Dr. Steve Surujbally

Article taken from Stabroek news with Dr. Surujbally Permission.

Last week we dealt with the symptoms of ailments in the mouth. In order to have a closer look in the oral cavity, one has to open the mouth and examine the inside. Generally, neither dogs nor cats like this intervention too much.

Three things we must understand and accept before attempting to open the mouth. Firstly, only the bottom jaw (mandibula) moves. There is no sense trying to pull open the top aspect of the jaw (maxilla), because it is an integral part of the whole skull. Secondly, no dog, and especially not one that is experiencing pain because of some ailment in the mouth, is comfortable with the idea of you manipulating its mouth.

Please also keep in mind that problems in the mouth might exhibit themselves (as symptoms) elsewhere. For example, there are sub-mandibular lymph nodes beneath the jaw (you can feel them as small pea-like structures at the angle of the lower jaw bone), which can become swollen, if there is an infection of certain tissues in the oral cavity, especially those in the throat area.

Just as a nail wound on the sole of the feet can cause a swelling of the lymph nodes in the inguinal (groin) area, so too a throat infection can create a painful swelling of the sub-mandibular lymph nodes. So, even before you try to open the pet’s mouth, look first at various areas around the mouth on the outside, in order to ascertain whether there might be an external associated condition which is manifesting itself inside the mouth and vice versa.

How does one open a dog’s mouth? There are different methods to open a dog’s mouth. I prefer to go with my left hand from the top, holding the upper jaw in such a way that my thumb and fingers squeeze a piece of the upper lip skin inwards. In this way, if the dog bites upward, it will hurt its own skin first, my fingers being protected by the skin fold. Then, with my right fore finger, I can pull down the lower jaw.

This enables me to get a good look inside the mouth. In case of the cat, just get a good hold of the scruff of the neck with the left hand, and then pinch a fold of skin at the front of the lower jaw with the thumb and forefinger of the right hand, pulling downwards. The oral cavity opens up and you can examine it at will.

If you just want to examine the gums, or the teeth, or the pet’s bite (how the teeth of the lower jaw and the upper jaw meet), you could simple raise the upper lips and the lower lips in turn. Healthy gums are pink and smooth; healthy teeth are firm in the socket and should be without plaque and not ‘rotten'.

Pale gums are a reflection of an anemic condition which could be caused by worms or some internal injury causing a blood loss, or even an iron deficiency or poor diet. Bad teeth are often a sign of poor nutrition. I should mention that one text entitled the Dog Owner’s Home Veterinary Handbook advises that a dog’s mouth can be opened by placing your thumb in the space behind the canine tooth while exerting pressure against the roof of the animal’s mouth.

You then pull down on the lower jaw with the other hand. In order to see (beyond the tongue) the tonsils and the back of the mouth, you may push down the back of the tongue with your finger.

Now, for me, all of these explanations are straightforward. But, of course, I’ve been doing this for 40-plus years. It is to be expected that during such a long period, some degree of dexterity would have been learnt. You, on the other hand, may need an actual demonstration. That’s what your vet is there for.

He/she would be more than willing to show you, on the spot, how the manipulations described above are carried out. Please implement disease preventative measures (vaccinations, routine dewormings, monthly anti-heartworm medication, etc) and adopt-a-pet from the GSPCA’s Animal Clinic and Shelter at Robb Street and Orange Walk, if you have the wherewithal to care well for the animals.

Do not stray your unwanted pets; take them to the GSPCA’s Clinic and Shelter instead. If you do not wish your pet to have puppies or kittens, you may exploit the GSPCA’s free spay and neutering programmed. If you see anyone being cruel to an animal, or if you need any technical information, please get in touch with the Clinic and Shelter by calling 226-4237

GSPCA has a FREE Spaying and Neutering Programme. Make good use of it after all is FREE!!!!!!

WHY SPAY/NEUTER......

The neutered male has a decreased urine odor, less of a tendency to fight and roam, and a significantly lower likelihood of spraying urine to mark territory (this is especially true in the male cat). The neutered male dog also is less likely to roam or mark territory, and is usually much less aggressive to other dogs and humans. The neutered dog has a much lower risk of prostate disease and cancer. The spayed female cat and dog will not have reproductive tract disease problems, and will have a much lower risk of mammary cancer.

Trench mouth (Vincent’s stomatitis)

This is extremely painful stomatitis caused by a bacteria-like germ.It is most common form of stomatitis in the dog. It is characterized by a beefy red look to the gums,Which bleed easily when touched. There is a characteristic offensive odor from the mouth, usually accompanied by the escape of a brown, Purulent, slimy saliva which stains the teeth, muzzle.

