Wednesday, July 31, 2019

Teethsy No 2 - Don't let Old Dogs Down - doggie dentals

My dental blogs over the next month is going to be like a scavenger hunt, where you have to work through the clues to go to the next one! In other words, it is going to be in the order which doesn't seem to make sense (except to me).

Mr Hill, my history teacher from High School (back in the 1980's) got upset with me in one of my history examinations. He was angry that my discussion about World War II was back to front.  So, in keeping with my teenage self, I shall start at the end stages of a pet's life as I talk about teeth.

It is at this stage of their life where age is a disease, as like any other disease, it affects the pet's ability to get the treatment they need for the problems they may have. As a vet though, we are trained to think, and many of us believe, that age is NOT a disease.

Its a constant challenge for me when I  have owners saying "at their age, I don't want to put them through that" when I have the knowledge that their pet is in pain now. Ignoring this pain is  not going to make it go away.

And at their age, they are not getting any younger. No owner wants to think that their pet is pain, but it is a sad reality for many of our pets out there.
An old Teddy!

The comorbidities may be enough to make the owner think twice about dental work - you know, the pet that is arthritic,  has heart disease, kidney disease. Is it the dollars that is stopping them too? If there is alot of disease, it is likely to cost alot of money, into the thousands, to address this.

The pet where the owner sometimes wakes up some mornings, only to go over to their pet to wonder if they are still alive.
Very much alive, but sleeping.

These pet owners are often (understandably) loathe to subject their elderly pet to an anaesthetic just to clean some teeth.

This is where the problem lies - whenever I recommend a dental procedure for a pet, it isn't just to get them back to being pearly white, but to examine, identify, and then treat any disease that is hiding in that mouth of theirs. My goal is to make their mouth pain free.
Abscessed teeth  - identified on radiographs, but the mouth didn't look "too bad" visually.

If all I am  doing is flicking tartar (brown stuff) off teeth, well, you might as well do that yourself, or get your dog's hairdresser to do that.
An older photo of our dental set up

To say that is what a "dental" is, is to not understand what a "dental" is. (that is a soap box talk all of its own).

What can we see in older pet's mouths?

Advanced dental disease in a fat maltese terrier -  still eating well but so much pain.
- Abnormal wear from too much playing with tennis balls, chewing on rocks, chewing on themselves
- Draining sinuses from fractured teeth
- Ankylosis of bone and tooth
- Periodontal disease (significant bone and/or gum loss ) - although not necessarily an old dog disease
- lumps on the gum or bone
- broken teeth
- fractured jaw from advanced dental disease.
Fractured jaw from advanced dental disease

And the signs they show we often subscribe to just being old. They may chew slowly, not move around much, not be so keen to play. But they are still eating well.

Please do not let your pet's first anaesthetic for a dental procedure be when they are older. Start your pet's dental program from when they are younger, address any issues as they come along.

This is the best gift you can give your fur-companion.

Book your pet in now, whatever age they are, for a dental check. They are free at Russell Vale Animal Clinic all year round. For the month of August, selected Vet hospitals all over Australia are also offering FREE dental checks.

Even if your pet has had a recent vet check for their vaccinations, take them in for a dental check alone, to make sure that sufficient time is given to discuss your pet's oral health, and to give you information on how to keep your pet's mouth healthy.

I am Dr Liz, the mad vet of Bellambi at Russell Vale Animal Clinic, all for happy healthy pets, which comes with great oral health.

Looking forward to seeing you all soon.

Sunday, July 28, 2019

Dental Month 2019 = Teethy Troublesy Numbery Onesy (No 1)

Another year rolls on into Dental Month for us in Australia. It is (almost)  August, and August in this neck of the woods means Pet Dental Month.

I find that really strange - our teeth seem to suddenly turn up in August and ask to be considered important, but are ignored every other month of the year?

That doesn't happen on my watch! Every day is pet dental month in my house (aka Russell Vale Animal Clinic). Anyone who knows me knows I take teethies very very seriously.

But the National Pet Dental Month is here, so here we are!

So this month is all about teeth.... so if you are not into teeth, or don't have any of your own, or your pet does not have any teeth, then feel free to avoid August editions of my blog.  We will see you in September!

