Simple Tooth Brushing Tips and Techniques..

CHEEEEZE

I firmly believe that if the important parts of our routine healthcare tasks were easy more of us would make the time to do them. Take for example, nail trimming, grooming, and tooth brushing. Today's topic is to simplify brushing teeth to encourage more of you to do it every single day.

Pet dental disease is the most common, most overlooked, and most easily avoidable of all of the pet care health needs that I see in the clinic.

If I told you that you could in almost all cases avoid the expense, worry, and need of anesthesia to clean your  pets teeth wouldn't you want to try?

For something to work, happen every single day, and be helpful it has to be quick, simple, and easy.

Here is my at home How-To on brushing your pets teeth at home.

Last Two Cents;

• Focus on brushing the upper arcade of the maxilla (top set of teeth).
• Use your finger instead of a tooth brush. This way you can feel where you are and get to the teeth all the way in the back. Keep poking your finger inside the upper lip towards the ear, there are little teeth hiding back there. These are one of the most diseased and overlooked teeth in the mouth (probably because they are so well hidden).
• The tongue takes care of the inside surfaces of the teeth.. this is also super helpful because it keeps your fingers out of the biting zone.
• Use your nose as much as you use your eyes and fingers. Bad breath is often caused by diseased teeth. If their mouth smells it's time to see your vet and inquire about a dental cleaning and possible extractions.
• A dental without anesthesia is a waste of time and money. If you are so afraid of anesthesia that you can't bear a dental cleaning under general anesthesia start brushing now and do it daily. If you think that you cannot afford a dental under general anesthesia I would say that you probably cannot afford to NOT do it. A rotten tooth will cause pain and keep infection in the bloodstream causing detrimental effects to the entire body, especially their heart. Dental radiographs and probing of the teeth only happen under general anesthesia, along with extractions. Veterinary dental surgeries relieve pain, cure infection, and provide return to normal eating function.
• I do not think that toothpaste is necessary. I find that it just causes most pets to lick, and you are more apt to get your fingers chewed on. If your pet thinks of tooth brushing as more fun because a tasty treat is involved, and it makes it easier for you to brush them, then squeeze away with the chicken flavored toothpaste and enjoy!
• The objective is to stimulate the gums and remove the plaque, tartar and calculi that accumulates on the smooth surfaces of the teeth.
• Make this daily chore a part of your daily routine. Keep a jar of gauze by the bedside table, coffee table, or kitchen table. As you prepare for bed, tv time, or dinner take a minute out to brush your dogs teeth.
• Finish every brushing with a hug and a kiss. Every task is easier with love!

If you have a pet related question you can ask me anytime for free on Pawbly.com. You can also find me on Twitter @FreePetAdvice. I am also at the clinic Jarrettsville Vet in Jarrettsville Maryland.

Many Thanks to my friends, staff, Willow and her family for helping!

 Bitsy smiles for her grooming!
(She does have beautiful teeth though!)

Cat Dental Disease. How much does it cost and what does it entail?

This is Satin, a middle-aged domestic short haired cat who was found to have calculi and mild gingivitis on her last annual veterinary examination. Dental disease is one of the most common and most overlooked ailment that we see in veterinary medicine.

Dental disease can present in numerous ways, they include;

1. Drooling. Excessive saliva from the mouth.

2. Pawing or rubbing the face or mouth on things or using the paws to rub the face. Most cats doing this have brown matted fur on the inside of the lower front legs, or crusting of saliva on the chin.

3. Reluctance to eat. Trouble picking up the food.

4. Bad breath, or bad odor to the mouth.

5. Loose or missing teeth. These may be found, fall out in the food bowl, be seen projecting from the mouth at weird angles, or appear as empty spaces when they meow.

6. Dropping food from the mouth while eating. For instance they attempt to pick up the food with the mouth, shake the head, or drop the food. This is often caused by pain in applying pressure to the teeth to pick up the food and swallow it.

7. Weight loss. The pain or difficulty in picking up food causes weight loss.

8. Pain, or meowing when the face or head is touched.

Satin was deemed a Grade 2 with her dental disease. We use the grading scale as a way to explain and discuss the presumed severity of the dental disease.

Here are Satin's post dental cleaning photos.

Satin had a pre-op exam ($45) bloodwork and urinalysis ($130). Satin's dental included an i.v. catheter ($40), i.v. fluids ($40), anesthesia ($100), dental cleaning ($95), and post-op injectable 10 day antibiotic ($50). Satin also was microchipped ($10). Nail trims are free with exams and surgeries. He did not have any teeth removed. His total bill for his dental was $335.

