Browsing tag: mouth

Keep Your Rabbits Gnashers Gnawing Gnaturally!

Bunnies cropThe most common cause of illness in rabbits is poor dental health, they suffer terribly with their teeth and problems can become so severe, it is not unusual for bunnies to be euthansed because of them. However, the news is not all bad because it is actually very easy to keep a rabbits gnashers gnawing gnaturally!

Rabbits have teeth that grow all the time and are kept short by both a natural diet of tough, woody grasses and also by the upper and lower sets grinding on each other. However, since bunnies have been domesticated their diets can be very different from the wild, often consisting of more soft rabbit food and vegetables than hay and grass, and this is what causes the problems. Firstly, because the teeth aren’t worn down by these softer foods and secondly because they can become calcium deficient; leading to the jaw bones softening, the teeth shifting and no longer being in alignment with each other. This problem is particularly prevalent when the rabbit is fed the muesli type diets, which they tend to selectively eat by picking out their favourite bits and so they don’t get a balanced diet.

When they over-grow, the molar teeth can develop sharp spikes that dig into the sides of the mouth or tongue and cause a lot of pain. The incisor teeth can become extremely long and curl out of the mouth (which makes them easy to spot) or, worse, into it and dig into the flesh and bone. Again this is very painful and makes it almost impossible for the rabbit to eat. Also, the roots of the teeth can become impacted because of the back pressure and as well as being very sore, can also become infected; causing nasty abscesses which can be extremely difficult to treat.

Spotting dental problems is not always easy because rabbits will hide when they are poorly but checking their weight regularly, examining their mouths and carefully monitoring their appetite are all good ways of picking up on issues. To check your bunny’s mouth, hold them on your lap and gently lift their lips up to have a look at the incisor teeth. These should be smooth, even and short. It is more or less impossible to check the molar teeth without a special scope but by feeling along the upper and lower jaw bones you can pick up abscesses and swellings.

If you are at all concerned you should take your rabbit to your vet. The treatment of over-grown teeth can be a challenge and once they have developed them, many bunnies need to go in regularly for them to be trimmed, which can require an anaesthetic. Over-long incisors can be removed, which is a good idea because it solves the problem and the rabbit will still be able to eat without problems.

However, by far the best thing is prevention rather than cure and this is done very easily by making sure your bunny’s diet is as similar as possible to that of their wild cousins; lots and lots and lots of chewy hay and grass!

What Your Rabbit Really Needs

Bunnies crop

Rabbits are really popular pets in the UK, second only to cats and dogs, and they can make great companions. However, despite peoples best efforts their needs are often misunderstood and rather than being treated as the intelligent, social animal they are, many are condemned to a life of loneliness and boredom in a cage at the bottom of the garden. It is not difficult to look after rabbits in a way that will keep them both healthy and happy, so what do they really need?

The most important thing you can do to keep a rabbit healthy is feed them a balanced diet. The most common problems that vets see in rabbits are over-grown teeth, tummy upsets and obesity related disease, all of which are directly related to them being fed incorrectly. The vast majority of a rabbit’s diet, at least 80%, should be good quality hay. As a rough guide, every day a rabbit should eat a pile of hay as big as it is. Rabbit’s teeth grow continually and without hay to grind them down, they can develop painful spikes, which rip into the tissues of the mouth, and nasty abscesses in the roots. Hay is also required for good digestion (rabbits can easily die from upset tummies) and helps prevent them getting fat. In addition to hay rabbits should have a small amount of fresh vegetables every day, half a handful is enough and a small amount of pelleted rabbit food, no more than a tablespoon twice a day. This is often where people go wrong, leaving the rabbit with an over-flowing bowl of rabbit food, which, because it is high in calories and very tasty, it is all they eat, giving them a very unbalanced diet.

Rabbits are extremely social creatures, in the wild they live in large family groups, and they should never be kept on their own. The best thing to do is to buy sibling rabbits when they are young. You can introduce rabbits when they are adults but it has to be done with care as many will fight at first. However, it is important to persevere and get the right advice as rabbits are miserable when alone. They are also very intelligent, so make sure they have a variety of toys in their cages and runs to keep them entertained. These don’t have to be expensive, there are plenty of commercially available rabbit toys or just a couple of logs they can play on and nibble are fine.

All rabbits should be neutered, even if they are kept with others of the same sex, and this can be done from the age of 4 months for boys and 6 months for girls. Neutered rabbits make much calmer pets and are far easier to handle. They are also much less likely to fight with each other; 2 entire males kept together, even if they are siblings, can become very aggressive once their hormones kick in. Neutering also has huge health benefits, particularly for the females, of whom 80% will get uterine cancer if they are not spayed.

For most people the whole point of owning a rabbit is because they are cute and cuddly creatures but anyone who has tried to pick up a startled or poorly handled rabbit will know that they can do a lot of damage with their strong nails and back legs! So, it is important that they are played with and handled everyday so they are used to human interaction. Rabbits are prey animals in the wild and their only defence mechanism when frightened is to struggle and try to run away. This is why they don’t always make great pets for children, who can be, unintentionally, quite rough or unpredictable in their handling and it is a big reason why rabbits bought as pets for children end up forgotten and neglected at the bottom of the garden; because no child will play with a pet which has hurt it. However, with regular, careful handling from an early age rabbits can become great companions and members of the family.

