2000 CASE: THE 6-MONTH-OLD DOG'S MOUTH IS FULL OF SALIVA
Dr
Sing Kong Yuen, BVMS (Glasgow), MRCVS
First written: 3 July, 2000
Updated:
21 July, 2010 |
 toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
"Lots of saliva flowing out of his
mouth every day," complained Ms
Palomaski. "What would be the
cause of this and how come he had
such bad breath?"
Excessive salivation a 6-month old
male part Alsatian part Labrador
dog adopted from the animal
shelter called Noah Ark sometime
ago was unusual. He was very good
looking but in such a manner that
you could not remember how he
looked like after a while.
 He
looked healthy and had an
excellent appetite. His
teeth were snow white. But
he would not permit his mouth to
be opened for further examination
by Dr Melissa Chua. The
veterinarian said: "I hope
your dog is not suffering from a
malfunctioning salivary gland
which leaks saliva profusely into
the mouth!"
"Be careful, he bites," warned Ms
Palomaski. "It must be painful. If
you can't cure him, he may have to
be put to sleep as the carpet is
all wet and smelly with his thick
saliva."
A tranquiliser was injected into
his back muscles. There was
a bad smell of rotting tissues.  The
upper gums on the right side were
ulcerated too. As if a virus had
attacked the gum tissues.
These tissues started to rot and
strands were hanging loose from
the gums and lip commissures as
the bacterial germs took advantage
of the breakdown of the tissues.
What cause the severe mouth
ulcerations. Young cattle in
Scotland do get oral ulcerations
caused by the mucosal virus.
But this is a dog, a different
species. What virus could cause
such an extensive damage?
Why the affected ulcerations were
present only in the upper gums and
not everywhere? The
dog did not eat bones or was known
to bite gates. The cause
remained unknown.
It was most likely a viral attack
due to the decrease in the
immunity of this young canine.
He was never vaccinated and might
have encountered one of the dog
viruses. Most cross breeds
in Singapore don't get vaccination
to protect them against viral
diseases nor do they get dewormed.
Internal parasites could cause the
immune system to be depressed,
leading to the inability of the
dog to fight off viral infections.
Antibiotics would be taken for at
least days for this patient.
Plain water and dry dog food were
given. Recovery was good
once the antibiotics killed off
the necrotising bacterial germs
and the dog becomes stronger in
his immune system as he grows
older.
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2010 CASE: THE 6-MONTH-OLD BICHON FRISE HAS A VERY
PAINFUL MOUTH AND SEPARATION ANXIETY
Dr
Sing Kong Yuen, BVMS (Glasgow), MRCVS
21 July, 2010 |
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
SEPARATION ANXIETY.
A couple in their 30s purchased a Bichon
Frise at around 2 days ago. The
dog barked a lot when the couple
went to work. He has "separation
anxiety," I said. The couple
had tried all solutions from the
internet including placing a
clock. "The neighbour downstairs
now close their windows. They do
not do that before," the wife
observed. This meant that the
Bichon must be barking the whole
day long. How
to solve the couple's problem?
I asked the couple to check out
the dog's previous routine. He was
always caged at home as the
student owners were busy.
So the dog has no exposure to the
outside world.
1. Spend time with the dog but
this is not possible. Spending
time means changing clothes to go
out to work but the couple goes
out and comes back in 5
minutes. Then increase the time of
outing. Don't go out after
dressing to go out. These need several days to
be effective.
2. Bring the dog outdoors more often.
Not a practical advice. "The dog
is afraid of going out. He just
wants to sniff around," the
husband
said. He had asked the previous
owner and found out that the dog
was seldom taken outdoors.
3. Get another puppy. Not
practical as the HDB apartment
regulations prohibit more than
one and the couple has no
intention of getting two puppies.
4. "Get a rabbit," I wanted to let
him adopt a rabbit on a trial
basis as I have one for adoption
but nobody wants him. "The dog will
kill him," the husband said.
