All I Want for Christmas is My Two Front Teeth

This popular holiday song is a perfect Practical Pet Vet blog topic on Christmas Day. However, every day of the year veterinarians are confronted by toothless dogs and cats. Unfortunately there is no Kris Kringle Tooth Fairy waiting in the wings to deliver a second set!

As pets are living longer and are viewed as furry family members, dental care is becoming an increasingly important part of veterinary care. Aside from causing terrible breath, the oral bacteria associated with plaque enters the bloodstream and travels throughout the body to cause disease in the liver, kidneys, heart, brain, and elsewhere! Moreover, severe dental disease (bleeding gums, loose teeth, abscess) is known to be painful and decreases a pet's quality of life. Most owners don't recognize this change in their pet until after the pet has healed from a dental procedure. Then many report their dog or cat is acting like a puppy or kitten again!

As with most medical conditions prevention of dental disease is preferable to treatment. Regular tooth brushing is the best prevention. No, crunchy dry food is not going to do it. (If you ate nothing but carrots and corn flakes you would still need to brush your teeth and see your dentist!) Dogs and cats can learn to enjoy tooth brushing as a special treat or bonding time with you...ask your veterinarian for suggestions on how to do this. Certain treats and chewies will help reduce tartar, but some, like real bones, can actually break teeth so again check with your veterinarian.  There are many gels, sprays and water additives available through your veterinarian that can also help reduce the disease-causing bacteria in your pet's mouth. And for dogs there is an annual dental vaccine!

So what if your pet already has bad breath, severe tartar and missing or loose teeth? It's time for a dental procedure. No matter how nice your dog or cat is, sedation or anesthesia is required to properly clean the teeth and perform any surgical procedure. Some groomers offer tooth brushing or "cleaning" as part of their services. Any type of oral care your pet allows is great, but not even the best groomer on the calmest pet can clean the teeth below the gumline where the majority of tartar and disease resides. Cleaning the exposed part of the tooth above the gumline creates a nice smile and reduces halitosis but creates a false sense of security that all is well in the mouth!

Like people most dogs and cats over the age of 3 would benefit from preventative dental cleanings (yep, under sedation) at least once a year. Very small dogs (e.g., Yorkies, Maltese, Chihuahuas, etc.) ideally would have cleanings twice a year!

Some owners bring their pets in for dental cleaning and request that the veterinarian "not pull any teeth unless absolutely necessary." Oh, boy. Obviously, these people have never had to extract a fractured and painful but not yet abscessed and mobile tooth before. It is no walk in the park. Nope, veterinarians (the ones I know at least) would never extract a non-diseased tooth just to rack up the final bill! Really, it's not worth the effort.

The goal is to AVOID needing this many extractions!
However, this dog undoubtedly feels better without
the chronic toothache these diseased teeth caused!

If by the end of the dental procedure (or after lifelong dental procedures) your pet's smile is more toothless than toothy, don't fret too much. The missing teeth would have eventually fallen out anyway (with more pain, more chance of complications like retained roots and no antibiotic therapy), and your pet will probably still eat dry food. Most dogs and cats don't chew their food well with teeth (another reason regular dry food does not prevent tartar formation). I've even met some dogs with few remaining teeth who actually still enjoy gnawing their chewies!

If you've been told your dog or cat needs a dental procedure, here are some questions to ask your veterinarian:
1. Will my pet have pre-anesthetic blood testing done?
2. Do you expect my pet will need any extractions?
3. If my pet has extractions, what kind of medications will s/he go home with (pain relievers, antibiotics)?
4. What can I do at home after the dental procedure to keep my pet's mouth healthy?
5. Can I get an estimate for the dental procedure?

February is National Pet Dental Health Month. With the winter holidays behind us by then, February is the perfect time to focus on getting your furry family member scheduled for dental assessment and/or treatment!

'Tis the Season to be Gentled

Farm boy gentles foal

The happy conclusion of Laura Ingalls Wilder's Farmer Boy (the biographical story of her husband Almanzo's childhood) is Mr. Wilder granting Almanzo's greatest wish--a horse of his own--with the promise "We'll take him out on a rope, first thing tomorrow morning, and you can begin to gentle him."

