For those families adding a feline member during Adopt-a-Cat Month this June, keeping your cat young and in good health is a priority. Here are The Animal Medical Center’s top six tips to achieving purrfect health and maintaining a long life for your feline family member.
1. Give your cat a routine. Research has shown changes in feeding schedule or in caretaker can result in “illness behaviors” such as having a poor appetite, vomiting and not using the litter box. Basically, cats don’t like surprises.
2. Provide your cat with an interesting environment. Cats need climbing structures where they have a good view of the room and a window with an outdoor view. The perch should be comfortable for resting. Leave a radio on tuned to quiet music when you are away.
3. Encourage your cat to hunt. Not outdoors, but indoor hunting. Use food dispensing toys such as the FunKitty line. Keeping your cat’s brain active by having her “hunt” for her food will keep her engaged and active longer.
4. Cats may have a “hands off” personality, but when it comes to healthcare you need to be hands on, and the hands should be those of your cat’s veterinarian. Visit your cat’s veterinarian for routine health checks at least once a year and twice a year if your cat is 10 years of age or older.
5. Clean your cat’s teeth regularly. The American Veterinary Dental College and the AMC Dental Service recommend daily tooth brushing and annual cleanings under general anesthesia.
For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.
When people go to a human dentist, we sit in the dentist’s chair, often time grasping the armrests tightly with white knuckles in anticipation of the procedure about to happen. When the dentist or hygienist tells us to say “ahhhhhhhh” or turn our head, or open our mouths, we may be reluctant, but we can follow their directions to facilitate their work. When they place x-ray films or digital sensors in our mouths and tell us to hold them while they walk out of the room, we do as they say.
The photo shows a dog under general anesthesia having its teeth scaled. You can see the “breathing tube” inserted in the mouth and attached to an anesthesia machine.
February is Veterinary Dental Month. Our pets need the same dental care as we do; maybe more, since they don’t brush or floss twice a day. Our pets are not as cooperative when it comes to saying “ahhhhhhhh” or when it comes to following directions, yet they often experience the same anxiety as their owners when a stranger is poking and squirting things around their mouths.
There has been recent movement to perform anesthesia-free dental cleanings on veterinary patients. The rationale for performing dentistry on awake dogs and cats is that it will be cheaper for the client and safer for the patient. This movement is in direct opposition to the American Veterinary Dental College’s position statement entitled, “Companion Animal Dental Scaling without Anesthesia.”
I understand that many people are reluctant to perform proper dental procedures because of the need for general anesthesia, especially in the older patient. I am a firm believer that “age is not a disease,” and age should not be the deciding factor in determining the safety of general anesthesia for any patient. Pre-anesthesia testing can help determine the risk associated with general anesthesia and aid in the decision whether or not to perform a dental procedure. These tests help determine the function of the internal organs such as the liver, kidneys, heart and lungs, which are necessary to help the body safely handle anesthesia.
Proper anesthesia starts with the pre-op testing but also involves choosing the proper anesthetic drugs safest for each pet. The Animal Medical Center’s Dental Service always places an intravenous catheter to administer drugs, fluids and emergency drugs if needed. We also place an endotracheal, or breathing, tube to protect the airway and deliver the anesthetic gas and oxygen mixture to the lungs. Anesthetized dogs and cats at the AMC are connected to various monitoring equipment to measure the vital signs such as pulse rate, blood oxygen levels, blood pressure, electrocardiogram, and carbon dioxide levels. Finally, we monitor at regular intervals to make sure the vital signs are stable. If any painful procedures need to be performed, we also have the ability to utilize local anesthesia to minimize the amount of general anesthesia needed.
There are many advantages to performing any dental procedures under general anesthesia. First, when we scale the calculus (also known as tartar) off the teeth, there are often large or small pieces of calculus removed. If an animal is properly intubated with a breathing tube, then this calculus cannot be aspirated into the lungs or “swallowed down the wrong pipe.” The biggest advantage to working on a patient under general anesthesia is the ability to work around every side of every tooth. In the awake patient, the veterinary dentist has a very limited view of most of the teeth in the mouth. It’s easy to see the outside of the front teeth, but virtually impossible to evaluate the inside surfaces of many teeth and impossible to see many of the back teeth. A proper cleaning involves cleaning off all of the calculus from every surface of every tooth, both above and below the gum line. In the awake patient, the area below the gum line cannot be seen, yet under anesthesia it is much easier to fully visualize this area.
Once the teeth are cleaned, they need to be evaluated for periodontal disease. This involves gently probing under the gum line in several areas around each tooth in the mouth to measure periodontal pockets, or separation of the gums from the tooth root surface. Imagine trying to do this in an awake dog.
