Henry's Big Day. Neutering a Small Breed Dog

Henry and I on Sunday December 1, 2013.
He was at the clinic for our annual Pets With Santa event.
Coincidentally this was the day before his neuter.

Henry is a 7 month old Yorki-Poo. How is quite possibly the cutest scruffy pup you will ever see.

He has been to the clinic almost weekly since his parents adopted him at 8 weeks old.

There are a few important things that a small breed puppy needs.

First, every new puppy (or pet for that matter), should be to visit the vet within their first three days with you.
Bring your puppy and a fresh fecal sample.

Also, bring a list of questions. Your first visit (and every one thereafter), is the time to get your feet solidly in the ground.

For small puppies, (or sensitive dogs), I recommend splitting up vaccines. You are more likely to see a vaccine reaction if you give multiple vaccines. Smaller dogs seem to be more sore after vaccination also. The advantage to splitting them up is that we can reduce the likelihood of soreness and if you do get a reaction you know what vaccine caused it. The disadvantage, well, you have to make more trips to the vet. At my clinic, however, you will not pay for a separate office visit if we decide to split up the vaccines. But this is something to ask at your first visit. The cost of a vaccine is somewhere between $10-$30, but an office visit might be $30-$50, or more.

Another note on vaccines: All vaccines have the potential to cause a reaction. It doesn't really matter how many times a pet has been vaccinated, had the same vaccine, or whether they have never had a problem before. It can happen at anytime and with any vaccine. For this reason, I always recommend that you vaccinate your pet on a day that you can be with them after the vaccines have been given. You should also have the vaccines given as early in the day as is possible. Nothing worries me more than vaccinating a pet with known prior reactions 15 minutes before closing time. The worst reaction (anaphylactic shock, respiratory or cardiac arrest, or even death) is most likely to occur within the first few minutes to hours of the vaccine. Pets with known previous reactions should be watched very closely for a few hours after their visit. Some of my patients stay in the clinic for about 30 minutes after in the reception area so we are steps away from help if needed. Assume a reaction might happen and be prepared for it. But, remember vaccines save countless lives so please keep your pet vaccinated, and if you do have a problem talk to your vet about it. There are lots and lots of options!

At the puppy visits we discuss basic training, housebreaking, leash walking, socializing, behavioral concerns, any special breed health concerns, how to successfully get your pet used to having their teeth brushed and nails trimmed, etc.. We also set up the vaccine schedule for the first four months (or longer if you started late) of age. Spaying and neutering age is usually about 6 months old.

Henry dressed up in our ravens room.
Looking so dapper!

For Henry, like most small breed dogs, we waited and watched for his deciduous (baby) cuspid (canine) teeth to shed. This is never normally a problem in the larger breed dogs, but many smaller  breed puppies do not shed. These can cause significant and severe dental disease, tooth decay and affect overall health and longevity. If the teeth have not fallen out by 9 months old, they probably never will, so they should be removed under general anesthesia either with the spay/neuter or as a separate anesthetic event.

In Henry's case we waited until he was 7 months old in the hopes that they would depart on their own accord.

When they did not we scheduled his neuter and removed them.

Lucky for Henry, our resident dental expert was on hand. She removed his baby teeth as I removed his testicles.

Dr. Hubbard, our resident dental expert works on the front end, while I neuter the back end. Only the luckiest of dogs has two vets to work with them at the same time!

A prefect extraction!
The entire tooth was removed and the adult tooth was not damaged
or jeopardized in the process.

Henry also has vestigial rear dewclaws. Puppies should have these removed between days 2-5 after being born. Henry was not adopted from a breeder who followed this. So we removed them at his neuter.

Many clients ask me about dewclaw removal, (I have been asked to remove them from 10 plus year old dogs). The discussion about removal is multi-factorial and needs to be a discussion with your vet. Don't just ask them to remove them without your vet examining the feet and discussing the surgery.

For Henry the rear dewclaws were not articulated with the foot. They were what I refer to as "just hanging in the breeze." They had nail, but they were small. These nails will grow and bleed if you cut them too close, but becuase they are not held close to the leg they often catch on things and can tear easily. Because they are not articulated (joint and bone attached to the foot) they are easily surgically removed. Removing them at the time of neuter saves having to risk anesthesia and pay for a another surgery.

For those pets with dewclaws that are articulated (tightly adhered to the leg/foot), then we talk about why the client wants them removed. Most clients want them removed because they are cosmetically not pleasing. The client had expected they would have been removed before they adopted their puppy, or they are not comfortable trimming nails. Because these nails are not in contact with the floor they are not worn down naturally so they need to be trimmed. Nails should not be surgically removed because a parent can't (or won't or is afraid to) trim nails. Also those dewclaw that are held tight to the foot (articulated) must be surgically amputated at the joint that is at the very base of the toe. This can often cause a long (anywhere from an inch to multiple inch long) scar. The hair may, or may not grow back over this scar. The cosmetic after may not be as "pleasing" as the owner expects.

Henry's caudal half, post-op. He has some abnormal scrotal erythema (redness) and needed an ice pack post op. He also has two one inch incisions to remove his dangling dewclaws.

Waking up.

I don't bandage the feet unless I am worried about bleeding and want to keep pressure on the incision.

Bandages, in my opinion, are just a cover to hide potential disaster. They get wet, they hold in infection and they provide the perfect hiding place and environment for badness, warmth, humidity, and secrecy! Bandages in my hands are only used for very limited periods of time and under very close supervision. Bandages need to stay dry, be removed as soon as possible if they get wet (water or blood) and never be on longer then a few days.

Now he is awake!

Going home with momma! And an e-collar!
The more incisions you put in a puppy the more they want to investigate them!

Post-operatively for the tooth extractions, Henry should be offered softened food (either add water to dry food and let it sit until softened) or wet food for the first 3-7 days. A healthy mouth will heal very quickly after a tooth extraction, if it is done with minimal trauma, clean techniques, and surgical closure after. 

For the neutering Henry had a cold pack applied to the scrotum to reduce redness and aid in the discomfort of the incision.

For the dewclaws we keep them clean, dry, monitor for infection. Use booties if he goes outside and it is muddy, snowy, etc. 

For more information on puppies;

The Puppy Primer, The First Instructions

Crate training Your Puppy

Housebreaking Your Puppy

Puppy Diets

Baby Teeth Blog

If you have any pet questions you can find me at Pawbly, or on Twitter @FreePetAdvice.

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.