Sunday, February 5, 2012

The Dirty Mouth Dilemma

The DogsLifeKC packs wants to thank Oak Park Veterinary Clinic's Jennifer S. Strickland, DVM, RN for sharing her time and thoughts with us.

February is National Pet Dental Health Month. Talk to your veterinarians about what is appropriate for your dog. Ask about possible specials during this upcoming month.

People often ask me "Do dogs really need dental care?" My answer to them is "Absolutely!"

Regular home care in addition to professional dental care can be beneficial in many ways for your dog:
  • A cleaner mouth leads to less halitosis or "bad breath."
  • A cleaner mouth is a healthier mouth. Regular dental care helps prevent spread of bacteria from the mouth to vital organs like the liver, kidneys and heart. 
  • A cleaner mouth is a more comfortable mouth, resulting in a good appetite and over all better quality of life.
A discussion by veterinarians on dental health is often viewed with a glazed look in the client’s eyes as many feel professional dental disease prevention is not essential to overall pet wellness and really is just a way of increasing the bottom line profits of the clinic. This could not be further from the truth. Veterinarians get involved in dental procedures and cleanings when severe periodontal disease has set in, and as the second line of defense against the onset of the disease. Therefore, your pet needs a combination of in-home (first line of defense) and professional care on a continual basis to keep their mouth clean. So let’s go through what you can do at home to avoid extra trips to your veterinary professional.

Periodontal disease is the number one infectious disease in dogs and cats. We see periodontal disease in about 80% of our canine patients and in about 70% of our feline patients. Periodontal disease is exclusively due to poor dental hygiene. Tartar buildup in our pets occurs at a rate five times faster than in humans. This is why you can’t compare your personal dental needs to your pet’s dental requirements. Home dental care is critical in avoiding periodontal disease among our pets.

Some basic signs that your pet may be suffering from periodontal disease are oral pain, bad breath which is totally unnatural in dogs and cats, infected or bleeding gums, loose teeth, and difficulty chewing dry food.

The disease process begins with bacteria invading and infecting the gums resulting in gingivitis. This bacteria is created when food debris is combined with oral epithelia cells, mucin, and oral glycoprotein. Just one milligram of plaque contains over one trillion bacteria cells. If left untreated the bacteria will advance beyond the gum line and into the supporting structures of the tooth. If allowed to continue to advance the bacteria will eventually attack the alveolar bone slowly eroding it to the point that the tooth will eventually fall out on its own. All the while this bacteria is moving into the bloodstream potentially doing damage to the heart, liver, kidneys, and lungs.


Stage 1: Periodontal disease is not very visually noticeable at this stage. It begins with gingival inflammation and variable accumulation of plaque. There is no discoloration at this stage. There is no deterioration of the supportive structures at this stage. Plaque control at home during this stage can reverse any pathologic changes.

Stage 2: The first visual signs of destructive periodontitis can be seen. Plaque and calculus begin to form below the gum line. The pet’s breath is now mildly offensive. There can be up to 25% tooth attachment loss at this stage. Even at this stage the disease is still reversible with a professional dental cleaning and proper home care.

Stage 3: Now moderate periodontitis has set in. 
The pet’s breath is now very offensive and noticeable at a short distance away from the mouth. There can now be up to 50% tooth attachment loss at this stage and up to 30% alveolar bone loss. There are now moderate to deep gingival pockets that have formed. The only option to cure the disease at this stage is aggressive periodontal therapy, but it is too late to correct the permanent pathologic changes that have occurred in the mouth.

Stage 4: This is the advanced periodontitis stage. 
The  recession of the gum line is extensive. The pet’s breath has become intolerable to the human nose. Teeth have become loose to the touch. There is now more than 50% bone loss and extensive deep pockets. Pets at this stage will require professional dental care up to and including complete dental extractions or root canals. A course of oral antibiotics will be necessary to curb the bacterial infection that has set in.

So how do we prevent periodontal disease? By developing a complete home and professional care plan we can keep the disease at bay. It starts with prevention and not just professional treatment.