Rabbits can make great pets but they need just as much care and attention as other animals and shouldn’t be seen as an ‘easy’ option. Although they are often bought for children they are not always the most suitable pet for young people and they should always be kept with at least one other rabbit. However, they can be real characters once you get to know them and really give back what you put in, provided, of course, you give them what they really need!

For details on examining a rabbit, neutering and vaccinations, take a look at our Pet Care Advice pages. If you are worried about any symptoms your rabbit may be showing, talk to your vet or use our Rabbit Symptom Checker to help decide what to do.

“Please don’t tell me I have to brush my cat’s teeth, because I’d rather keep my fingers…”

Lucien's teethMy last article talked about a few of the dental problems most commonly seen in cats, and how easily they can be missed by both owners and vets. Remember, a cat with dental disease will probably act just like a healthy cat, but that doesn’t mean they’re not in pain! I’ll continue now by mentioning some of the preventative measures and treatments that can help keep your cat’s mouth healthy and pain-free.

What can I do to help prevent dental disease in cats?

Of the diseases mentioned previously, periodontal disease (gum disease) is by far the most common but fortunately the easiest to help prevent. Although genetics plays some role in whether or not a particular cat is going to have bad teeth, there are several things you can do to help keep the pain and inflammation to a minimum:

Brush the teeth – OK, this is admittedly not going to work for everybody. Or even most people. Or really even more than just a few people. But it’s worth giving it a try because if you are lucky enough to have one of the most chilled out cats on the planet, tooth brushing is the gold standard in preventative dental health care. By removing the bacteria before they are able to cause disease, the whole disease process is stopped in its tracks. Just use common sense and don’t get bit – if your cat doesn’t even like to be picked up or stroked, he probably won’t take too kindly to you shoving a toothbrush in his mouth.

Dental rinses or gels – These products work by killing off some of the bacteria in the mouth before they have a chance to cause disease. For cats (who let’s face it, probably won’t let you get anywhere near their mouths), one of the most sensible options is an antiseptic liquid (often containing chlorhexidine) that you put in their drinking water which can have the added benefit of freshening your cat’s breath. In most cases, if it sounds too good to be true, it probably is so although products like this can have some beneficial effect, they are not likely to solve all of your problems.

Special dental food – Some vets still say that plain old dry kibble helps keep your cat’s teeth clean. And many food manufacturers make similar claims to that effect. Although there is likely to be some truth to this, it is probably not as effective as we like to think. Most dry food is small and easy to swallow whole, so only a small percentage of it actually gets chewed. And I’ve seen plenty of cats who have seen nothing but dry food their whole lives with horrible teeth. If you want to help prevent dental disease with your choice of food, do your research and choose one that has been scientifically proven to decrease plaque formation. These foods tend to be more expensive, larger in size so they have to be chewed thoroughly before swallowing, and made in a special way such that they achieve maximum contact with the tooth surface. Ask your vet for their preferred dental health diet, which is often only available by prescription.

Regular dental cleanings at the vet – Unfortunately, even if you could train your cat to open her mouth and sit still on command, this would probably still require general anaesthesia. Vets use the same kinds of dental instruments on cats that dentists use on people (ultrasonic scalers, polishers, and drills) and the procedure itself varies from mild discomfort (with a simple scale and polish) to severe pain (with a surgical tooth extraction) and the use of local anaesthetics is not as reliable in cats because they can’t tell us what they feel. Also, dental cleanings require a lot of water and it is essential that an endotracheal tube (soft rubber tube inserted into the trachea or windpipe after they are asleep to aid breathing) is placed to prevent water from being breathed into the lungs. Although a general anaesthetic may sound like a risk that is greater than the benefit of clean teeth, most people both overestimate the risk and underestimate the benefit. When you consider that severe periodontal disease can have potentially fatal consequences, a dental cleaning can actually help save your cat’s life. Many people are (understandably) also concerned with the cost of having their cat’s teeth cleaned. I can assure you that if vets had figured out an easier, faster or less expensive way of cleaning animals’ teeth, we would all be doing it. And by having routine dental cleanings throughout an animal’s life, you can help prevent major vets’ bills down the road from complicated surgical tooth extractions or related systemic illness. As they say, an ounce of prevention is worth a pound of cure!

How can I tell if my cat has dental disease?

Signs of severe dental disease or pain in cats include bad breath, wobbly teeth, excessive salivation or drooling, teeth chattering or strange gnawing motions. Other symptoms can include lethargy, decreased appetite, depression or hiding/not wanting to be touched, although these can be seen with almost any illness! Another important yet subtle sign is whether or not your cat actually chews their food before swallowing it. Even some cats with no teeth at all will happily eat dry food by swallowing it whole, so instead of just assuming that everything is ok, try to notice how much crunching they do with each bite. If you’re particularly observant, you may even notice your cat chewing more on one side of the mouth (the healthier side) to avoid touching a painful tooth.

