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Thursday, April 14, 2011

Rotting Mouth

In 13 years of practice I've seen some really bad dental infections.  But today I saw one of the worst in my career.  He's a dachshund around 12 years old and when my associate saw him a few days ago she knew that he would need some teeth pulled.  But none of us knew just how bad it would really be when he came in today.

We got him under anesthesia and before my assistant started doing any cleaning I figured that I'd see how many teeth would be left to actually clean.  Within a matter of a couple of minutes I had pulled almost every tooth on the right side of his mouth!  The odor was unbelievable and even made me have to breathe shallowly.  Most of the teeth were literally held in the mouth by extensive dental calculus.  The tartar went to the bottoms of many roots and the gums were rotting away due to the extent of the infection.  When I extracted the upper canine teeth (those long teeth, sometimes called "eyeteeth" in people), I quickly noticed that there was a direct hole into the nasal passages (an oronasal fistula if you want the medical term) and blood started coming from the nose.  This isn't uncommon when you have extensive periodontal disease, as the roots of these teeth pass just under the sinuses and when infection is this bad the bone is eroded, thus allowing a connection between the nose and the mouth.

The pattern continued with no tooth unaffected.  By the time I was finished I had extracted EVERY tooth in this dog's mouth due to the severe infection and bone loss.  The front of the lower jaw was unstable due to the degree of bone infection, though this will hopefully heal.  The dog went home on antibiotics and pain medications and will need to eat soft food for the rest of his life.

The sad thing is that this was preventable and didn't need to reach this point.  Seeing the vet regularly would have led to this being noticed in the early stages when a routine cleaning could have been done without waiting for infection.  And there are many ways to do preventative dental care, such as dental-specific diets, treats, toys, rinses, and tooth brushing.  I would recommend everyone check out the Veterinary Oral Health Council's web site to see more information on periodontal disease as well as dental care products they have endorsed.

Want to see what the teeth looked like?  I'm going to be talking about this on my webshow on Gabcast.tv tonight and showing some of the teeth I extracted.  Join me live at 9:15EDT/6:15PDT, or check it out afterwards in the archived section of the Pet channel.

17 comments:

  1. Have you heard of this product: http://www.virbacvet.com/Products/DentalHealth/RinsesandFoams/C.E.T.AQUADENTDRINKINGWATERADDITIVE.aspx

    It contains xylitol, which I've read from several reputable sources as very dangerous for pets.. But I also know it's a good dental disease preventative.. Huh?

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  2. Hmmm, interesting. I'm familiar with Virbac's products and their CET line and have always thought they were a good company. However, you're absolutely right that xylitol is a potential toxin for dogs (look at this link...http://vetmedicine.about.com/od/toxicology/qt/xylitol_tox.htm), so I'm not sure why it's in their product. I'll have to look more into that and perhaps contact a Virbac rep.

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  3. A dachshund huh? Shocking. Just kidding.

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  4. Wow, that is some serious infection. I'm a periodontist and I deal with similar situation often. Poor doggie... btw, I know this sounds stupid, but how do you tell if a dog has dental pain? It's quite easy to tell if a human has it.

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  5. Alecho, it's not as easy as you might think since pet's can't tell us. Sometimes it's a subtle as the pet merely slowing down a bit. Other more obvious signs can be a decrease in eating, pawing at the face, or difficulty keeping food in the mouth.

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  6. I recently rescued a 9 year old chihuahua. He only has 2 bottom fang teeth remaining and they are rotten and loose. He has been to several vets with varying opinions of treatment. I was told to leave the teeth because the jaw will completely breakdown without the teeth there to anchor the jaw. I was told by another vet that if I leave the teeth they will make the jaw infected. The rescue group I adopted the dog from says leave the teeth in because the jaw will break if the teeth are pulled. I'm not sure if this is a question futon website but I would really like some feedback, option and/or experiences with this type of situation.

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  7. Great question, Laura. I'm discussing it over 2 days in a recent blog post. http://avetsguidetolife.blogspot.com/2012/08/who-do-you-believe-part-1.html

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  8. So sad because today, my Lab is in surgery. So far vet called and had 14 teeth pulled. Almost the same story here. I took him to vet every year except the past two years b/c of financial issues with divorce. I still gave him dental bones and a mouth wash for his water but I nearly killed my baby! The count may go up but again still waiting. I wish dogs could go on my family medical plan! LOL

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  9. For one I must say If you are a vet your bills do not change if you choose to help someone out or not. I am talking your regular bills as stated in the post. If a person comes to you with a injured animal and you turn them away because they do not have payment on demand or they do not qualify for Care Credit. You are not loosing anything but than you are not gaining anything. Why not allow them to make payments? If you take payments you will at least get some money even if they default. If I was a vet I would. There are too many vets that charge way too much for services that many people are doing things on their own. Does this not tell you something? And in all honesty if a vet turned my animal down and told me that there was treatment available however I could not afford it and I could only afford the bill to kill the animal. I would grab my animal and bring them home. This type of vet mentality is what caused me to do everything on my own in the first place. At least I know that I did everything I could and I did not break the bank doing it. The fees vets charge are ridiculous. And at the end of the day if I have to put the animal down a bullet is far cheaper and far less painful than the toxins vets inject into them. And they know that I am right next to them when they do die.