Step 1: The easiest way to prevent plaque and tartar buildup on a daily basis without a lot of fuss is to give your pet a clinically proven dental chew designed for dogs and cats. There are several very good products on the market today. We recommend and use C.E.T. chews at our clinic. They are made by Virbac Animal Health and come in chewable sizes designed for all pets. These chews combine a natural antiseptic with abrasive action on the teeth to break up plaque and tartar. Whichever chew you choose it is important to know who is making the chew and where it is being made and with what ingredients. Far too many chews on the market today are doing more harm than good. Consult your veterinarian for safe brands.

Step 2: We know how hard it is to get your kids to brush their teeth so we are very aware of how difficult it is to find the time and energy to brush your pet’s teeth. Daily brushing yields the very best results but we know that may be unrealistic in most households. So we say that doing it is better than not doing it at all. Aim for three times a week and try to work up to daily brushing. The more you do it the easier your pet will be to work with. Again there are many fine products on the market, but we prefer C.E.T toothbrushes and toothpastes. They are specially formulated and designed with your pet in mind. The toothpastes come in several pet-friendly flavors. Your veterinarian will offer a complete dental care kit to get you started. The key to success with brushing your pet’s teeth is to go slowly. Maybe the first few days you are simply touching the mouth with your fingers without using any paste at all. Then you slowly ease your pet into the process by putting some toothpaste on your finger and working it around your pet’s mouth. Once your pet is used to the procedure you can then introduce a pet toothbrush or ribbed finger brush. Then brush just like they were your own teeth for about two minutes. Keep in mind what it would feel like if you had not brushed your teeth for a whole year and then suddenly had someone aggressively brushing out of the blue one day. You wouldn’t like it very much either and might try to run away. Success is built with small steps for a week or two. Both of you will be happier with the whole process if you approach it in this manner.

Step 3: Your veterinarian should conduct an annual dental exam as part of your pet’s annual wellness exam to check up on your home care. They can determine if your home care is keeping tartar and plaque at bay or if you need to step up your home dental treatments or maybe even have a professional dental cleaning to give you a good dental foundation to build from. Be sure to ask what they see and what the care plan should be going forward.

In addition your veterinarian may suggest/prescribe some dental health food designed specifically to assist in reducing the bacteria that causes gingivitis. You should consult with your veterinarian to see if a dental diet food is right for your pet. Whatever you do be sure not to put off proper pet dental care. Delaying treatment can lead to other previously discussed health concerns that can do permanent damage to your pet.

Pet Dr. J

Jennifer S. Strickland, DVM, RN

You can also visit her clinic on Facebook! 

The Big "C"

The DogsLifeKC packs wants to thank Oak Park Veterinary Clinic's Jennifer S. Strickland, DVM, RN for sharing her time and thoughts with us.

I remember watching a movie from the 1980’s “St. Elmo’s Fire” and in that movie filled with brat-packers there was a character who was the mother of one of the recent college grads who every time she had something horrible or horrific to say she would whisper the key word.  One of those words was the “c” word.  Cancer.  For some reason that image has stuck with me all these many years.  Well while the “c” word is horrible and horrific for both humans and pets it is by no means the end.

Let’s first clean up some terminology often used interchangeably with cancer.  The term neoplasia is any uncontrolled abnormal growth of tissues or cells in the body.  The proper term for this growth is called a neoplasm which is often called a tumor.  These neoplasms can be non-malignant (benign), or malignant (cancerous).  These non-malignant neoplasms do not grow aggressively.  They do not attack surrounding body tissue, and do not spread throughout the body via the blood or lymphatic system.  The term tumor is usually used to describe the area of swelling or mass associated with the neoplasm. 

Neoplasia is a very common among our pets especially as they age.  Malignant neoplasia is responsible for nearly half of all deaths of pets over the age of ten.  Dogs get cancer at the same rate as the human population while cats develop cancer at a slightly lower rate than humans.  Here are some various types of Neoplasia.

A lymphoma is one of the most common types of neoplasia in our pets.  It is typically an enlargement of one or more lymph nodes in the body.

A neoplasia in the abdominal cavity is also very common.  Unfortunately, this is a neoplasia that is very difficult to make an early diagnosis.  An early warning sign is sudden weight loss.

