Dental disease in dogs and cats: why you should brush your dog’s teeth! Part 2

The most important question pet owners fail to ask is how often do I need to brush my pet’s teeth?  For you to take the best possible care of your pet’s teeth, they need to be brushed once daily! A daily brushing will certainly reduce your pet’s frequency of professional veterinary dental cleanings, but probably will not eliminate them. Remember, under anesthetic and with the best possible lighting, your vet will see things you cannot and can perform a very thorough exam and cleaning.

If you take care of your pet’s teeth (and that means daily brushing), the gums will remain much healthier and the dental procedures will be simpler and less frequent. Almost 15 years ago I adopted a 5 year old rescue dog with very heavy tartar accumulation, but fortunately little gum disease. After a thorough dental prophylaxis, I began brushing his teeth every day. It wasn’t easy to get him used to it (he was 5 years old and no one had ever tried), but in a few weeks he was becoming much more cooperative and ultimately came to enjoy it (they love the taste of the veterinary pastes). He lived another 11 years and never needed to have his teeth cleaned again. This dog was the exception, but had I not chosen to brush his teeth every day, he would have needed to be anesthetized for professional dentals every 6 to 12 months for the rest of his life. 

Our pet’s dental health is similar to ours and once the gum tissue has become infected and receded (leaving the exposed dental roots), it will not grow back. After a thorough dental prophylaxis, this area will rapidly refill with tartar and the gum disease will continue to progress. Ultimately the involved tooth or teeth will become unstable and need to be pulled. So don’t wait to have your pet’s teeth cleaned and to begin home dental care.

The sooner you begin to practice good dental hygiene with your pet, the healthier his mouth will remain. It is important to remember that we are not simply talking about cleaner teeth. Heart and kidney disease and other serious health issues are known to be caused by untreated periodontal disease and the associated bacterial infection that floods our blood stream. And, we aren’t even talking about the pain and discomfort caused by infected gums and loosening teeth. 

Yes, your pet will need to be anesthetized to have his teeth cleaned, but with new anesthetic regimens and appropriate monitoring, this is a safe procedure. In fact, the odds of serious complications from untreated dental disease are much greater than the risks of general anesthetic for most pets. Neither you nor your vet should ignore your pet’s dental health! Don’t rely on the occasional dental prophylaxis to take care of your pet’s teeth without the benefit of home dental care. You wouldn’t stop brushing your own teeth and simply rely on your dentist to take care of your teeth and you shouldn’t take this approach with your pet! If you need more suggestions on how to brush your dog’s teeth or how to take better care of your cat’s teeth, talk to your veterinarian.

Dental disease in dogs and cats: why you should brush your dog’s teeth! Part 1

Dental disease is all too common in our pets. Every time you go to the dentist the hygienist gives you advice on how to better care for your teeth. Does your veterinarian suggest how to take the best care of your pet’s teeth?

When your pet is getting his annual exam, be sure that the mouth is opened and there is a thorough oral exam. Not only ask but take a careful look to see how your pet’s teeth look. Inquire about what you might be doing at home to help your pet maintain a healthy mouth.

The simplest suggestion is one that will help both canines and felines: limit feed dry food. Canned food tends to leave a paste residue over the surface of the teeth. Free feeding (the food is allowed to stay out all day) and nibbling throughout the day is no better for your pet’s teeth than frequent snacking is for our teeth. Every time we eat, more plaque is left on the teeth.

Dental diets and treats may help some, but not at all if your pets doesn’t chew them thoroughly, and some pets, especially cats and small dogs, may simply swallow them whole. Unfortunately, there is no substitute for brushing your dog’s teeth. (The same could be said for our cats, but while few cats will allow us to brush their teeth, almost all dogs can be trained to have their teeth brushed.) We are only talking about 1 to 2 minutes daily.

When you adopt a puppy, you should get him used to your opening his mouth and looking around. When you need to give your pet a pill, the process will be much easier; it will be possible to pull something out of his mouth if you need to, and once his adult teeth have all erupted (about 6 months of age), you can begin brushing his teeth. Until this time he will be getting used to your handling and playing with his mouth.

For most dogs a small or pediatric tooth brush works well. A used brush (with the bristles somewhat crushed) is great. Always use a veterinary tooth paste. Human paste actually contains soap and is not meant to be swallowed, and pets hate the foaming action of our tooth paste. In addition, because we live so much longer than our pets, their past can be much more abrasive (and effective) than ours.