I shall warn you though, that I won't just write about teeth this month, but will write about whatever else comes into my mind (and knowing my brain, it has the potential to be a bit weird! That's what happens when you haven't blogged for a while - it them becomes a tsunami of posts (and hopefully not the rubbish that a tsunami rushes in).

So lets talk teeth. Lets talk facts.

  • 80% of dogs of 2 years of age or older will have some form of dental disease. 
  • Dogs who are less than 10 kg are more likely to have periodontal disease 
  • Commercial food does not cause dental disease - wild animals from hundreds and thousands of years ago had dental disease, but they did not go grocery shopping for a tin of Chum (or whatever brand is sold in supermarkets now).
  • Bones do not keep teeth healthy. They may be white but not healthy.
  • Every pet deserves a pain free healthy mouth. 
These facts on dental disease have not changed in the thirty years I have been a vet - why? 

What sort of dental issues do I see in GP land? 

I have no doubt that there is disease in the mouths of the pets I see that I am missing just because I can't see it or because of my own ignorance.  Many years ago, I was very unaware of dentigerous cysts, impacted teeth, base narrow canines, caries, resorptive lesions in dogs (I knew about them in cats).

Many years ago, I was blithely unaware of the enamel trauma caused by dogs chewing on bones - after all, bones keep the teeth healthy and white do they not? I was unaware that bones can also fracture teeth, cause pulpal infection and pain.  

How many puppy owners know about "Base Narrow Canines " (Lingually displaced mandibular canines). or about unerupted first lower premolars? 
Puppy with "Base Narrow Canines" - Ouchie.

How many cat owners think about their cat having "Feline Odontoclastic Resorptive Lesions" (or whatever the recent terminology is for the same disease). 

I know what the answer is to those questions.  It is "very few". 

Most owners think of dental disease as the brown stuff on teeth.  They think that if their pet had a tooth ache, they would say so (such as rubbing at their mouth, or  not eating well, or dropping their food as they eat). 

Whilst I hate the thought of my pets in pain, how I wish (oh how I wish), that when they were in pain, they showed it. 

You see, our animals hide their pain from us - whether it be dental, muscle or joint. Sometimes their pain is so severe that they can't hide, or sometimes, they are at a point in their lives where they just want to die.

It is usually at this point that the owner may present them to us saying "my pet is in pain". 

If there is going to be one take home message from here - our pets, no matter how much they love us, or how much we love them, hide their pain, and this includes dental pain.

If you are looking at your pet right now, and you think that they are healthy - I give you a challenge - take them to a vet and get that confirmed by them.

You need to take advantage of the free dental checks that are occcuring in vet hospitals all over Australia. These are there for YOU - the pet owner - not for me, the vet, but for YOU, to educate YOU about your pet.

I know you are busy, so just in case August does not suit, remember that every day is Pet Dental Month at Russell Vale Animal Clinic - you can keep this in mind for future reference. We also start our dental checks at the puppy or kitten's first visit, and recommend a 6 month visit from such a young age.  Our goal is to increase the pet owner's awareness of what is going on inside their pet's mouth.
A younger version of me checking the teethies.

In vet hospitals all over Australia, there are specially trained professionals just waiting for your call, able and willing to examine your pet's mouth.

 Once they have done that, they will be able to give you the information you need to keep your pet happy and healthy. 

Numbery Onesy is done... be sure to hang in there for number 2. 

I am Dr Liz, the mad vet of Bellambi. If you are in our neck of the woods, why not drop in? We are opposite the new Bunnings store, so it is definitely worth the trip.

Here is another older version of me, at one of our Open Days. Honestly, other than few grey hairs which haven't made it onto film yet, I still look the same!

Wednesday, July 24, 2019

Musings of Dr Liz - Random Acts of Kindness

Welcome to  another one of my "musings".

Only a few months into the 2019 year and already alot of interesting things are coming across my Facebook newsfeed, via my email, and via the many forums that I am part of.

There is a common theme that has struck me - it is the amazing kindness of many many members of our community, locally and abroad.

Whilst the movie Pollyanna hasn't aired in a while, it is a movie that I admittedly like to watch when it comes on.

  The reason being is that there is a particular scene which the local priest reads a locket which says "When you look for the bad in mankind, expecting to find it, you surely will. - Abraham Lincoln."

