LBAH Informational Articles

Peter and Kallie – Masai Mara Trip October 2007

Kallie was a birthday girl, so she gets extra photos

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Lions of Tsavo

In September of 2005 Dr. P joined an Earthwatch group headed by Dr. Bruce Patterson of the Field Museum of Natural History in Chicago. His team helped gather research data on the maneless lions of Tsavo National Park in Kenya. These lions are the descendants of the lions that killed 140 railway workers in Kenya in 1891.

Tsavo is a huge National Park in Southeast Kenya made up of two segments, Tsavo East and Tsavo West. Technically, our research poject was located in a private reserve called Taita Ranch located in between the two Tsavo segments.

To get to Africa from the U. S. most airlines connect through a European city. Dr. P used British Airways through London on a 10 hour flight landing at Heathrow airport. Heathrow is mammoth, and is truly an international airport. You will see airplanes from all over, especially Asia and the Middle East.

After an overnight in London there is an 8 hour flight to Nairobi. Upon arrival in Nairobi at 9 PM we went directly to the Fairview Hotel. It goes back to the colonial times and is quaint and comfortable. Security is an ever-present part of life in Nairobi.

Security

The next morning you join your Earthwatch group for the 7 hour car ride down the Mombassa Highway to Satao Camp at Tsavo. This ride is probably more dangerous than being in the bush with the wildlife. The road is poorly maintained in most areas, the traffic is bogged down by the number of trucks going to and from Mombassa, and there are overturned trucks and problems all along the highway. It was par for the course to drive on the shoulder as we passed an overturned truck or some other obstacle. The pollution from the trucks is not something we are used to.

MombassaHwy

Voila! After days of travel we finally made it to our camp called Satao. It is literally built on a rock outrcop, and offered a great view of the bush and a local waterhole. There were permanent tents, hot showers, and our own personal kitchen built into the rock.

SataoCamp

We stayed on a vigorous schedule for our two week stay. The first week we observed lions and wildlife from 4 PM – 8 PM, then again from 10 PM – 2 AM. The second week we kept the 4 PM – 8 PM run, but in the evening we did a 3 AM – 8 AM run. Needless to say we were exhausted at the end of our stay (and we actually paid to go through this?).

Schedule

So, every day at 4 PM we climbed into our open Land Rovers and bounced our way through the Africa bush until dark.

FourPM

Everyone had a job to do for an hour, then we rotated to a new job. Here is Dr. P taking a break from his telemetry tracking of radio collared lions.

Telemetry

One morning after the 3 AM to 8 AM run, somebody went to Starbuck’s for our morning java fix. After a long day (or was it night?) in the bush we came back to nice hot meals, then off for a nap!

Coffee

To keep the wildlife out of camp our security fence was some large tree trunks strung in front of our campsite. It was called “the psychological barrier” for the wildlife because it wouldn’t hold back much of anything. This is a view of the barrier in the daytime and on a beautiful night with the lights of the camp on the barrier. Luckily we had an armed guard on call all through the evening.

CampGuard

This is what we came for, the maneless lions of Tsavo! Since lions are mostly active at night in this area this is the first view you get of a lion. Our million candle power light reflects off an area in the back of the retina called the tapetum lucidum. It is this structure that enhances night vision for animals. A little flash added to the scene verifies it is a lion, but you could tell from the picture on the left of course, couldn’t you.

NightEyes

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We have much more to show you about the camp and our research. If you follow this link you will see nocturnal Africa at its best, and learn how we observed and sedated lions while observing the African bush up close and personal. When you are finished come back here and we will continue on to the wildebeest migration.

After 2 weeks of hard labor (oops, I mean research) at Tsavo we took our last pictures and headed off to the Masai Mara to see the tail end of the wildebeest migration

Reflection

We flew from Satao to the Mara, via Nairobi, on one of those bush planes you see in the movies

BushPlane

We never got a good view of Kiliminjaro from Satao camp. We made up for it on this flight.

Kili

We stayed at the Mara Bush camp at the far north end of the Masai Mara. It was a very comfortable tented camp with all the amenities and then some. This is the way to see Africa!

MaraDining

The permanent tents have hot bucket showers, flush toilets, and comfortable cots.

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Our hats are off to the men that took care of us at this camp

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The Masai were our camp guardians, and would escort you to your tent from the dining room each night

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Paul and Gillian run the show and really know how to make you feel at home. They continually surprise you with their ambiance and class, and an occasional story or two. Hmm, I wonder if we really were eating what he told us it was.

Surprise

A primary reason many people go here is to watch the wildebeest cross the treacherous Mara river as part of their annual migration. You never can predict when it will occur, so plan on spending several hours waiting, with numerous false alarms. Some people have elevated their waiting techinique to a fine art!

Waiting

One day our big chance finally came. The wildebeest were congregating, the crocodiles were waiting, and our camera’s were ready (we even remembered to take the lens caps off)!

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The congregation started milling around the water’s edge. Even the zebra were ready to go.

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First to cross was a lone zebra mare

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She made it all the way, right in front of a crocodile

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She then turned around and started ninnying towards the other side

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And believe it or not, after a few minutes she went back!

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On the return trip she went much faster!

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As it turns out, she had a foal that wouldn’t cross, so she stayed with the foal

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While all of this was transpiring the wildebeests just stood and watched. Those darn wildebeests had no interest in crossing whatsoever. So, our big chance to watch the spectacle did not materialize. Guess this means we have to go back soon…..

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Several prides make the Mara their home, so if you enjoy observing lion behavior you have found your spot. Here they are, doing what they do best.

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There are cubs to entertain you

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Males with beautiful manes

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And females on the prowl

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We have many more lion pictures, including mating lions….

The Masai are a fascinating people that live off the land. You will see them off in the distance tending their animals. Their primary possession is their cattle and goats. They live a very simple life in huts with their animals.

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Almost everyone that goes to the Mara goes on a balloon ride. They leave very early in the morning to catch the currents.

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We leave the Mara with a nice sunset over the plains

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Red Footed Boobies

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Dental Disease

This page has a large amount of information that will inform you of this serious and overlooked problem. Please set aside the time to fully understand it due to its importance regarding your pet’s quality of life.

Oral hygiene is one of the most overlooked areas of medical care for animals. As we increase our knowledge of animal health we realize that proper dental care does not just make your pet’s breath smell better; it is mandatory for your pet’s long term quality of life. Dental disease is prevalent in almost every dog and cat we examine.

Prevention is the key, and in addition to professional cleaning which we provide, the most important thing you can do is to brush your pet’s teeth. If started at an early age this “bonding time” is an enjoyable time for all. Start the brushing when the adult teeth are in, which is around 5 months of age. We can tell you when to start if you are not sure, and show you how to do it.

Yes, you can brush your pet’s teeth, and yes, you can make it an enjoyable experience for both of you! Bring your pet in and we will show you how. If you start when your pet is young it will be much easier. This can be started when you do your puppy behavior training.

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People sometimes wonder why pets need their teeth professionally cleaned by us, and then brushed by you, when they have memories of growing up with dogs and cats and never doing this. It doesn’t take much to answer this question. Pets nowadays eat diets that makes them prone to plaque. They also live longer, and just like in people, are more prone to disease as time goes on.

We did not have the knowledge decades ago to understand how dogs and cats lived lives of chronic pain because we did not know, or could not diagnose, the periodontal disease that is occurring below the gum line. With the advent of digital radiography, and our current body of knowledge, we realize that we did not treat dental disease anywhere near as thoroughly as needed. This ignorance lead to poor quality and shortened lives for our pets.

This is the crux of the problem. When you look at the teeth and see some tartar it doesn’t seem like much of a problem. Just scrape the tartar off and the teeth will look better.

