Baby Teeth: What the Veterinary Tooth Fairy Pays Out For Them.

Many people have a special affection for a specific breed. For some of us it is the first dog we ever had. The memories we carry through our adulthood drive us to find another second dog to relive and remind us of those long ago special times.

If you look around our clinic you will see lots of Labs (we are in Maryland after all), but we also have a large number of Jack Russells, and Boston Terriers.

This past week Boomer came in for his neuter. At six months old, he was right on time.

As I performed his pre-neuter exam I noticed that he still had his baby teeth.

For many smaller breed dogs, in particular the brachycephalic dogs, the baby teeth are reluctant to leave their spot as the adult (permanent) teeth erupt.

Retained baby teeth (correctly referred to as persistent deciduous dentition) occurs when the baby teeth root(s) do not resorb as they are supposed to. As the adult teeth are starting to grow and push up out of the gums they become crowded or even displaced by the unrelenting baby teeth. This causes the adult teeth that are trying to erupt in the mouth to become either mal-aligned or displaced and can this can cause bite problems. Can you imagine if your teeth were hitting the roof of your mouth every time you tried to close your mouth? Not only would the roof of your mouth hurt, but you wouldn't ever be able to close your mouth. They can also cause dental disease because the gums do not surround and support the teeth properly.

This puppy has retained upper and lower canines (cuspids).
The lower adult teeth are inboard (inside or lingual). These baby teeth are causing the adult teeth to be pushed inside the mouth. They need to be removed so the adult teeth erupt in the normal position.

Do you know which tooth is the adult and which is the baby?
As a veterinarian you better be sure if you are going to pull one!

A pet with retained baby teeth has a mouth that looks like a shark, little double rows of teeth trying to occupy the same foundation.

By the age of six months the baby teeth should have all moved out. If they have not it is time to talk to your vet about how to evict them.

Here is how the usual course of events happens at my clinic.
I see a pet for their kitten or puppy boosters every three weeks between about 8 weeks old and four months old. At every visit I check the teeth. We can estimate the age of a pet by their teeth and if they are not growing or losing teeth on the expected schedule we start to make plans for worst case scenario.

The baby tooth is to the left.
The brown crud in between the teeth is calculi, food, and if left will cause dental disease.

If the baby tooth is not lost by the four months old, (last puppy/kitten exam), then I recommend a re-check at 6 months old. At the 6 month exam we pull pre-op blood for the spay/neuter and perform another physical exam. If the tooth is still there I recommend extracting it at the time of spay/neuter.

Why is this so important? If you do not take that tooth out it will cause your pet problems. It can cause seriously dental disease, and jeopardize the teeth, the gums, and even your pets overall health.

If the baby tooth is left in the mouth long enough will cause bad breath. (Bad breath in almost all cases is because you have bad teeth).

This is Boomer. He has not lost his baby teeth and he is at the clinic at 6 months old for his neuter.

His mom knew that he would have his baby teeth removed today. And so he lost two testes and two baby teeth. (Do you think the tooth fairy doubles up on the booty?).

A routine neuter and a careful bilateral retained deciduous cuspid extraction and Boomer was out the door lickety-split.

There are a few pointers that I want to mention about this common and routine procedure.

1. Talk openly with your vet about your pet/puppy/kittens teeth.
2. You should know what to look for, which teeth are which, and be monitoring for worsening of the bite, the angle of the teeth, and for debris that often gets stuck in between the over crowded teeth.
3. Ask if your veterinarian is comfortable with dental extractions? 

With all dental procedures it is very important to be careful that you do not injure the adult teeth as you remove the baby teeth.

It is also very important to remove the entire tooth root. Any pieces that are left behind can cause problems done the road.

For post op care I recommend;

• softened food for about three days.
• monitor for bleeding, swelling, or excessive drooling.
• monitor the bite. If there has been some malalignment it may correct itself once the baby teeth are removed. If it does not correct see a veterinary dental specialist for long term resolution options.

Once those adult teeth are in its time to start brushing! Start those good habits early.

Did you know that it takes four days a week of constant year around brushing to adequately keep the teeth clean, free from debris and calculi, and the gums healthy? If you think that's a lot would you like to be brushing ONLY four times a week?

If you have any questions about this, or anything else pet related, or if you are a person who wants to help other pets, please join me on Twitter @Pawbly, or at our home Pawbly.

As always, always be kind.

Emergency Kit. The Veterinarians At Home Kit.

I was asked by a follower on Twitter for "my best pet advice," so I had to think about this open ended question for a moment and decided that one of my best pieces of advice was that every pet owner should have an at home emergency kit.

