Oral Pain In Companion Animals

Finding Help-Restoring a Quality of Life
Conquering Toothaches and Gum Disease
Don DeForge, VMD-Animal Doc AM Multi-Media

“It's the hardest thing in the world to go on being aware of someone else's pain.” 
― Pat Barker

In the last twenty years, modern veterinary dentistry in companion animals has grown from being a "new baby" in the 90's to an actuality with an identity mirroring human oral care in 2012.  

Veterinary dentists are available in most communities.  Please view the Internet for the designation of Fellow of the Academy of Veterinary Dentistry and Diplomate of the American Veterinary Dental College.  These sites will in detail explain the differences between a Fellow and a Diplomate.  It will describe their Mission Statements and the work being done by each group to provide quality and pain free lives to the companions you love by addressing their oral problems.

No pet should live with a toothache or gum disease.  To identify the problem, the pet owner first must be very conscientious in examining their own pet's mouths.  Is there a mouth odor present?  Is there redness or the gums or is pus or blood noted when looking at the area where the gums meet the tooth?  Has your pet stopped eating dry food?  Has your dog stopped playing with their favorite toys?  Is your cat sleeping more or pawing at its mouth?  Does it hurt your dog or cat for you to lift their lips and look at their teeth?  Have your noticed any behavioral changes in your special friend?  Is your pet sleeping more and not interested in the family? Has your pet become aggressive to you or to other family members?  Do you hear teeth grinding or a clicking sound when your pet eats?  Much oral pain is hidden and you must be a good detective to determine if any of the above signs of pain are present in your pet.

During your yearly wellness exam have your veterinarian do a preliminary "look-see" and give you a "run-down" of what the mouth appears to be showing on physical examination.  Ask your doctor if they have oral-x-ray equipment to take tooth x-rays if a problem appears on physical exam to be abnormal.  Without oral radiology, a definitive diagnosis and treatment planning is impossible.  It is not possible for any veterinarian to diagnose an oral problem in an exam room.  Important observations considering the seriousness or advancement of a pathology can be made but the definitive diagnosis of all oral problems is with dental x-ray and sometimes biopsy if oral cancer is suspected.  

We must stop for a moment and discuss pre-anesthetic testing.  No patient should be anesthetized for oral care without a physical exam and a Chemistry Profile and a CBC.  If a patient has heart disease or any other serious medical problem an internal medicine doctor and/or cardiologist should be contacted for a complete review prior to the usage of anesthesia.  

Keep a detailed record of all veterinarians and specialists you have seen in the past and always bring this with you to each and every veterinary consultation appointment that you make. You are your pet's first and foremost advocate.  This information must be in the hand of each and every doctor examining your pet for completion of an updated Problem Oriented Medical Record by your doctor.

After Clearance for Anesthesia is obtained, the safety of the patient under anesthesia is scrutinized by the doctor and a nurse anesthetist technician.  If a patient has an advanced cardiac or pulmonary problem, a veterinary anesthesiologist can be contacted to be part of the health care team during the anesthesia experience.  Other specialists that could be called upon in these extremely ill patients are the Internal Medicine doctor and the Emergency and Critical Care doctor.  The key is to assemble the health care team that is dictated by the condition of the patient on admittal examination and after pre-anesthetic testing is performed.  Never leave a companion in pain.  Seek assistance from your LDVM and with that assistance seek an individual trained in oral care that can remove pain and restore a quality of life.

Listed below are some of the chief oral problems that can produce pain:

• Tooth root abscesses
• Resorptive lesions in cats
• Advanced Periodontal Disease [i.e. gum disease]
• TMJ pathology
• Jaw fractures
• Subluxated and luxated teeth
• Cavities in the crown or root of teeth
• Impacted teeth
• Cat Stomatitis
• Dog Stomatitis
• Fractured teeth from trauma
• Open pulp canals in teeth from fracture or hard chewing
• Cysts and Tumors in the oral cavity
• Pulp Inflammation from trauma

Lastly, all oral care must coupled with excellent pain control.  Pain control begins when the patient is first met and continues until all oral problems are completely treated and resolved.  Remember, animal pain can be hidden.  All of our companions need to be supported so that there is no pain.  This is the responsibility of the veterinary profession coupled with the love of the pet owner as Pain Control Advocates.