"Put the rabbit inside the cage
for a few days first,"
I said. "Let the dog know him.
Later, let both meet and observe.
If the dog and rabbit gets along,
this dog will have company." The couple rejected
my "thinking out of the box" idea.
The rabbit can be returned to me
later but they don't like the idea
of an extra responsibility, I
presume.
So, I took the young rabbit home.
It is hard to put a young rabbit
to sleep. The ex-owner could not
keep the rabbit as she sneezes
whenever she is near the rabbit
and had requested euthanasia. My
radical idea has no chance to work
in this case. It may work but then
the couple will have two creatures
to care for.
5. "Come back for lunch daily," I
said. This was not practical in
the long-term as the husband has
work obligations and the wife
definitely cannot make it.
6. The husband found out from the
previous owner that the dog does
not bark if let out of the
confined room and is given access
to the whole apartment. "Don't do
this," I said. "He will pee and
poop every where." This was true,
as the dog did that with the
previous student owner.
7. "There is no solution," Mr Aung,
my groomer said when I asked him.
"De-bark the dog." This was not
acceptable by the owner as it was
deemed cruel.
"Electric and chemical collars
don't usually work," I said. In
any case, the owner was not
interested in this method of
controlling barking.
8. Final recommendation. The dog
had been warded for 2 days as he
has a rare problem of the gums
(see below). When the dog is taken
home, this is the following advice
to try.
7.1 Continue to put the dog
inside the crate and don't
give him attention after
coming home from work. Cover
the crate with heavy towels
of 3 sides so that the dog
feels secure and uses it as
a den. Put the crate inside
the bathroom as the dog
seems to prefer the bathroom
with the door open.
7.2 The dog will pee and
poop onto the floors or
newspapers of the bathroom.
This floor will be easy to
clean. Take the dog out to
play for half an hour and
put him inside.
7.3 Use Kong balls with food
inside the ball now that the
dog can chew properly after
the gum surgery (see below).
Give the dog treats around 7
days later as the gums need
to heal after the surgery.
7.4 Give the dog a routine
of eating and playing and
see what happens to his
separation anxiety.
7.5 Neuter him later if the
owner wants to.
|
|
 "The dog has great difficulty
eating dry food," the owner said.
I checked the teeth. This dog had
a congenital abnormality of the
gums - a very rare problem.
Here are some pictures of the
operation done by me. The
anaesthesia was isoflurane gas.
Electro-surgery was useful and
there was little gum bleeding. |
 |
My intern Ms Lai finally manages
to pry open the mouth for me to
take these images before the gum
surgery |
 |
 |
 |
|
Can't see the premolar 4 as it is
enveloped by the abnormal gum |
Electro-incision is done on the
lateral sides first for both upper
jaws |
Undermine the tissue which is not
attached to the premolar 4 |
 |
 |
 |
|
Puppy premolar 4 is seen below the
permanent one |
Electro-incision of the medial
side |
Electro-incision of the
medial side |
| |
 |
 |
| |
Premolar 4 is now exposed after
the abnormal gum tissues are cut
off |
After electro-incision of the
lower gums. Puppy teeth is
extracted. Dental scaling done
later |
Anaesthesia:
Isoflurane gas with no
sedation as this is the
safest method.
Surgery: Electro-surgery
is useful as there is
practically no bleeding when
compared to the use of the
cheaper scalpel blade. The
electrode incises the
lateral sides of the gums
first for both upper jaws.
Then the medial sides are
incised. The whole gingival
(gum) epithelium is
undermined with scissors and
cut off. Around 3 puppy
teeth trapped inside are
extracted. The whole surgery
for upper and lower jaws
take more than an hour.
Beautiful snow-white teeth
can be seen now. The dog
still feels gum pain and so
I cannot show the couple the
results of the surgery. The
dog was purchased for $400
but the anaesthesia and
surgery cost around $700
which is considered
inexpensive.
