GDV - The Emergency to Beat All Emergencies

Dear Dr. Jody:  We have just adopted a seven month old standard poodle.  Friends of ours mentioned that their old standard poodle died from “bloat”, and that the breed is predisposed to this condition.  What is “bloat” and how to we prevent it from happening to Stella?

Bloat, more correctly known as gastric dilatation and volvulus, or GDV, is a serious lift-threatening emergency in which the stomach becomes distended with gas and twists around on itself, cutting off the blood supply to multiple organs.

Think of a normal healthy digestive tract as a garden hose with a large dilation in the middle of it.  One end of the garden hose is the esophagus, delivering food to the stomach from the mouth.  The dilation in the garden hose is the stomach, where food is broken down and partially digested.  The other end of the garden hose is the intestines, which receive partially digested food from the stomach.  Under normal circumstances, things flow smoothly through this garden hose, and all in one carefully coordinated pattern. 

In a dog suffering from GDV, the stomach becomes bloated with gas.  If the stomach bloats so quickly that the dog is unable to burp to relieve the gas pressure, the distension with gas can cause the stomach to become twisted.  Think of our garden hose example, and imagine twisting the hose at either end.  As soon as you twist a garden hose, water can no longer pass through.  Similarly, a stomach that has flipped over results in a twist at the esophagus and at the intestinal end.  This not only prevents gas from being burped up but prevents food from escaping into the intestine.  As the normal process of food fermentation continues, more and more gas is produced, but cannot be relieved.  Additionally, a twist at either end of the system prevents blood from entering or exiting this organ.  The twist can effectively block several major blood vessels and can prevent blood from returning back to the heart. 

Because the spleen is intimately associated anatomically with the stomach, it is often involved in the twist.  Think of the spleen as an enormous blood-filled sponge with dozens of major blood vessels coming and going.  When the spleen twists and blood cannot flow through it back to the heart, the severely compromised cardiovascular system is further enraged.

So now we have a stomach and a spleen that are rapidly dying because blood cannot get into or out of these organs.  We have a stomach that is getting larger and larger because the dog cannot burp.  We have a very angry heart that is beating faster and faster because the dog is in extreme pain and due to a lack of blood flow.  The heart suffers from a potentially fatal arrhythmia called a ventricular premature contraction, or VPC, and the entire cardiovascular system is at risk for collapse from shock.

If the dog does not receive immediate life-saving procedures, he will die within a few hours from this condition.  The treatment involves decompression of the stomach, either via placement of a stomach tube or through trocarization (passing an extremely large bore needle through the abdominal wall and into the stomach to let off the gas).  Decompression, however, is only one of several necessary steps.  The dog must have heart arrhythmias identified via ECG and treated.  It may take several days of hospitalization to stabilize the heart.  The veterinarian must attempt to resurrect a failing cardiovascular system through aggressive use of IV fluids.  And the dog must immediately undergo surgery.

The point of the surgery is twofold:  firstly, dead and dying tissues in the stomach and spleen must be identified and removed.  If the dog is merely decompressed via stomach tube and not surgically explored, within a few days the parts of the spleen and stomach that suffered compromised blood flow will die and start to decay and the dog will die.  Often, the entire spleen requires removal.  Secondly, an extremely important surgical procedure, known as a gastropexy, must be undertaken to prevent recurrence of the GDV. 

A gastropexy is a brilliantly designed technique whereby a flap of the outer layer of the stomach is elevated, tucked under part of the rib cage, and tacked back down to the stomach.  This effectively prevents the stomach from ever twisting over on itself again.  Without the gastropexy surgery, about 75% of GDV patients will relapse at some point in their life.  It has even been recommended to prophylactically perform a gastropexy in at-risk breeds during their spay or neuter so that they do not experience a GDV when they are older. 