Approximately 75% of cats presenting for dental procedures have a decay of their teeth called tooth resorption. These are holes or decay in the teeth that often start at the gum line. They are quite painful and diagnosed by probing along the gum line with an instrument called an explorer. Again, this is not the type of procedure that could be tolerated by a cat without general anesthesia.
Proper dental procedures require intra-oral x-rays to make a diagnosis. A piece of film or a digital x-ray sensor is placed in the pet’s mouth. The person taking the x-ray steps out of the room and exposes the film or sensor and then walks back in the room. Not too many awake pets will tolerate this type of procedure.
Finally, with 75% of cats having tooth resorption and 80% of all dogs over the age of 5 years having periodontal disease, most veterinary dental patients need some type of surgical procedure to correct the abnormality. Finally, it is much easier to perform oral surgery when I’m not working on a moving target.
Given the complexity of the procedures necessary to clean, diagnose and treat a pet’s mouth, it is easy to understand why general anesthesia is so vital to performing proper veterinary dental care. My recommendation to anxious pet owners over the years is to use a little general anesthesia every year in order to maintain a healthy mouth, rather than wait until the mouth has severe disease and needs several hours of surgery to clean up a messy and painful mouth.
For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.
February is National Pet Dental Health Month and complete oral health involves not only dental hygiene, but also monitoring the oral cavity for other problems such as cancer. Oral cancer accounts for 3% of all cancers in cats, a rate comparable to that in humans. Oral cancer is an important cause of morbidity and mortality in both humans and cats. Cat owners often ask me what they can do to prevent this deadly disease in their cats, so in keeping with this month’s theme of oral health, here are my suggestions for the cat owner.
Similar to oral cancer in humans, oral squamous cell carcinoma (SCC) is the most common oral cancer seen in cats. Use of tobacco products and consumption of alcohol are known risk factors for the development of oral SCC in humans. Most cat owners are unaware that research has shown cats living in a household with smokers are victims of second hand smoke exposure. There appears to be a relationship between exposure to second hand smoke and the development of oral SCC in cats. If you smoke and can’t quit for yourself, then quit for your cat.
Cats should be seen by a veterinarian at least once a year and twice a year as they move into the American Association of Feline Practitioners “mature” life stage. Mature cats are 7-10 years of age and the average age for cat to develop oral SCC is 10 years, so the mature cat is at the target age for early detection of this tumor. During a scheduled wellness examination your veterinarian will assess the oral cavity and determine the need for dental cleaning or the presence of an abnormality requiring biopsy.
During National Pet Dental Health Month, pet owners will be reminded to brush their pet’s teeth daily. As a cat owner, you need to start early and teach your kitten to allow brushing. But don’t stop there, practice opening your kitten’s mouth to allow a visual examination of its oral cavity. Starting early will get your kitten used to having its mouth manipulated and make home monitoring of the oral cavity and vet visits easier for everyone. An added benefit of teaching your kitten to allow you to open its mouth will be less resistance to medication administration if required when your kitten is older.
When you look in your cat’s mouth, look everywhere. Oral SCC can occur anywhere in the oral cavity including on the tongue, under the tongue, gums or either the upper or lower jawbone. The tumor appears as a lumpy, reddening of the surface of the oral cavity, but this tumor can be devious. There may be nothing visible in the oral cavity, but the observant owner will notice swelling near one of the eyes, discharge from only one eye or reluctance to chew on one side of the mouth. Any of these changes should provoke a visit to your cat’s veterinarian.
Regular veterinary visits are vital to keeping your pet healthy. Our pets are experts at hiding things from us, including various illnesses; this is why routine veterinary care is so important.
The Animal Medical Center is open 24 hours a day, 7 days a week and is available for routine, specialty and emergency care. For more information or to make an appointment, please call (212) 838-8100 or visit www.amcny.org.
Like people, our pets are prone to dental disease. Pet Dental Month, in February, focuses on the importance of controlling and preventing dental disease in our cats and dogs. Untreated dental disease is associated with both infection and pain.Recent studies in people and dogs show that untreated infection in the mouth has also been linked to infections in other parts of their bodies.
Many pets present to the veterinarian with broken teeth. Traditionally, a veterinarian might say, “it’s not bothering the dog or cat so we’ll leave it alone.” If my own dentist told me that regarding one of my own teeth, I’d be looking for a new dentist.
Identifying the Issue How do we know if a broken tooth is painful? Dogs and cats don’t have the ability to communicate that, but often their teeth hurt in the same way that our teeth can. There are several things we can do to access the viability of a tooth that has been broken. First, if there is obvious pulp exposure, then we know that tooth is dead or is dying, depending upon how long it’s been broken. Pulp is a combination of nerves and blood vessels that live within the center of a tooth. Once the pulp is exposed to the outside world, it rapidly becomes infected and that tooth will die over several weeks to months.