Here is what I think it should have in it;

1. A list of emergency phone numbers. 

I give out business cards so that my clients have one for their regular vet and also a card for our emergency clinic. (It has their number in very big NUMBERS so even in the emergency you see it). I also want the directions to be on the card. When you get stressed you forget to listen or pay attention to anything.

Pet Poison Hotline. Their number is 1-800-213-6680, a fee applies for their services.

2. A big blanket. 

It can act as a straitjacket, a warming blanket, and absorb fluids if needed.

3. Thick absorbent bandages and Tape. 

Some people actually use women's maxi pads. They are cheap, and highly absorbent, and pre-packaged. Vets love Vetwrap. You can find it pet supply stores, or stores that sell horse products. It sticks to itself but not your pet, or their fur.

4. 3% Hydrogen Peroxide. 

If you are concerned that your pet ingested something toxic or dangerous you need to have this on hand. Call your vet or the Pet Poison Helpline BEFORE inducing vomiting. Their number is 1-800-213-6680, OR call your vet, OR local pet emergency clinic. DO NOT WAIT. Seconds count, and hours can kill. (For more information on when to use this please see my blog, To Puke Or Not To Puke, That Is The Question..)

5. Benadryl (generic is called diphenhydramine). 

You need this anti-histamine for bug bites, (or if you are my dog Charlie, eating frogs) or any other allergic reaction. If your pet gets red skin, or hives, or is even having a worse allergic reaction it is your go to drug to try to slow or stop the progression of the reaction. If your pet is having trouble breathing, get in the car and go immediately to the closest ER.

6. Eye wash. 

Over the counter generic eye wash, sterile saline, is fine. Cheap stuff. Use it to flood the eye if the eye looks inflamed, has any abnormal discharge, or is being held shut (squinting). If the eye doesn't appear to be improving after an hour, or if it is painful, or you see yellow or thick discharge you need to go to the vet ASAP.

7. Thermometer and Lube. 

Please use a digital thermometer. The old mercury ones are too dangerous and fragile. What would happen if your pet sat down while you are trying to take their temperature? The normal temperature of a dog or cat is about 100.5  to 102.5 degrees F, or 38.5 to 39.2 degrees Celsius. If your pet is below 98 or above 104 degrees F go to the vet immediately. DO NOT WAIT! It is very likely the temperature is on its way to worsening, and seconds count!

8. Nail trimmers and Quik-Stop.

It is important to have the right trimmers for your pet. Ask your vet to show you what they use, and how to use them. Kwik-Stop is the product we use to stop the bleeding if we accidentally cut the nail too short. Here is my primer on How To Trim Nails.
I swear I have had this same bottle since 1995. It is still full, it takes forever to go through a bottle, and you get better at trimming nails with practice.

I also have very definite opinions on nail trimmers. Don't buy the cheap guillotine kind. Buy spring loaded heavy duty nail trimmers if your dog is over 30 pounds. ALWAYS have quik-stop standing by JIC.

9. If your pet has any medical issues you may need other drugs in this kit. 

I keep an NSAID, (old dog pains), and ear wash for floppy eared Beagle-pup. Along with previously prescribed drugs, ointments, etc. Always ask your vet before using old medications. many expire, and often clients inadvertently use the wrong drug on the wrong species or at the incorrect dose. I also keep heartworm, flea and tick preventatives close by in a locked container.

Please remember to not use prescription medications, (or ANY medications) without your Veterinarian's "OK" first. Many clients over use and abuse the prescription ear medications and over time make the ears much harder to treat.

Always use the medications given to you completely and exactly as directed on the label. I also have unfortunately seen many owners give their pets "human drugs" that are toxic to pets. I have actually lost pets due to owners giving medications that are toxic, and/or giving doses of drugs that are way over what a pet can tolerate. If you are in doubt, "Don't give it!"

10. I also keep my pets medical records with the medical kit. 

So if you need to run to the emergency Vet you have your pets records.

11. A Leash, Harness, Collar, and/or Pet Carrier.

If you need to get your pet somewhere fast it really helps to have these things at your finger tips.

12. Something to use as a Muzzle.

Also, some dogs do not do well with shock collars, or invisible fences. Please seek advice before purchasing products that might be potentially harmful and/or not work for your pet.

In the event your pet is hurt, or scared be prepared with a soft cloth muzzle. You can make one yourself with a long scarf, leash, a necktie, or pantyhose (if you use this don't pull it too tight this stuff is hard to get off and can act like a tourniquet) or length of gauze. I promise you your pet will bite if they are in pain and you are trying to do anything to them. When you are in pain you are not the same individual. Ask any woman who delivered a baby what came out of their mouth in the delivery room. A dog, or cat, or anything reacts without thinking if you touch them, and they are in pain. So just put one on and then don't get upset if they resent the muzzle. Improvise your own muzzle by making a noose by tying a loose knot in the middle of the length of the strip, leaving a large loop. Approach the dog quietly from behind and slip the noose over their nose. Do not block the nose, they need to breathe through this. If your dog is really struggling to breathe then do not tie the noose so tight. It should only be tight enough to not allow their mouth to bite you. Put the noose about mid-way on their muzzle/nose. Pull the know tight with the know on the chin, then pull the ends behind the ears and fasten a bow.