Here is the same tooth as it is being removed while this pet is under anesthesia. The root on the right is rotten, compare it to the normal root on the left. We find these rotten teeth only by probing under anesthesia or taking x-rays. A rotten root is painful. In this pet’s case it felt significantly better when removed.

This is a video of a different dog having its teeth cleaned under anesthesia. When our doctor examined the canine tooth it was found to be infected, with pus coming out of the gums. This would never had been found if we were not thorough and checking for this, and this dog would have had a painful mouth long term. Just as importantly, the large amount of bacteria that is entering the bloodstream on a chronic basis causes damage to the internal organs.

You can see the pus on the probe as it is moved around the base of the canine tooth

Cats get a unique dental problem, called neck lesions (also called FORL- Feline Odontoclastic Resportive Lesions), that are painful. When we encounter these problems we need to remove the bad tooth.

Dentistry-FelineNeck

What seems like just a red gum is actually the painful condition of the root called FORL

The short video below is an example of how painful this is. This cat is completely anesthetized, yet when we tap its premolar teeth it moves it’s jaw in obvious pain.

It is the periodontal disease that is occurring out of sight and below the gum line that causes the most problem. This is the area we thoroughly need to address when we clean a pets teeth under anesthesia.

We take this problem seriously, and spend considerable time caring for this problem. Many dogs and cats are brought to us in advanced states of dental disease. Their teeth are infected and rotting out, and they have tremendous odor (severe halitosis) from the infection. For animals that have such keen senses of smell this chronic odor is very irritating.

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Dogs and cats with advanced dental disease need to be anesthetized, given a thorough oral exam, and have dental radiographs. They are closely monitored during the procedure, and all their dental problems are taken care of. This takes considerable time and effort on our staff.


Dental disease is a treatable and preventable problem, and since your pet cannot tell you how it feels, it is up to all of us, as members of your pet’s health care team, to address this problem. Most people wait too long to get their pets teeth cleaned professionally. Teeth cleaning should be considered a preventive measure, not a way to treat a problem that is already present. Good dental care revolves around the control of bacteria under the gumline where it is not visible. We will teach you how to prevent it and how to treat it.

We have a summary page on dental disease if that suits your needs better.

Normal Tooth Anatomy & Development

The diagram below illustrates some of the structures of the normal tooth. It also shows Stage III periodontal disease, which you will learn more about later. On the left side you can see the bone of the jaw and the blue periodontal ligament. It is this ligament that keeps the tooth attached to the bone in the socket. You can also see the blood supply and nerves to the tooth. They are the vertical finger-like projections in the center of the tooth.

On the right side we have illustrated what happens in gum disease. The brown area between the tooth and gum is tartar and its associated bacteria. This tartar is intert, is not causing any significant gum disease, and removing only this tartar does nothing to the bacteria that are below the gum line. It is the bacteria surrounding and within this tartar that we are after. Notice how a significant amount of tartar is below the gumline, and thus cannot be seen. Also, notice how the gum is pulled away from the tooth leaving a pocket.

As the bacteria progresses further down the tooth, the gum is pulled further and further away, the jawbone literally erodes away, and the periodontal ligament can no longer hold the tooth in the socket. The tooth rots out, or is removed when we clean the teeth. The bacteria that eventually causes this erosion enters the bloodstream and can cause disease in other organs. It is this bacteria below the gumline that is causing all the trouble, and is the bacteria we remove when we professionally clean the teeth.

After the teeth have been professionally cleaned we can use non anesthetic dental from Pet Dental Services to prevent the problem from recurring. You are fooling yourself if you think you can take your pet somewhere to have them scrape the tartar off once gingivitis is present. The teeth look nice, which means you have done something cosmetically nice for your pet, but you haven’t touched the medical problem.The teeth need to be cleaned by trained professionals from our hospital or Pet Dental Services.

This radiograph of a tooth shows the same anatomy as above. We will show it again later when we show radiographs of diseased teeth. Notice how tightly the roots of the tooth fit into the healthy jaw bone. When we show you radiographs of diseased teeth later this jaw bone will be partially gone.

Dogs have 28 deciduous (temporary or baby) teeth and 42 permanent teeth. Anatomically they have 4 different types of teeth: Incisors (I), canines (C), premolars (Pm), and molars (M).

This is an x-ray of the lower jaw (mandible) of a dog. You can see how deep the roots go.

In comparison to dogs, cats have 26 deciduous teeth and 30 permanent teeth. They have the same types of teeth that dogs do, but in different proportions. They lack premolar #1 found in dogs due to a different evolutionary path.

The deciduous teeth start being replaced by the permanent teeth (in this picture they are the 2 large central incisors marked by the arrows) at 4 months of age. The puppy teeth that were there were probably swallowed.

Dogs seldom have problems with teething, although they do tend to chew things during this period. It is advisable to supply them with synthetic bones for this purpose, or else some of your personal items might get recycled! By 8 months of age all the permanent teeth have appeared.

Congenital Abnormalities

Small breed dogs tend to have dental problems more often than large breed dogs. This may be due to the fact that they have smaller oral cavities and the teeth are forced closer together. Cats get comparatively few congenital problems regarding their teeth. Any condition where the teeth are not normally positioned is called a malocclusion.

Malocclusions are corrected only if there is a problem with mastication (chewing). Undershot jaw (lower jaw protrudes beyond the upper jaw) is seen on occasion, and is prevalent in small dogs and in breeds like Bulldogs, Shih Tzu’s, and Lhasa apso’s. Overshot jaw (upper jaw protrudes beyond lower jaw) is similar to buck teeth in people.

Occasionally, a dog will not shed a deciduous tooth when a permanent tooth starts to come through the gums in the same location. These retained deciduous teeth, along with any extra teeth, should be removed because they will result in displacement of the permanent teeth. Problems of this nature are discovered by our doctors on routine exams. This enforces the importance of bringing in young pets for vaccines and exams at an early age.

Biofilms

So what is it that causes dental disease? It all boils down eventually to bacteria. When it comes to dental disease, because of the unique environment of the mouth, we measure bacteria counts in the billions (yes billions)! Bacteria that adhere to the enamel of teeth colonize and begin synthesizing molecules, the most important of which are carbohydrates. These carbohydrates are sticky and act as a glue to attract more molecules on the teeth, eventually forming plaque. As time goes on calcium carbonate deposits on the plaque, hardens, and then becomes calculus. This is the hard material deposited on teeth people sometimes call tartar.

Tartar is made up of calcium salts, food debris, bacteria and other organic matter. It is orange to brownish in color and although soft when deposited, it quickly hardens. It collects primarily on the cheek (buccal) side of the premolars and molars, although it can occur in any tooth.

Periodontal disease results when the bacteria at the center of this plaque move under the gumline. There are many different bacteria in the mouth that start the process of plaque development. Some are aerobic, and live off the rich oxygen supply in the mouth (can you guess why the mouth has a rich oxygen supply?). As mentioned above, some of the bacteria in the plaque that migrate under the gumline go to an area of no oxygen, and are called anaerobic. The anaerobic ones tend to cause the most problem. Here is a list of some of their scientific names (warning-they are tongue twisters, so you better brush up on your Latin):

  • Actinobacillus actinomycetemcomitans

  • Bacteroides asaccharolyticus

  • Fusobacterium nucleatum

  • Eikenella corrodans

  • Porphyromonas gingivalis

  • Actinomyces viscous

There is no oxygen under the gumline, so the main type of bacteria to colonize there is called an anaerobe. The anaerobic bacteria cause an inflammatory reaction, and break down the periodontal ligament. The end result; the tooth rots out. Also, as these bacteria invaded deeper into the tooth cavity they reach the blood supply to the tooth and can enter the bloodstream where they cause significant damage to the liver, kidney, and heart. It can even predispose to diabetes mellitus (sugar diabetes).