When an animal is under anesthesia, there are radiographic changes that may be seen in a non-vital (dead) tooth. As we age and our teeth mature, the body constantly produces new layers of dentin along the outer walls of the “pulp chamber.” As an animal ages, the pulp chamber diameter becomes smaller and smaller. A tooth with a dilated pulp chamber as seen on x-rays indicates that that particular tooth is non-vital. Also, over time, a dead tooth may develop changes around the root of the tooth seen on x-rays called a periapical lucency (see image on left). This is an area seen around the root tip that usually represents and infection from bacteria that has invaded into the pulp chamber of the tooth, or a cyst developing from inflammation associated with the dead pulp leaking into the bone around the root of the tooth.
Any teeth with pulp exposure, dilated pulp chambers or a periapical lucency should be treated and there is a likelihood that this tooth may be painful to a pet. There are multiple treatment options, although “leaving it alone,” is not in the pet’s best interest.
Saving the Tooth The option to save the tooth involves endodontic or root canal therapy. First the tooth is evaluated to make sure there is no concurrent disease of the tooth. This includes periodontal disease, fractures below the gum line or advanced destruction of the tooth root. The tooth root must also be mature enough to be treated with endodontic therapy. Endodontic therapy involves cleaning out the pulp chamber of the tooth with a combination of filing and flushing with a disinfectant. Next the tooth is filled with a sealant to prevent the leakage of bacteria through the canal of the tooth. Finally, a filling, or “restoration,” is placed on the opening of the tooth to also prevent bacterial leakage into the pulp chamber. If performed correctly, endodontic therapy is highly effective at salvaging broken teeth with pulp exposure. Endodontic therapy does require follow up care with dental x-rays to make sure the therapy is successful and that the restorations remain intact.
If a fractured tooth is immature, the root is not fully developed, and the fracture is very recent, then a broken tooth may be treated with a procedure called a vital pulpotomy and direct pulp capping. The goal of this procedure is to keep the tooth alive long enough to allow the tooth to mature to a point where endodontic therapy can be performed. If the fracture is not very recent, then a procedure called apexogenesis may be performed to encourage enough maturation of the tooth root to perform endodontic therapy.
Extracting the Tooth The other treatment option is extraction therapy. This involves removal of the affected tooth. This may be relatively simple or may involve surgery, depending upon which tooth is involved. After the extraction of broken or non-vital teeth, pets are often much happier than those with these teeth left in their mouths. Extraction therapy means the function of that tooth will be lost, but once the extraction site is healed, there should be no residual pain.
Making the Right Decision
The most important issue is that our pets do not need to live with painful teeth and/or broken teeth, and therefore these decisions should not be neglected. The decision whether to perform endodontic therapy or extraction therapy should be made in consultation with a veterinarian and is often based upon several factors including the overall health and age of the patient, the ability of the patient to safely undergo anesthesia, the extent of damage to the tooth, which tooth is involved and the cost of the procedures. Leaving a fractured tooth with pulp exposure in a pet’s mouth is not considered a humane option, however.
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About Stephen Riback, DVM Dr. Riback received his veterinary degree from the New York State College of Veterinary Medicine at Cornell in 1985. He was a general practitioner from 1985 until 1999 and owned the Oakdale Veterinary Hospital from 1989 until 1999. Dr. Riback has worked at the AMC since 1999, first in the Community Medicine dept. and then from 2003 in the Dentistry dept. where he studied dentistry under the mentorship of Dr. Dan Carmichael, who is the only board certified veterinary dentist in New York City.
The department of dentistry is the only full service veterinary dental practice in New York City and operates Monday through Friday at the AMC. Dr. Carmichael works on Mondays and Dr. Riback is in Tuesday through Friday. Dental procedures and oral surgeries are performed Monday through Friday.
It seems that cats are getting the short end of the stick when it comes to veterinary care. Research has shown that cat owners are taking their cats to the vet less often. Research sponsored by the American Veterinary Medical Association determined 83% of dogs see a veterinarian annually while only 64% of cats see a veterinarian annually.
Cats are medically underserved, in part because owners are unaware how sick their cat is. Cats, being the clever creatures that they are, can hide illness until it has reached catastrophic proportions.