Although a GDV can happen in any dog, certain breeds are considered highly predisposed to this horrible condition.  These breeds tend to be deep and narrow-chested, and include Great Danes, German Shepherds, Weimaraners, St. Bernards, Doberman Pinschers, and Standard Poodles.  It has been reported that as many as 50% of Great Danes will GDV at some point in their lifetime.  Owners of such breeds may decrease the risk of bloat by feeding two or more meals per day (as opposed to just one) and avoiding exercise immediately following mealtime.

If your dog displays the classic symptoms of GDV such as a bloated appearance, distress, anxiety, agitation, and frequent unproductive attempts to vomit, please treat this as a potential life-threatening condition and get him to your veterinarian immediately.

With rapid diagnosis and aggressive treatment, many GDV patients recover and go on to live healthy normal lives.  Sadly, without such treatment, most patients die rapidly. 

  

Human Pain Relievers for Dogs and Cats?

Dear Dr. Jody:  Occasionally, our 8 year old lab, “Sadie”, seems stiff and sore after a good day’s exercise.  We don’t want her on long term pain medication, but we would like to be able to relieve her discomfort as needed.  Are there safe, low doses of Advil or Tylenol that we can give her from time to time?


Thank you for asking!  I am always so relieved when owners take the time to ask this question before medicating their pets at home.  It is surprising how frequently a pet owner will mention to me that they have given their pet a human pain reliever.  Although most pet owners give relatively low doses (often using baby aspirin or Advil), this is still a potentially life-threatening practice.


It is important to understand that dogs and cats are not little people in fur suits.  Dogs and cats are vastly different physiologically from people.  When a human takes Tylenol (acetaminophen), a variety of complex chemical reactions occur in the liver to break the drug down into non-toxic components that are harmlessly excreted by the kidneys and into the urine.  One of the enzymes that catalyze these chemical reactions is called glucuronyl transferase, or GT.  Cats do not possess GT in their bodies.  Because felines lack this critical enzyme, even a minuscule dose of Tylenol is rapidly fatal to an otherwise healthy cat.  Tylenol can, in rare instances, be safely used in dogs; however, not only must the dose be carefully calculated by a veterinarian, but the dog’s bloodwork requires frequent evaluation to ensure that no long term damage is occurring.


Advil (ibuprofen) is another pain reliever that I see used non-judiciously by pet owners.  Allow me to explain how this non-steroidal anti-inflammatory (NSAID) works.


NSAIDs such as ibuprofen work by inhibiting the production of prostaglandins.  Prostaglandins chemicals that are involved in the development of inflammation and the perception of pain.  By inhibiting the production of prostaglandins, NSAIDs are decreasing inflammation and the perception of pain.  Sounds pretty good, doesn’t it?


Well, yes and no.  Prostaglandins also have some other important functions.  One of these important actions is that they promote the secretion of the protective mucus lining in the stomach.  Without this lining, highly acidic and corrosive stomach juices can easily start to digest the lining of the stomach, leading to stomach ulcers.  When prostaglandin production is inhibited by NSAIDs, the protective mucus barrier disappears.  Dogs and cats are more sensitive to this process than humans, and are far more likely to suffer from ulcers as a result of NSAID use, even at very low doses.


Prostaglandins also promote a healthy blood supply to the kidneys.  When prostaglandin production is inhibited, renal blood flow is compromised and kidney failure can easily develop within a few days of ibuprofen administration. 


A third human pain reliever that clients frequently administer to their pets is aspirin (acetylsalicylic acid or ASA).  One of the prostaglandins that ASA inhibits is the prostaglandin that makes platelets sticky.  Platelets are the tiny little structures floating around in your bloodstream that allow you to clot your blood when you are injured.  In order for platelets to form a clot, they must be able to adhere together once the clotting reaction has been initiated.  The administration of ASA inhibits the production of the particular prostaglandin that makes platelets work properly.  This is the reason that low doses of aspirin are used as a “blood thinner” or anti-coagulant in human patients who are at risk of forming blood clots that may lead to certain heart diseases or stroke.  The good news for humans taking this medication is that our bodies metabolize and eliminate the drug fairly rapidly and it does not build up in our system.  When a person takes a single dose of aspirin, all traces of the drug have been eliminated from the body within 30 hours, which makes daily dosing reasonable. 