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    1. Obviously you don't understand basic business structure. If a business provides services and doesn't get paid, or gets paid only a part of the bill, they DO lose! They are providing something that cost the business, yet are not getting full payment for it. Should a mechanic absorb the costs of a car repair if a client can't pay the whole bill? Should a grocery store write off the cost of food because the customer can't afford to pay the whole thing? Veterinarians run on an extremely slim profit margin and a large number of practices go bankrupt because they do things like you're outlining. How does that help anyone?

      Also, veterinarians do not charge outrageous prices. Believe me (and you probably won't because I'm obviously part of the problem to you), it costs a LOT to run a veterinary practice. Veterinary salaries are about 1/3 that of human physicians with equivalent education and experience. We have a higher debt-to-income ratio than any other medical professional. And we charge far LESS than comparable services in human medicine.

      "If I was a vet I would." And if you did that you would quickly go out of business. The reason why so few vets take payments is because they have lost considerable amounts of money doing so.

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    2. If you can not afford proper medical and dental care for your pet, or is too selfish to pay for the vet fees, then please do not get a pet. Because its CRUEL to not provide your pet with veterinary care.

      When YOU take ill or have dental needs you go and have it addressed. Your pet is dependent upon YOU to get it to the vet when annual check-ups are due or should it becomes ill.

      I am currently pet-sitting a really sweet very old small dog who has REALLY REALLY HORRIBLE breath and the associated dental health probrems. Hence, I am gonna have a long talk with its owner!

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    3. Are you serious!!! So your saying someone who is a total dog lover but isn't so we'll off financially shouldn't get a dog. But I guess some rich asshole can go get a dog and abuse it, fight it, etc. just as long as he can afford the vet bills then huh?? What a freaking idiot!! Yes if people get sick we go to the hospital.Because regardless of whether we can pay or not we can still get treatment and make payment. Unlike at a vet office who turns their patients away if they can't pay in full. So you really can't use that because like I said, even broke people will get treated. But to say that someone that can't afford to pay vet bills shouldn't have a dog is just stupid. You don't have to be rich to love and care for an animal and you shouldn't miss out on a wonderful experience and part of your family because of your income either. Besides, most people that can afford those big vet bills are usually people who don't really need and shouldn't have pets. Emergencies come up yes, but you can't ever know if you can afford vet bills or not because your pet may need constant medical care but could also never need the vet except for regular visits. That's like saying Don't have children unless you can afford everything for it Including 4yrs of college and especially the bill you get from having them...To some people that's basically what that's saying to them because their pets are the only kids they will ever have. Totally just disagree with your way of thinking!! Rant Over. Thanks

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  10. My Chihuahua's back teeth came in already in bad shape (loose and brown) due to illness as a puppy, and should really be pulled. She gets seizures and is very frail and the veterinarian recommended I don't even get her spayed yet due to potential lethal issues with anesthesia. What can I do about her teeth if she can't be anesthetized? Suggestions please.

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    1. I would get a couple of opinions from different vets and maybe even talk to an internal medicine specialist about the anesthesia. There are many different ways to do anesthesia, some safer than others. There is not one "anesthesia", but instead several ways to do pre-medication, induction, and gas anesthesia. It may indeed be that your dog can't have any kind of anesthesia, but this is rare. Even dogs who have seizures can have surgery if proper precautions are taken. If it is truly unsafe to put her under anesthesia, I would recommend taking her to a veterinary dental specialist to explore options.

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  11. I've noticed that vet prices have doubled in the past few years along with everything else. It's absolutely true. Everytime I go to the vet I receive a bill for hundreds and hundreds of dollars and have to do the speech- no over expensive RX diet food, no probably unnecessary test,
    Get real it's a problem- I haven't been able to get my dogs teeth cleaned as much as I've wanted. I rescued him and he has many health issues I attend to btw. If vet care was accessible more people would be able to afford to care for their pets better. Don't act like only wealthy people should own pets! Who had 500$ everytime they go to the vet?

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    1. Veterinary prices are still a fraction of human costs. Also with increased knowledge and technology we have the ability to provide better care. I've never said that only wealthy people should own pets, just that people need to be prepared for costs of health care if they own pets. Vets are not wealthy and it isn't cheap to give high quality care to a pet.

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  12. My dauchsund is going thru this right now. And for those of you saying don't get a pet if you can't afford,well I have news for you, I had pet health insurance and then my family was struck by its own health crisis and now I'm dealing with not being able to work and no health insurance for myself due to an illegal running a red light and of course didn't have auto ins. So I did at one time carry pet ins but I'm screwed now and my pet is also suffering. Her teeth are so green and I am sure my dog has this same problem. I can't afford it. I wish they would allow us to make payments but I haven't found one that was willing and that's not going to charge me the price of a used car practically. If anyone can recommend someone in Glendale Arizona plz let me know my baby is 14yrs old a mini dauchsund.

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