Related Blogs;
Simba's Abandonment and Dental Needs.

How Much Does The Average Cat Tooth Extraction Cost?

If you have a pet question please find me on Pawbly.com. Pawbly is free to use and open to all pet people. Learn about your pets health, their behavior, and how to provide the things they need to flourish.

If you are in my neck of the woods stop by the clinic, Jarrettsville Vet and say "Hello." I am also on Twitter @FreePetAdvice.

Bad Breath..Is it the Food, The Teeth, Or your Nose?

Charlie, my pup, and his excellent pearly white teeth.
When you are examining your pets teeth it is important to look at all of the teeth under the upper and lower lip from the tip of the nose to the far back of the mouth (past the back corner of the eye).
The teeth that tend to see the most damage and tartar are the canines and the back molars.

I have been answering questions on Pawbly.com. Here is one of the most common questions I get;

"My 3 yr old Pom has terrible breath, and has since I became his mommy 18 mos. ago. Will brushing his teeth, improve his breath, and remove the tarter on his teeth??? If so, what toothpaste do you recommend? Toothbrush or finger brush?"

A professional dental cleaning includes general anesthesia, digital oral x-rays,
scaling, polishing and any needed extractions.
Many clients get very upset with the number of extractions that a pet sometimes requires.
If the teeth are compromised they should be removed.
It is far better to remove them now then to have a pet go home with a bad tooth
and the need to return a few months later for another extraction.

Here is my  answer;

"In general bad breath is caused by bad teeth. And the smaller the breed of dog the faster and worse the teeth seem to get. 

Brushing certainly helps keep the teeth from getting caked with calculi and slows down things like gingivitis and gum recession, BUT, if the teeth are already diseased (as evident by having bad breath), then you probably need a professional dental cleaning with your vet before the brushing will be beneficial.

My best advice is to make an appointment with your vet to have them look at the teeth. They can tell you whether it is time for  dental cleaning, or whether the brushing is enough.

A few points to mention:

Brushing needs to be done daily (at least 4-5 times a week) for it to be beneficial. (Afterall we brush twice a day, AND floss..so it makes sense that our pet needs brushing daily).

It doesn't really matter how, or what you use to brush. As long as you are making contact with the outside of the teeth along the inner cheek. Dogs and cats tend to get the worst calculi on the canine teeth and back molars. I recommend gauze squares wrapped around the index finger and then brush/rub the outer surfaces of these teeth just inside the upper cheek..(I will post a video later on my blog with a demo..KMDVM.blogspot.com). I don't usually recommend any fancy products..and pets tend to want to chew your finger if you use toothpaste.

Another thing to discuss with your vet is the food you feed. The soft chewy foods tend to stick to teeth and accelerate the tartar/calculi gum disease process. The flip side is that hard food might help little bit in adding abrasion to the teeth surfaces and probably don't stick to the teeth as much as soft food, you still need to brush daily.

All of those products that are marketed to keep teeth clean (like chew sticks, water additives, chew toys, etc). help a little tiny bit,,,but in the big scheme of your pups 15 year life span they don't make enough of a difference to allow you to not brush.

Last note, unfortunately, I have seen 3 year old small breed dogs who need dentals. So, have your vet take a peek at their mouth. 

Best of luck,, and thanks for the question.

I hope this helps!

Krista"

This molar (at the area of the bleeding, top maxilla furthest to the right, just in front of the finger),
 could only be assessed after we removed the thick layer of calculi.
The roots are exposed and the tooth requires extraction.
The tooth in front of it (to the left) is likely also compromised and likely needs extraction. 

A fractured PM4. Gum recession, and a diseased likely painful tooth.
Extraction is recommended.

If you have any pet related questions you can ask them for free at Pawbly.com..Or you can just visit us there and share your pet  photos, help others with pet questions, or create your own pet topic. Pawbly is a place where people who love pets help other pet people.

Or you can find me chirping away on Twitter @FreePetAdvice.

Or come visit me at the clinic, Jarrettsville Vet.

Here is an excellent blog on brushing teeth, Fidoseofreality.com.

I have every intention of posting a video of my method. It's on my To-Do list, which, gets longer day after day.

Kisses from and to a race observer at the annual
Our Lady's Manor Races in Monkton MD. yesterday.

Laddie, a dear JVC friend models in front of our banner.