The veterinarians at The AMC recommend annual examinations for all healthy younger cats and for senior cats (>7 years of age) twice annual examination. During the examination, your cat’s veterinarian will monitor your cat’s weight and body condition score as a measure of his/her overall health. The American Association of Feline Practitioners recommends the minimum database in senior cats include a complete blood count, chemistry screen, and urinalysis. Once cats pass their 10th birthday, testing thyroid function and blood pressure are recommended. Together, you and the veterinarians will discuss your cat’s lifestyle and decide on what preventive healthcare measures are required to keep you cat in tip top condition. The preventive measures include: vaccinations, parasite prevention, behavioral interventions and nutritional recommendations. Your cat’s veterinarian may suggest testing for occult infections such as feline immunodeficiency virus, feline leukemia virus and feline heartworms.
People other than just those of us at The AMC are thinking about cats and cat health too. There is an interesting new cat website (www.kittytest.com). This website displays the frequency of important cat diseases by geographic location. The information contained in this website will help the cat owner determine how often a disease is diagnosed in their county and open the door for a risk analysis for their cat with the family veterinarian. This website is similar to, but not the same as, a registry of disease for people like the governmental vital statistics bureau. The data shown on the website is compiled from the tests performed since 2000 by only one laboratory, but it will help cat owners to know how common these diseases are in their neighborhoods and give them some information with which to open a discussion with their veterinarian. Ultimately, any medical tests and treatments should be customized to the lifestyle issues of your cat.
_______________________ For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.
Oftentimes the owners of my older patients dismiss changes in their pet’s behavior by saying, “Well, you know he is 13.” I would like to caution all of us to think critically about the changes we are seeing in our older pets and examine the potential causes of these changes.
The American Association of Feline Practitioners classifies a senior cat as one that is older than 11 years of age and the American Animal Hospital Association defines a senior dog as one older than 6 or 7 years of age. There is great variability in the expected lifespan of dogs compared to cats and your veterinarian may not consider your dog to be senior until 9 or 10 years of age, depending on the breed. Panels of the American Association of Feline Practitioners and the American Animal Hospital Association recommend the senior pet be seen biannually.
Weight Gain Older pets tend to pack on the pounds as they age. Your Dalmatian may be sluggish because she is carrying around too much weight for her slender frame. Pet owners who are successful with a weight loss plan often comment on how much more active their pets are after they reach an ideal body weight. Veterinarians can help you to design a safe weight loss program which includes both diet and exercise for your pet. Obesity not only slows your pet down, but is a risk factor for diabetes, arthritis, respiratory disease, urinary tract disease and, worst of all, a shortened lifespan.
Arthritis Slowing down may be a clinical sign of arthritis. Arthritis brings to mind the limping Lhasa or the achy Afghan, but did you know arthritis is commonly under-diagnosed in cats? Diet change, weight loss and non-steroidal anti-inflammatory drugs, specifically developed and tested in pets, can completely revert your arthritic pet’s personality back to normal.
Dental Problems Tooth problems can also slow your pet down too. When a pet experiences pain, it often causes a pet to be quieter than usual and dental pain is no different. An oral examination should be part of a complete physical examination. Removal of plaque build up, extraction of diseased teeth and treatment with antibiotics may be necessary to bring your Persian with a pout back to its usual vigorous self.
Cancer
When some types of cancer occur in a senior pet, the only clinical sign seen by the pet owner is a general decrease in activity. The decrease in activity may be due to pain or may be due to the growth of the cancer. Internal cancers, such as those of abdominal organs, lungs or nasal passages are types that can progress undetected, with the only sign being general malaise in your pet. Your veterinarian my recommend diagnostic imaging, such as x-rays, an ultrasound or CT scan to detect a possible cancer.
So remember, age is not a disease. Be sure to have your senior pet checked on a regular schedule and whenever your Abyssinian is apathetic.
To make an appointment for your pet, please call The Animal Medical Center’s appointment desk at 212.838.7053.
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For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.
The importance of dental care for dogs and cats. Part 3 of a 3 part series by Stephen Riback, DVM Like people, our pets are prone to dental disease. This month focuses on the importance of controlling and preventing dental disease in our cats and dogs. Untreated dental disease is associated with both infection and pain. Recent studies in people and dogs show that untreated infection in the mouth has also been linked to infections in other parts of their bodies.
An Explanation of Dental Costs and Preventative Care Tips for the Pet Owner
I am asked why the cost of veterinary dentistry is expensive. It is true that over the past several years there has been a change in veterinary dental fees. This is a direct result of the increase in technology that is available for the safe anesthesia and treatment necessary to practice the highest quality veterinary dentistry. The good news is with this new technology, we can provide much better quality oral care for our pets and have them live healthier, happier lives.
