Dawg Business: It's Your Dog's Health!

Tuesday, February 21, 2012

Dental Emergency: Billy's Story (Part XVII)

By Dr. Jonathan Mitelman and Barbara Kelly
Continued from part 26

When we last left Billy, ongoing concerns about his weight loss despite increased food intake were abruptly put on hold with a new development. Billy was bleeding from his mouth.

Barbara: Billy has always been co-operative about having his teeth cleaned. He always allows access to his teeth, with minimal fidgeting.

I was doing a routine cleaning when I noticed blood on the brush.

It was coming from somewhere on the left side and I assumed it was from his gums. Perhaps I had been a little too enthusiastic with the cleaning,

There was nothing different about Billy's demeanor. He was eating normally and still chewing his nylon bones.

When I checked his mouth the next day he pulled away.

I was able to see more blood on the same side. He was restless and was not letting me have a good look inside. Knowing that dental issues should be investigated, I called Dr. Mitelman, who arranged to see Billy a little later that same day.

Dr. Mitelman: At first glance, Billy was behaving in his usual way. Barbara reported that several attempts to look in Billy's mouth had been unsuccessful. She said that he had pulled away and would not unclench his jaw.

It is important that any concerns such as bleeding from the mouth be investigated.

The gums are an organ with a large surface area and close contact with the blood stream. I needed to have a look inside to assess the situation.

We propped Billy up in Barbara's lap. Billy's mouth was clenched closed but I was able to lift the lips to see the sublingual tissue beneath his tongue, which was crushed between his teeth, and had some ulceration on both sides.

I attempted to pry his mouth open and Billy let out a shriek.

Not willing to let it go, we still did not have our answers, I tried again. At first glance it looked as though there might be a cracked tooth. I tried to pry his mouth open again. In a fraction of a second Billy shrieked again, lurched forward to snap and bite.

Barbara: Well, I certainly didn't anticipate what came next.

Dr. Mitelman jumped back and in an instant I took the bite. Billy is not a biter and this was unexpected. The pain was excruciating and my thumb was bleeding.

But all I could think of was the pain that Billy must have been feeling to react that way. As he hunkered down and watched the activity around him, I could tell he felt bad. He was quiet and looked confused.

Dr. Mitelman: Dogs like Billy have jaws like crocodiles. Up to 2,000 pounds per square inch of strong, shearing force.

Dogs with oral pain may not show any change in appetite.

I believed there could be an exposed nerve or some kind of injury to his tooth. Perhaps there was some foreign matter within. Some dogs develop what appears to be jaw pain when in fact there’s an abscess or mass behind the eye that interferes with the operation of the jaw.

Any of these could cause pain when opening the dog’s mouth.

A brief discussion ensued and we scheduled an oral exam under anesthesia for the next day.

Barbara: The family was concerned that Billy's pain might actually prevent us from being able to handle him. We gave him some tramadol and let him sleep in the comfort of his crate overnight. First thing in the morning, we took him to the clinic.

Any concerns about anesthesia were set aside by the understanding that this emergency procedure was necessary. Dr. Mitelman explained that it had been sufficient time since his previous anesthesia and the same medications and induction agents would be used.

Billy always has done well with this in the past.

Dr. Mitelman: We proceeded to do the dentistry.

We saw that many of Billy's teeth had worn down enamel and several had dentin exposed. We radiographed Billy's whole mouth to perform complete intraoral radiographs, just like at your dentist.

Based on the x rays and observation we found three problem teeth.

The first was a fractured mandibular third premolar. The pulp containing blood vessels and nerves had herniated and there was red flesh sticking out. The pain from this would be phenomenal. This was the source of Billy's sudden reaction to the prying open of his jaw. Although there was likely a constant ache it became acute when touched and tickled by the air.

Two other teeth were identified as needing extraction. There are six top incisors. These are the little teeth between the canines. On the top left Billy had four incisors instead of three. This resulted in overlapping and insufficient gum coverage.