 The following picture is from "The Dog Lover's Companion," Fog City Press, a great resource for all dog owners.

Here is a picture of Savannah, my dog, modeling, (unhappily) an improvised muzzle.

And here is Joe, my husband, being a goof, because I asked him to show me how put it on ( a little quiz to see if he was paying attention), after I had put it on Savannah.

Here are some of my pets. I promise you that I have used my emergency kit on every one of them. (Did I ever tell you about the time my whole staff came over to our house to go fishing and my dog Charlie bit into the 3 pronged barbed fishing hook? That was emergency sedation, first-aid, and surgery. I'll tell you that story later.)


Ms. Pig just saying "hello"

Miss Pig, Ambrose, and Savannah on a perfect summer day. That's Ms. Pigs house. It is insulated and cozy year around.

Here is Squeak Box, DC, and Donner. We only go out on supervised outings. They are indoor kitties. But they love to go for walks with us and think of themselves as vicious predatory jungle lions.

Ambrose looking for attention.

Lilly, my moms dog. She's another story. In this photo she has Cushings disease. It was not treated at this point. Now she's an Addisonian. I'll explain her saga someday.

Puppy Mills Cruelty

Puppy Mills

I got a call from Grace at Animal Rescue asking me if I would look at a 7 year old Golden Retriever that they had rescued from a shelter. Animal Rrescue takes in so many dogs abnd cats that they provide spays and neuters to all of the pets that they adopt out at their shelter. When they were preparing to spay this dog they injected her anesthetic and proceeded to try to pass an endotracheal tube into her esophagus to provide her the oxygen and anesthetic gas to keep her under general inhalant anesthesia. For the Veterinarian we approximate what size endotracheal tube to use on the pet based on their size, weight, and breed. I have seen some toy breed dogs take a tube used routinely for cats. And I have had to use a tube three sizes smaller than I estimated on a bulldog.

As a side note: There are a lot of helpful anesthesia tips for brachycephalic dogs. I always have a long discussion with these owners prior to placing these guys under sedation or anesthesia. You should expect to pay more and be asking questions if you are not.

In the process of trying to pass the endotracheal tube the Veterinarian noticed that her vocal cords were abnormal. She also noticed that the size of the lumen (the opening of her airway) was significantly smaller than it should have been. As I have said before your body will respond to an insult (fancy medical term for damage) by scarring. Scarring in a tubular structure is called stricture. A stricture causes the tube to narrow. Her vocal cords were unable to open normally, (they open like drapes around a window) because she had been brutally de-barked.

When Grace called to ask me about this dog she was calling to ask if I could use our laser to try to remove the scar tissue that was like a webbing holding her vocal cords together. It is always very difficult to give an opinion on a case over the phone. I need to see a pet and understand not only the condition about which they have come in, for but also assess the pet, and in many cases the owners ability to follow through with any post operative care. I told Grace that I needed to better understand this dog’s condition by seeing her. I also told Grace that I wasn’t sure what she was talking about when she explained to me that she had a 7 year old dog that had been de-barked at the puppy mill. I had never heard of a de-bark being done by anyone other than a veterinarian. (This is a procedure that used to be done pretty routinely in the “old days,” thankfully it has fallen out of fashion).  Grace sent me a drawing of the dogs larynx as the Vet had described. She also went on to say that the way puppy mills de-barked was to “shove a pipe down their throat, to break the vocal cords.” I wanted to vomit. I couldn’t believe that people could be so cruel. I also couldn’t believe that I had been doing this for as long as I had and never heard of this. (Something about ignorance being bliss ran through my head).  I told her that I was appalled to hear about this girl but I would be happy to see her.

Thankfully she did well under anesthesia and recovered without any problems. It was decided that based on her age, her lack of clinical signs and how well she seemed to be doing that we would take a “watch and wait and see” approach.

My hope is that she will never need another surgery and that she will be with a family that loves her. She may have started out with a terrible cruel person who didn’t care about her, but hopefully she will end up with the exact opposite.

Puppy mills only stay in business because there are people willing to buy a pet from them. If you don’t know the breeder and you haven’t met and visited their facility personally please don’t support them by buying a pet from them. They will only stop abusing when there isn’t someone buying their product.

There is not much information available on de barking, but here is an interesting debate;
http://tinyurl.com/3rdfugb