All dental procedures should be performed under general anesthesia. Safe anesthesia starts with prescreening to determine the overall health of a patient. This includes a comprehensive physical examination, blood tests and sometimes other tests such as chest x-rays, echocardiograms or electrocardiograms. Anesthesia drugs, administration and monitoring pets undergoing dental procedures have become very sophisticated so that we can now anesthetize higher risk and older patients with a higher degree of safety. While a patient is under general anesthesia, several vital signs are monitored to ensure the patient is tolerating the anesthesia well. Monitoring often includes an electrocardiogram, blood oxygen, expired carbon dioxide and blood pressure. The prescreening process and administration of anesthesia is quite similar to the process used in human medicine.
Through the use of intra oral x-rays, technology has also advanced to allow us to diagnose dental disease that was previously undetectable. Many practices now use digital radiography or a computerized x-ray image. This eliminates the need for dental films and the slow process of developing x-rays by hand. Now, a digital sensor is placed in the patient’s mouth and the image shows up on a computer screen seconds later. The amount of radiation necessary for digital images is only a fraction of what was used for film x-rays. Intra oral radiography is the single most important tool for the diagnosis of dental disease.
Many veterinary dental practices are now using “high speed” drills for use in oral surgery. This allows us to more easily treat teeth, extract teeth and perform many oral surgeries. As a result of all the advances in veterinary dentistry, we have an increased ability to treat the dental disease that is present with higher degrees of sophistication. All of this adds to an increased cost of care, but the best news is that we now have pets that seem to feel much younger, happier and more energetic after being treated for dental disease.
With increased knowledge of dentistry, we are now capable if diagnosing and treating a much wider variety of dental disease. These new therapies allow us to save teeth in many instances and help to maintain mouths with a lesser degree of oral pain. Some of the procedures that are commonly performed include endodontic therapy (root canal therapy) for broken or dead teeth, advanced medical and surgical techniques for treating periodontal disease, orthodonture for animals whose natural bite might be causing oral pain, newer techniques for the treatment of jaw fractures and the placement of crowns on working dogs with fractured teeth.
Part of every pet’s examination should include an oral evaluation. In the awake patient, only a limited view of the mouth is obtained, but often good enough to determine if an anesthetic exam and dental cleaning should be performed. The veterinarian is often looking for evidence of halitosis (bad breath), calculus or tartar on the teeth, gingivitis, periodontitis, broken teeth, loose teeth, decay of the teeth, etc. Any of these changes warrants an anesthetic evaluation and treatment.
Preventive dental care at home should include daily brushing of the teeth. Brushing less than once a day has been shown to have little positive benefits on the prevention of dental disease. There are now diets and chews approved by the Veterinary Oral Health Council (VOHC). The VOHC seal of approval certifies that a dental diet or product will decrease plaque and tartar accumulation on teeth. Annual oral exams performed by your veterinarian can help screen for dental disease and annual prophies are recommended to minimize plaque and tartar build up. Keeping the teeth clean is the best way to prevent periodontal disease and keep our pets healthier and happier.
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About Stephen Riback, DVM Dr. Riback received his veterinary degree from the New York State College of Veterinary Medicine at Cornell in 1985. He was a general practitioner from 1985 until 1999 and owned the Oakdale Veterinary Hospital from 1989 until 1999. Dr. Riback has worked at the AMC since 1999, first in the Community Medicine dept. and then from 2003 in the Dentistry dept. where he studied dentistry under the mentorship of Dr. Dan Carmichael, who is the only board certified veterinary dentist in New York City.
The department of dentistry is the only full service veterinary dental practice in New York City and operates Monday through Friday at the AMC. Dr. Carmichael works on Mondays and Dr. Riback is in Tuesday through Friday. Dental procedures and oral surgeries are performed Monday through Friday. To make an appointment, cal 212.838.7053.
The importance of dental care for dogs and cats. Part 2 of a 3 part series by Stephen Riback, DVM Like people, our pets are prone to dental disease. This month focuses on the importance of controlling and preventing dental disease in our cats and dogs. Untreated dental disease is associated with both infection and pain. Recent studies in people and dogs show that untreated infection in the mouth has also been linked to infections in other parts of their bodies.
Feline Odontoclastic Resorptive Lesions
The most common dental disorder in domestic cats is a decay of the teeth called Feline Odontoclastic Resorptive Lesions (FORLS). This is present in 50-75% of all cats presenting for dental procedures. We do not know what initiates the process, but we do know that a cell within the tooth called and odontoclast gets “turned on” and removes calcium, from within the tooth structure. These teeth then start to decay often from the inside out. This is different from “carious decay” or cavities in people that begins from outside surface of the tooth. When these lesions break through to the surface of the tooth, they become painful. The only approved treatment for FORLS is extraction of the affected teeth. Many cats are living with FORLS and do not show overt signs. Some cats may have difficulty eating dry food or avoid using teeth with FORLS present and some cats may have jaw “chattering” while chewing.