The problem does not end there when it comes to periodontal disease. It can also lead to spontaneous jaw fractures, deep seated bone infection, and cancer (neoplasia) at the affected tooth. Since bacteria are the main culprit in periodontal disease, it makes sense that antibiotics will be used to treat the problem. The two main ones we use are Clavamox and Antirobe. In select cases, where it is impossible to clean the teeth professionally, we will sometimes use one of these antibiotics in what is called pulse therapy. They are given for one week each month indefinitely. They are reserved for cases where the heart or other internal organs are seriously diseased and unable to withstand the sedation needed for professional teeth cleaning. Antibiotics are certainly no replacement for professional cleaning, but have a place in some select cases. How do you prevent these bacteria from starting the problem all over again after the teeth are professionally cleaned? Brush the teeth, or use the enzymes, Hill’s T/D food, chew toys or sprays on the teeth to minimize plaque buildup.

Symptoms

Symptoms of dental disease can range from subtle to extreme. One of the most common symptoms is bad breath (halitosis). Sometimes a pet with dental disease will cry in pain when you touch it anywhere near its muzzle. Another symptom is a partial or complete inability to eat (anorexia). A pet that has this problem may eagerly go to the food bowl, and either just look at the food or drop the food out of its mouth after only a few bites. Other pets might drool from one or both sides of the mouth. Unfortunately, many pets are stoic (do not show outwards signs of pain when it exists on the inside) do not show any symptoms until the problem is well entrenched and we have a difficult time correcting the problem.

The important point to remember is the fact that once you notice any of these symptoms, your pet’s dental disease is already causing discomfort or pain, and even affecting other body organs. Therefore, it is important for you to be aware of the existence of this problem, to learn how to perform a basic oral exam at home, learn how to brush its teeth or use gels or sprays, and to bring your pet in for regular (every 6-12 months) dental exams by one of our veterinarians. Every 6-12 months seem like a lot to some people. Compared to the typical lifespan of a dog or cat, it is not very frequent. Your pet cannot tell you its mouth hurts, it is up to us, as a team, to ensure that this inevitable problem is properly monitored and treated before it causes discomfort and pain, and sometimes premature organ failure.

Stages of Gum Disease

The close up shot of the gums of this normal dog are how the gums should look. Click on them to enlarge, and look at the detail of the gingiva (where the gums meet the tooth), and how adhered the gingiva is to the tooth). This is the way the teeth and gums should look.

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Stages of Periodontal Disease

There are 4 stages of periodontal disease. The first stage occurs when bacteria cause an invisible film of plaque to form on the teeth. The bacteria react with minerals and other debris that accumulate in the oral cavity, eventually causing tartar. You learned about his already in the biofilms section.

Gingivitis appears prior to tartar formation. It is seen as the reddened gum along this canine tooth. Since the gingiva are the first line of defense for the tooth against bacteria, any gingivitis is considered significant. This pet should be treated now before the problem progresses to more advanced periodontal disease, an all too common diagnosis in our hospital.

If we treat the gingivitis now, when it is at Stage I, we can reverse the process in many cases. As the periodontal disease progresses it becomes increasingly difficult to reverse this process.

Dentistry-CanineToothTartar

Here is another example of canine Grade I periodontal disease. It doesn’t look like much of a problem, and is easily ignored at this stage, which is a mistake because it is now that we can do the most good in preventing progression to other stages of periodontal disease. This is the time to professionally clean the teeth, not when it progresses as you will see in the next slides.

A tooth that starts with the tartar of the teeth shown above will rapidly progress to this more advanced state, which is Stage II periodontal disease in the dog. The underlying gum is more inflamed and is pulled further away from the tooth.

As the periodontal disease progresses tartar buildup also continues. The underlying gum is pulled further away from the tooth, and Stage III periodontal disease is present. The pocket of bacteria under the gumline in this tooth is significantly weakening the periodontal ligament and weakening the bone of the jaw.

Untreated Periodontal Disease

Stage III periodontal disease eventually progresses to Stage IV periodontal disease.

This tooth shows advanced periodontal disease as evidenced by the ulcerated gums (blue arrow), pus along the gum line, and severe tartar. When this happens your pet will experience pain and will become internally ill from the bacteria spreading to internal organs via the bloodstream. Pet’s with this problem are in jeopardy of internal organ failure.

Here is another dog with a similar problem. The tartar is so thick that it is literally holding the teeth in place! Notice how far up the inflamed gums are. In Stage IV periodontal disease the tartar can be so extensive that it is the only thing holding the teeth in the socket in some cases. When we remove the tartar the teeth literally fall out.  Its hard to believe that someone would let their dogs teeth progress this far. Unfortunately, this is not an uncommon situation.

Here is another dog that was left to progress so far that it is systemically ill. Imagine how this dog feels!

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Some dogs that chew on their skin due to allergies will get the hair wrapped around their teeth and erode the gums

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When we remove it the roots of the teeth are exposed due to the erosive nature of the hair on the gums.

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The arrows point to the exposed roots. This is painful, and the teeth need to be removed.

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In some cases the infection under the gumline has eroded away the gum tissue that normally covers the root. If the tooth has 2 roots it will cause a hole to appear between the roots where the gum has eroded- this is called a furcation lesion. The cat in the picture below is well on its way to getting this problem.

 

This is one potential outcome when pets with periodontal disease are not treated. The teeth in this cat literally rotted out of its mouth. This situation is completely preventable. Fortunately, pets that have no teeth can still eat well, but that is small consolation for this cat. The years of chronic bacteria that were released into this cats bloodstream when the periodontal disease progressed from Stage I to Stage IV can seriously affect the internal organs and cause this cat to have premature organ failure.

This is another potential outcome for a pet that has periodontal disease. This dog’s lower jaw (mandible) is fractured at the chin because of long term periodontal disease. You can see this fracture (the arrow points to it) as a separation where the two lower jaw bones meet at the chin.

This jaw had to be wired back together after the teeth were cleaned. It will also need to be on long term antibiotics. Unfortunately, the problem might get worse as time goes on. The wire (marked by the arrow) can be visualized just to the right of the tongue at the very center of the picture. It is wrapped all the way around the jaw and anchored under the chin. It will need to stay in place at least one month.

Here is another cat with the same problem, click on the picture to enlarge it.

There are other serious complications that can occur when proper oral hygiene is neglected. This dog had a seriously infected tooth that created a fistula (arrow) into its upper jaw. Food will go into the passage and end up in the nasal cavity, which is not a place where food belongs. This dog will have chronic infections because of this, which can even lead to life threatening pneumonia.

Complications of Dental Disease

The heart is one of the internal organs that can be affected in advanced dental disease, because bacteria from the mouth infection can readily deposit on the heart valves (especially the mitral valve). Our heart page has extensive information if you would like to learn more. This picture is from our heart page. The top arrow points to a normal valve leaflet. The bottom arrow points to a thickened valve leaflet, which could be the result of chronic bacteria from the mouth. The thickened and rounded lower leaflet causes the problem.

The thickened valve can malfunction and leak blood backwards through one of the chambers of the heart, instead of forward like intended. This turbulence of blood as it flows through this leaky valve can often be heard as a heart murmur. The result of this back pressure is a buildup of fluid in the lungs (pulmonary edema) eventually. Fluid in the lungs will cause your pet to start coughing and feel very ill- it is a serious sign that requires immediate veterinary care.