The front legs, which the dog uses to rub its inflamed mouth, also get stained. Flush the mouth with a weak solution of peroxide (one part in 10) several times a day and administer a course of penicillin for at least one week(Often, a 3-week long treatment course is necessary).

Aspirin should be given to control the pain. All antibiotics should be used only under veterinary supervision. Yeast stomatitis (thrush).This is a specific kind of stomatitis usually seen in young dogs after long-term treatment with a broad spectrum antibiotic. You will note that the mucus membranes are covered with soft white patches which coalesce to form a whitish film on the gums and tongue. Painful ulcers are seen as the disease progresses. This antibiotic inhibits bacterial growth and fungi tend to proliferate.

Treatment

Nystatin is the drug of choice. Cortisone is used to reduce the inflammation. Feed a soft diet. Large doses of a B-Complex vitamin also are recommended.

Recurrentstomatitis. In this condition, ulcers develop in the mouth when jagged, broken or diseased teeth may rub repeatedly against the mucus membrane lining of the lips, cheeks or gums. Excessive build-up of tartar in the teeth is a predisposing cause. Bacteria and fungi quite commonly are associated with these ulcers.

Treatment. The teeth should be cleaned. Consider removing any tooth that is diseased. Put your dog on a good home care oral hygiene programmed (we’ll discuss this later). Persistent cases may require antibiotic treatment supervised by a veterinarian.

Gingivitis (sore gums)

The smart text books define gingivitis as an acute (suddenly beginning) or chronic (over a long period) inflammatory process of the gums which is characterized by swelling and redness.

Right at the outset, let me tell you this is not an easy ailment to cure. When I was a young vet practicing in Europe, lots of dogs (mainly Poodles, not Puddles as I have heard many say) and cats came into the clinic for treatment of this malady.

The text books and experienced professors and senior assistants all had good advice to give, but in the end, it was the devil’s own job not only to affect a cure, but to keep the disease from recurring.

I remember one case that defied the traditional treatments; but, the moment the owner (who was a ‘lady of the night’ and who had frequent visitors to her apartment), changed her life style for a more permanent association within wedlock, the disease evaporated. The consensus at the time was that this particular gingivitis case had its origin in a psychological disturbance of the pet, brought on by the unsettled and unsettling habits of the owner.

More commonly, the causes of gingivitis are associated with primary diseases. Foremost among these would be tartar build-up (dental calculus). Tartar is a dark brown chemical deposit (a salt) on the teeth, especially the canines, the pre-molars and molars.

In fact, one can argue that any condition that allows the gums to recede from the sides of the teeth would cause small pockets and crevices to develop. These, in turn, would trap particles of food and an assortment of bacteria. As a consequence of this bacterial invasion, root abscesses and serious tooth decay could develop. Under such conditions, one is almost always confronted with gingivitis.

The symptoms of gingivitis are pretty obvious. A foul smell emanates from the mouth; the gums become red and swollen. If you touch them they may bleed. The gums are painful to the touch. The edges of the gums depart from the teeth, producing a narrow band of bright red tissue surrounding the neck of the tooth. If left untreated, the gums become more swollen, and even ulcers may develop. Later, the swelling is enormous. Even then, I have experienced dogs not exhibiting great signs of discomfort. Only when a severe periodontitis (tooth decay) develops will we witness an in appetence (cessation of eating)

Last year on December 13, 2009, we discussed the various possible causes of pharyngitis (the consequence of infectious diseases, inflammation of nearby tissues, extension of a rhinitis, air pollutants, unskilled administration of oral medicine, the eating of hot food, genetic defects, etc).Now let’s have a look at the tell-tale sign associated with this malady.

Symptoms

● Obviously if the back of the throat is inflamed, there is going to be severe pain resulting therefore. The animal with pharyngitis will therefore ingest food slowly or not at all. This is usually the first sign.

● If the pain is really severe, the animal would not even drink water. Signs of dehydration may appear (elasticity of the skin is reduced).

● If the owner were to touch the outer area of the pharynx, the dog would react immediately to the pain.

● There may be an accompanying swelling (and even pain) of the lymph nodes in that general area. The tonsils (lymph nodes) may also be red and swollen.

● In severe cases the lymph tissue in the back of the throat can become so swollen that breathing becomes coarse and raspy.

●Very often, laryngitis may accompany the pharyngitis. In this case, you may provoke a slight cough if you squeeze the pharyngeal area.

● If the pain inhibits the swallowing reflex, even the saliva, instead of being swallowed, will drool out of the mouth. Also, the pain and inflammation could cause vomiting and coughing. When the dog is subjected to such spasms, the vomited material could end up in his lungs (aspiration pneumonia).

● Fever, especially when there is great infection of the pharynx.

● The dog usually shows some nasal discharge.