Don DeForge, VMD

Animal Doc AM-Multi-Media

Fellow of the Academy of Veterinary Dentistry

Silver Sands Veterinary Center

17 Seemans Lane - Milford, CT. - 06460

203-877-3221

1-800-838-3368

E-Mail DoctorDeForge@yahoo.com

Visit us at www.SilverSandsVeterinary.com

16October2012

The Next 100 Years

Veterinary Medicine of the Future

In this essay, Dr. Don DeForge, Animal Doc AM Multi-Media, explores the Future Road Veterinary Medicine must take to provide and care for the Animal Kingdom 

"Rest when you`re weary. Refresh and renew yourself, your body, your mind, your spirit. Then get back to work." Ralph Marston

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     In their feature A 100 Year Family Tradition-Veterinary Practice News-October 2012, Marissa Heflin reviews a family that has had ties to veterinary medicine for 100 years. Dr. Jennifer Olson graduated from Cornell University in 2009.  Her great grandfather initiated the line of veterinarians in this family when he graduated from Cornell in 1909.  Four generations of graduate veterinarians from Cornell, all from this same family, have carried the "torch" of veterinary medical practice from 1909 to 2009.  It is quite an accomplishment.
    
Jennifer states, "My Dad has taught me to be a good veterinary by example...he has a lot of integrity and is very honest with clients.  When I watch him talk to people, I know he stands by what he is saying.  That's what he would do if it were his cat.  If they can't afford something or it is not within their reach, he tries to work with them.  You get in the business because you like science, you like animals, but really you are taking care of people, and he taught me that."

The next 100 Years of Veterinary Practice in the United States will be challenging.  As a veterinarian who has practiced for four decades in veterinary companion animal medicine and surgery, I have seen great change.  We are quickly moving away from the small privately owned practices to corporate veterinary medicine.  In the corporate model whether it be human or veterinary, there is more efficiency with the sharing of equipment and the localization of multiple specialists under one roof of veterinary care.  With that increase of specialization and excellence in diagnostic equipment comes increased cost to the client.  For this model to help all, we much find a mechanism of veterinary health care management that allows each pet owner to experience the finest in diagnostics and treatment.  This is one of the major challenges of the next 100 years.

Other challenges must be addressed.  As we extend the life of our veterinary patients, there can be no dissociation from senescence with a subtraction of care.  As the aging process brings patients greater discomfort, it spells out a need for an addition not subtraction of special assistance. 

Another challenge is not to lose our identification with client's feeling.  There can be no loss of empathy in our profession.  That means we cannot fail to assist or care for the companions of the poor or discard them from having care when suffering or in pain.  There must never be an abandonment or lack of concern for ALL aspects of the Human-Animal Bond.  This  abandonment concern is not just with companion animals but MUST include farm animals, zoo species, aquaria species, wildlife, and all other members of the Animal Kingdom.  There can never be a separation of the veterinary field from an active pursuit of preventing suffering.  The American Veterinary Medical Association must work hard to create a National Registry of Animal Abusers in all states.  Individuals found guilty of animal abuse in a court of law shall be for life be included in a National Registry which prevents ownership, sale, control, or contact with any member of the Animal Kingdom.

The concept of euthanasia on demand of healthy animals cannot continue. If a client becomes weary of their responsibility of being a caretaker of their companion, they must seek an adoption facility, a rescue group, or a new private owner for this pet.  Veterinarians along with municipal animal shelters must increase their roles and participation in such companion animal transfers of ownership without remuneration.

It is my belief that in the next 100 years the word COMPASSION must be the key to unlocking all of the doors of growth of our profession.  State licenses in veterinary medicine must state:
The individual examined by our State Board according to the laws and regulations relative to registration in this state entitle that individual to the right to practice veterinary medicine and surgery with exactitude, compassion, and respect for all members of the Animal Kingdom.  Compassion is a form of social conscience.  Once veterinary medicine loses social conscience the profession will become "faceless".  A faceless veterinary profession will be scorned with fewer vocations as young brilliant minds look to collateral medical careers.

Dr. Leo Bustad, humanitarian, scientist, educator, and Dean of Washington State University was a pioneer in teaching the significance of the Human-Animal Bond.  We must continue his mission and remember that the Human-Animal Bond is not a credit card or a multi-thousand dollar payment for a veterinary service but a contract in CARING and COMPASSION.  Being a doctor of veterinary medicine is a privilege and with that privilege we cannot ignore the responsibility connected to our doctorate designation.

Dr. Don DeForge
Animal Doc AM Multi-Media
October 9, 2012
Silver Sands Veterinary Center-17 Seemans Lane-Milford, CT 06460
www.SilverSandsVeterinary.com
1-800-838-3368
E-Mail DoctorDeForge@yahoo.com
Visit us on FB at Silver Sands Veterinary