In addition to heart (cardiac) problems, dental disease can affect the kidneys and the liver. These are both vital organs, and require a pet free from dental problems if they are to function properly. Some pets do not live a full life due to the chronic affect the bacteria has on their internal organs, leading to premature organ disease.

Diagnosis

 

Since there are numerous diseases and conditions that can mimic dental disease, the diagnosis of dental disease must be performed by a veterinarian. During a routine physical exam we will be be performing a complete examination, including the oral cavity. As with any illness, the diagnostic process is carefully followed so that a correct diagnosis is actually made and other problems that are a result of the dental disease (ex-heart murmur), or are occurring simultaneously (ex-kidney disease), are not overlooked. Our doctors will gladly point out what problems (if any) your pet is having with its teeth and gums.

We will also show you how to perform a basic oral exam so that you can monitor your pet’s progress at home. The oral exam is not complete until we exam your pets mouth (the medical term for the mouth is oropharynx) under anesthesia. Only then can we check for tumors, ulcers, gum disease, foreign bodies, and infections, and enlarged tonsils.

Pre-anesthetic Preparation

 

The first step in the process is yearly exams by one of our doctors, and more often if there is a medical problem of any kind or you pet is on chronic medication. Many people will have this yearly exam performed when their pet comes in for yearly vaccines. We will look inside the mouth and determine if any oral disease is present. If there is enough gum disease to warrant professional cleaning, pre-anesthetic tests will be ordered. We will also try to identify teeth that might need removal if there is an obvious problem.

For pets under 5 years of age a routine in-house blood panel will suffice in most cases. For older pets, or those with other problems, a more thorough blood panel will be ordered. These blood panels will let us know if your pet is ready for anesthesia, will check your pets health in general, and will allow us to assess any damage to the liver or kidneys from the chronic bacteria in the bloodstream. In addition, our doctors will sometimes recommend other tests prior to anesthesia. These tests commonly include radiographs of the lungs or abdomen, along with an electrocardiogram to assess the heart.

Our pre anesthetic diagnostic tests page covers these tests in more detail. Our doctor will analyze the results of the pre-anesthetic diagnostics tests and customize an anesthetic protocol for your pet. In many cases Intravenous fluids will be given prior to and during the professional cleaning. These fluids, when used in combination with pre-anesthetic tests, dramatically minimize the risk of anesthesia. as a final preparation prior to professional teeth cleaning one of our doctors might put your pet on antibiotics.

Anesthesia

 

When significant gingivitis is present proper dental care involves more than just scraping tartar off the teeth. Just scraping the tartar may temporarily make the teeth look better, but it is not addressing the real problem that occurs under the gumline. Thorough dental care involves scaling, probing, radiographing, flushing, measuring, fluoride and polishing. You will learn more about these in the next section. These treatments can only be accomplished on an anesthetized pet. It is not realistic to think that all of this can be accomplished on an awake pet, and be as thorough as we can on an anesthetized pet.

When these procedures are performed properly we can reverse the periodontal disease in some cases, and keep the teeth and gums healthier for a longer period of time. Since the risk of anesthesia is negligible with the precautions we take and the precise method available to administer and monitor anesthetic, it is well worth the negligible risk in order to clean the teeth and gums properly. In reality, the risk of disease occurring by not cleaning your pet’s teeth professionally is greater than the risk of anesthesia. We have extensive experience in anesthetizing pets, especially the geriatric pets that so commonly have advanced dental disease. To minimize any anxiety you have over anesthetizing your pet, one of our doctors will personally discuss our anesthetic protocol with you and set up an anesthetic plan that is specific for your pet’s condition. Our anesthesia page has extensive detail on how we anesthetize animals.

We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.

Surgery-Monitor

Professional Cleaning

Oral Exam and Charting

The first aspect of the cleaning process is an examination of the complete oral cavity. It is only when a pet is sedated can this be completed thoroughly.

The arrow is pointing to a cyst in the mouth of this dog that was not seen until it was sedated. The owner did not know it was present, nor did this dog show any symptoms. We were able to remove it before it became a problem.

 

After our thorough oral exam we chart the problems encountered.

Dental Unit

The equipment you will find in our hospital is the most advanced available. It allows us to provide a wide array of dental services. We use a specialized ultrasonic scaler that is made for animal teeth.

 

Radiology

 

Radiography is an important part of dental care and is commonly performed as the next step after the oral exam. During your pet’s oral exam under anesthesia our staff will measure the depth of the pocket on the teeth that have disease. If the depth is 4 mm or greater we might take a radiograph of the tooth to make sure the underlying jawbone and root are healthy. If the root or jawbone are not healthy the tooth needs to be removed or a root canal at a specialist needs to be performed.

Our dental x-ray machine is made specifically to radiograph animals

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The machine is automated, allowing us to rapidly take high quality radiographs

The high definition of these radiographs allows us to see problems that are not apparent during the oral exam. Here is the normal tooth radiograph you saw at the beginning of this page.

 

This radiograph shows a problem around the root. Do you see the dark, semicircular area around the root of the tooth in the very center of the picture? Compare it to the other root of this same tooth just to its right. This dark semicircular area radiographically is called lucency, and is an indication of deep seated infection in the tooth. It is painful and needs removing.

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In this radiograph the jaw bone has been eroded down to expose parts of the roots on both teeth. This is the furcation lesion shown earlier.

Calculus Removal above and Below the Gumline

 

If the tartar is extensive, as it is with this dog, a special dental instrument is used to crack off large pieces of tartar before we use the scaler. This enables us to clean the teeth faster, another method to minimize anesthetic time. It also reduces wear on the ultrasonic scaler tip.

 

Scaling teeth is greatly facilitated by a special instrument called an ultrasonic scaler. By vibrating tartar off the teeth with the scaler we cause minimal trauma to the tooth enamel. In addition, the rapid manner in which it removes the tartar minimizes anesthetic time. The gentle nature of the scaler allows us to clean under the gumline and not irritate the gums.

These teeth belong to Socrates, a dog that was brought to us for teeth cleaning. The tartar is obvious. Do you see the inflamed gums also?

 

The tip vibrates 18,000 times per second, and literally vibrates tartar off the teeth. It does not harm the enamel, and lets us clean the teeth faster than doing it by hand. It continually sprays water to minimize heat buildup which could irritate the gums.

Dentistry-USScaler

Socrates’ tooth just after it has been scaled. Notice the small amount of blood at the gumline. This is gingivitis, and needs to be addressed.

Probing and Measuring

 

Here is a close-up of the probe. Each of the notches is 1 mm, the total length being 10 mm. Anything more than a 3 mm pocket under the gums in dogs, and o.5 mm in cats, is significant.

Lets have a little fun and show you just how small 10 mm is, courtesy of Uncle Abe

 

When we measured the depth of the pocket on this tooth it was obvious from the bleeding and the depth of the probe that Socrates has Grade II periodontal disease.

 

If we think the bone loss seen on the radiograph is manageable, and the gum pocket is not too large, we can place a long acting local antibiotic, called Doxirobe®, under the gumline. This will continually kill the bacteria causing the gingivitis. The ultimate goal is to save the tooth from advanced periodontal disease and the need to remove a rotten tooth. If the problem is too advanced for this treatment, we will remove the tooth.

Dentistry-Doxirobe

The Doxirobe is placed under the gum, where it will harden and release continual amounts of tetracycline antibiotic. We are trying to prevent further periodontal disease leading to removal of the tooth in the future.

We checked Socrates other teeth for gum problems and found out they are just fine. We plan on checking Socrates in 3 months to see how his healing is progressing.