When a dog takes a single dose of aspirin, detectable levels of the drug persist for three days.  This means that, if you give your dog one dose of aspirin daily, you are giving each subsequent dose when there are still significant quantities of aspirin in his body from the previous day’s dose.  Over the long term, this can dangerously inhibit your dog’s ability to clot his blood.  And what about cats?  A single dose of aspirin remains in your cat’s body for three weeks!  That is, if your cat survives the other potential side effects of gastric ulceration and kidney failure that might result from the use of human NSAIDs in a species for which they are not designed.

There have certainly been occasions when I have prescribed ASA for dogs.  But these doses are very carefully calculated and are used for very short term treatments for very specific ailments. 


The good news is that researchers have developed NSAIDs specifically for cats and dogs.  These medications are far less likely to cause the inhibition of the helpful prostaglandins than human NSAIDs, and are therefore highly unlikely to lead to kidney disease, stomach ulcers, or clotting problems.  Because of the unique physiology of cats, fewer options exist for owners of cats who require long term pain medication, but there are still a few choices available. Please consult your veterinarian if you would like safe pain relief options for your pet.


Remember – just as you would not take your pet’s pain medication, you should not offer your own pain medication to your pet!

Myasthenia Gravis

Dear Dr. Jody:  Our six year old German shepherd, “Harley”, has recently started regurgitating and choking on his food and water immediately after swallowing it.  What can we do to give him some relief from this aggravating condition?

The symptom you are describing is suggestive of a condition known as megaesophagus which often stems from yet another condition known as myasthenia gravis (MG).  MG is a frustrating condition in which nerve impulses that are meant to stimulate muscle contraction are not strong enough to cause or maintain a muscle contraction.

In a healthy animal, the brain sends messages to muscles via nerve cells, or neurons.  A neuron is made up of three parts:  its “head” is located in the spinal cord; its “body” or axon is a long strand that runs from the spinal cord to the muscle, and its “foot” is a projection inside the muscle at a site called the neuromuscular junction.  When an impulse travels from the spinal cord through the neuron’s head down through its axon and into the neuromuscular junction, it stimulates contraction of the muscle by releasing a chemical transmitter called acetylcholine from the foot process.  Once the chemical message has been transferred to the muscle and the muscle has contracted, an enzyme comes along and “mops up” all of the leftover acetylcholine and recycles it.  If this enzyme did not remove the leftover acetylcholine, the muscle would continue to contract indefinitely.  This entire process is a very effective and efficient mechanism, when it works.

In animals and humans with myasthenia gravis, the body develops antibodies against the neuromuscular junctions and destroys them.  The result?  When a nerve sends a signal to the neuromuscular junction to secrete acetylcholine and thereby cause a muscle contraction, very little acetylcholine makes it across the badly damaged junction, and the muscle cannot contract.

The most common symptom of MG in dogs is a secondary condition called megaesophagus (ME).  In dogs with ME, the esophagus loses its ability to contract during the swallowing of food or water.  If the dog tries to swallow and the esophagus isn’t contracting properly, food or water can pool inside the baggy saggy esophagus before reaching the stomach.  This often leads to choking or regurgitation of the food and water.  If the dog chokes on this material and inhales any of it, potentially fatal aspiration pneumonia can develop.

Unfortunately we cannot repair damaged neuromuscular junctions.  The most common treatment for MG is a medication called pyridostigmine which prevents the little “janitor enzyme” from mopping up the leftover acetylcholine.  By keeping this chemical transmitter at the neuromuscular junction longer, it may be possible to slightly improve muscle contraction.  A second medication that may be helpful called bethanechol.  Bethanechol causes more acetylcholine to be released from the neuron at the level of the neuromuscular junction.  The hope is that the more acetylcholine that is released, the more will make it across the damaged neuromuscular junction and stimulate a muscle contraction.  Thirdly, medications such as steroids may be used to combat the immune system’s destruction of the neuromuscular junction in the first place. 