House Cleaning, Pig-Pen Style.

Today is Friday, July 5th, 2013.

Yesterday, the Fourth of July the clinic was closed so we all got a day off and a reason to hit the pool parties, fireworks, and barbecues. I took full advantage of all!

Today, is the second day of my long weekend and the first official day of the long To-Do list.

At the top was pig house cleaning.

Now I realize most people don't have a pet pig, but, most of us have pets, and all of those pets need a scheduled cleaning and exam.

For the dog people out there I recommend the following schedule:

• Puppy. Visit the vet within 3 days of adopting your new pup. See puppy primer.
• Puppy. Visits for vaccines based on the puppy visit schedule your vet prescribes.
• Puppy. Set up a schedule for nail trimming, grooming, tooth brushing on a calender. You may also need anal sac visits, ear cleaning, skin fold maintenance and behavior classes. Schedule as needed for as long as is needed.
• Adulthood. Yearly veterinary visits, which may include; fecal examinations, dental cleanings, heartworm, and tick borne disease tests, urinalysis, blood screenings, set up monthly heartworm and flea and tick prevention schedule. Discuss any items to be addressed before the next yearly examination. (This may include re-checks, bi-annual exams, maintenance of persistent or chronic problems, like allergies, arthritis, heart or other disease monitoring, etc.).
• Senior. Bi-annual examinations to better monitor onset or progression of disease or change in health or ability.

My point is to remind all of us that a coordinated and agreed upon schedule is the best way to avoid time sneaking up on us and problems slipping through the cracks of our ever busy lives. 

Every aspect of our pets care benefits from a thorough understanding of what is needed when and how to do it efficiently.

A few very good examples will follow in the next few blogs.

It is always my hope that I can educate my clients to understand, identify and address their pets needs before they get out of hand and need my intervention.

For my house my pet pig, Strawberry, this is; spring hoof trimming (ugh, the drama of that. pig hoof trimming, .), summer housecleaning, and fall is winter prepping. I also check on her daily when I feed her. Everyday is a quick visual exam and careful monitoring for her overall health and mentation.

I watch her walk to her food bowl.

• Is she walking comfortably and in a direct path? Is she using all feet equally and fluidly? Are her hooves too long? 
• Are there any wounds, scratches, or evidence of bruising, hair loss, or drainage from eyes, ears, mouth, etc.
• Does she seem bright, alert, responsive, AND happy? This is an assessment of mental health and mental well-being.
• Does she dive into her food..let me tell you, for a pig, or my beagle this is the one sure sign that they are feeling good. 

I check her house to make sure it is safe, sound, clean, and comfy.

Strawberry's house is emptied from all of the hay that insulates her house during the winter.

For your pet remember to clean bedding, toys, clothes, bowls, and their coat, nails, teeth, anal sacs, ears, etc. on a routine set schedule.

For dogs I recommend;

• Daily. Monitor for mentation, eating, ambulating, hearing, seeing, attitude, sleep behavior, teeth, urination and defecation, etc. Clean food and water bowls.
• Weekly. Monitor, ears, nails, coat. Brush and comb out the coat. Clean bedding. Check all toys, wash or dispose of if damaged.
• Monthly. Provide monthly flea & tick and heartworm prevention. Check grooming schedule. Check yearly, or bi-annual schedule for veterinary needs. Check all pets identification collar, tags, leashes. Replace any that need to be.
• Yearly. Check microchip and confirm information with microchip provider. Plan for the next month and year. Discuss your pets care with your veterinarian at your visit. 

For cats the same schedule applies except I would add; 

• Weekly. Change and clean litter boxes. Add fresh catnip to scratching mats. Clean out the water fountains. 
• Monthly. New scratching mats. Fresh grass to grow in the cats flower pots.

Food is the best way to get pig out of her house so it can be overhauled.

Watermelon is the best summer snack for pigs.
Lots of water and fun to eat!

A clean house, new hay, and fly tapes.

 For those of you that have a pig, or an outside pet. It is imperative to have a shady spot, a safe protected house, unlimited always available fresh water, and a place to hide, or retreat to, if needed.

Strawberry may not be the most popular pet in America, but she shares basic needs that all of our pets do. Like all of my pets, I am responsible for her health and well-being, and I love her for the independent self-reliant little bundle of obstinacy that she is.

The best care that you can give your pets is to be attentive to them. Whether you are two or four legged, toed or hooved, we all need food, housing, attention, medical and emotional care.