Push the paste down into the bristles, hold your pet’s mouth closed (pets hate to have their mouth forced open), lift the cheek on one side of the mouth and brush away. You are mostly interested in brushing the surfaces of the maxillary (upper) teeth. These actually scrape off and clean the lower teeth as your pet chews. Be sure to include the last molars on each side as well as his fangs (canine teeth). Check his incisors (the smaller teeth between the canines) carefully. Many (especially large breed) dogs maintain healthy, clean incisors and they don’t appreciate your brushing them (because you are often closing you pet’s nose while you try to get to these teeth). However, some dogs (especially smaller breeds) accumulate heavy tartar and plaque between these smaller teeth and the gums become red and irritated as they recede. If a careful examination shows anything but perfect incisors and gum tissue, this area will need to be brushed also. While you are at it, check the lower incisors. In some dogs this can be a real problem area and may also need your attention. On a weekly basis I try to hold my pet’s mouth open and briefly brush the inside surfaces, but this is difficult (and often ineffective) and the inside surfaces tend to accumulate much less tartar than the outside surfaces.

We’ll continue this discussion in another week!

Part 2 of 2: Euthanasia of the Potbellied Pig

The big mastiff calmed down quickly and the couple led me to the barn to see why I was here. I retrieved my house call kit from the car and followed them between two old barns out into a fenced area that looked like it once held livestock. Other than 2 goats in an adjacent area there were no more farm animals to see now.

“We got our potbellied pig, Jimmy, for our kids about 15 years ago. He’s lost so much weight. He used to be fat and now he’s skin and bones. He can hardly walk. Our regular vet put him on some medications a while ago, but they are not helping anymore. We think it’s time.”

I first drew up a sedative and gave him an injection in the neck muscle. (Recommended in this area because the pigs have so much fat everywhere else and the injection needs to go into the muscle and not the fat.)

Euthanasia solution is best given directly into the vein and the most accessible vein in a pig is in the ear flap. Mrs. Arnez headed into her house to get me a bowl of water to wash up the area. I needed to thoroughly clean the outside of the ear and improvise a tourniquet to force the vein to stand up for me. This would be the sight of Jimmy’s injection.

He was sleeping soundly from the sedative. Once the ear was clean and the tourniquet was in place, I could still not see a vein. The next step was dousing the area with alcohol and tapping or lightly “slapping” it with your hand until the vein stood out. My worry was, what if after the sedative and the prep, I still couldn’t find a vein? Or what if I found a tiny vein but couldn’t successfully feed the needle into it?

There was no problem. The vein became obvious after the alcohol treatment. Jimmy felt nothing as I gave his injection and he peacefully went to his final rest. 

Part 1 of 2: The Brazilian Mastiff and the Potbellied Pig

Have you ever driven down a street and seen a sign: aircraft may also use this road for landing? Or seen a street sign that says: aircraft only? If you haven’t, then you haven’t driven through an air park in Tucson where homes, planes, horses and wildlife share space. When I was heading to a house call a few nights ago and saw these signs, coyotes, jackrabbits, multiple Gambel quails  and the many homes that shared their backyards with private aircraft, I knew my GPS had mislead me. I had even been forewarned by my new client. Luckily, I still had cell phone reception and could get directions. Making house calls in unfamiliar areas around Tucson, the most frustrating experience is to be lost and not have cell phone reception.

I was heading out to euthanize a potbellied pig. He was weak; he was old and had been losing weight for a long time. I hadn’t dealt with one of these guys for many years, but I had done my homework and was prepared.

It took me so long to find their home that it was getting dark by the time I arrived.  The directions weren’t easy (I have a terrible sense of direction anyway), but when I passed their barn, rusting antique tractors and horse stalls, I knew I was in the right place.

As I pulled over to park, 2 huge dogs came running over to greet me. The Great Dane was quiet and friendly. His much larger companion wasn’t happy to see visitors; he barked and snarled as foaming saliva flew all over my dust covered car (I had just driven 3 or 4 miles down a dirt road to get here).  I assumed when I saw my client walking across his driveway that he would call off his guard dog, but he paid no attention. I wasn’t getting out while this snarling giant was waiting on the other side of my car door. Finally a woman walked out the front door and she thought to call this big boy to her side.

When I felt safe enough to leave my car, the first thing I asked was, “How big is that dog? He kind of dwarfs your Great Dane, doesn’t he?”

“He’s about 225 pounds. The only thing we could get that was bigger was a steer.”

I had to agree and you’ll have to wait for the next blog to hear about the pig.

Pet Food: Should I feed an all-natural or grain-free diet?

