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March 20, 2016

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Lessons Learned (too) Close to Home

February 9, 2016

This is a reprint of an article Dr. Singh wrote in February, 2012. Sadly, his cat Oliver passed away due to cancer in 2014. Lily, however is a healthy 11-year-old whose teeth are still in good shape due to annual professional dental cleanings. 

 

One the benefits of a Professional Oral Prophylaxis (POP), also known as a “dental,” is finding previously undiagnosed diseases and treating them. Cats usually have 30 teeth and dogs have 42. Any single one of these teeth could be diseased. The signs of disease may be absent or subtle and many people, including veterinarians, will miss them or misinterpret them.  Last year, I examined Oliver and Lily, two unrelated six year old cats from the same household. They always had their annual wellness examinations and had been fed high quality diets their whole life. On physical exam they appeared healthy other than mild tartar on their teeth and mild gingivitis. The owner did not routinely brush their teeth. I recommended a POP after routine pre-operative blood tests were normal. I noted that the teeth and periodontal disease did not look bad at the exam and that this should be a routine cleaning procedure.

 

Surprisingly, at the dental procedure a number of problems, including painful resorptive lesions, were found using probing and dental x-rays. These lesions are often not visible on a visual exam until they are at a very advanced stage, and x-rays are required to properly evaluate this condition. Multiple tooth extractions were required in both cats. After the procedure, the cats went home and seemed friskier, friendlier and more relaxed. The owner was very pleased and vowed to have his cats teeth cleaned every year to prevent unnecessary painful lesions requiring tooth extractions. What makes this story especially interesting is that Oliver and Lily are my own cats.

 

Thinking back, I wonder why was I surprised. Oliver was howling every night waking me up at 2 AM. Lily was shy and afraid of contact. Could it be that mouth pain was contributing to a poor quality of life? Why did I miss the lesions on the oral exam before surgery? I am a veterinarian – don’t I have x-ray vision? Don’t I talk to the animals?

 

First lesson learned: monitor your pet closely for behavior changes – they can be indicative of pain or discomfort.

 

Second lesson learned: Have your pet’s teeth cleaned before tartar is visible, starting at age two, once a year if they are a cat or a small dog, and every other year in large breed dogs, even if they appear healthy at a physical exam.

 

Third lesson learned: Do more to protect your pet’s teeth at home between dental treatments. There are many food, treat, tooth brushing and other home care products available.

 

Finally, don’t be surprised when a problem is found on a “routine dental.”

Since their POPs, I started Oliver and Lily on dental diets and treats. At Lily’s last recent POP she did not require additional extractions. Oliver’s POP is scheduled next week on Valentine’s Day. I am sure he will treasure his present. 

 

Dr. Raj Singh has owned Sunnyvale Veterinary Clinic since 2002. He is a board-certified specialist in canine and feline practice. He also works (as a general practitioner) with rabbits, small mammals, birds, reptiles and amphibians.

 

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