Sunday, 14 October 2018

Teeth talk

Periodontal disease is one of the most common problems seen in veterinary practice. It occurs in two forms: The first is gingivitis, a reversible inflammation of the gums. The second is periodontitis, an inflammation of the deeper structures supporting the teeth.
The problems begin when plaque that is made up of food particles, saliva and bacteria, starts to build up on your pet's teeth.To start with, the plaque is a soft off-white material on the teeth. If plaque remains, it quickly mineralises and hard brown tartar forms on the teeth (also called dental calculus). It commonly leads to gum inflammation (gingivitis). Bacteria begins to build up between the gums and the teeth.

Periodontitis develops as a continuation of gingivitis. If this inflammation is not controlled, the bacteria continue to accumulate between the teeth and gums, causing irritation, infection and bleeding. This inflammatory and infectious process can destroy the periodontal ligament as well as the substance that holds teeth in their sockets, which is called cementum. The roots may become so severely affected that some teeth become loose and fall out.

Bacteria surrounding the roots gain access to the blood stream and can affect your pet's organs -  the liver, kidneys, heart and lungs.

Treatment is directed towards preventing gingivitis from progressing to periodontitis and delaying the progress of periodontitis if it is established.

Signs of dental disease may include; 

  • Bad breath ( Halitosis)
  • Dribbling
  • May become head shy and resent mouth being touched
  • May avoid harder foods
  • May avoid eating on one side of the mouth
  • Poor grooming 
  • Rubbing or pawing at the mouth
  • Redness of the gums / bleeding gums
  • Discolouration of the teeth
  • Swelling on the face

It is important to remember that pets with dental pain may not show obvious signs and they frequently maintain a normal appetite.

Throughout October and November we are offering a FREE DENTAL HEALTH CHECK for your pet with a vet! Even if your pet is not showing any signs of dental disease it is worth coming along so that the vet can assess your pet's oral health. (If further treatment to recommended the vet will provide an estimate) 

Toby has his teeth cleaned 

Lovely seven year old Toby belongs to our head nurse Jazmin. He recently had a dental scale and polish after it was noticed that he had an accumulation of tartar on his teeth. Once tartar has formed on the teeth it needs to be removed professionally by the vet, as at this stage, home brushing will not remove it.

For this procedure animals require a general anaesthetic, so prior to the dental, Toby had a health check which involved a physical examination and then a blood test to assess the function of his liver and kidneys. With a clean bill of health, Toby was booked in for a dental. Cats and dogs need to be starved before having a general anaesthetic, so Toby was not allowed any breakfast on the morning of the procedure.

Toby was given an injection of pre-medication which helped him to relax (pictured). Jazmin then settled him into a kennel to allow some time for the pre-med to take effect. Jazmin set up the dental equipment and the equipment needed to anaesthetise Toby. After about 30 minutes Toby was feeling sleepy and was ready to be anaesthetised. 

Vet Lavanya, assisted by Jazmin, gave Toby an intravenous injection of anaesthetic; this is called induction. Toby was then intubated which involves inserting a tube through the mouth and into the trachea (windpipe).The tube is then attached to an anaesthetic circuit which provides anaesthetic gas and oxygen. This enables us to control and maintain the level of anaesthesia for the patient.

Lavanya used an ultrasonic dental scaler to remove the tartar and plaque from the visible surfaces of Toby's teeth. It is important to clean the unseen bits too - below the gum margin where plaque can accumulate. She also assessed the health of the teeth; Toby did not need any extractions. After scaling each tooth, they were polished using a dental polisher and special toothpaste to leave a smooth tooth surface. This also helps to prevent the rapid re-attachment of plaque.

Following the procedure Toby recovered well from the anaesthetic. Jazmin was able to take him home the same afternoon. It was important to keep Toby quiet and rested at home for the next 24-48 hrs whilst he recovered fully from the anaesthetic.

Toby back home with his friend Ruby 💜

Now that Toby’s teeth have been cleaned, it is important that he receives home dental care in order to maintain the health of his teeth and gums and prolong the need to repeat a scale and polish in the future.

Regular tooth brushing is the best way to keep the teeth clean and healthy. Special toothbrushes and pet toothpastes are available for dogs and cats. Human toothpaste should never be used. Your vet or nurse can give you plenty of advice on introducing your pet to brushing and will demonstrate how to brush their teeth too.
Ideally puppies and kittens should be introduced to dental hygiene at an early age, however it's never too late to start! With patience and time even older pets can learn to have their teeth brushed.