Kindness can show itself in many ways, but there is a single constant in every act of kindness - it is done with an open generous heart, with no strings, no expectations of anything in return.

This is the type of kindness that our animal friends give to us.

The beautiful gift I received in
the Christmas of 2017

The other kind of kindness they give us is their lack of judgement.

When I first heard that quote from Pollyanna, it rings true.

It is like the quote,  "If you think you can or you think you can't, you will be right" (my paraphrased version of it).

In my industry, it is all too easy to look at the negative, to look at the sadness, the death, the bullies, the abuse... the list is long.  If you look for the bad.... its there.
Beautiful Cushion I received In July 2019 in Memory of Baia.

It never fails to amaze me how many animals seek our companionship, how they are happy just to sit with us, or walk with us.

Why can't we be like that too?

There are so many acts of kindness out there, just open your eyes and look. 

There are some days when I struggle to see the good in people, but when I see unexpected acts of kindness from one person to another, it makes me realise that our animal friends are right after all. We are worth it.

I am Dr Liz, the mad vet of Bellambi.  This isn't a photo of me, but of our clinic cat, Pandora (otherwise known as the boss!).

Monday, July 22, 2019

Help with the Itchy Puppy - Russell Vale Vets

As an owner of an itchy dog, and having to deal with that on a daily basis, I am thankful that Piper didn't show signs until she was a year old.   Granted, she had a whole heap of other medical issues in the first year of her life, but adding allergic skin disease at that time, would've been just too much.

So my heart goes out to those pet owners who have 8 to 12 week old puppies who are itchy, and just want to know why, and how to fix it quickly. 

What I try to communicate with all of these pet owners is that there are quite a few things that can cause a young puppy to be itchy, and the ideal treatment is the one directly targeted towards the cause.  As we are often dealing with very itchy puppies, it is not unusual for us to do a few simple skin tests, and treat for the most likely culprit (or even for multiple things). 

Yeast infection

What are the more common causes of itchy puppies? 
- Occult scabies
Ear Mite
- Mites
- Fleas
- Food Allergy
- Early onset Atopy (allergies to grasses, pollens, dust mites)
- Ringworm
- Yeast infections
- Bacterial infections

This is where the problem lies - some of these conditions are easy to treat and curable, such as scabies and Ringworm.

Some of these conditions need many weeks of therapies before you start to see signs of improvement  (Food Allergies, yeast and bacterial infections)

And some of these conditions are incurable (manageable, but incurable), such as Food allergies and early onset Atopy.

Some pet owners get frustrated very easily, and chop and change therapies without giving them a decent chance to work.  And I get it!  As an owner of an itchy dog, it is frustrating that things take time to get better.

Be patient, and speak to your vet if you are not happy. We are here to help.

What are the important tests that need to be done at the vets? 

Skin scraping - this helps us look for demodex mites, and scabies.

Skin cytology -  this helps us look for fungal hyphae, Malassezia yeasts and bacteria.

Woods Lamp - this helps us look for Ringworm, as 50% of these cases will shine as green as a Granny Smith apple (50% do not, hence the need for Fungal cultures).

What about Fungal Cultures?  Possibly.  It just depends. 

What are some simple steps you can do at home?
1. Therapies against Fleas, Ticks, Mites and Lice

2. Food Trials - these are a challenge, as we need to give a novel protein diet exclusively (including no treats or flavoured medications).

3. Keeping your pet's skin protected with conditioning rinses such as Alpha Keri Oil or QV Bath Oil. There are some oatmeal based conditioners which are also good to use.

As for the rest,  that is where I come in - with a few simple tests, I formulate a strategy to help identify what can be causing the skin problem, and dispense any treatment that is needed.

Any questions? Please ask.
I am Dr Liz, the mad vet of Bellambi.

Thursday, July 18, 2019

The Supervets amongst us - superheroes are out there!

Who doesn't love watching the show called Supervets, all about the amazing work done at Fitzpatrick Referrals in the Uk.

It is an amazing show, not just because of the veterinary work where the boundaries have been pushed beyond what was thought possible, but also from the genuine compassion and love for our animal friends that flows from the TV screen out to envelope you.

To see and feel such love is addictive.

