Thursday, August 5, 2010

Dog: Teeth scaling and follow-up on an abscessed carnaissal tooth chihuahua

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: 06 August, 2010
Be Kind To Pets
Veterinary Education
Project 2010-0129

A mother with four children - 12 years, 15 years, 19 years and 23 years brought 2 Malteses that are 2 years old for their annual vaccination. She made an appointment for dental scaling. Dental scaling was done under anaesthesia. Lots of brown tartar in the canine and back teeth, but the teeth are still solid and strong.

Questions asked by the mum:

1. Yearly dental scaling? Not necessary if there is no tartar. Just ask the vet to check the teeth.

2. Must brush teeth daily? Yes, if practical. If not, every 3 days.

3. Dog does not like brushing. What to do? Use thumb brush or rag to rub back teeth. Use treats to motivate.

4. How to prevent tartar build up on the teeth? Presently the dogs eat chicken meat mainly. "Add dry dog food for the dog to chew," I said. "There are also chew ropes, but one way is to feed dry dog food and brushing of the teeth."

"My dogs will never eat dry food," the mother said.

"Even you will never eat biscuits if forced to," I said to the caring mother. "The trick is to add 5% to chicken meat, gradually increasing to 50% after one month. Delay dinner as the dog eats once a day."
As I had time, we talked about our experiences in bringing up children and she had four of them. "My 15-year-old is the naughtiest and always wants to go out."

"That's due to her hormones", I said. "She wants to meet boys. You need to spend some time with her, for example. exercising the two dogs together with her. Bonding with her, getting to know her better." I had thought that the 12-year-old daughter would be harder to manage as she should be having hormonal changes to become a woman. Yet it was the 15-year-old. I don't know much about daughters as I don't have any.

The mum said she used to take half-hourly walks when first diagnosed with Diabetes Type II. Now, she gave up exercising. "You need company," I said. "It is just too boring to walk by yourself and spouses are usually not available or interested.

"You have two dogs. Just take one dog down at a time since two dogs are noisy. If you don't take care, you may get diabetes Type I and then you will need to inject yourself everyday ", I advised the mum. She has to take care of herself as she has 4 children and 2 dogs and that is a heavy responsibility.
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
06 August, 2010
Be Kind To Pets
Veterinary Education
Project 2010-0129

What to do if you, as a vet do not feel comfortable in performing anaesthesia in old dogs which may only be cured if surgery is done?

I know of one vet who just simply refers all cases to another practice. "At least I don't lose clientele when I refer to this practice," the vet told me. This practice has several vets and if this vet believes that referring her difficult cases to this practice will not cause her loss of clientele, I find it hard to believe. I reserved comments. A practice with more vets has higher overheads and therefore needs the caseload to sustain the profitability of the big operation. Recently I asked my mentor about this vet's comments. My mentor who is in his late 60s said: "Once you refer a case, you lose your client."

Referring to other practices means losing clientele. There is no way to stem such losses if the vet does not want to perform risky surgeries that will harm his or her professional reputation.

Deaths on the operating table are very emotional and unpleasant issues. In this Chihuahua with an abscessed carnaissal tooth, the vet just advised conservative treatment for 12 months. This vet would not perform surgery knowing that it would be very risky. Anaesthesia in old dogs is going into areas where angels fear to thread as it is high risk. Yet, some surgeries cure the dog promptly. There is always a big dilemma for vets encountering such situations.

It was a joy to see this Chihuahua some 7 months after I extracted her abscessed carnaissal tooth and many other teeth. I tried my hand at making a short video with the help of an intern at: Abscessed Carnaissal Tooth Diagnosis and Treatment Video Education For Vet Students. Three follow-up pictures of the pretty Chihuahua are taken for viewers:

7 months ago
Dirty, wet itchy left facial area below the eye. The mum had to clean the non-healing wound for the previous 12 months. It was a daily chore for the old mother for 12 solid months.

7 months later
No pain and good looking and a happy mum. The grown up son had to seek a vet who would operate on the dog but he knew it was a high risk anaesthesia. It is not always a happy ending. Yearly dental check up by your vet will prevent so much dramas and worries for the family members who are care-givers to the dog.

More info at: Dogs or Cats
To make an appointment: e-mail
tel: +65 9668-6469, 6254-3326
Be Kind To Pets
Veterinary Education
Project 2010-0129

Pictures are at

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