It is important for dogs suffering from MG and the resultant megaesophagus to be on medications to prevent erosion of the esophagus with stomach acid.  Because the esophagus lacks tone, it is not uncommon for stomach acid to reflux up into the esophagus, causing heartburn and painful ulcers.

Affected dogs may have an improved ability to swallow food and water if they are fed a liquid diet with their body held in a vertical position so that gravity can help bring the food and water down into the stomach.  Devices can be built that assist the dog to maintain this otherwise unnatural posture during and after feeding. 

Myasthenia gravis is a relatively uncommon yet highly frustrating disease.  With the correct diagnosis and treatment, some dogs can experience relief of their symptoms.

Systemic Lupus Erythematosus

Dear Dr. Jody:  Our six year old golden retriever, “Honey”, has just been diagnosed with a dangerous form of lupus.  What is lupus, and what can we do to help her?

Systemic lupus erythematosus (SLE) is an uncommon condition characterized by massive body-wide destruction of healthy tissues by a faulty immune system.  There are several complicated reasons as to why a previously healthy immune system would suddenly turn on its own body and attack it.  However, in most cases, we are unable to accurately identify why this deadly disease occurs in each individual patient.  Allow me to explain a little Immunology 101.

Imagine antibodies as microscopic Y-shaped structures floating around in the bloodstream.  When an antibody spots a foreign invader such as a virus or bacteria, it attaches to the invader (also called an antigen) with the arms of its “Y”. 

Like pieces of a jigsaw puzzle, antibodies are usually specific to which antigens they can bind and therefore destroy.  This is why disease-specific vaccinations are important.  For example, when you get a tetanus vaccination, the bits of tetanus bacteria that are injected into your body have been killed or altered in some way that they cannot actually create the disease.  But they still structurally resemble live tetanus bacteria, and so your body churns out antibodies that it has specifically manufactured that match the “shape” of the tetanus bacteria.  The antibodies attach to the bacteria and lead to its destruction.  Once the “infection” is cleared, there are still some leftover antibodies that hang around in your body indefinitely, so that if you ever step on a dirty nail in a horse pasture and get tetanus bacteria in your bloodstream, the leftover antibodies that have the right “shape” go to work and bind the invading bacteria and lead to its destruction.  On a side note, one reason why vaccines fail – as in the case of the ever-changing flu vaccine – is that the disease-causing organism is constantly mutating.  The jigsaw puzzle mechanism of the antibody only partly fits onto the newly changed shape of the antigen.  Your immune system will be better equipped to fight the infection than if you didn’t have the vaccination, but it may not be effective at completely preventing the disease. 

Once an antibody has both of its Y-shaped arms bound to antigens, the entire unit causes a chemical reaction in the body that stimulates the rest of the immune system (there are a lot more players in this complicated process) to destroy the entire antibody-antigen complex, including the kamikaze antibody itself. 

In SLE, the dog has somehow developed antibodies against its own tissues.  More specifically, it has developed antibodies against nucleic acid, an important ingredient in a cell’s nucleus.   And when an antibody binds to the nucleic acid in the body’s cells, it triggers the chemical reaction in which the rest of the immune system destroys the entire antibody-antigen complex: cells, antibody, and all.

Because nucleic acid is everywhere, and because the immune system of an SLE dog is destroying cells that contain nucleic acid, SLE dogs experience destruction of cells in almost every body system, including skin, joints, muscles, kidneys, blood (red blood cells, white blood cells, and platelets), lymph nodes, spleen, lungs, and central nervous system.  It’s a terrible disease, and it can be very painful, especially if joints are involved.

Unfortunately the disease can be tricky to diagnose because there is no 100% reliable test for SLE.  There are, however, several key tests and physical exam findings that will allow your veterinarian to diagnose the disease with relative confidence.  Once the diagnosis is made, the treatment for lupus is usually multi-faceted.  Not only do we have to try to shut down the  rampant immune system, we need to treat what is wrong in each of the affected body systems.  If there is kidney damage, we need medication to make the kidneys feel better.  If there is joint pain, we need medication to take away pain.  If there is blood cell destruction, we need medication to bring the blood cell counts back up.