Our nurses run FREE dental health clinics where you can fully discuss your pet's needs and get recommendations on the best way to care for your pet's teeth. 

There are specially designed foods, oral hygiene gels, toys and chews available to help keep pets’ teeth clean and are suitable methods if brushing has proved unsuccessful.

Regular dental examinations are important. Ideally, twice a year - at your pet's yearly booster vaccination health check and again six months later.

Disclaimer: The contents of the Arden House animal hospital website are for informational purposes only.The content is not intended to be a substitute for professional veterinary advice, diagnosis, or treatment.Always seek the advice of your veterinary surgeon with any questions you may have regarding your animal’s medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Tuesday, 21 August 2018

Pet of the month Hall of fame - Loki (June 2018)

During the spring bank holiday (28th May), Loki had fallen from a height of about 50cm and hit his head. He appeared confused and was reluctant to move, so his owner called our emergency service and vet Karolina who was on duty arranged to see him straight way. Loki was given a thorough examination and fortunately he had not injured his back and neck, and he was alert and able to move around.  However, he had a small puncture wound on his lip and a sore jaw that he wouldn’t allow Karolina to touch. Karolina gave Loki an injection of pain relief and allowed him home for the night so that he could rest in his own familiar surroundings. She arranged to see him again the following morning. Loki was happier but his jaw was still sore and he was having trouble eating his nugget food. Karolina could now see that his lower jaw was broken in between his two front teeth, an area called the mandibular symphysis, where the bones of the right and left mandible meet. This meant that his jaw was unstable and preventing him from chewing his food –something that rabbit’s like to do all day. It is also vital for their health; Rabbits thoroughly chew and grind their food so that their teeth, that are continually growing, are worn down and renewed. Loki required a general anaesthetic so that his jaw could be realigned and the fracture stabilised.

Vet Kirstie anaesthetised Loki and firstly took an x-ray of his skull to check for other injuries and to assess the lower jaw injury. The next stage was to meticulously realign the lower jaw bones before using a special tissue glue to glue the two lower incisors together. This effectively stabilised the jaw. She then used a thick suture material to further secure the jaw fracture in place. 

Loki recovered well from the general anaesthetic and it was important that we provided nutritional support throughout his recovery until he was able to eat well enough by himself. At home Loki has a hutch mate called Poppy whom he lives with, so to ensure neither of them became lonely, Poppy came to stay. Loki was a much happier bunny and managed to eat some grass and greens by himself. Loki was allowed home the following day and he continued to do really well.

Six weeks after his operation, Loki came to see Kirstie and she was so impressed with his progress that it was time to remove the suture material. Loki was given a short acting anaesthetic to enable Kirstie to do this. The glue that had been used just disperses naturally as the teeth grow.

We are all so pleased to see that this gorgeous boy is better. For being a brave and tolerant patient and for his cuteness, Loki is a much deserved pet of the month! 

Malocclusion is a complication that can develop following an injury like Loki's. This is where poor teeth alignment lessens the effectiveness of chewing and leads to overgrown teeth. It can inhibit their ability to eat. Rabbit's teeth can also become overgrown because of a poor diet or due to malocclusion present from birth.

Loki's owner will continue to monitor him closely to ensure that he is eating.

Friday, 20 July 2018

Pet of the Month Hall of Fame - Jeffery ( May 2018)

The Great Dane is an unmistakeable breed. They may be a large dog but they are often referred to as gentle giants and six year old Jeffery is no exception.
Like other large breed dogs, they are at risk of a life threatening form of bloat. 
Gastric dilatation - volvulus (GDV) is a veterinary emergency which occurs as a result of the stomach filling up with gas (a bit like a balloon), becoming increasingly distended, and the gas cannot escape (dilatation). The stomach can also twist on itself impairing blood flow (volvulus).
This is a rapidly progressive emergency as the blood vessels on the stomach's surface become stretched, reducing their ability to supply blood to the stomach wall. As the stomach twists, it cuts off the blood flow to vital blood vessels, which can lead to the stomach tissue dying. Circulation is also impaired. The animal quickly deteriorates, becoming increasingly weak and shocked. This fatal process can happen within a few hours so it is important to spot the symptoms and seek immediate veterinary attention - surgery is the only cure. 