One of these teeth was dead and the other had a decaying root. As these were single root teeth, an elevator (with a sharp beveled edge) was used to loosen them and I was able to fulcrum them out.

The extra incisor was a supranummary tooth. It was grey and transparent. Extraction left a small but harmless gap in Billy's mouth.

The larger, cracked tooth was separated laterally with a high speed drill. It was extracted, the gums reapposed and sutured together.

Billy's teeth had very little plaque, but were ground down by his aggressive chewing and gnawing habits.

His teeth were cleaned and polished. He woke from anesthesia without any concern and was able to go home about three hours later.

Barbara: We actually don't know if the bleeding in Billy's mouth had resulted from the lesions on his tongue or from the fractured tooth. Needless to say, I wasn't too eager to have a look at his new dental work.

We gave him tramadol for the pain and continued with the antibiotic amoxil. In order to give him a softer diet I took a hammer to crush his kibble and mixed it with pumpkin puree. We didn't want to risk introducing any new wet food and possibly causing a tummy upset.

We knew this unexpected bump in the road had just been a diversion from our other concern.

Why was Billy losing weight and what were we going to do to help him?

***

The Kingston Road Animal Hospital, and its founder Dr. Morris Samson, are celebrating the clinic's 25th anniversary this year. VETSToronto, the veterinary emergency trauma service, is housed in this location in the Beach area of Toronto.

The hospital is a full service emergency/after hours/critical care facility that provides around the clock care. There is a doctor on site 24/7/365. Owners Dr. Samson and Dr. Mitelman oversee all cases, providing continuity of care.

Referrals from other hospitals are examined, stabilized and treated, then returned to their regular clinic. Follow ups are done with both the referring veterinarians and the pet's owners.

As a full service hospital we have the following:

on site ultrasound
on site endoscopy
laser and orthopedic surgery
emergency/critical care specialists, internal medicine specialists, and surgeons on call

Monday, February 20, 2012

Adoption Monday: Chealse II, Hovawart Mix, Brookhaven, MS

Chealse II is a Hovawart Mix. She is black and tan in color.

She loves to roll around in the grass and go for long walks.

Chealse II is a kind soul. She also love tummy rubs.

Leash trained, "sits" on command. Gets along well with other dogs. Vet checked, wormed, spayed and current on shots. Also has been chipped with an ID microchip.

Check out Chealse II's Petfinder listing.

***

Established in 1981, the Brookhaven Animal Rescue League is a non-profit, limited intake, volunteer-based animal welfare group, located in Brookhaven, Mississippi.

Brookhaven Animal Rescue League provides loving care, food, water, shelter and veterinary services for abandoned and orphaned dogs and cats until they are adopted.

Sunday, February 19, 2012

What Is Reasonable For You To Expect From Your Veterinarian?

I do hope that by now you all have your own copy of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life by Dr. Nancy Kay. Truly.

I deem this one to be the single most important dog book you will ever read.

You can take my word for it, or you can learn things the hard way, as we did. I do not recommend the latter.

I have an excuse - the book wasn't written yet when we would have needed it the most.

Would I have read it if it was? Doubtfully. Because I too believed that nothing bad was ever going to happen to my dog.

Sadly, bad things do happen to good dogs. Will you be prepared?

Do you know how to find a good veterinarian? Do you know how to make decisions about your dog's vaccinations? Do you know what symptoms you should pay attention to? Do you know how to be a medical advocate for you dog should they get sick?

If your answer to any of these questions is no, then go and get the book.

Faced with Jasmine's medical disasters I had to learn a lot of things very quickly. One thing I also learned in the process, though, was that were I better educated from the beginning, some of these medical disasters likely could have been avoided to start out with!

What is reasonable for you to expect from your veterinarian?

Image Useless Humor

Did you ever return from a hairdresser with a disastrous haircut? Did you ever get burned by a mechanic? Who do you blame?

The truth is, my friend, that the only one you have to blame is yourself. Either you chose them poorly, or you had false expectations, or you didn't express your expectations clearly. Your hair will grow back, and your car can be fixed or replaced. Poor decisions about your dog's health and treatment can't always be undone.