Gentle (v.) 1. To make less severe or intense. 2. To soothe, as by stroking; pacify. 3. To tame or break (a domestic animal, for instance). 4. To raise to the status of a noble. (American Heritage Dictionary)

I'd read Farmer Boy as a child but my strongest memories of this term are from veterinary school when I volunteered to socialize the school's training dogs so they could find real homes.  These dogs had been used to teach veterinary students restraint and examination skills. However, students were increasingly bringing their own pets in to practice on, and the teaching dogs were happily becoming obsolete. It was time for them to retire. The kennel workers who cared for these dogs' needs really cared for these dogs, but years spent in a cage had made the dogs socially inept. It was up to us volunteers to help the dogs learn how to be human companions.

We followed a behavior modification protocol developed by a veterinary behaviorist. The first step in the program was "Gentling and Body Massage." In this program, "gentling" is described as the process of raising a gentle adult animal. The dogs we worked with were already adults and used to being handled, but we needed to be sure they felt relaxed and comfortable around people. Gentling involves establishing trust that human hands are positive, safe things. Anyone who has successfully tamed a feral cat or kitten has used gentling techniques.

Gentling is basically petting that progresses to massage and manipulation of the body parts. As with any behavior modification program, this was a gradual process. The animal's tolerance for touch dictated the rate of progress. If at any point the dog tensed, pulled away, became apprehensive or aggressive, we had to stop and slow down or rework the previous stage of gentling before proceeding. Eventually all the dogs learned to appreciate not only regular petting but more thorough touching of their feet, ears, lips and bellies. Being comfortable with this level of touching would allow their future owners to provide them a higher level of care (e.g, checking for ticks, tooth brushing, trimming nails, etc).

Once the dogs had been thoroughly gentled (it took weeks for some dogs, months for others), we were encouraged to work on deference training. Deference training is essentially teaching a dog manners. Proper deference training is gentle and consistent, never harsh or violent. We do not need to force the puppy or dog to submit (the popular model of human as "alpha" has fallen from favor and is far more detrimental than helpful!) In deference training, every good thing the dog receives -- meals, treats, petting, playtime, walks, etc. -- comes after the dog is sitting calmly and attentively. This behavior can then be built on for advanced obedience, retrieving, agility, and even canine assistance.

Relaxed dog sitting calmly

Satisfied that the teaching dogs were relaxed around people and understood basic commands, our final task was to help acclimate the dogs to the outside world. Having grown up in simple kennel with limited exposure to a fenced exercise yard and classrooms, some of the dogs were unnerved by things like bicycles, strollers and umbrellas. Even children were a strange new species to the dogs. Relying on the trust we'd established through gentling and deference training, we attempted to expose the teaching dogs to as many new experiences as possible. If the dog became anxious we asked it to sit and watch us. By focusing on us and watching us for cues, the dog became used to the strange new thing and learned not to fear it.

After months of socialization and training, all the former teaching dogs found loving new homes. The new owners were taught the gentling protocols so they could reinforce and advance their new pet's training.

According to the American Heritage Dictionary, taming a domestic animal may be done by "gentling" or "breaking." Although used synonymously these words imply very different techniques. Gentling is the time-tested and animal-lover approved way to tame and train animals of all kinds. That doesn't mean people don't find it challenging to do properly. In our fast-paced modern lives, the patience required to slow down and work at another being's preferred speed may be hard to summon. However, the rewards of "gentling" an animal rather than "breaking" its spirit are worth the effort. Because in the end, a gentled animal will act gently and, if American Heritage is correct, perhaps even nobly.

The Twelve Days of Christmas...Pet Vet Style

On the first day of Christmas my pet vet sent to me:
a wellness exam for my pet


On the second day of Christmas my pet vet sent to me:
2 core vaccines
and a wellness exam for my pet


On the third day of Christmas my pet vet sent to me:
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the fourth day of Christmas my pet vet sent to me:
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet

On the fifth day of Christmas my pet vet sent to me:
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the sixth day of Christmas my pet vet sent to me:
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the seventh day of Christmas my pet vet sent to me:
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the eighth day of Christmas my pet vet sent to me:
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet

On the ninth day of Christmas my pet vet sent to me:
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet

On the tenth day of Christmas my pet vet sent to me:
10 toenail trimmings
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the eleventh day of Christmas my pet vet sent to me:
11 joint supplements
10 toenail trimmings
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the twelfth day of Christmas my pet vet sent to me:
12 heartworm tablets
11 joint supplements
10 toenail trimmings
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet!