The diagnosis and treatment of FORLS involves general anesthesia. Animals should be prescreened to ensure they are good anesthetic candidates before undergoing a dental procedure. This often involves a thorough physical exam, blood tests and sometimes x-rays of the heart and lungs, or an echocardiograms of the heart. Once a patient is safely anesthetized, the teeth should be cleaned to evaluate for dental disease. Probing around every surface of every tooth in a cat will screen for FORLS. In the early stages, a FORL may look like a small hole within the tooth. As the FORLS progress, more destruction of the tooth may be present. Many times, gum tissue will grow over the exposed FORL giving the appearance of the gums growing onto the tooth surface. “Intra-oral” or dental radiographs can also be taken to help diagnose FORLS. Many practices now have “digital” or computerized dental X-Rays that do not need dental films and require much less radiation than the old X-Rays. The combination of dental probing and X-Rays can help determine the best treatment for an individual patient. Many cat owners report that after successfully extracting teeth with FORLS, their cats seem happier and more active. Cats seem to thrive better with extracted teeth, versus painful teeth.
Some FORLS seem to be associated with inflammation at the gum line. Many FORLS will develop independent of gingival inflammation. Keeping gingivitis under control may help prevent some FORLS, but many are not preventable. Cats who develop FORLS in some teeth will usually develop new FORLS in other teeth in the future, so annual oral examinations are recommended to identify new lesions as they develop.
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About Stephen Riback, DVM Dr. Riback received his veterinary degree from the New York State College of Veterinary Medicine at Cornell in 1985. He was a general practitioner from 1985 until 1999 and owned the Oakdale Veterinary Hospital from 1989 until 1999. Dr. Riback has worked at the AMC since 1999, first in the Community Medicine dept. and then from 2003 in the Dentistry dept. where he studied dentistry under the mentorship of Dr. Dan Carmichael, who is the only board certified veterinary dentist in New York City.
The department of dentistry is the only full service veterinary dental practice in New York City and operates Monday through Friday at the AMC. Dr. Carmichael works on Mondays and Dr. Riback is in Tuesday through Friday. Dental procedures and oral surgeries are performed Monday through Friday.
The importance of dental care for dogs and cats. Part 1 of a 3 part series by Stephen Riback, DVM Like people, our pets are prone to dental disease. This month focuses on the importance of controlling and preventing dental disease in our cats and dogs. Untreated dental disease is associated with both infection and pain. Recent studies in people and dogs show that untreated infection in the mouth has also been linked to infections in other parts of their bodies.
Periodontal Disease
The most common disease in dogs is periodontal disease. It affects 85% of dogs over 5 years old and occurs in cats as well. Plaque and tartar accumulating on the tooth surface are full of bacteria that may cause a loss of attachment of the tooth to the supporting bone, gum tissue and periodontal ligaments. This attachment loss creates an increased space between the teeth and the gums that can harbor a more harmful bacteria. This space is called a periodontal pocket. It is the harmful bacteria or infection, living in this space that causes the halitosis or bad breath that we associate with periodontal disease.
Untreated periodontal disease causes progressive attachment loss and ultimately leads to chronic infections under the gum line. Dogs with untreated periodontal disease are prone to having their teeth fall out, they are prone to spontaneous jaw fractures, and they are more prone to diseases of other organs including the heart, lungs, kidneys and liver. The underlying periodontal disease can also be painful, but we tend not to notice our pet’s pain because it creeps up slowly over several years. As pet owners we tend to assume our pet slowing down is just part of the normal aging process. Many times, it’s the oral discomfort from dental disease causing the changes. If your pet has halitosis, or bad breath, periodontal disease should be considered. Red gums, bleeding gums, root exposure, gum recession and loose teeth may also be signs of advanced periodontal disease.
Diagnosis and treatment of periodontal disease requires general anesthesia. All patients should be prescreened to determine their ability to safely handle anesthesia. This includes a thorough examination, blood tests and sometimes other tests. Diagnosis is made by probing the periodontal tissues surrounding each tooth to look for evidence of bone loss and gum loss. Intra oral radiographs or X-Rays are also taken to evaluate the amount of bone loss present. Treatment for periodontal disease in our pets depends upon how advanced the disease is. Treatments include dental prophies (routine cleanings) for mild cases, medical or surgical therapies for moderate cases and extraction therapy for advanced cases. Many pet owners report that their pet seems happier or younger after successful treatment of periodontal disease.
Periodontal disease is often preventable through proper oral hygiene. This involves thorough home health care including brushing the teeth daily. Dental diets are also available for keeping the teeth cleaner. Dental sealants may be used to prevent plaque and tartar accumulation. There is a new periodontal vaccine that may be helpful in reducing bone loss associated with periodontal disease. Also, regular cleanings under general anesthesia are recommended to keep the teeth clean above and below the gum line.
