Tuesday, October 9, 2007

Dental X-Rays of a 3 Year Old Cat with "Apparently" Perfect Teeth!


Note the root destruction of the large tooth on the left compared to the right. Without x-rays this cat would be sent home with improper treatment. A consultation with a dental specialist was performed and the tooth removed based on his recommendation. This cat would have had to suffer with a painful root abscess if no x-ray was taken. Unfortunately, many pets don’t receive crucial care when corners are cut. South Beach Animal Hospital is the only hospital on Miami Beach currently using routine intra-oral x-rays.

Monday, October 8, 2007

No Anesthesia teeth cleaning myth

I'm up way too late but I'm starting a new one. Every day I see pets in terrible agony and suffering with dental/oral problems more so than any other single injury or disease. THATS HUGE!!!!!The idea that some misguided individuals are promoting non-anesthetic cleanings and calling it friendly to pets is driving me nuts. This is the worst of the worst . It's so pet unfriendly it's not even funny! These folks are really hurting the pets they're trusted to help. It's a real crime in my book and there are vets in my neighborhood selling this snake oil. I'll take you directly to the expert here. A board certified veterinary dentist. He's Fraser Hale from ontario where he's run a dental specialty hospital for many years. He was kind enough to allow me to link to his site and quote from his wealth of knowledge and experience.
Here's the site; http://toothvet.ca/
When I told Dr. Hale about my blog he referred me to a newsletter from the governing body of veterinarians for the entire province of Ontario, Canada. page 18 of the attached newsletter from the College of Veterinarians of Ontario (our provincial licensing/disciplinary body). The fact that the CVO has now stated emphatically that offering unanesthetized veterinary dental care falls below the standard of practice for the entire province of Ontario .By the way, It is substandard right here in the US of A! From the site he talks about "Standing Dentals" i.e. without anesthesia and how it's absolutely impossible to serve our pets needs this way. I'll also follow this with a blog about anesthesia and how incredibly safe and important it is. Enjoy an exerpt from Dr. Hales website:
This myth likely grew from client concerns about the risks involved in general anesthesia. In order to offer some level of dental care at reduced risk, some veterinarians have offered the “Standing Dental”. Groomers and breeders have also been known to offer this service. When finished, the visible portions of the teeth look clean to the naked eye and the animal’s breath is often less offensive. This, coupled with a much lower fee and no anesthetic risk tends to satisfy the client. “Standing Dentals” leave plaque and calculus in places where the owners can not see it, so the owner is given a false sense of security that the mouth is healthy. “Standing Dentals” scratch the enamel surface but do not allow polishing so the tooth is left even more plaque retentive than before. “Standing Dentals” are unpleasant for the animals and so can make them head-shy which makes instituting an effective home-care program much more difficult. “Standing Dentals” often lead to damage to the gingiva as the animal wiggles about while there is a sharp instrument in the mouth. “Standing Dentals” do not allow for a thorough oral examination and so subtle problems are left undetected and untreated until they become serious and obvious problems which are usually much more difficult to treat. I recently saw a very sweet, 14 year old sheltie owned by a very dedicated and capable owner. This owner will do anything for her dog if she feels it will improve his health and well-being. Unfortunately, the advice she received over the years was that her dog needed only coronal scaling with sedation. This had been done many times throughout the dog’s life. By the time I saw the dog, he had such severe periodontal disease that I had to extract 24 teeth (2 canines and all his remaining posterior teeth). The good news is that, within two weeks, the owner reported that the dog was chasing squirrels like he had not done in years. If this dog had received appropriate dental treatment from an early age and had the owner been given proper instruction regarding home-care, the extractions and the years of suffering from dental infection would have been prevented. Since “Standing Dentals” do more harm than good, refuse to offer this service. A “Standing Dental” is bad for the patient (there are risks with no benefit), bad for the owner (who pays for worthless, potentially harmful treatment) and bad for the profession (as it under cuts those offering proper dental care and undermines our recommendations).

Heads up on TRUE MYTH(is that an oxymoron?)

Grapes and raisins can be highly toxic to dogs and cats!!!!!!!!! So is chocolate. Aspirin, tylenol, ibuprofen etc. can be deadly as well. It's late but I wanted to get this info up on the blog to get the info out there. I'll post the details soon. Remember, call your vet before giving any home remedies to your pet's!!!!!!