Reducing veterinary costs
I reduce the owner's cost by
not demanding blood tests
and X-rays which will have
grossed me more revenue of
around $300 as I consider
this not ethical. Sometimes,
ethics take second place to
generating revenue to
sustain a business but in
vet school, the professor
will advise blood tests and
X-rays. Sometimes it is best
to do it as part of
defensive medicine in case
the owner sues for not
getting the test done.
Economics of puppy ownership
If the couple is
calculating, it seems that
it is preferable to buy a
new puppy. But they appear
happy that the dog now is
going to be normal in
mastication.
No veterinary inspection
post-purchase
How this poor dog lives to 6
months old without normal
back teeth to enjoy eating
his food, I cannot
understand. He can only eat
wet food and eating dry food
is painful for him. He
probably just swallows them.
Post-operation
Painkillers and antibiotics.
A/D diet. The dog goes home
on the second day. He has
diarrhoea. The owner is
asked to observe another day
and not to give dry dog food
for 24 hours. The dog is to
be crated in the bathroom as
described in above.
Painful mouth for the
last 6 months
Ms Lai, a young intern who
wants to study veterinary
medicine although she has a
first degree was fortunate
to see this case of the
abnormal gum development as
it is a very rare case.
She has little dog handling
experience as I can see that
she cannot open the dog's
mouth for me to take
photographs. The dog moves
his head up and down and
sideways. I waited patiently
for 5 minutes. She could not
do it. I showed her how to
do it. Somehow she managed
and I took some pictures of
the gum prior to surgery.
Based on the difficulty in
opening the mouth, I had
presumed that only the upper
jaws were affected. During
anaesthesia, even the two
lower jaws were affected too
as the gum envelopes all the
back teeth (see images).
On Day 2 after the gum
surgery, I asked Ms Lai to
open the dog's mouth again
to test her. The same
difficulties for her as the
dog weaved his head up and
down. Sideways and away from
her. She would consider a
failure in dog restraint. I
asked Mr Saw to do it. He
encountered strong
resistance. A Shih Tzu
client whose puppy had
diarrhoea was waiting for
me. I had to do it. I held
the dog's muzzle and gave
the dog a loud command. The
dog appeared to be obedient
and permitted Ms Lai to pry
open the lips for me to
quickly snap some images
which I will display later.
Ms Lai had gone to the U.K
last year to have an
interview for admission to
the vet school but was
unsuccessful. She
practically had no
veterinary knowledge and why
she went to attend the U.K
college interview, I do not
know.
 I
feel sad for her as the
money going to U.K was money
down the drain. But life
nowadays is so competitive
and the young ones with
average academic results
must be humble and know
what to do to get a
place in college that
requires interviews. Or get
a job unless he has top
academic scores. There is no
guarantee of success for
such young ones as they are
not proven in academic
excellence nor in the battle
of commerce. They usually go
for job interviews with no
idea of what to prepare well
prior to the interviews and
this is incredible in the
golden age of the internet
where knowledge is so easily
accessed.
In this Bichon Frise, the
gum surgery practically can
guarantee that he will have
a normal life eating and
enjoying his food and I hope
his separation anxiety will
diminish as he becomes
normal.
P.S
Gingiva (gums) is the
mucosal layer that covers
the jaws. It has 3 different
types of epithelium -
gingival, junctional and
sulcular. These 3 types form
the epithelial cuff between
the tooth and the mouth.
Gingival epithelium - No
direct attachment to the
tooth.
Junctional epithelium -
Attaches to the tooth
Sulcular epithelium -
Touches but is not attached
to the tooth.
In this Bichon, I presume
that it is the gingival
epithelium that has
developed abnormally since
birth (congenital) and
prevents the back teeth from
erupting.
What is the medical name
for this condition, I don't
know yet.
|
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More info at:
Dogs or
Cats
To
make an appointment: e-mail
judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326 |
toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
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