This is an interactive blog! Please comment any items that you check with your pet. And please share your thoughts, experiences, and pet stories with me. I can be reached anytime @pawbly, pawbly.com or here, at KMDVM.blogspot.com.

Have a wonderful summer everyone! 

Taffy's Tongue Tumor. Part Three of the Mass Removal Series.

Taffy is a 13 year old long haired orange tabby. He has been struggling with a decreasing appetite for months. His mom has been trying every kind of food and every kind of texture to try to convince him to eat. It has been a roller coaster ride that has been full of frustration and worry.

His first visit to the vet revealed an irregular ulcerative red spot under his tongue. Despite trying antibiotics and watching to wait and see over time the mass had grown to cover over half of his tongue. Taffy's tongue was swollen making ti hard to hold in his mouth. The mass was painful and the pain made Taffy reluctant to eat, and he was now drooling constantly. The decreased food intake was causing weight loss and muscle loss. The muscle loss was causing him to have more and more difficulty in getting up and walking. (Quick cat tip: cats often show weakness in their back legs. They will walk plantigrade (with the hocks (ankles) dropped. So instead of walking on their back toes they walk on the foot from the toes to the ankle. If you notice this in your cat go to the vet. This is also one of the first signs we see in diabetic cats). He needed relief quickly or he was going to continue to slip downhill and that down hill slope will get progressively steeper as you slide into the abyss. At some point your pet will not be able to crawl out of that abyss.

I saw Taffy for his surgery a few days later. Before surgery I gave him another thorough examination, reviewed his pre-op history and diagnostics and took some x-rays to make sure that there wasn't any evidence of cancer. We thought that the lesion under the tongue might be cancer so we look very hard everywhere else to see if it has spread. IF the cancer had spread his prognosis would be much worse and the surgery might be done just for de-bulking, temporary relief purposes, instead of getting clear margins. All of these thing are vitally important points to discuss before surgery.

My point is to be proactive and not wait until that mass is your pets death sentence.

Induction agent being delivered to put Taffy under anesthesia.

After Taffy was sedated to be intubated we could see for the first time the complete source of his pain.

Intubating for inhalant anesthesia.

Looking down the throat to see where to put the endotracheal tube.

Looking to check before placing the endotracheal tube.

My very good friend, and fellow veterinarian, referred Taffy to me specifically because at our clinic we have a laser that we can use to remove masses. The laser reduces the bleeding and surgical time and she believed was the best tool to try to remove Taffy's tumor.

Taffy's tumor was in a tough spot. All the way in the back half of the underside of the tongue. Until he was under anesthesia completely we weren't really sure how big or how deep it was. Many times in surgery it is as much discovery and examination as it is attempt to surgically correct and/or remove. (That's why it is sometimes very hard to give a definitive estimate for services). I was not sure I was going to be able to remove this with even the laser, and I was not sure what "IT" was to begin with.

We began surgery with the laser. Removing the mass was made much easier with the laser but there is only so much tissue that you can remove at the base of the tongue and it is a fine line between enough to get Taffy comfortable and able to eat again and too much tissue removed and the tongue becomes non-functional.

Ready to be draped in for surgery.

OUCH!

Ready for surgery!

Begin lasering.

After the mass was lasered off the tongue was sutured closed. The tongue is essentially one large muscle, and muscle bleeds readily. In order to reduce the normal trauma that the tongue encounters as it moves in the mouth and rubs against the teeth I had to close the surrounding tissue.

The tongue is sutured and the mouth should be much more comfortable. I expect that with a few days of antibiotics and pain management that he will be back to eating voraciously.

The tissue should be sent out for a biopsy to diagnose the lesion and help treat it appropriately. The biopsy will also assist in prognosis and future treatment should it recur.

To adress the chance that the lesion might be related to dental disease we cleaned and polished the teeth. Taffy's owners will also be instructed on how to brush them and be advised to do this daily.

Taffy is part three of the "wait until the last minute" mass removal. This series was written to remind us all that medicine is often a juggling act. We are always juggling risk versus consequence. The important thing to remember is that the plan will change as the patient changes. Don't be afraid to re-assess, re-think, and change course.

Be proactive and try not to use age as a reason to deny possible life saving treatment.

If you have any questions or comments about this blog, or any aspect of veterinary care please leave me a comment. You can also find me, and a whole bunch of other pet experts at Pawbly.com. We are happy to help you and your pet live a long healthy life together.