Antibody Titer Testing Myth

Antibody titer testing has come to the fore since the vaccine protocols have reduced. These are blood tests that show whether your pet has antibodies against the diseases we vaccinate for. The idea being if your pet has good antibodies , they should have proper immunity. Pet owners are eager to have the blood test because they think that it's the substitute for the yearly vaccine. They'd rather have a test than an unnecessary . Without getting too much into the details I'd like to refer as I often do to folks smarter than I am. Dr.'s Ford and Wolf are two prominent internal medicine specialists who addressed this issue in a recent immunology bulletin. In it they asked; "What are the indications for performing antibody titers?" I quote "Veterinarians cite several reasons for performing antibody titers in individual patients. For example, owners who are particularly concerned about the potential for vaccine-induced injury may request titers in lieu of annual vaccination. Veterinarians who are reluctant to implement triennial vaccination recommendations for core vaccines may elect to submit serum for titers annually before administering a core vaccine. Conclusion Whether a practitioner administers booster vaccines annually or triennially, there are few indications for routinely substituting antibody titers for vaccination. Differences in test methodologies and vaccine types and the ability of the individual patient to mount a protective immune response are significant variables in defining the value of antibody titers in assessing vaccine response."
On the surface it seems a great alternative to vaccine and it would be a huge income boost to my hospital. However, I could not justify offering it on a routine basis to my clients after researching the scientific data and opinions of experts that I trust.

Myth of the yearly vaccine

Myth of the yearly vaccine I think most of my clients have caught on to the trend in veterinary medicine to reduce the frequency of vaccinations for common viral diseases. When I started practicing it was standard to vaccinate dogs and cats yearly for both rabies and distemper combo vaccines. The vaccine companies listed annual re-vaccination on the labels but this was arbitrary timing as there had been insufficient study to show a longer duration of protection. As time went on the research showed that we had great protection up to at least 3 years. This is after a puppy series and first year shots. The experts had felt confident as early as the late nineties that we could start the 3-year protocols in cats. All of the veterinary schools then went to the 3 year intervals in dogs not long after. As soon as I saw the new recommendations were backed by science and well-respected study groups deemed them a standard, I changed the protocols at South Beach Animal Hospital from every year down to every 3 years. Many vets followed suit but many clung to the old protocols for reasons I don't like to think about. This is all old news for most but if your vet is still selling you annual vaccines for distemper/parvo/FVRCP etc. you need to challenge this. If your vet doesn't agree then ask why every vet school in the country has adopted the three-year protocols. Keep in mind there are a few circumstances in which a yearly vaccine is needed. Some countries and municipalities don't recognize the 3-year rabies so if you travel with your pet you may need yearly rabies. This does not apply to bordetella, lyme or Feline leukemia vaccine. Those are still given yearly. By the way, Indoor cats shouldn't need leukemia vaccine but should still get the 3 year distemper vaccine. Beware the corporate hospitals that frequently sell every possible vaccine every year including those most vets don't even carry. I feel badly for folks that go to these clinics to save money but get taken on procedures the pet doesn't need. I'll finish here dispelling the myth of the yearly vaccines. See the next blog about a blood test for vaccine efficacy called Antibody titer testing. Is your vet selling this to you?

Wednesday, October 3, 2007

Keep your eye on the sparrow!

As I was driving along a beautiful mountain road a few weeks ago I was reminded of the Sammy Davis Jr. theme song to Barrettta. A little bird swooped down in front of my car. I could tell by the trajectory that I clipped him and looked in the rear view to asses the damage. I saw the poor thing fluttering on the side of the road. I race to turn around and go help her. She was sitting up panting but looking quite conscious. I immediately headed toward a little animal hospital nearby where they told me about a wildlife aid facility just up the road. There , a nice young lady took her in where the nurses would try to save her. I wanted to check out the place and told the receptionist that I was a veterinarian, however the policy was that no one could enter the work area of the facility. As it often does my admission of my profession led to an impromptu consultation about the receptionists poodle. Her 13 year old poodle had developed cataracts this year and was slowly blinded by the condition. She was sold a solution by her vet called ocu-clear, and according to her, was told that it would help dissolve the cataracts and help her dog see again. She paid $125 per bottle and was on her second bottle. So far the dog was still blind after months of use. I cringed when I heard this as I know that there's no medical cure for this condition. There is a cure though and many pets can regain their vision with a surgery.
I can't be sure if this person was told that the product would fix the problem but she sure seemed to have that expectation. Sometimes this could be a miscommunication. I checked the website for the product and they don't make the claim that it's a cure. They do make the following statement: "Other nutrients in Ocu-clear help to reduce the incidence of cataracts in dogs and cats by promoting optimal eye health" .
I can't find any scientific data to back this claim. I advised that she see a specialist to evaluate and make a recommendation and it's likely that if she gets the surgery her beloved poodle will regain her sight.
The moral of the story is Buyer Beware. Please seek second opinions and get as much info on remedies as possible.
By the way, I don't know if I want to call the facility back to find out if the sparrow made it. I don't want to know if it's bad news. She looked pretty good when I dropped her off. If someone wants to check , her case number is 1924 and she's at the greenwood facility.
http://greenpeople.org/webpage.cfm?memid=18858&pmtlevel=0&linkpage=http%3A%2F%2Fgreenwoodwildlife%2Eorg%2F
Could someone check and only tell me if it's good news?