If you notice halitosis, red gums, bleeding gums, loose teeth, discolored teeth or oral discomfort in your pet, you should be considering an oral evaluation for periodontal disease or other dental problems seen in dogs and cats. Our pets give us so much love. The least that we can do for our pets is help to maintain them with healthy, pain free, infection free mouths.
Reader’s Poll:
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About Stephen Riback, DVM Dr. Riback received his veterinary degree from the New York State College of Veterinary Medicine at Cornell in 1985. He was a general practitioner from 1985 until 1999 and owned the Oakdale Veterinary Hospital from 1989 until 1999. Dr. Riback has worked at the AMC since 1999, first in the Community Medicine dept. and then from 2003 in the Dentistry dept. where he studied dentistry under the mentorship of Dr. Dan Carmichael, who is the only board certified veterinary dentist in New York City.
The department of dentistry is the only full service veterinary dental practice in New York City and operates Monday through Friday at the AMC. Dr. Carmichael works on Mondays and Dr. Riback is in Tuesday through Friday. Dental procedures and oral surgeries are performed Monday through Friday.
For those families adding a feline member during Adopt-a-Cat Month this June, keeping your cat young and in good health is a priority. Here are The Animal Medical Center’s top six tips to achieving purrfect health and maintaining a long life for your feline family member.
Posted by Fur the Love of Pets 
The veterinarians at The AMC recommend annual examinations for all healthy younger cats and for senior cats (>7 years of age) twice annual examination. During the examination, your cat’s veterinarian will monitor your cat’s weight and body condition score as a measure of his/her overall health. The American Association of Feline Practitioners recommends the minimum database in senior cats include a complete blood count, chemistry screen, and urinalysis. Once cats pass their 10th birthday, testing thyroid function and blood pressure are recommended. Together, you and the veterinarians will discuss your cat’s lifestyle and decide on what preventive healthcare measures are required to keep you cat in tip top condition. The preventive measures include: vaccinations, parasite prevention, behavioral interventions and nutritional recommendations. Your cat’s veterinarian may suggest testing for occult infections such as feline immunodeficiency virus, feline leukemia virus and feline heartworms.
this website will help the cat owner determine how often a disease is diagnosed in their county and open the door for a risk analysis for their cat with the family veterinarian. This website is similar to, but not the same as, a registry of disease for people like the governmental vital statistics bureau. The data shown on the website is compiled from the tests performed since 2000 by only one laboratory, but it will help cat owners to know how common these diseases are in their neighborhoods and give them some information with which to open a discussion with their veterinarian. Ultimately, any medical tests and treatments should be customized to the lifestyle issues of your cat.
Older pets tend to pack on the pounds as they age. Your Dalmatian may be sluggish because she is carrying around too much weight for her slender frame. Pet owners who are successful with a weight loss plan often comment on how much more active their pets are after they reach an ideal body weight. Veterinarians can help you to design a safe weight loss program which includes both diet and exercise for your pet. Obesity not only slows your pet down, but is a risk factor for diabetes, arthritis, respiratory disease, urinary tract disease and, worst of all, a shortened lifespan.
All dental procedures should be performed under general anesthesia. Safe anesthesia starts with prescreening to determine the overall health of a patient. This includes a comprehensive physical examination, blood tests and sometimes other tests such as chest x-rays, echocardiograms or electrocardiograms. Anesthesia drugs, administration and monitoring pets undergoing dental procedures have become very sophisticated so that we can now anesthetize higher risk and older patients with a higher degree of safety. While a patient is under general anesthesia, several vital signs are monitored to ensure the patient is tolerating the anesthesia well. Monitoring often includes an electrocardiogram, blood oxygen, expired carbon dioxide and blood pressure. The prescreening process and administration of anesthesia is quite similar to the process used in human medicine.
Through the use of intra oral x-rays, technology has also advanced to allow us to diagnose dental disease that was previously undetectable. Many practices now use digital radiography or a computerized x-ray image. This eliminates the need for dental films and the slow process of developing x-rays by hand. Now, a digital sensor is placed in the patient’s mouth and the image shows up on a computer screen seconds later. The amount of radiation necessary for digital images is only a fraction of what was used for film x-rays. Intra oral radiography is the single most important tool for the diagnosis of dental disease. 
Part of every pet’s examination should include an oral evaluation. In the awake patient, only a limited view of the mouth is obtained, but often good enough to determine if an anesthetic exam and dental cleaning should be performed. The veterinarian is often looking for evidence of halitosis (bad breath), calculus or tartar on the teeth, gingivitis, periodontitis, broken teeth, loose teeth, decay of the teeth, etc. Any of these changes warrants an anesthetic evaluation and treatment.
