Dental Disease Part 1. Why does it develop? Why perform dental surgery?

Dental disease is extremely common in our pets but why does it develop? This is likely due to a combination of reasons, including:

Conformation of your pet’s mouth; smaller breed dogs and breeds with short muzzles have the same amount of teeth in a smaller space. This can be described as ‘overcrowding’. This results in trapped food and increased risk of tartar build up.

Diet; dry diets help to abrase the surface of your pets teeth helping to keep them clean. Your pet may be more likely to develop dental disease if fed solely on a wet diet. That being said, sometimes this doesn’t make much impact if you pet’s food barely touches the sides in the first place! 

Species specific dental conditions. Cats are prone to developing resorptive changes in their teeth.  The exact reason for this is unclear but the condition is painful and teeth can eventually become fused to the surrounding bone.

Oral masses. Growth of benign or malignant masses in the oral cavity can encroach on surrounding teeth causing them to become wobbly or food can build up in between them causing decay.

 

Why is it important to perform dental procedures for our pets?

  • To improve their oral comfort therefore quality of life
  • By removing tartar we reduce the risk of subsequent gingivitis, gum recession, root exposure and ultimately tooth extractions
  • By removing those already diseased teeth we reduce the risk of tooth root abscess and oral pain
  • There is the added benefit of better breath too!

 

What does a dental involve?

A dental involves a general anaesthetic and close inspection of each individual tooth. We also have dental x-ray facilities which means we can x-ray tooth roots if needed. Teeth requiring removal will be carefully extracted and those remaining will be descaled and polished. Your pet will come home with pain relief after this procedure and often antibiotics if extractions have been performed. Dogs and cats do remarkably well after their dental procedures and many owners say what an impact it has on their quality of life.

However, we find lots of our clients worry about performing dentals on their animals so we hope we can reassure and clarify some common worries for you.

Generally, most animals requiring dental surgery are older which means people worry more about the general anaesthetic. As part of the decision to perform a dental we will take a thorough history and perform a thorough exam to identify any concurrent problems that may impact on the general anaesthetic.  We also think that performing a dental sooner rather than later is best; actively deciding to address the teeth whilst your pet is fit and healthy is safer than waiting for them to become an issue. 

People are also concerned about how many teeth will be removed. We will only ever take teeth out that require extraction. However, it is impossible to predict the number until we remove all of the tartar and carefully examine every aspect of each tooth. In some cases the majority of teeth need to be removed. Although disconcerting to us, this is the best thing for your pet and they will feel much more comfortable. Both cats and dogs cope very well with only a few to no teeth remaining and many are still able to eat a dry diet!

 

What next?

If you would like your pet’s teeth assessing for dental disease then our nurses are happy to look in your pet’s mouth in a free nurse consultation. However, if you have other concerns about your pet at the time then a vet consultation is recommended.

Please watch over the coming weeks for some ‘before and after’ examples. Also watch out for ‘Dentals part 2: preventative health care-what and how?’.

 

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Hyperthyroidism in Cats

Hyperthyroidism is a term used to describe an overactive thyroid gland. There are two Thyroid glands located within the neck. The exact mechanism is unclear, but these glands become enlarged and start to release excessive thyroid hormone. Thyroid hormones play lots of important roles in the body but their regulation of metabolism is most significant. 

Hyperthyroidism is a very common condition in older cats. The typical presentation includes a cat which is eating excessively but losing weight. Other common signs include vomiting, diarrhoea and excessive drinking. Cats can also have a hyperactive demeanour, increased restlessness, an unkempt hair coat and increased vocalisation.

Without treatment cats will continue to be excessively hungry, thirsty and lose weight. This isn’t necessarily painful for them but it can impact on their quality and length of life. Thyroid hormones can also stimulate the heart muscle; with prolonged exposure this can lead to significant heart disease which can have more serious consequences.

So How Can We Manage Hyperthyroidism?