A neoplasia of the bone is usually seen in large breed dogs older than seven years of age.  This neoplasia is rarely seen in cats.  This neoplasia usually attacks the bone near a joint.  Early warning signs are lameness, swelling at or near the joint and continual pain at or near the site.

A neoplasia of the skin is very common in older dogs but rarely seen in cats.  When they are seen in cats they are almost always malignant.  They are rarely malignant in dogs.

Mammary Gland
A neoplasia in the mammary gland is a serious thing.  More than half of all neoplasia in dogs are malignant and more than 85% of neoplasms in cats are malignant.  You can greatly reduce the risk of this form of cancer by spaying your pet before they reach one year of age.

Mouth & Nose
Neoplasia of the mouth is rare in cats but is not uncommon in dogs.  Warning signs are a tumor on the gums, bleeding coming from the gums, a foul order in the mouth, and difficulty eating and chewing.  Many of these tumors are malignant so consult your veterinarian immediately in order to begin an aggressive treatment plan.  Neoplasia may also develop in the sinus cavities causing severe swelling to the face and bleeding from the nose.  This too should be brought to the attention of your veterinarian immediately for quick diagnosis and treatment.

Warning Signs
  • Weight Loss
  •  Loss of Appetite
  • Difficulty eating, chewing, or swallowing
  • Difficulty breathing
  • Difficulty urinating
  • Difficulty defecating
  • Continual lameness or stiffness
  • Wounds that do not heal
  • Abnormal swellings that continue to grow or remain
  • Bloody discharge from any body cavity
  • Unusual pungent odor
  • Loss of energy

Neoplasia is usually detected during a routine medical examination normally associated with an annual wellness exam that includes full blood chemistry.  These may be discovered with a head-to-toe hands-on visual exam of your pet.  Your veterinarian may ask to do a needle stick to remove a sample of neoplasia cells for viewing under the microscope during your visit.  This can act as a rule-out of a possible malignant neoplasm.  Often these tumors are no more than fatty lipomas that are noticeable to the touch but harmless to your pet.

Once a neoplasia is suspected or detected your veterinarian will want to run several tests to confirm or dismiss the initial findings.  These may include blood work, radiographs (x-rays), ultrasound exams, and the afore mentioned biopsies.  These tests are needed to determine the malignant or non-malignant nature of the neoplasm.  Early detection and diagnosis is critical to the long-term effective treatment of all neoplastic diseases.  The sooner they are discovered and treated the better the prognosis.  Many of the symptoms associated with neoplastic diseases are symptoms shared by other disease processes and need immediate veterinary medical attention no matter what the ultimate diagnosis is. 

Once your veterinarian has completed testing and made a final diagnosis they will discuss treatment plan options for your pet.  They may offer multiple treatment plans from very aggressive to minimally aggressive depending on a variety of factors such as the pet’s age, overall wellness, client’s financial situation, and ultimate expected outcome.

Possible treatments may range from surgery, radiation therapy, chemotherapy, cryosurgery (freezing neoplasm), or immunotherapy.  This may be incorporated with a nutritional treatment plan to improve your pet’s response to the overall treatment plan.  Often pain management is part of any good overall treatment plan.  You should consult with your veterinarian about all aspects of the plan. 

There are 100% cure rates with some types of neoplasia if they are detected early and treatment is started promptly.  Time is the enemy when it comes to cure rates.  The longer it takes to detect and treat a pet the lower percentage of full recovery.  However, some types of neoplasms can only be managed to limit the spread of the disease and make your pet comfortable.  In these cases your family may consider euthanasia for your pet.  Before making any final decision regarding euthanasia you should consult with your veterinarian in order to make the best informed choice possible.

We learn more and more every year through research and newly developed diagnostic methods about the “C” word.  Every advancement in science will lead us closer to a final cure of this horrible disease process.  Until then, early detection and aggressive treatment plans are our best defense.  This is just another reason why continual consultation and annual examination with your veterinarian is vital to the overall wellness of your pet. 

Pet Dr. J
Jennifer S. Strickland, DVM, RN

You can also visit her clinic on Facebook!