Preventive dental care at home should include daily brushing of the teeth. Brushing less than once a day has been shown to have little positive benefits on the prevention of dental disease. There are now diets and chews approved by the Veterinary Oral Health Council (VOHC). The VOHC seal of approval certifies that a dental diet or product will decrease plaque and tartar accumulation on teeth. Annual oral exams performed by your veterinarian can help screen for dental disease and annual prophies are recommended to minimize plaque and tartar build up. Keeping the teeth clean is the best way to prevent periodontal disease and keep our pets healthier and happier.
Dr. Riback received his veterinary degree from the New York State College of Veterinary Medicine at Cornell in 1985. He was a general practitioner from 1985 until 1999 and owned the Oakdale Veterinary Hospital from 1989 until 1999. Dr. Riback has worked at the AMC since 1999, first in the Community Medicine dept. and then from 2003 in the Dentistry dept. where he studied dentistry under the mentorship of Dr. Dan Carmichael, who is the only board certified veterinary dentist in New York City. 
The most common dental disorder in domestic cats is a decay of the teeth called Feline Odontoclastic Resorptive Lesions (FORLS). This is present in 50-75% of all cats presenting for dental procedures. We do not know what initiates the process, but we do know that a cell within the tooth called and odontoclast gets “turned on” and removes calcium, from within the tooth structure. These teeth then start to decay often from the inside out. This is different from “carious decay” or cavities in people that begins from outside surface of the tooth. When these lesions break through to the surface of the tooth, they become painful. The only approved treatment for FORLS is extraction of the affected teeth. Many cats are living with FORLS and do not show overt signs. Some cats may have difficulty eating dry food or avoid using teeth with FORLS present and some cats may have jaw “chattering” while chewing.
The diagnosis and treatment of FORLS involves general anesthesia. Animals should be prescreened to ensure they are good anesthetic candidates before undergoing a dental procedure. This often involves a thorough physical exam, blood tests and sometimes x-rays of the heart and lungs, or an echocardiograms of the heart. Once a patient is safely anesthetized, the teeth should be cleaned to evaluate for dental disease. Probing around every surface of every tooth in a cat will screen for FORLS. In the early stages, a FORL may look like a small hole within the tooth. As the FORLS progress, more destruction of the tooth may be present. Many times, gum tissue will grow over the exposed FORL giving the appearance of the gums growing onto the tooth surface. “Intra-oral” or dental radiographs can also be taken to help diagnose FORLS. Many practices now have “digital” or computerized dental X-Rays that do not need dental films and require much less radiation than the old X-Rays. The combination of dental probing and X-Rays can help determine the best treatment for an individual patient. Many cat owners report that after successfully extracting teeth with FORLS, their cats seem happier and more active. Cats seem to thrive better with extracted teeth, versus painful teeth.
Untreated periodontal disease causes progressive attachment loss and ultimately leads to chronic infections under the gum line. Dogs with untreated periodontal disease are prone to having their teeth fall out, they are prone to spontaneous jaw fractures, and they are more prone to diseases of other organs including the heart, lungs, kidneys and liver. The underlying periodontal disease can also be painful, but we tend not to notice our pet’s pain because it creeps up slowly over several years. As pet owners we tend to assume our pet slowing down is just part of the normal aging process. Many times, it’s the oral discomfort from dental disease causing the changes. If your pet has halitosis, or bad breath, periodontal disease should be considered. Red gums, bleeding gums, root exposure, gum recession and loose teeth may also be signs of advanced periodontal disease.
Diagnosis and treatment of periodontal disease requires general anesthesia. All patients should be prescreened to determine their ability to safely handle anesthesia. This includes a thorough examination, blood tests and sometimes other tests. Diagnosis is made by probing the periodontal tissues surrounding each tooth to look for evidence of bone loss and gum loss. Intra oral radiographs or X-Rays are also taken to evaluate the amount of bone loss present. Treatment for periodontal disease in our pets depends upon how advanced the disease is. Treatments include dental prophies (routine cleanings) for mild cases, medical or surgical therapies for moderate cases and extraction therapy for advanced cases. Many pet owners report that their pet seems happier or younger after successful treatment of periodontal disease.
Periodontal disease is often preventable through proper oral hygiene. This involves thorough home health care including brushing the teeth daily. Dental diets are also available for keeping the teeth cleaner. Dental sealants may be used to prevent plaque and tartar accumulation. There is a new periodontal vaccine that may be helpful in reducing bone loss associated with periodontal disease. Also, regular cleanings under general anesthesia are recommended to keep the teeth clean above and below the gum line.