One of the most frequently used medications for SLE dogs is prednisone.  Prednisone is a steroid that can be wonderful and terrible all at the same time.  When used at high doses, prednisone strongly inhibits the immune system.  If a healthy individual were to take prednisone, we would be more susceptible to all kinds of infections in the respiratory tract, skin, and gastrointestinal tract, because we have wiped out our immune system.  When an SLE dog (whose immune system has gone haywire) takes prednisone, the drug can be fairly effective at halting the immune system’s destruction of the dog’s own tissues.  Unfortunately, the side effects of prednisone (massively increased thirst and urination, increased appetite, weakness, continued weight loss, and some risk of developing diabetes) make the drug less than perfect.   

If prednisone does not work, there are other drugs that can be considered, but most of them are very expensive.  It is nearly impossible to predict which medication will work the best for your dog, and this decision is often a matter of trial and error. 

Unfortunately, SLE cannot be cured.  At best, it can only be managed.  This means that your dog will always have SLE, no matter how successful the treatment is.  The disease may go into remission for a while, but will likely flare up from time to time.  Some dogs do not respond to treatment and continue to deteriorate.  And some dogs experience such severe side effects from the treatment that treatment is not an option.  (Remember:  the treatment should not be worse than the disease!).  There is a relatively poor prognosis for SLE dogs.  Sadly, 40% of dogs diagnosed with SLE do not survive more than a year. 

Feline Infectious Peritonitis (FIP)

Dear Dr. Jody:  Our new kitten, “Oscar”, has been diagnosed with corona virus.  We have read on the internet that corona virus causes FIP in cats.  What is FIP, and should we be worried?

Feline Infectious Peritonitis (FIP) is a devastating viral disease of cats that results from the mutation of the relatively harmless feline corona virus into its deadly evil “twin”. 

Feline corona virus (FCoV) is a very common, contagious, but usually harmless virus of cats which causes mild to moderate cases of diarrhea.  It has been estimated that 30% of solitary household cats and up to 90% of cats in multi-cat households, catteries, and shelters have been exposed to the virus at some point in their past.  The vast majority of these cats and kittens go on to clear the infection on their own and live normal, healthy lives, even without specific treatment.

Unfortunately, in rare instances, the harmless FCoV virus can mutate into a deadly variant, resulting in severe lethargy, fever, poor appetite, weight loss, and sometimes accumulations of fluid in the lungs and abdomen.  Sadly, there is no effective treatment for FIP, and the disease is rapidly fatal in all cases.

A mutated corona virus causes all sorts of havoc inside a cat’s body.  Interestingly, most of the damage from the infection occurs as a result of the cat’s immune system trying to fight off the disease.  An angered immune system, while attempting to combat a foreign virus, can actually cause significant damage to the body’s own tissues.  This damage is what leads to the pleural and abdominal fluid accumulations called effusions.

So how can we prevent it?  I have searched current research papers to gather the most up to date information possible on this devastating disease.  Frustratingly, researchers still have yet to figure out what causes the harmless form of the virus to mutate into the deadly form.  Because we don’t understand why the virus decides to mutate, we can do very little to prevent that mutation from occurring.  And sadly, there is no effective vaccine available against either the harmless or the deadly form of FCoV. 

The other frustration is that researchers have not developed an effective and accurate diagnostic tool to help confirm whether a cat is indeed infected with the deadly FIP mutation.  If your veterinarian suspects your cat may have developed FIP, he or she will certainly run several blood tests to help gather clues as to the cause of the illness.  These tests are helpful in ruling out other illnesses that can have similar symptoms to FIP, but they cannot definitively rule in FIP.  The only completely accurate test to diagnose FIP is through an autopsy. 