We also use a Clindamycin gel under the gums when there is a problem

Dentistry-GelLabel

It comes in a prepackaged syringe

Dentistry-GelSyringe

It allows for precision placement of this antibiotic under the gums, with the long term goal of saving the tooth

Dentistry-Gel

 

In some pets the tooth problem is so severe that removal of the tooth is necessary. After we remove the tooth we place a special bone graft in the opening called Consil.

Dentistry-Consil

Here it is being applied to the opening where a tooth was removed

If we have a need to pull a tooth we use a local anesthetic, while your pet is already under anesthesia, to eliminate pain.

Dentistry-NerveBlock

Root Planing

This is probably the most critical step in the professional cleaning proces. By scraping the bacteria under the gumline with this special instrument we take care of the problem at its core. This can only be done on your pet when it is under anesthesia.

We use a specially designed instrument that is gentle

Dentistry-RootPlaning

Flushing the Gums

After the teeth are scaled and probed, and the roots have been planed to remove the originating bacterial cause, we spray them with chlorhexidine to further help eliminate the bacteria that are causing gingivitis. It is only after this point in the professional cleaning process that we have significantly decreased those billions of bacteria.

Polishing

Polishing the teeth makes them look whiter. It also smoothes off the enamel surface and makes it more difficult for bacteria to adhere. Once bacteria get reestablished, the cycle of plaque leading to tartar and eventually gingivitis gets started all over again.

Dentistry-polish

Fluoride Treatment

One of the final steps in the cleaning process is the application of fluoride to prevent cavities. We bathe the teeth in fluoride for a few minutes, then rinse it off. It has a very nice smell, too bad we can’t transmit smells over the Internet. We even put fluoride on the teeth of pets when they are spayed or neutered to help protect their teeth when they get older.

If the enamel on your pet needs a sealant, we use Oravet. It significantly reduces plaque and tartar formation by creating an invisible barrier that helps prevent bacteria from attaching to your pet’s teeth.

Dentistry-Oravet-3

Prevention

Just like in people, routine preventive care is critical to proper dental hygiene. This saves your pet from extended periods of pain and unnecessary tooth loss, and can save you the expense of the veterinary care needed to treat advanced dental disease. Your pet’s teeth should be checked every 6-12 months by one of our doctors, especially if it has already had gingivitis and had its teeth cleaned. Any pet that has had periodontal disease should be checked every 3 months. One of these check ups can be accomplished when your pet is brought to our hospital for yearly booster vaccinations.

One of the most important things you can do to slow down the recurrence of dental disease is to brush your pets teeth. This will help keep the gums healthy and prevent tartar buildup on the teeth on the cheek side (buccal) of the mouth, although it does not work as well on the teeth on the tongue (lingual) side of the mouth. Even though this may sound like an impossible feat for an uncooperative pet, or even a ludicrous idea, it is one of the best ways to prevent dental disease. Even though the teeth will eventually need professional cleaning again in the future (most people get their teeth cleaned several times per year), proper brushing will decrease the amount of dental disease that occurs and the number of times we will have to clean your pet’s teeth over its lifetime.

Due to the short life span of pets in relation to people, proper home care of your pet’s teeth becomes an important health measure. When brushing the teeth there are some common sense things to do to make the process go smoother. One of our technicians will demonstrate some of these techniques with one of our hospital cats (they love the attention). It is important to remain calm and patient, since for most pets having something put into their mouths is a new experience. With a little tincture of time, the procedure progresses smoothly. also, it is highly advantageous to start the brushing process at an early age.

Patience is the key! Try to do something positive (feeding it, playing or walking)  with your pet just after brushing to condition the behavior for the future. Try to make the whole process fun, and don’t ever let on that you are doing something good for your pet (kinda like child psychology- if its good for them they won’t do it). With your pet near you or on your lap, maybe while watching TV, let your pet get used to your finger near its mouth. Dipping your finger into a food or liquid your pet has acquired a taste for helps start the process smoothly. When it is comfortable with your finger, use a soft gauze to massage the gums and gently rub the teeth. a cotton tipped applicator can also be used. Eventually you want to progress to a toothbrush.

In smaller pets, especially cats, proper restraint is important. There needs to be a proper balance between too little and too much restraint, a balance that varies with each pet. This is especially true with cats. For smaller pets, placing them on a table will make the process go smoother. Larger pets can also be placed on a table, if feasible, or can be restrained on the ground. Only one or two people should be involved in the cleaning process, usually without children present. We have a complete page demonstrating this restraint technique. Eventually, introduce a soft bristled toothbrush.

These toothbrushes are available in our dental kits. A rubber finger brush can be used but a toothbrush is preferred. You should not use your personal tooth paste to brush your pet’s teeth because the taste can upset their stomachs. Our dental kit has toothpaste that is specially made to be palatable to animals. These kits also have suggestions to make it easier to brush your pets teeth.

If you consider daily tooth brushing a chance to enhance your bond with your pet, you and your pet will find it more enjoyable. Brush the teeth in a slow and circular motion with a small amount of toothpaste. Its important to brush the outside of the teeth (the teeth up  against the lips and not the teeth up against the tongue) since that is where the plaque is most prevalent. If your pet is cooperative brush the insides next. Your goal is to brush at least 3 times per week. This will decrease plaque by 90%.

If you encounter resistance on a pet that normally lets you brush, or see blood or there are blood tinges on the toothbrush, smell any odor, see any inflamed area or swelling, or a buildup of tartar or inflamed gums, you should bring your pet in for an exam. If the tartar is significant it is time for a professional cleaning.

In some cases brushing is just not feasible. In these situations you can use sprays, gels and chew toys to control the buildup of bacteria. Another excellent way to prevent the tartar buildup that leads to gingivitis is the food called T/D. It is particularly useful for small breed pets, which are prone to significant dental disease. Just like in people, routine preventive care is critical to proper dental hygiene. This saves your pet from extended periods of pain and unnecessary tooth loss, and can save you the expense of the veterinary care needed to treat advanced dental disease. Your pet’s teeth should be checked every 6-12 months by one of our doctors, especially if it has already had gingivitis and had its teeth cleaned. Any pet that has had periodontal disease should be checked every 3 months. One of these check ups can be accomplished when your pet is brought to our hospital for yearly booster vaccinations.

Non Anesthetic Dental from Pet Dental Services

MildGingivitis

It is at this level of tartar that we used Non Anesthetic Dental. Anything more requires a complete dental under anesthesia as you learned already from this page.

For many people the most convenient way to prevent dental disease is with a professional technician scraping the tartar off the teeth before the problems starts. This means it should be started when your pet is 6-12 months of age, and continued at least every 3-6 months for the rest of your pets life. This non anesthetic technique is not used for pets that have gingivitis or periodontal disease, since as you already learned, these problems needs to addressed with professional cleaning and root planing. After the teeth are cleaned we recommend the non anesthetic dental, usually anywhere from monthly to every 6 months, to prevent the problem from ever recurring again.

We have contracted with outside licensed technicians from Pet Dental Services to perform non anesthetic teeth cleaning on the 4th Monday and Wednesday of every month. You can make an appointment and wait while it is being performed, or you can drop your pet off and pick it up later. They will give you a chart of the teeth cleaned, and let you know of any problem areas to watch for. All legitimate non anesthetic dental people are licensed by the state of California to perform this technique. This can only be performed legally in the state of California under the direct supervision of a licensed veterinarian. This law is obvious for your pets protection. Many unscrupulous people perform this procedure because they tell you they are saving you money and fooling you into thinking they are actuallly doing something medical for your pet. They prey upon the irrational fear people have of anesthesia. In reality, all they are doing is setting up the stage for the bacteria that is under your pets gumline to to wreak havoc later on.