● Stiffness of the neck.

● Impaired breathing (respiratory distress) in advanced cases – especially if the dog has been subjected to strenuous activity.

NB

(i) The worst thing that can happen in a severe pharyngitis attack is the development of an edema (tissue swollen with fluid). This could lead to suffocation, as the swollen tissue blocks the air from going easily into the lungs.

(ii) In some cases, the dog (because of pain) will not open its mouth for you to look in. In such cases, the vet may have to sedate/anaesthetize the dog in order to have a peek at the pharyngeal area.

Treatment

As usual, the treatment should mirror the cause of the problem. For example, if the pharyngitis has been provoked by a mechanical trauma (some foreign body stuck in the throat), then we must remove the offending object. I tend to support the actual removal of the object with a follow-up antiseptic solution.

Some practitioners might wish to suggest that one uses expectorants as part of the therapy. Expectorants are drugs which assist in the removal of secretions from the air passages, especially since a lot of mucus build-up can take place in severe pharyngitis cases. I personally tend not to implement such regimes because some expectorants can precipitate vomiting. Other drugs that can be used to ‘paint’ the back of the throat are iodine in glycerin or a silver nitrate solution or Lugol’s solution.Treatment

I would introduce penicillin-based antibiotics (or sometimes sulfonamides), if the conservative local treatment is not showing quick improvement. For the pain, I tend to prescribe aspirin.

It is imperative that we do not feed an animal with a throat ailment any hot, hard foods. In the case of pharyngitis, liquid foods are compulsory. In fact, if the inflammation is bad enough, I would feed the animal intravenously.

Laryngitis
I had promised to write about laryngitis this week. However, space will not permit us to deal with this matter comprehensively and as one whole topic. Next week we’ll deal with this inflammation of the larynx (the organ of the voice, which also forms part of the air passage).

Allow me to again wish the companion animal care-givers, throughout Guyana and abroad, all the very best during 2010.

Please implement disease preventative measures (vaccinations, routine dewormings, monthly anti-heartworm medication, etc) and adopt-a-pet from the GSPCA’s Animal Clinic and Shelter at Robb Street and Orange Walk,

if you have the wherewithal to care well for the animals. Do not stray your unwanted pets; take them to the GSPCA’s Clinic and Shelter instead. If you do not wish your pet to have puppies or kittens, you may exploit the GSPCA’s free spay and neutering programme. If you see anyone being cruel to an animal, or if you need any technical information, please get in touch with the Clinic and Shelter by calling 226-4237.

Dog (Pit Bull) fighting

Last week, we took a break from the current topic of Liver Diseases and discussed the brutality associated with the so-called training of dogs by people who themselves need training.The weekend before we alluded to “factory-breeding” of cute mongrels with all sorts of enticing breed names which have no scientific base.

Today, we’ll have a cursory look at a new “sport” which has entered Guyana, and which is illegal.

Many decades ago, cock fighting became a crime. Dog fighting falls into this category. The first thing that springs to my mind is: What kind of person relishes the blood and gore associated with dog fighting? There is a certain patho-psychology associated with gaining pleasure at the pain and suffering of others. I refuse to believe that this sadism has only to do with money. How much can be won if my dog beats your dog?

Look people, this is not a bird whistling competition. The dogs rip each other apart. Those who survive must be showing severe lacerations. Who stitches them up? Vets? Veterinary surgeons may not refuse treatment to an animal whose condition was brought on by the dastardly acts of man, but they can certainly report the matter to the authorities and agitate for action. Veterinary technicians? This group can be easily managed by the authorities, but perhaps the dog with deep bites and hanging flesh is simply killed by the owner.

Whichever way you look at it, dog fighting is as odious as it is callous. It is an atrocity which no civilized person should condone or support. This includes spouses of those who are involved in such heinous “sport”.

Can you imagine being the spouse of a person who gets happiness at baiting dogs and then allowing them to tear each other to shreds? This includes the handymen who have to wash down the blood after the fight. This includes neighbours and any other witnesses or those who have knowledge of the malevolence.Of all the wonderful things that one can do on Sunday morning, surely only a sick mind can want to achieve an adrenaline surge from such bestiality. To be quite honest, I really do think that people who are engaged in Pit Bull fighting need psychiatric help.

I implore them to seek such help.

Can you imagine how innocent passersby can be mauled by dogs which have been “trained” (in the most brutal of ways) to be vicious and aggressive. In recent times, reports in the press are documenting instances when school children, old men and handicapped persons are seriously damaged by dogs, some of which are bred for fighting. Someone has raised the idea of banning Pit Bulls from being reared in Guyana. This is another issue, and for other reasons it has to be dealt with. However, I do believe that if there were no Pit Bulls in Guyana, these promoters of dog fighting would train Rottweilers and Dobermans and even common breed dogs to fight each other.