At a recent family function, to celebrate my brothers birthday, one of his good friends spent alot of time telling me how wonderful Supervets was.  He went on to even say that they are so wonderful that they do all of that for free.

Ah well! I didn't want to ruin the evening by saying that someone paid for those procedures, even if it was not the owners, as nothing is ever done for free.  No one works for free, everyone who works is paid something, which is generated by something else being paid.

There is a good reason why money or costs are never discussed in these shows, as those of us in the industry, usually have  a good idea how many times that turns out.  But in fairness to the specialists, they, by their very nature, get clients who are willing and able to spend that money in the first place.

Do you know what the definition of a hero is?

I never really thought about that until my eldest son received a Hero award when he was in primary school many years ago.  One of the other mothers came to me and told me that it was wrong that he received that, as no one in the school knew that award existed until that year. My son (now an adult), got that award because he defended a student being bullied badly by his fellow students.

That is the definition of a hero.

A hero stands for what is true, courageous and valiant. With no one watching, with no expectation of someone giving them a pat on the shoulder, an award or any recognition of what they did. They did it because it was the right thing to do.

What about a Supervet?  Do they have hero properties also?

Stupid question, Dr Liz!  Of course.

Are there Supervets amongst us?

What a day of stupid questions, Dr Liz. Of course!

There are so many vets out there doing amazing things, not always doing experimental fracture repairs that seem to be always successful, but still making an amazing difference in the life of our animal friends and the family that loves them.

The hero vets are there, with  you and your pets working every day. From the most dreaded expressing anal glands, to the holding of your pet's paw as they take their last breath. 

The hero vets often have to work with limited resources to try to figure out why your pet is sick.

The hero vet is one that is there at the end of the phone to answer those questions that are bothering you about your pet's health.

There are so many vets out there who suffer from 'imposter syndrome", who are intimidated by the assumed perfection of colleagues around them.  I have days of feeling like an imposter also, I suspect many of you have felt like that some days at work too.

To all of you superheroes, thank you.

I am Dr Liz, the original mad vet from Bellambi.

Any questions or comments, please share.

Sunday, July 14, 2019

2019 - the Mad Vet is Back!

Just a quick note to say that whilst I promised the blogging Dr Liz would be back in 2018, Dr Liz (aka me, aka the Mad Vet), decided to take a different journey.

But.... gotta love the but.

But, this time, I mean it - I am back, albeit it is mid 2019!
Dr Liz and Dirk in Tasmania (AVA conference) 2018

Why did I stop?  Well, I didn't stop writing, I just stopped publishing.  What I was writing was a bit on the dark side, the sort of thing that, whilst I could share it, would go against what I wanted this blog to be.

What I was writing was not a real reflection of me, just a reflection a frustrated, angry, very tired, version of me.  It is the sort of thing that a rational me would look at, and say "Really?"


Like life, the last few years have been a struggle. A  hurdle, that needed an Olympic effort to get through.

Ok, I am lying!   I did stop writing alot,  but it was because I was spending my days and nights looking after the beautiful animals of the Illawarra.  Sharing what I was doing that was very difficult, because I just wanted to put my poor sore knees and feet up, watch a B grade soap opera, and have a hot chocolate at the end of a big work day.

Ok, that is a lie too. Who would've thought that the Mad Vet couldn't give a straight excuse why she promised to blog but didn't.

Moment of truth!

We have had the biggest few years of our amazing special little practice, for reasons that I cannot explain.

I have had health issues - it comes with age. (meniscal tear in a knee) (so the sore knees story is true).

I have been doing extra reading and study (because I love to study).

All of the above, meant that despite my love of writing, I couldn't publish what I wrote when I did write something (if that makes sense), it shouldn't really be shared.

Ok, truth moment is over.

So, short version is - I am honestly, really back. And excited and happy to be also!  It does not mean that all of the above reasons are no longer there, but I am going to work around all of that, to be back blogging.

Any comments or suggestions? let me know.

I am Dr Liz, and I am the Mad Vet (and the only vet)  of Bellambi!  (Be aware of imitations!)

July 2019.

PS I had to laugh when I wrote the line of "beware of imitations", as bizarrely enough, there is a vet who is calling themselves the Bellambi vet also, simply because they are targeting my area for their business.  That's cool. They say imitation is a form of flattery.