Radio-iodine treatment

The gold standard treatment for hyperthyroidism is radio-Iodine therapy; it has high rates of success and can significantly increase survival time. It involves an injection of radioactive Iodine which targets the affected thyroid cells. It is important to ensure that this therapy is appropriate for your cat and that any other illnesses are stable and well controlled. Specialist centre’s have to perform this therapy and your cat will require at least a 2 week stay in most of these facilities. Once at home there will be a period of time where their urine and faeces is still radioactive and must be handled safely. We have had a few of our own patients visit the Hyperthyroid cat centre with really good results. Due to it’s specialist nature this treatment can be expensive and may not be an option for those cats that are not insured.

Oral medications

In many cats we start long term oral medications. These work by reducing the production of thyroid hormones. Medications come in both tablet and liquid formulations and are generally given twice daily. Initial stabilisation and control of the thyroid level can take a couple of weeks and requires repeated blood tests during this time. Once we have found the effective dose you should see an improvement in your pet’s clinical signs. For example, their appetite and thirst should normalise and they should put on weight. Long term monitoring of your cat’s thyroid level is continued, this is based on how they are doing at home but the general recommendation is every 3-6 months. Of course, administration is a big factor to take into account when selecting this option.

Surgery

It is possible to surgically remove the affected thyroid gland. Firstly, we have to make the decision whether a general anaesthetic and surgical procedure is appropriate for the patient. Some cats will present unwell and many will have concurrent kidney and heart disease therefore surgery is often not the treatment of choice. Some cats will also have ectopic thyroid tissue; this is an abnormal piece of thyroid tissue located elsewhere in the body, its presence means that surgical removal of the normally located glands may not completely resolve your pets clinical signs. Your cat will also require stabilisation on oral medications before embarking on the surgery. In the surgery, the affected gland is removed. However, it is common for the remaining gland to later develop the same condition and so multiple surgeries can be required. Post surgery, there can be the risk of low calcium levels; the parathyroid gland which regulates calcium is closely situated to the thyroid gland so can be disrupted during the surgery. As you can see, there can be lots of things to consider and on a whole surgery is not something we generally recommend for our patients.

Diet

Iodine is required to produce thyroid hormones. Therefore, restricted Iodine diets have been formulated to help manage this condition.  Only this diet must be fed for this to be effective. Limitations arise with fussy cats that won’t consistently eat the diet and this approach is not really suitable for outdoor cats that can hunt and eat elsewhere.

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Key Hole Bitch Spays at Hollybank Veterinary Centre

What does a bitch spay procedure involve?

When we spay a bitch we remove both ovaries. In the removal of both ovaries we stop female hormone production; it is these hormones that drive the problems associated with having an entire female. In certain cases we will elect to remove the uterus too. For example, a dog with known or suspected uterine disease. however your vet will have identified the potential for this prior to surgery. In the vast majority of cases only the ovaries will be removed.

How do we perform a bitch spay procedure?

Bitch spays are conventionally performed by open abdomen surgery. The surgeon directly handles the ovaries and uterus via a mid-line abdominal incision.

At Hollybank veterinary centre we now also perform laparoscopic spays which are performed via keyhole surgery; the surgery involves specialised equipment and specialist training. The advantages to a laparoscopic spay include:

  • A minimally invasive surgery and a generally safer procedure
  • Associated with lower levels of pain during and after surgery
  • Recovery times following the procedure are quicker
  • Post operative care is more manageable with minimal rest and no buster collar due to only 3 small wounds being created

 

It is important to note that key hole spays can only be performed in candidates that fall within a set weight and shape category. Dogs that are too small do not really benefit from the keyhole technique over the conventional spay and the technique is less safe for those overweight. This is also true for those dogs requiring their uterus to be removed. The decision will be made at our discretion in the best interests of your animal.

If your pet does not fit within our guidelines they will have a conventional spay. This involves one slightly larger wound. The outcome is essentially the same but post operative care and recovery times differ as they will require slightly stricter rest and will also need a buster collar. If indicated a laparoscopic bitch spay may have to be converted to a conventional bitch spay. Again this decision will be made in the best interests of your animal

Please read our ‘What happens when your female dog is spayed’ guidelines to read in more details why we recommend spaying and when this can be done.

 

 

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