Miscellaneous Dental Problems

 

Carnaissal Tooth abscess

The carnaissal tooth (upper 4th premolar) may become infected and result in the formation of an abscess around the root. This is a very painful condition and is often accompanied by fever, loss of appetite and depression. a classic symptom of the problem is discharge through the face below the eye. This tooth needs to be removedfor the problem to be corrected. It has a deep root and needs careful extraction to correct the problem.

Lymphoplasmocytic Gingivitis

This disease, seen almost exclusively in cats, is a specific inflammation of the the gum tissue. It is a painful and debilitating condition that is controlled but not cured. It is treated in various ways, including surgery with a laser.

Cracked Teeth

It is very common for pets, especially dogs, to break or loosen their teeth while playing or chewing. This can cause significant discomfort and predispose your pet to dental problems later on in life. Injured teeth are usually removed, under general anesthesia, to ensure that the whole tooth is removed, including the root. If the root is not removed there will be a continual problem. In some cases we will refer you to a specialist that will determine if the tooth can be saved.

This dog fractured its tooth by chewing rocks

It was so badly traumatized it had to be removed. This tooth has 2 deep and strong roots, so it has to be split in half with a high speed drill.

The tooth just after removal

Cavities (caries)

Due to the nature of their enamel dogs and cats do not routinely develop cavities. If they do, the cavity looks like a black area on the tooth, usually seen at the gum line or on top of the molars. Cavities can lead to pain and difficulty in chewing. The usual treatment is extraction of the tooth, although we can refer you and your pet to a specialist in veterinary dentistry to fill the cavity and save the tooth.

Discolored Teeth

Discolored teeth are seen in some pets. This can be caused by diseases like Distemper, the administration of certain antibiotics during the first few months of life, or trauma. If you notice discolored teeth please bring your pet in for an exam to determine the cause of the problem and if treatment should be instituted. Teeth that are red stained or red tinged have internal bleeding and need dental care.Antibiotics like tetracycline, if used when your pet is young, can stain the teeth permanently

Worn Down Teeth

Worn down teeth are usually caused be chewing rocks, chains, and fences. This is a behavioral problem that should be corrected to prevent long term problems. also, dogs that continually chew or bite at the skin due to allergies or fleas will cause the incisor teeth to be worn down, sometimes all the way to the gum line.

This problem can be detected during a routine exam and corrected by prevention of chewing on itchy skin before the teeth get worn down too far

At this stage there is no way to correct the problem without extensive dental work with a specialist

Growths

Pets can get growths in the oral cavity, some of them can be benign, some malignant. Any growth or inflamed area in the mouth should be biopsied.

A benign gum growth that occurs usually in older dogs is called an epulis.The growth of the gum sometimes become so large that it covers a tooth almost completely

This is the same growth as above 1 week after removal using the laser

What is the next step?

If one of our doctors feels your pet needs to have its teeth professionally cleaned there are several steps you should take:

  1. Make an appointment to have the teeth cleaned before you leave our office. This will give you greater flexibility in your scheduling and allow us to accommodate you as much as possible. One of our receptionist’s will give you a written price estimate based on the doctor’s written instructions.  An estimate will be given that covers all anticipated costs. Even though our estimates are very accurate, there may be slightly greater, and more often lesser, charges on the final bill. This might be because some teeth need removal or medication needs to be sent home, or even finding something on the oral exam while under anesthesia that was not readily visualized during the initial exam. If there is any significant change in the price we will call you before proceeding. Please leave a phone number where you can be reached.
  2. If one of our doctors feels your pet needs pre anesthetic diagnostic tests, have them obtained while you are here, or drop your pet off and return to pick it up later when the tests are complete. Any test samples sent out to our outside laboratory will be available the following morning. Please call our office after 10 AM the next day for these test results.
  3. The night before the teeth cleaning take away all food and water before you go to bed, and make sure your pet does not eat anything in the morning. Our office opens up at 7:30 AM for drop offs. We appreciate having your pet in for its teeth cleaning by 8 AM.
  4. We will anesthetize your pet and clean its teeth sometime in the morning or early afternoon. One of our doctors will call you as soon as the procedure is complete.  It is very rare for a pet not to go home on the same day its teeth are cleaned. Your doctor will let you know if he plans on keeping your pet overnight. This might be because your pet is older or has a medical problem that requires us to monitor its progress in the hospital for an additional night. The best time to pick up your pet is in the late afternoon or early evening.  We are open until at least 9 PM every night for your convenience.You will be given written post dental instructions when you pick up your pet. If you have any questions after reading these instructions please let us know. Your pet may be groggy the first night. This is not because of the anesthesia, it is because of the pain injection many pets are given after their professional cleaning.
  5. Contact with children and other pets should be supervised by an adult the first night. Give it a small amount of water and soft food an hour after getting home. If it eats and there is no vomiting, give it some more food and water. It might experience some grogginess that evening because of the pain shot we give (some people welcome this, especially with young and active pets), but should be back to normal by the next morning. Please call us the next morning if you have any questions or you feel there is a problem (ex.-not eating, very lethargic).
  6. If we send your pet home with pain medication or antibiotics use them exactly as prescribed.
  7. Call us if your pet does not resume its normal activity and eating habits within 24 hours.
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Symptoms of Diseases

Here are 5 basic areas you should observe on a daily basis.

Eating

Watch your pets daily eating habits for :

  • difficulty chewing
  • odor
  • swelling
  • pawing at its muzzle

Since dental disease is so prevalent please follow the link to learn how this can affect your pet’s eating.

Breathing

When your pet is at rest count the number of times it breathes per minute (watch it for 15 seconds and multiply that number by 4). A typical dog or cat breathes 30-40 times per minute, although this can be variable based on breed and external temperature. The important thing to watch for is an increase in its respiratory rate over a period of time. Trend this on a piece of paper weekly so you can see this trend as it gets going. This can be a subtle but very important parameter to measure since an increase here can be for many serious reasons.

Urination

Look for any changes in the following:

  • Urinating more often or in greater amounts than normal
  • Urinating small amounts frequently
  • Straining to urinate
  • Inability to urinate
  • Licking at genitals

In female dogs it can be difficult to assess some of these parameters, so try to pay close attention when she squats to urinate.

Defecation

Any significant change here is important:

  • Continual diarrhea of any type
  • Straining to defecate
  • Licking at anus
  • Scooting
  • Any blood on feces

Walking

Obvious lameness is readily noticed. Also look for a pet that is leaning more towards one leg or the other, tires easily after walking or playing, is slow at getting up after resting, or is reluctant to go up or down any type of elevation like stairs or jumping into a vehicle.

Now that you have observed your pets daily habits lets look at how you can look for problems that are not so apparent by going to our In Home Exam page.

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Our Guides

Boli was quite knowledgeable. He gave us a great presentation every day using the high definition plasma display to teach us the history, flora, and fauna of Galapagos.

Now, about his jokes……

He was also a good photographer. Some of his photos are on this Galapagos page.

Christina was just as charming and knowledgeable

Its fun to bust the guides at a candid moment

They made a great team!

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Lions of the Southern Serengeti

Lions tend to be evening hunters, although our guides told us several prides in this area hunt in the daytime frequently. Even though I love the cheetahs nothing is more intense than a lion that is in the act of hunting.

You will encounter playful lion cubs on this page. Those babies had to come from somewhere….

When they are relaxed and their bellies are full they lay around and groom each other

We came across this lioness one morning feasting on a cape buffalo killed the night before.
If you click on her picture you will see a few seconds of video on how she pulls pieces
of flesh off.

Lioness eating

Her face is a mess because she had it deep in the buffalo carcass while feeding

She was surrounded by cubs

Great shot Dominic!

Lions have a strong instinct to hunt, even when they have recently eaten. This lioness
was resting in the shade after gorging on her meal. When these wildebeest and zebra
came around she could not resist the temptation.