You only want what's best for your dog. But do you know what that is and how to achieve it?

If you've read Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life you know how to look for a great veterinarian. How do you know if you found one? And how do you bring out the best in them?

We had veterinarians in the past, who we thought were good.

It wasn't until things got serious that we realized that they were not good enough.

Your Dog's Best Health: A Dozen Reasonable Things to Expect from Your Vet will teach you what you should be able to expect from yours.

Should you be able to expect your veterinarian to discuss things with you, rather then just do stuff and present you with a bill? Did your vet ever just give a prescription for some medications without explaining what they're for and what the potential side effects might be? Did your vet ever decide on a treatment of their choice without presenting you with all the options? Did your vet ever just vaccinate your dog for whatever they felt like without talking to you about it first?

Do you think such things don't happen? Do you think they should?

Is it reasonable for you to expect your veterinarian to give you a referral for a second opinion or specialized care? Is it reasonable to expect round-the-clock care for your hospitalized dog? Is it reasonable to expect your vet to provide you with a written cost estimate?

Do you think it's important to know what you should be able to reasonably expect?

Don't you think you should find out?

It's your dog's health,
Jana

***
Dr. Nancy Kay graduated from Cornell University’s College of Veterinary Medicine. Since the release of her book, Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life, Dr. Kay has lectured and written extensively about medical advocacy. She was a guest on the National Public Radio show, Fresh Air with Terry Gross. Dr. Kay is a specialist is small animal internal medicine. She was selected by the American Animal Hospital Association to receive the 2009 Animal Welfare and Humane Ethics Award. In 2011 Dr. Kay received the American Veterinary Medical Association’s Leo Bustad Companion Animal Veterinarian of the Yea Award, give to an individual whose work exemplifies and promotes the human animal bond.

Check out her Spot Speaks blog or her Facebook page.

Related articles:
Speaking For Spot: The Single Most Important Dog Book You Will Ever Read
Veterinarians Are People First
A Small Practice Does Not A Lesser Veterinarian Make
Emailing With Your Vet And The Miracle Of Web-based Medical Records
A Word On Second Opinions
Finding Dr. Wonderful And Your Mutt's Mayo Clinic: Getting Started
Even The Best Veterinarian Can Make A Mistake
Making Tough Medical Decisions For Your Dog
It's Your Dog's Health
Does Your Vet Listen To You?
Help! My Dog Is Purple!
Veterinary Drive-Thru: Coming Soon To A Veterinary Hospital Near You!

Saturday, February 18, 2012

Demodectic Mange: The 4 Most Important Questions You Should Ask

by Simon Tong

Demodectic mange is one of the types of skin problems referred to as mange; which affects dogs around the world. The demodectic type may seem like the rather harmless one, but that doesn’t mean that it can be taken lightly – if spotted in older dogs, it could mean the presence of other, more serious conditions below the surface.

Image medi-vet.com

What is demodectic mange, exactly?

Demodectic mange, known otherwise as follicular or red mange, is a medical condition that leads to irritation the skin of a dog, causing it to become inflamed.

The main characteristics of demodectic mange include a development of scaly textures on the skin, as well as hair loss and inflamed skin.

In more advanced conditions, oozing pus can also be found on the skin, which will harden and eventually produce a crusty texture. The problem areas are usually not itchy, however.

Demodectic mange typically appears in dogs that do not have a fully functioning immune system, such as puppies and dogs that have had their immune systems weakened.

What causes demodectic mange?

This skin condition can be blamed on the presence of the demodex mite. These little bugs can’t usually be seen with the naked eye, but they strongly resemble tiny cigars with legs when viewed under the microscope.

The demodex mite can be found in virtually every dog in existence.

The only reason why they have not caused a ‘mange epidemic’ yet is that these mites aren’t actually very tough; they are easily beaten by the immune systems present in the bodies they live in. As a result, demodex mites only exist in a tiny amount, and are too weak to cause any serious damage.