A few weeks ago, Jeffery's owners found themselves in this very situation. It was Sunday teatime and after finishing his dinner, Jeffery went out into the garden for a wander. His owner Karen noticed that he'd been outside for a while so went to check on him. Jeffery was pacing around the garden and he looked like he wanted to be sick. He attempted to vomit, but was unable to bring anything up apart from some thick saliva secretions
(unproductive vomiting). Jeffery was restless but he had become lethargic and kept lying down - all tell-tale signs of  a GDV. Karen managed to take Jeffery indoors where he began to cry in pain and it was then that Karen noticed that Jeffery's abdomen (belly) had become swollen and distended - a classic symptom of bloat. Recognising the situation, Karen called the hospital and got in touch with the head vet Cathy who was on duty.

From the symptoms described by Jeffrey's owner, Cathy suspected that Jeffery was suffering from GDV and arranged to meet them at the hospital straight away.

Upon arrival, Cathy examined Jeffrey and confirmed the diagnosis .With the assistance of student nurse Becky, Jeffery was given pain relief and fluid via an intravenous drip.  His owners consented to the surgery and Jeffery was admitted to the hospital. His stomach was hugely distended, so to relieve the pressure, Cathy inserted a large gauge needle through his body wall and into his stomach to allow some gas to escape. Becky set up in theatre and prepared the anaesthetic equipment . Jeffery was now stabilised  enough for him to undergo the general anaesthetic required.
Once in theatre, to surgically correct the GDV,  Cathy firstly needed to very carefully 'de-rotate' the stomach back into it's normal position. Jeffery's spleen had also twisted due to the movement of his stomach, so Cathy needed to place this back into it's normal position in the abdomen. Next Cathy assessed the tissues of his stomach and spleen and luckily the blood supply and tissues looked active and healthy. The next step was to pass a stomach tube down Jeffery's oesophagus and into the stomach in order to empty it's contents and further relieve the pressure. Unfortunately this procedure was unsuccessful due to the stomach content being too thick, so Cathy was then required to carry out a procedure called a gastrotomy in which an incision is made into the stomach wall. This way, Cathy was able to remove the stomach contents. The last part of the operation was to carry out a gastropexy. This is where the stomach is attached to the inside of the body wall, so it can no longer shift and twist. Throughout the emergency operation, student nurse Becky closely  monitored Jeffery's general anaesthetic. 

Jeffery recovered very well from the general anaesthetic, and the surgery proved to be a success.

After a night in the hospital, Jeffery was looking so much happier and he had re-discovered his appetite. The nurses monitored him closely for signs of vomiting and discomfort as well as ensuring his surgical wound was clean and dry. He enjoyed having some gentle strolls around the garden and getting lots of attention from the nurses.

(Pictured with our head nurse Jazmin) .

Cathy was so pleased with Jeffery's progress that she allowed him to go home just two days after his life saving operation. Fortunately the quick thinking action of his owners meant that Jeffery was seen within an hour and an half from when his first symptoms developed - this contributed to a successful outcome. 

We are all so pleased to see that Jeffery has recovered so well and is a much happier boy!

For being so brave and for his gorgeous nature, Jeffery is a much deserved pet of the month!

The causes of GDV are not clearly known but there are several factors that appear to increase an individual's risk of developing the condition. Whilst any breed of dog and even cats can develop GDV, it is most commonly seen in large/giant breeds of dog which are deep chested. Nervous, anxious dogs under stress may be more prone to developing it, as are animals that eat a large meal  or drink a large amount of water in one go. Eating rapidly may also contribute to the animal gulping in air. Exercising just before or after a meal is another possible factor. 

In order to minimize the risk of developing GDV it is suggested that dogs should be fed frequent smaller portions of food rather than one large meal. Don't allow your dog to heavily drink in one go, especially after a meal - instead offer smaller amounts often. Strenuous exercise and excitement such as play should be avoided before and after eating.

Most importantly, be aware of the signs of a GDV - panting, discomfort, restless, pacing, lethary, drooling, unproductive attempts to vomit ( retching and only bringing up white froth ), crying and a distended abdomen ( belly ) -  bloated, full appearance.
Remember, pets don't read the text books - symptoms can vary and not all symptoms will be seen. If in any doubt, do seek immediate veterinary advice.

      The contents of the Arden House Animal Hospital website are for informational purposes only. The content is not intended to be a substitute for professional veterinary advice, diagnosis, or treatment. Always seek the advice of your Veterinary Surgeon with any questions you may have regarding your animal’s medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.