Her final assault was a test to see if there was any easy prey in the herd. No luck this time. 

This quivering tail is the first we saw of a different lioness as she was resting in the shade
of an  embankment. We saw the zebra coming before she did because of our higher
vantage point. 

When she heard the zebra she walked along the embankment and decided they
were worth checking out

The zebra were just on the other side of the embankment- she could hear and smell
them but she could not see them just yet

When you see her fixation and tense muscles it gets your heart going

She couldn’t resist so off she went over the top of the embankment

This picture is worth a second look. Notice her power and grace, and also her full tummy and large nipple
(she is actively nursing). She just ate so her motivation is not at its highest, she is just following her strong predatory instincts. 

No luck again as her half-hearted attempt gave the zebra a chance to elude her

Success is inevitable. This wildebeest calf is only a few days old

This lion caught an unusual prey- an ostrich

People commonly ask why wild animals do not need their teeth cleaned or get tooth problems.
They do, as evidenced by the conical erosions on the lower canine teeth and also worn lower
incisors on this lioness. 

This lioness, the one eating the ostrich above, has missing lower incisors. In this case it
might be due to trauma. 

On our 2009 Tanzania trip we saw a lioness hunting and killing a wildebeest from beginning to end. Click
on the picture below if you want to see the sequence, then come back here for the rest of this trip.

Lioness Hunting

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Neuter- Feline

One of the most common surgical procedures we perform is a cat neuter, know medically as an orchectomy. It is performed for several reasons:

  • It minimizes roaming
  • It minimizes aggressive behavior
  • It prevents male cats from impregnating females.
  • It minimized urinating in the home (urine spraying).

Male cats are territorial and prone to fighting, which leads to serious diseases, especially viral diseases like FeLVFIP, and FIV. Neutering minimizes this fighting, helping also to cut down on these serious contagious diseases.

At the Long Beach Animal Hospital use of the laster is mandatory for all neuters. In this page we will first show you the surgery using the laser, then the traditional way this surgery is performed without the laser. The advantages of using the laser will be obvious.

Sometimes people get a jaded mindset when it comes to routine surgeries like neuters, that are performed by the thousands, especially at low cost spay and neuter clinics. It is a major surgery, and we treat it as such at the Long Beach Animal Hospital, which you will learn about in this page.

Several days prior to any surgery please bring in your pet for a preanesthetic exam and blood panel to confirm your pet is ready for anesthesia. At that time one of our doctors will go over any questions you have.

On the day of surgery we need your cat in the hospital between 7:30 AM and 8 AM. Please take away all food and water when you go to bed the evening before surgery, and do not give your cat anything to eat or drink the morning of surgery.

Our surgeon will call you after the surgery is complete and your cat is awake. It can go home in the late afternoon the day of surgery unless instructed otherwise. Please call our office at 4 PM for pickup time, you will be given written post operative instructions then. We are open in the evening if you need to pick up later.

Graphic surgical photos on this page.


Anesthesia

Pre-anesthetic preparation is important in every surgery we perform, no matter how routine. all of our neuters receive a physical exam prior to surgery. After this exam will we draw a small amount of blood for an in-hospital pre-anesthetic test. When everything is in order we will give a sedative. This will calm the pet down and make the administration of the actual anesthetic, along with post operative recovery, much smoother. Once a pet is anesthetized, prepared for surgery, and had its monitoring equipment hooked up and reading accurately, the surgery can begin. Cat neuter surgery is a short procedure, and only a small amount of anesthetic is needed.

This is a sterile surgery, and our surgeon starts the pre-surgical process by using special soap to clean his hands

_D2A8630

While our patient is being anesthetized our surgeon is already in our surgical suite setting up instruments. Our surgeon is ready to start before our patient is at a proper plane of anesthesia. Once the anesthetist gives the green light the surgery starts immediately. We want our surgeon waiting for his patient, not the other way around.  All of this is to minimize anesthetic time.

OVH-rabbit-2

OVH-rabbit-3

We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.

This machine monitors:

Temperature

Heart Rate

Heart rhythm

Oxygen saturation

Carbon dioxide level

Respiratory rate

Surgery-Monitor

In addition to our monitoring equipment our anesthetist stays “hands on” in monitoring important physiologic parameters

Rabbit-femurfx-9

Surgery

In general, neutering males cats is a straightforward procedure. Most cats have both testes in the scrotum, making them readily accessible by a scrotal incision. We do not suture the scrotum after the procedure since it heals very rapidly by itself.

In this picture a small incision has already been made in the scrotum with the laser, and the testicle is visible.

Our surgeon has the testicle in his hand which allows visualization of all the internal structures. You can visualize the white and glistening vas deferens at the top of the picture going from the body on the right to the testicle on the left. The vas deferens will be used to tie off the blood supply to the testicle.

Due to the small size of the blood vessels we can use the natural anatomy of the testicle to prevent bleeding when we remove the testicle. The black arrow points to the knot in the vas deferens made by the surgeon. After several more of these knots are applied the testicle at the far left will be cut off.

Another technique to tie this knot involves the use of a hemostat. This picture shows the beginning of the knot.

After the vas deferens and blood supply are wrapped around the hemostat they are then passed through the center.

Here is the final appearance after the knot has been completed.

At this point anesthesia is stopped and it is moved to recovery to be monitored by our technicians.

Cat-PostOpTowel

When fully awake we will call and let you know.

Staff-ShannonPostOpCall

On occasion both testicles are not in the scrotum. This means that one of them is in the abdomen or in the inguinal canal, which is the passageway through the body wall into the scrotum. Either way, we have to find this testicle and remove it because it will continue to secrete hormones and can potentially become cancerous.

The skin has already been incised and our surgeon is preparing to enter the body cavity. The white glistening structure visible is the section in the center of the abdomen where the abdominal muscles and their tendons meet. It is called the linea alba. We make the incision here due to minimal blood supply and good holding power for sutures

The testicle is not the only thing that resides in the abdomen. This is a picture of the urinary bladder (we hope you didn’t think it was the testicle!) that bulged out of the incision in the abdomen. Obviously, it can interfere with the surgery when it is this full with urine, so we remove the urine before proceeding further.

Testicles that reside in the abdomen are very small because they have atrophied (shrunken in size) due to lack of use. They can be quite difficult to find, and necessitate careful exploration of the abdomen. The black arrow points to the atrophied testicle.

In this case we use suture material to prevent bleeding. The black arrow is still pointing to the testicle to help keep you oriented.

This picture is from another surgery. We have already removed a normal testicle from the scrotum and an abnormal testicle from the abdomen. You can see the difference in size and shape

When the surgery is complete we sew up the incision in the muscles and skin, and give a medication for pain. Once the hair grows back it is impossible to tell if surgery was performed.

Laser Surgery

Using the laser has many advantages over using a scalpel blade. These include negligible bleeding during the procedure and post operative pain. We can use the laser to make an incision in the scrotum, which makes the healing process much more comfortable. Our Laser Page has detailed information on the use of the laser for various surgeries.

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Spay – Feline

One of the most common surgical procedures we perform is a cat spay, known medically as an ovariohysterectomy (removal of the ovaries and uterus). It is performed for several medical reasons:

  • It prevents cats from going into heat.
  • It prevents cats from getting pregnant.
  • It significantly helps prevent cats from getting breast cancer later in life.
  • It prevents cats from getting uterine infections later in life.

We have pictures at the end of this page of complications like cystic ovaries and an infected uterus that can occur in unspayed female cats.

In addition to these medical reasons spaying prevents unwanted pregnancies, a significant problem in our society. Millions of cats are euthanized every year because they are strays.