Even though there is no vaccine to prevent feline corona virus, you can help to keep your cat safe from FCoV by keeping him indoors.  Indoor cats are significantly safer than outdoor cats simply because they are not being exposed to other cats carrying the virus.  If you do decide to let your cat outdoors, consider vaccinating your cat against Feline Leukemia Virus (FeLV).  Cats that contract FeLV are more likely to have a harmless corona virus infection mutate into the deadly FIP.  Additionally, if you are considering purchasing a purebred cat, you need to be aware that purebred cats seem far more susceptible to FIP than mixed breed cats.

The good news is that if your cat or kitten has moderate tummy upset and has been diagnosed with an active feline corona virus infection, he or she will likely recover uneventfully within several days.  Your cat should be kept away from other cats during the course of the illness in order to minimize spread of the disease.  Your veterinarian may provide fluids or other medications to support your cat’s health while his immune system is mounting an army of antibodies to effectively fight the harmless virus. 

The other piece of good news is that fewer than 10% of cats who are exposed to feline corona virus will actually develop the deadly mutation FIP.  And despite the fact that the harmless form of FCoV is highly contagious, the deadly mutation, FIP, is not.

Dear Dr. Jody:  Our nine year old toy poodle, “Micro”, has developed bad breath recently.  We give him dental chews every day and he eats nothing but dry food.  Why is his breath so bad, and what can we do about it?

Boy, have you come to the right place!  Having just returned from an exhausting four day veterinary dental conference in Boston, I am bursting with new knowledge and fine-tuned skills that I am eager to share. 

Firstly, it is important to stress that feeding dry food does not prevent dental disease in pets any more than eating crunchy foods such as carrots and granola will prevent dental disease in humans.  You and I brush our teeth multiple times a day, including right before we go to bed.  But when we wake up in the morning, our teeth are anything but clean.  Bacteria multiply in the mouth very quickly.  The sticky filmy plaque that forms on teeth is made up of these bacteria and their waste products.  Yuck!  These microorganisms can quickly lead to gingivitis (red, inflamed gums) if not removed regularly.  Gingivitis, in turn, will lead to periodontal disease (disease around the tooth root, below the gum surface), if not treated promptly.  Imagine what your teeth would look like – and feel like! – if you did not brush your teeth for a whole year.  Dogs and cats are no different.  If we want their teeth remain comfortable and functional for a lifetime, they require the same degree of dental care we provide for ourselves. 

But what about coyotes and cougars?  Nobody is brushing their teeth in the wild and they do just fine, don’t they?  Well, yes and no.  Have you ever performed a dental exam on a wild predator?  I have, and it isn’t pretty.  Most of these wild creatures have multiple fractured, decaying, and abscessed teeth.  Unfortunately, they don’t have the luxury of professional dental care, so they must exist with diseased mouths.  But surely our beloved pets deserve better.  I believe all pets deserve a mouth that is comfortable and free from pain and infection. 

In a recent study conducted in the United States, approximately 80% of dogs and cats older than three years of age had some degree of periodontal disease, but only 20% of pet owners actually believed their pet had an unhealthy mouth.  Nearly 50% of dog owners and 25% of cat owners surveyed believed they were managing their pet’s dental health by feeding dental treats and dry kibble.  There are countless dental treats and chews available, all claiming to reduce or prevent dental disease.  Sadly, there is no law requiring a dental product to actually do what it says it can do.  So how do we know which products work and which don’t?

Here’s where a fabulous organization called the VOHC comes in.  The VOHC (Veterinary Oral Health Council) is an unbiased third party that was developed to carefully scrutinize the claims of these countless dental products.  There is no requirement for products to be VOHC certified, however, products that do carry the VOHC seal of approval have been put through rigorous controlled clinical trials over long periods of time.  These trials have confirmed that the label claims made by the product are true. 

For a list of VOHC approved treats that you can confidently offer your pet as well as other tips on how to ensure your pet enjoys lifelong dental health, visit www.vohc.org.  And, as always, if you believe your pet has unpleasant breath despite feeding dental treats, please contact your veterinarian.  Where there’s smoke, there’s fire.  And where there’s bad breath, there is likely periodontal disease, even if your pet isn’t saying “ouch”.