Your Pet Pooped on the Floor: Why Your Vet Can't Assume It's Behavioral

Here's the scenario. A family adopts two "teenaged" spayed female cats from the shelter. These two teeny boppers are welcomed into the household by the older neutered male cat and the family's dog. The introduction appears seamless. The new kitties cuddle with the labrador and cavort with the cat. But someone has pooped on the couch! And the rug! The owners know it's one of the cats but which one? Is it Mister, latently unhappy about sharing his digs? Is it one of the new kitties, unsure of her surroundings or just reveling in her new freedom to go where she pleases? The poops are pretty normal looking, so it seems like a behavioral issue.


As the family's veterinarian, my first response is "we gotta get a stool sample and run some tests." The only way to diagnose a behavioral toileting problem is to rule out medical causes first.  


"But how will we know whose poop is whose?"

Sometimes that matters and sometimes it doesn't. I like to run the fecal tests on the aberrant stool...one that's softer or yuckier than most or the one that's been deposited where it doesn't belong. The owner of the stool-- when we're talking cats--usually doesn't matter if the problem is infectious or parasitic. Because cats generally share litter boxes we assume that if one of them has worms (for example) they all have worms and all need to be treated accordingly.

Before long I was in possession a fresh sample from one of the new kitties. When evaluating a stool sample for abnormalities, the first test is simple observation. Yes, it's gross, but what does it look like? How does it smell? Sometimes we'll probe the sample with a be-gloved hand checking for foreign material or worms, but 3 out of 5 senses is as far as it goes! This sample happened to be soft but formed with a portion being slightly runny. 

In my veterinary practice a complete fecal test includes a smear, a float and a Giardia "snap" test. These in-house tests identify the most common causes of inappropriate defecation and outright diarrhea.

The fecal float is the test most well known. This checks for parasites such as worms and Coccidia. Coccidia are a species-specific protozoa that commonly affect young or immune-suppressed pets. As for worms, most animals with light worm loads do NOT have worms visible in their stool, so please don't get a false sense of security that your pet is worm-free just because you see no worms! The fecal float helps us identify intestinal worm infestations by showing those worms' eggs. If the worms inside the pet are not reproductively mature or simply not shedding eggs on a particular day, this test may be falsely negative for worms.

The fecal smear helps identify a bacterial overgrowth of the intestines. Every normal gut has a mixture of beneficial bacteria that help digest the food and provide essential nutrients. A wide variety of internal or external factors can destroy this delicate balance and cause abdominal discomfort and/or diarrhea. Luckily most abnormal findings on the fecal smear are not contagious to other pets and people.

Meet Giardia

The final part of the complete fecal test a Giardia "snap" test. This is a highly accurate test to identify active Giardia infections. Giardia is a contagious and zoonotic (i.e., affects people) protozoal parasite that is  common in the environment. The parasite unfortunately also rears its ugly head in shelters and breeding facilities from time to time.

Lo and behold, while the first two tests showed no significant abnormalities, the kitty's Giardia test was an obvious positive. Wow! Even though the kitty's stools have appeared pretty normal, she has an infectious and contagious medical condition. This is the most likely explanation for poop on the couch and rug, NOT a behavioral quirk. 


The good news is this kitty has a treatable medical condition rather than a behavioral problem. The bad news is all the dogs and cats in the house need treatment because of their close quarters. Shed in the feces, Giardia cysts (i.e., eggs) can remain viable in the yard, litter box, bedding and pets' fur and cause re-infection, so a thorough environmental scouring is necessary. The pets were bathed, their bedding and litter boxes washed, and the yard picked up. Each pet is currently undergoing treatment for Giardia to be on the safe side. The owners have been warned to practice good hygiene when handling the animals and to contact their physician for further advice regarding the zoonotic nature of this parasite.


It is said time and again in veterinary school, "You miss more by not looking than by not knowing." Even though the stool appeared normal and there were plenty of possible explanations for the couch poop, we discovered an important medical problem with our thorough test. Thank goodness we checked! And I'm sure the owners will feel the same way after they've completed a hellish week of medicating three feisty felines!