We usually spay a cat when it is around 6 months of age. This timetable is variable, the important point is to perform the surgery before it goes into heat. Increasing daylight encountered in late winter and early spring stimulate female cats to go into heat.

On the day of surgery we need your pet in the hospital between 7:30 AM and 8 AM. Please take away all food and water when you go to bed the evening before surgery, and do not give your cat anything to eat or drink the morning of surgery.

Our surgeon will call you after the surgery is complete and your cat is awake. It can go home in the late afternoon the day of surgery. Please call our office at 4 PM for pickup time, you will be given written post operative instructions then. We are open in the evening if you need to pick up later.

At the end of this page we have a short QuickTime video when we spayed our hospital mascot Elbee.

This area contains graphic pictures of an actual surgical procedure performed at the hospital. 


Anesthesia

Pre-anesthetic preparation is important in every surgery we perform, no matter how routine. All of our spays receive a physical exam prior to surgery. After this exam will we draw a small amount of blood for an in-hospital pre-anesthetic test. When everything is to our satisfaction we will administer a sedative. This will calm the pet down and make the administration of the actual anesthetic, along with post operative recovery, much smoother. Once a pet is anesthetized, prepared for surgery, and had its monitoring equipment hooked up and reading accurately, the surgery can begin.

This is a sterile abdominal surgery, and our surgeon starts the pre-surgical process by using special soap to clean his hands

_D2A8630

While our patient is being anesthetized our surgeon is already in our surgical suite setting up instruments. Our surgeon is ready to start before our patient is at a proper plane of anesthesia. Once the anesthetist gives the green light the surgery starts immediately. We want our surgeon waiting for his patient, not the other way around.  All of this is to minimize anesthetic time.

OVH-rabbit-2

OVH-rabbit-3

We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.

This machine monitors:

Temperature

Heart Rate

Heart rhythm

Oxygen saturation

Carbon dioxide level

Respiratory rate

Surgery-Monitor

In addition to our monitoring equipment our anesthetist stays “hands on” in monitoring important physiologic parameters

Rabbit-femurfx-9

Surgery

All our spays are performed under sterile conditions. Once our patient is draped and in the proper level of anesthesia the surgery begins

Feline-OVH-5

The spay procedure begins with an incision in the skin. We make a small one (we call it a bikini scar when it heals) because it minimizes anesthetic time when we have to suture the skin and muscles back together, and to minimize post operative discomfort. Smaller incisions also heal faster and minimize the chance of complications. We pick a specific location on the abdomen to make our incision. This location minimizes skin bleeding, gives us direct access to the muscles we need to go through to get into the abdomen, and puts us directly over the ovaries and uterus.

 Our surgeon is making this incision near the umbilicus (belly button) on this cat.

Feline-OVH-6

Cats have a layer of fat under the skin called the subcutaneous tissue. Once we cut through this fat we expose the abdominal muscles.

Feline-OVH-7

It is important to go through the abdominal muscle in the proper location. This location is called the linea alba, and is the area where the abdominal muscles meet. Making the incision here will yield almost no bleeding, and gives the surgeon a strong anchor to sew the muscles back together.

We start the muscle incision with a scalpel, then complete it with the scalpel or a scissors, taking special care not to cut any internal organs.

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An instrument called a spay hook is commonly used to bring the uterus out of the incision through the small opening in the muscle. We gently pull up the uterus until we have the ovary exposed.  The black arrow points to the ovary.The surgery is performed outside of the abdomen.

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The ligament that attaches the ovary to the bottom of the kidney is gently stretched to allow complete visualization of the ovary and its blood supply.

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Our surgeon then clamps the blood supply to the ovary using hemostats

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This is a picture of an ovary cyst from a different cat. This is one of the problems that can occur when a female cat is not spayed.

Using special suture material the blood supply to the ovary is cut off. This is repeated for both ovaries

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When both ovaries have been cut off from their blood supply the whole uterus with ovaries is brought through the incision site

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The uterine horns are now ligated with special suture material

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The muscle layers are sutured at a special section called the linea alba. Our initial incision was made here to facilitate suturing at the end of the procedure. The linea alba is a tendinous attachment between the muscles that holds the suture much better than the muscle itself. This prevents a hernia.

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The skin is sutured, usually with a suture material that dissolves on its own, so there is usually no need to return for suture removal. We will let you know in your post operative handout.

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After the skin is sutured we use our companion laser. This aids the healing process and decreases post operative swelling so your pet is more comfortable.

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Click on the video to see it in action

 

At this point anesthesia is stopped and it is moved to recovery to be monitored by our technicians.

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When fully awake we will call and let you know.

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Unspayed cats are at risk for a disease called pyometra. This is an actual infection of the uterus, and can be very serious. It is diagnosed in several ways, one of them being a radiograph. The black arrow points to a tubular structure in the abdomen of this cat this is a pus filled uterus.

This is what a pyometra uterus looks like. It includes the ovaries (arrows) at the left along with the cervix at the far right. If you look closely you will notice the swollen appearance to this uterus. This is an infected uterus that was removed from an older cat. If this cat had been spayed before its first heat, there is minimal chance it would have had to suffer this infection.

Before it wakes up from anesthesia we will give a pain injection.

Postoperative Care

 

Most cats go home late in the afternoon on the day we perform the surgery. They might be groggy from the pain injection which is advantageous because they will remain calm and allow the healing process to start immediately. By the following morning the grogginess will have worn off.

When you first get home do not be in a big rush to feed. after 1 hour at home offer a small amount of food and water. If the appetite is good, offer more several hours later. Do not over do the feeding the first night because anesthesia can make them nauseous.

Use the pain medication we prescribe to make your cat feel comfortable for the next few days.

Keep contact with children and other pets to a minimum the first night, and restrict activity for several days to allow the incision to heal. Do not let your cat go outside until healing is complete.

We were finally able to catch Elbee and spay her -double click on the movie box below and in a few seconds it will play. Grab your popcorn and enjoy the show…

Elbee’s Big Day

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Restraint Technique

Introduction

Brushing your pets teeth is not the easiest thing in the world to do, especially if your pet is not used to you handling it near its mouth. By getting your pet used to you working around and in its mouth at a young age, you will make the process of tooth brushing go smoother when your pet is older and needs brushing. Proper restraint is the key to getting your pet to cooperate. We will show you some techniques that can be used by one person or two people in cooperation.

A good time to start is when you are watching TV at night and your pet is in your lap. Get your pet used to your hands around its face, and eventually insert your finger in its mouth. Dipping your finger in food that tastes good to your pet is helpful. Eventually you will be able to use the finger brush to gently brush the teeth. If you are patient, take your time, and make it fun, you stand a good chance of being successful.

Restraining Small Pets

The key to restraining a small pet for tooth brushing is to use as little force as possible. One person can restrain while the other brushes the teeth, although one person can usually brush a small pets teeth alone.

Start by putting your friend on a table while talking in a soothing voice and petting it. Have your tooth brush or finger brush already on the table. Hug your pet to you with one hand while simultaneously holding its head and neck gently with your other hand. This method works well with many cats.

If your pet uses its front legs to push your hands out of its mouth you can solve this problem by holding the front legs, always with one of your fingers between the legs.

A towel can be used for some additional restraint. Wrap it loosely around the body and hug your pet to you. If necessary, the front legs can be held also.

It is sometimes advantageous to include the front legs in the wrap. This towel will need to be wrapped tighter if you want the legs to stay in.

Once restrained you can introduce your finger, a piece of gauze, a finger brush, or a tooth brush into the mouth. Rub in a gentle motion while talking in soothing tones to your pet.

You can turn the head gently or completely reposition yourself to do the other side.

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