions so we thought it would be useful to let you know how we do it at First Street Veterinary Hospital. A dental prophy is a professional cleaning of the teeth in order to prevent dental disease. The word prophy is short for prophylaxis, which means prevention. Other than the need for anesthesia, the visit for a pet’s dental prophy is not unlike a human’s visit to the dentist for a routine cleaning.

Our patients do need to be anesthetized during the cleaning in order to protect the delicate tissue of the gum from tearing due to sudden movement when a dental instrument is placed against the tooth. Patients are checked in for the day between 8 and 9 a. m. This process takes about 15 minutes. Next the veterinarian examines the patient, and pre-anesthesia blood samples are run if needed. The patient is given “pre-meds” which vary with the patient, but are drugs that tranquilize the patient so that there is less fear with the process of anesthesia. Fear causes the release of catecholamines, which are potent hormones involved in the “fight or flight” response. These are not useful and can be harmful during anesthesia. Our pre-meds are for the patient’s safety as well as comfort. They also allow us to reduce the dose of the anesthetic drugs we use, again making the procedure safer.

Next the foreleg is shaved and cleaned so that we can place an intravenous catheter. This allows us to administer IV fluids during anesthesia, to give intravenous medications to induce the anesthesia, and to give lifesaving medications in those rare instances where a problem occurs. Most of our dental prophy patients are older and may have some early kidney problems. Giving IV fluids to these patients keeps their blood pressure up so that they maintain good blood flow through the kidneys. This is important because lack of adequate blood flow is a contributor to kidney failure.

After the IV catheter is in place and fluid have been started, the patient is given an injection, which begins the anesthesia. This is called the induction phase. Again, the choice of induction agent varies with the patient, but all of them leave us with an unconscious critter. As soon as the pet is “out”, an endotracheal tube is placed in the trachea (or wind pipe). This tube is crucial because it allows us to deliver oxygen and our anesthetic gases. On the outside of the tube, forming a ring around it is a small balloon. This balloon is inflated so that all of the space in the trachea not already taken up by the tube is blocked off by the balloon. This is another important safety measure, as it prevents fluids from getting down into the lungs. Once anesthesia has been induced, the patient’s endotracheal tube is hooked up to an anesthetic machine, which delivers oxygen and an anesthetic gas (either isoflurane or sevoflurane) to the lungs. It also removes the carbon dioxide that is exhaled. The anesthetic gas maintains anesthesia even after the induction drugs have worn off.

As soon as the patient is hooked up to the anesthesia machine, an electrocardiogram machine is added which monitors the heart throughout the anesthesia. Now, finally the patient is ready to have the teeth cleaned. At this point the process is very similar to what happens when we go to the dentist. The main difference is that our patients typically have much more dental calculus (tarter) on the teeth than do people. This is broken up using sound waves with an ultrasonic scaler. Once the big pieces of tarter are removed the teeth are cleaned with hand held scalers identical to those used in human medicine.

After the teeth have been cleaned, they are polished. This is not just to make them prettier. The process of cleaning the teeth with the hand scaler makes microscopic cracks in the enamel that bacteria use to hold on to the tooth. Polishing removes these cracks so it is harder for bacteria to attach to the tooth.

Lastly we take any dental x-rays that are indicated (whole mouth views are always done in cats), and the doctor examines the teeth and the x-rays. If further work is necessary it is often done under the same anesthesia.

Once the pet’s dental prophy has been completed, the anesthesia is turned off, and the pet breathes pure oxygen for a few minutes before returning to breathing room air. As the patient is coming around the monitoring equipment is removed, and once the pet is able to swallow again the endotracheal tube is removed. The pet stays in the recovery area until such time as it can walk again, at which point they are taken to their run or kennel. Once the anesthesia is completely worn off, they can go home. In cases with extractions we will give pain medications, which may leave the pet a little groggy even when discharged.

What’s going on at the clinic:

I’ve been a vet for over 12 years now and it never fails that December/January is always our slowest time of the year. Feels like a vacation every day! But, we’re gearing up for spring and to kick it off we’ll be offering 15% off all dentals in February. If you’ve noticed a little “doggy breath” over the holidays, an exam will help determine if it’s time for a dental.

• A new roof! We’ve just had Interstate Roofing complete a new membrane roof to accommodate our upcoming SOLAR ELECTRIC system! We’re excited to be taking a forward looking approach to our electric needs and investing in a 10 Kilowatt Photovalic Solar array. It should meet a little over half of our electric needs AND when we’re not open or using all the power it will be set up to generate power back into the power grid...our meter will actually stop and begin to turn BACKWARDS! Mr. Sun Solar is doing the installation and should be completed soon. We’d be glad to share with you any info you might want to know about this system and we encourage you to investigate solar options for your business or home.
  New Windows! Oh my what a difference by changing out those 1950s windows. It’s so much quieter and less drafty in the whole building. We changed out all 17 to Low-e double pane vinyl windows. We’ll see how our energy savings goes over this winter.
• New Reception area. My husband Brian helped open up our reception area recently. I think you’ll agree that it really helped that area.
• Boarding Area. Christmas break was a busy time for caring for boarding animals. All our large runs were full for two weeks! Lots of love was spread around for our extended stay dogs. If you have a trip coming up consider us for boarding your pets. It’s great peace of mind knowing the vet is a few steps away if your pet needs any special treatment. We get a lot of special needs pets for boarding.