However, as you may have guessed, that is not true for puppies, old dogs and dogs that are ill. Their immune systems aren’t working at their usual capacity, which gives the demodex mites a foot in the door – so to speak – thereby causing all sorts of skin problems.

There are also some very rare cases where the mites have multiplied to such an extent that they can overpower a dog’s defenses, giving them the opportunity to increase their numbers exponentially and causing other complications as a result. In these cases, the dog’s condition is considered severe enough to warrant an emergency visit to the vet. Some dogs may even reach such an advanced stage of demodectic mange that there is no other choice but to be put down by the vet. Granted, such a scenario would be very rare indeed, but it also proves that demodectic mange is not something to be taken lightly.

How do demodex mites harm dogs?

The demodex mites make their home in the hair follicles of dogs (thus giving it the alternative name of ‘follicle mange’). The problem starts when the rapid reproduction of mites causes the follicles to become inflamed, thereby causing the hair to fall off. This is why one of the most obvious symptoms of demodectic mange is a drastic loss of fur.

However, hair loss and inflamed skin are not the only things that demodex mites can cause. If you will recall the part about rare fatal cases briefly discussed above, it shows that the mites are also capable of disrupting the immune system of the dog entirely. When that happens, the dog will be vulnerable to a host of other diseases unrelated to mange, which will complicate things a lot more.

How did my dog get this, anyway? And is it contagious?

Here’s a bit of good news: Demodex mites are not contagious at all. It’s very uncommon for a dog to get it by interactions with other dogs. It’s also impossible for humans to be affected by any interaction with a dog that has demodectic mange, so don’t worry about getting any of those while treating them.

But of course, you may be wondering, ‘How do dogs get this problem, then?’

The answer is that their own mothers were the initial source of the demodex mites, while they were still puppies.

It’s very possible that when the puppies were very young, perhaps even when they were just out of the womb, some of the mites would already have turned to them as their host of choice. The lack of a functioning immune system in the very early days of a dog’s life may well be the window of opportunity the mites needed to increase their population.

If you think about it for a while, this is actually in line with the fact that older dogs and sick dogs are prone to demodectic mange as well, because their immune systems were also malfunctioning.

Conclusion

Demodectic mange seems to be a rather benign problem; they don’t affect the average adult dog, they get killed by immune systems that work correctly, and they aren’t contagious at all. While it is true that they don’t cause much harm to most dogs, it still doesn’t mean that you should treat demodectic mange lightly.

A severe case of demodectic mange usually means that another health problem is threatening your dog.

Apart from that, they can also cause a lot of trouble with the fur and skin. This can mean a source of misery for you in regards to your dog’s appearance as well as health, if it somehow manages to become a major problem.

***

Simon is the owner of a Miniature Schnauzer, as well as http://dogskintreatments.com, a website devoted to educating visitors on dog skin problems. Simon started this website after his Schnauzer suffered from a severe skin condition.

For more information, visit this page to learn more about demodectic mange.

Friday, February 17, 2012

Veterinary Highlights: Cervical Arthroplasty, New Surgery For Disc-Associated Wobbler Syndrome

Wobbler syndrome is a disease of the cervical spine in the area of the neck, in which the spinal cord and spinal cord nerve roots are compressed.

This compression leads to neck pain and neurological problems like the wobbly walk dogs with the syndrome exhibit.

Wobbler's is a common cause of neurologic problems in large and giant breed dogs.

Dr. Pietro Filippo Adamo, DVM, of East Bay Veterinary Specialists and Emergency, pioneered a new surgical technique that involves a disc replacement. The diseased disc is replaced by a titanium cervical disk prosthesis.

Dogs who have undergone this new procedure have had terrific short and long-term results.

Cervical arthroplasty is a promising new technique to bring relief to dogs with the disc-associated Wobbler syndrome.

Source article: If Your Dog is a Large or Giant Breed, Stay Alert for These Symptoms

Further reading:
Cervical arthroplasty in two dogs with disk-associated cervical spondylomyelopathy
Wobbler Syndrome (Cervical Vertebral Instability)