Hardly a week goes by that I don’t hear a pet owner tell me that they have started feeding their pet a much more expensive food with no grain or an all-natural diet or a food with meat (instead of meat byproducts). The obvious question is: Are these the best foods to feed our pets and are they worth what we pay for them?

My opinion (also shared by the professional veterinary nutritionists I have spoken with) is that these foods offer no advantage to more traditional high quality diets, but we may be paying more to simply purchase some advertised ingredients. This post offers my opinion as a veterinarian who has researched and promoted careful dietary management for almost 40 years.

Let’s discuss low-end  pet foods first. Unfortunately, you get what you pay for when it comes to most pet foods. If you pay less, you are most likely getting less. Comparing labels and ingredients simply doesn’t help. To prove this point, years ago a major pet food company cooked down leather boots and then tested the product to come up with the guaranteed nutritional analysis. The results: the nutritional analysis was identical to most of the available canned pet foods, but a pet fed the cooked leather boots would have starved to death because the ingredients were not digestible. Some time ago when a new pet food was introduced by a major company, they wanted their label to have meat listed before meat byproducts (to look better  than a major competing brand). This diet contained less meat than meat byproducts, but by simply playing with the processing, they were able to list meat first. (Besides, quality meat byproducts are not necessarily an undesirable ingredient!)

When you look at the biggest pet food manufacturers such as Royal Canin, Iams-Eukanuba, and Purina, you see huge, multinational companies that can afford extensive research and feeding trials. They employ teams of professionals to formulate and evaluate their diets. These companies study the relationship between diet and disease and invest millions of dollars developing diets formulated to help control or treat many diseases. Often existing diets are reformulated and improved based on the results of these studies.

Yes, you do help pay for these studies, but you also benefit from the fact that these large companies can reduce their costs by buying large quantities of quality ingredients, and they pass this savings on to you. You are spending what is necessary to buy a diet with the very same ingredients that have been proven to keep our pets long-lived and healthy. So, what about the niche natural food diets, the no-grain diets, the diets with nothing but meat and vegetables and no byproducts?

There are pets that suffer from food responsive problems. Your veterinarian is best qualified to help you select the ideal diet for such a pet. Sometimes this may include a no-grain diet, but most often it will be a particular prescription diet that has been specially formulated to treat pets such as yours. But, when you are buying pet food, consider these facts. You have no idea who makes a store or generic brand pet food, but it’s not a major company that’s buying the highest quality ingredients or running extensive feeding trials. When you buy the niche diets, you are paying a premium for a special diet that for most pets has no advantage to the diets made by the major name-brand pet food manufactures. In fact you are paying a premium for what most professionals agree has no added value for a pet. Buy the higher quality and pricier diets from the companies you know and trust and you are investing in proven ingredients and not the marketing gimmicks that have led us to believe in the value of the all-natural and grain-free diets. Our pets have been domesticated for over 10,000 years and most thrive on high quality conventional pet foods.

(And, of course, regardless of what you feed, don’t overfeed your pet!)

    

Curing Diabetic Cats with Purina DM and Glargine Insulin

I went on a house call to put an old, debilitated dog to sleep, and as often is the case, we started talking about their other pets. They had a second dog and 2 other cats and all their pets were significantly overweight. The husband agreed there was a weight problem, but his wife didn’t want to deprive her pets. (Luckily, she had left the room as we continued our conversation.) Mr. Bedrow told me that one of his cats was diabetic, and they were giving him insulin shots every 12 hours. When I asked about special diet, feeding schedule and anything else the vet had recommended (because often with proper management, we can eliminate the need for insulin in these cats), I was quite surprised to hear that there were no other instructions. Both cats ate the same dry grocery store (name brand) food, and the food sat out all day every day.

“Did you know that most diabetic cats can be weaned off of insulin with scheduled and limited feeding of special (prescription) diets for feline diabetes and a human type of insulin. We can cure these diabetic cats."

His eyes widened as he responded, “I had no idea but I doubt we could get my wife to cooperate, but tell me more.”  