Chew on This

Dear Dr. Jody:  I have recently read that I should be brushing my dog’s teeth daily.  I have a very busy schedule and do not have time to do this every day, and he won’t sit still for it anyway.  I feed him lots of bones instead.  Is that adequate?

What a great question!   The topic of bone-chewing is a controversial one.  On one hand, bone-chewing does remove tartar and plaque above the gumline to some degree.  On the other hand, I diagnose at least one dog per week with a fractured tooth, usually from chewing on bones.  In the vast majority of cases, I find the fractured teeth during a routine vaccine appointment exam, with the owner having been unaware that there was anything wrong with the teeth.  In many cases, the rest of the teeth are relatively healthy, but that one fractured tooth must be addressed.  This usually requires surgical extraction. 

Fractured teeth that are not quickly dealt with usually lead to painful abscesses.  Sometimes these abscesses will cause the affected half of the face to swell up dramatically, seemingly overnight.  Pus often bursts through a hole in the side of the cheek.  Dogs that present in this way have usually been suffering from a painful tooth for several weeks or even months before the bacteria in the mouth finally make their way up the root through the tiny blood vessels in the pulp chamber and start to colonize and grow in the bone and soft tissues that surround the tooth root. 

The only way to potentially save a fractured tooth is to perform endodontic surgery such as a root canal, often in conjunction with the placement of a crown.  Most veterinary clinics do not provide this service, but there is a veterinary dental centre in Calgary that your veterinarian can refer you to if you would prefer this option.  In most cases, your veterinarian will recommend surgical extraction, followed by antibiotics and anti-inflammatories to assist in fighting the infection and swelling.  Within a few days, the recovering dog feels significantly better.

It is up to the owner to decide if continuing to feed bones is worth the risk.  Because I have personally diagnosed literally hundreds if not thousands of fractured teeth from bone-chewing, I cannot in good conscience recommend that owners feed their dogs bones.  In order for a chew toy to be considered safe, it must be flexible and have a surface that is easily indented with a fingernail.  It must also pass the “shinbone test”.  If you were to bang it against your shinbone, would it hurt?  If so, you probably should not offer it to your dog as a chew toy.  If you would not want to bite down on the object yourself, neither should your dog.  Dogs in the wild, such as coyotes and wolves, chew on bones regularly.  But have you ever considered what their teeth look like?  I have performed dental exams on these creatures, and their mouths are typically full of fractured, abscessed, decaying teeth.

Instead of offering tooth-cracking hard bones for your dog to chew on to clean his teeth, you would be well advised to start brushing his teeth at home.  Dogs have 42 teeth.  That is ten more than you or I have!  And they go way back in the mouth.  If you lift your dog’s lip straight up, you are seeing fewer than half of the teeth in his mouth.  Instead, pull his lip straight back towards his ear.  Farther.  Farther yet.  Keep going.  There you go!  It is generally those teeth at the very back that are most prone to dental disease, and this is where you should ensure you are brushing, daily!

Even with daily tooth brushing, you and I need to visit the dentist at least annually to have tartar removed from under the gumline, where we cannot brush.  It is no different for your pooch.  If you brush less than several times per week, your dog should have his teeth cleaned at least every six months. 

If “Bernice”, an 800 pound elephant seal at the Marine Mammal Center in San Francisco, can be trained to hold her mouth open and tolerate regular dental care, so can your four-legged friend.  Daily brushing and the avoidance of hard chew toys such as bones will give your dog the best chance possible to enjoy a lifetime free from dental pain.

If you would like a demonstration of tips and tricks to brushing your pet’s teeth, please contact your veterinarian.  And if your pet requires a dental procedure under anesthesia, please visit http://www.healthymouth.com/Articles.asp?ID=246 and click on the informative video for reassuring insight into what is involved in a comprehensive oral health procedure.