Let me hasten to add that dog fighting seems not to be very widespread in Guyana. At least the reports that we receive tend to support this belief. However, even if there is only one fight a week on the East Coast or elsewhere, that is one fight too many.

We are imploring those who are involved in this unkindness to discontinue it. We at the Guyana Society for Prevention of Cruelty to Animals (GSPCA) do not wish confrontation. We wish that you can convince yourselves that this blood sport detracts from your own sense of rightness, and from your being a superior species.

Please implement disease preventative measures (vaccinations, routine dewormings, monthly anti-Heartworm medication, etc) and adopt-a-pet from the GSPCA’s Animal Clinic and Shelter at Robb Street and Orange Walk, if you have the wherewithal to care well for the animals.  Do not stray your unwanted pets, take them to the GSPCA’s Clinic and Shelter instead. If you do not wish your pet to have puppies or kittens, you may exploit the GSPCA’s free spay and neutering programme. If you see anyone being cruel to an animal, or if you need any technical information, please get in touch with the Clinic and Shelter by calling 226-4237.

The final days of your pet

Well, we have spent quite a few weeks discussing the care of the elderly dog – trying to lengthen his life span. But the time will come when the pet’s health begins to deteriorate visibly and rapidly. Life is a pain and every movement is associated with agony.

You now are confronted with a difficult decision, not quite unlike that which you have to face when a close relative is terminally ill, but not with the same legal limitations. Yet, this decision is no less painful. This pet has been with you from the inception. It was a playful puppy/kitten that seemed to have boundless energy which was directed at your ankles with the objective of tripping you. And it had an infinite ability to get itself into trouble. That pet’s antics not only made the family laugh, but it brought you all together. The kids have grown up into teenagers and adults along with your pet. For all practical purposes, this animal has become an integral member of your family.

You have cried and blamed yourself when she fell off the verandah, or when you carelessly allowed the back of your rear wheel to clip her leg. And you were ecstatic when your vet told you that no internal organs were damaged and no limbs were broken and dislocated. You have watched her give birth to her puppies. Will you ever forget that face, that look of relief, which told you that everything was all right as she nursed her first litter – you, like her, not really knowing what’s the right thing to do.

You remember the days when ‘Rover’ went ‘roaming,’ while you were frantic at not knowing where he was. You scolded him, yet you hugged him on his return – looking bedraggled and perhaps even with a few wounds. You couldn’t help but feel proud, not only because he returned to you, to his home, but because there was a twinkle in his eye that told you he was top dog in the neighbourhood, and that his lineage was secure. You cannot forget how you stayed up with him through the night and gave him his medication, and cradled his head while he accepted the glucose-saline drip at the vet’s clinic; and you remember how you comforted him when thoughtless people threw squibs which sent him into paroxysms of panic. Yes, you and he formed a bond. You knew he would never desert you and that your home was his territory which he would defend – yes, even with his life.

You know that irrespective of what the scientists say, your dog cries, laughs, exhibits jealousy, anger, fear, guilt, but never ingratitude and treachery. And now, in front of your eyes, this true friend is physically collapsing, his life is no longer a joy and a pleasure. His condition is growing progressively worse and there is no hope for improvement. What to do? This is one time when your vet cannot make the decision for you. For your vet, the situation is also painful; after all, he too has known your pet from puppyhood. Ultimately, though, common sense and logic and even love forces you to admit that you owe him that final kindness to die quickly and painlessly. The family makes the decision.

Euthanasia

The trauma associated with the putting to sleep of an ailing old dog is psychological. For the dog, there is no physical discomfort. An anaesthetic is infused into his vein. The concentration of the anaesthetic is enough to induce an immediate and irreversible loss of consciousness. Before you can count to five, the whole procedure is over. There must be no regrets, no blame and no self-flagellation. Perhaps later on, when the family has recovered from the loss, you may wish to visit the Animal Clinic and Shelter of the Guyana Society for the Prevention of Cruelty to Animals (GSPCA) and adopt a new puppy or kitten. And the cycle of happiness begins again.

Please implement disease preventative measures (vaccinations, routine dewormings, monthly anti-heartworm medication, etc) and adopt-a-pet from the GSPCA’s Animal Clinic and Shelter at Robb Street and Orange Walk, if you have the wherewithal to care well for the animals.  Do not stray your unwanted pets, take them to the GSPCA’s Clinic and Shelter instead. If you do not wish your pet to have puppies or kittens, you may exploit the GSPCA’s free spay and neutering programme. If you see anyone being cruel to an animal, or if you need any technical information, please get in touch with the Clinic and Shelter by calling 226-4237.