I first explained that we used to treat diabetic cats like they were little dogs. We used high fiber diets (just like we prescribed for dogs); some of the cats stabilized but none lost their need for insulin. “Then we started treating them like they were cats. We went to high protein, moderate fat with very low carb diets. After a thorough evaluation to rule out any other problems, I recommend limit feeding Purina DM (prescription diet for diabetes) diet (mix a small amount of this with the cat’s regular diet and slowly increase the new diet as you decrease the old). Your cat’s daily amount of food should be divided into at least 2 meals. If he needs to begin insulin injections (and most do), the feeding intervals are coordinated with the injections so that he is fed as the blood sugar begins to drop. Initially simply a change in diet and careful limit feeding (the goal is an ideal weight) can be attempted to “cure” the diabetes, but I wouldn’t wait longer than a week before adding insulin into the picture because the longer cats remain untreated the more likely they are to start having complications from their diabetes and the more difficult it can be to ultimately wean them off of insulin. Glargine insulin is the most effective for eliminating the need for daily injections. The bottom line is when you combine a careful feeding management (optimal diet, quantity and schedule) program with the appropriate type of insulin, most cats can be weaned off of insulin.  Work with a veterinarian who not only wants to manage your cat’s diabetes, but also wants to eliminate the need for continued insulin injections. He can even make suggestions for monitoring your cat’s sugar at home to reduce the number of office visits.

I need to stress that almost all diabetic cats (and dogs) have type 2 diabetes, and this is the result of how we feed our pets. Too many people believe that if pet food is left out, cats will not over eat. That is simply not true. In other blogs I will write about the other important reasons to limit feed our cats (and dogs).

For all you ever wanted to know about treating your cat for diabetes follow this link http://www.catinfo.org/?link=felinediabetes. I don’t necessarily agree with everything the author says (especially when she discusses appropriate diets), but she certainly provides a lot of valuable information.

Send me any questions or comments you might have!

Limit feeding dogs and cats to prevent obesity, arthritis, diabetes...

I created this blog to entertain and to educate. (And, if you enjoy the blog, you will enjoy my upcoming book LAUGHTER AND TEARS, a Veterinarian’s Memoir and Lessons.)  One of the most important and money saving tips that a veterinarian can teach is how to properly feed a pet. In other words, what exactly is limit feeding and why is it such a big deal. Too many pet owners think their pet(s) won’t overeat. They feel guilty if food is not always available. Others think they are limit feeding because once or twice daily they put food in their pet’s bowl and ultimately (maybe by the end of the evening) it is finished. But, if your pet doesn’t empty his bowl before he walks away, he is not limit-fed and he is at increased risk for obesity, arthritis, diabetes and many other serious, health issues.

I define limit feeding as first determining how much food is necessary to maintain your pet’s ideal weight and then dividing this amount into 2 daily feedings. (A pup may be fed 3 to 4 times daily but no pet should be fed once daily.) A healthy pet instinctively will eat enough to maintain or increase his weight. In other words, a limit-fed pet will empty his food bowl within minutes twice daily 7 days a week. (Dogs may take less than a minute and cats may take several minutes.)

What’s the big deal? If your pet is limit fed and one day he doesn’t finish his food, there is a problem and either you or the vet needs to determine what that problem is. If food is always available, it is never obvious when your pet’s appetite changes.  

Why else would you limit feed? I have been making house calls for almost 40 years. The most common reason I go to someone’s home is that their pet is having a hard time getting around. They are arthritic and the owner is deciding whether euthanasia is the most humane solution. Often the reason for the arthritis is chronic obesity from over feeding (and under exercising). Most pets will overeat if food is always available.
  

How do you decide how much to feed your pet? The pet food probably has feeding suggestions on the label. But, remember these recommendations are for maintaining an ideal weight. If your pet should weigh 25 pounds but weighs 35 pounds, you should look at the instructions for feeding a 25 pound dog and even this might be 25% more than your pet needs. Your veterinarian might be your best resource for feeding instructions, but the bottom line remains, your pet’s ideal daily ration will be less than he wants but enough to maintain his ideal weight. For example, if his ideal weight is 20 pounds, this may be 1 cup of a quality name brand pet food each day. Every morning I carefully measure this 1 cup. He is then given ½ in the morning and the balance in the evening. This is measured once daily because it is easier and more accurate than measuring twice daily.

Limit feed your pet (dog or cat)! You will prevent weight problems, you will be evaluating how your pet feels twice daily, and you won’t be wasting expensive pet food or cleaning up excessive poop after your pet (either in the yard or the litter box).

How can I start my pet on this limit feeding schedule? Is it even possible to change a dog or cat from a free fed schedule to a limit fed schedule?  It’s much easier than you might think and whether your pet is a dog or cat, the process is the same. Once you begin to limit feed, if your pet walks away before the bowl is empty, pick up the balance and either throw it away or add it back to the main food container. (If this is beyond an introductory period, you need to know why he didn't finish his food.) It is not added to the other meal and it is not left out. It doesn’t take long for your pet to learn that this is no longer an all day buffet. He is getting hungrier before each meal and soon (within a few days) he is eating what he needs to maintain his (current) weight. Over time you can slowly adjust the amount until he is maintaining his ideal weight.