You may not ever notice them in pain, but more often than not owners remark after the painful teeth are removed that their cat is acting like a kitten again. This is further proof that they show such subtle signs of pain that they are often missed by owners and even vets, and although it is nice to be able to help them feel better, how much nicer would it be to prevent these problems from occurring in the first place! If you have noticed any of the symptoms listed above or are otherwise worried about your cat’s teeth, please speak to your vet. Because until your cat learns how to phone us herself, she’s relying on you to make sure that she doesn’t have to suffer with painful dental disease in silence.

The Importance of Dental Care

There are two types of dental care for pets: that given by the owner at home, and that given by the vet in the surgery. Both are very important to the wellbeing of our pets.

It is thought that two thirds of dogs and cats over 3 years old suffer from dental disease. This is not a cosmetic problem, although the appearance and smell from an affected mouth can be very unpleasant! More importantly, it is a cause of pain and ill health.

The most important type of home dental care is brushing the teeth. This is best started when the dog or cat is very young, even though we hope there will be no tooth problems at that age. This means that brushing will not hurt. Special veterinary toothpaste and a soft brush are needed, and it is important to brush every day. It might take time to get your pet used to the idea of tooth brushing, but at this age you can start gradually with paste on a finger and work up to introducing the toothbrush. Human toothpaste is not suitable for animals as they contain additives like fluoride which are meant to be spat out and not swallowed, but animals will lick their teeth and swallow the paste.

Some diets are specially formulated to help reduce dental plaque. The hardness and shape of the kibble help reduce formation of plaque and tartar.

Other products that can be used at home include mouth rinses and gels to rub into gums. Carefully designed chews and toys can also help to provide some mechanical cleaning of the teeth, but daily brushing is the most effective preventative.

Bacteria are present in all mouths, but only some of them cause a problem. They cause most problems when there is plaque on the teeth or in little crevices between the teeth and the gums. Plaque builds up over time in all mouths and is made up of substances contained in the food and the saliva. Over time, plaque hardens and mineralises to form hard calculus (or tartar).

In some breeds there is a higher likelihood of dental disease because of the shape of the head or overcrowding of the teeth. Another factor is the way the animal’s own immune system responds to the problem in the early stages, so you could have two animals with the same lifestyle and diet but with different amounts of dental disease. This immune response is particularly important in gum disease in cats (gingivitis).

Broken or cracked teeth provide a focal surface for plaque and bacteria, and so do retained temporary teeth. The so-called “baby teeth” usually fall out by about 6 months of age, to be replaced by the adult set. If a first tooth does not fall out and an adult tooth erupts alongside it, there is a crevice which traps food debris and allows bacteria to multiply.

Gum changes occur alongside dental disease, starting with redness and inflammation and mild discomfort, which can progress to the formation of pockets between the gum and tooth which will eventually destroy the attachment of the tooth.

When your vet examines your pet’s mouth, he or she will be assessing a number of things. After checking the general shape and health of the whole mouth, they will look for any lost, loose, broken or retained teeth. They will assess the teeth and gums for inflammation and calculus, and may need to use a probe at the gum edge. In cats in particular, they will also be checking for resorptive lesions, which occur when the surface enamel is lost, followed by the deeper structures of the tooth, eventually exposing the sensitive nerves.

If dental treatment is recommended, it will be carried out under general anaesthetic. Even in the most co-operative of patients, it is not possible to reach every surface of every tooth with the animal awake. It is also difficult to predict whether any extractions or x-rays will be needed until the teeth have been thoroughly cleaned. This also makes it notoriously difficult to estimate the cost in advance, but your vet should be able to give you a rough estimate or a range of possible costs if you ask.

As with any anaesthetic it is usually advised to have a blood test to check the pet’s general health, and in particular how well the liver and kidneys are working. This is because they are required to metabolise, or break down, the anaesthetic drugs. However, it does not mean that anaesthetics cannot be given if there is a problem with liver or kidney function; it usually means extra precautions will be taken, the choice of drugs may be different and intravenous fluids may be given. Most patients needing dental work tend to be middle-aged or older, but this does not make it too risky to give an anaesthetic. As long as the animal has been fully examined and blood-tested, the risks of the anaesthetic are often smaller than the risks from the dental disease itself.

Sometimes owners want to delay this type of treatment for as long as possible, especially if the dog or cat still has a healthy appetite, but this can make matters worse. If the animal is off its food because of dental disease, it is already quite advanced and will need much more treatment, and the animal’s general health may have deteriorated during the delay.

Antibiotics are often needed before and after a dental procedure. If bacteria from the infected mouth enter the bloodstream, there is a risk that they may settle in places like the heart valves.

The equipment used in a vet’s surgery for dental work is very specialised. An ultrasound descaler is used to remove calculus from teeth and another attachment is used to polish the teeth. Several hand held instruments are needed to do simple extractions. More complex extractions, where teeth have several roots, may need a full surgical kit. An x-ray machine and developer is needed for many dental cases so that hidden structures can be visualised. All of this equipment has to be sharpened or maintained and sterilised between each procedure.

Although the most common dental procedures carried out by vets are descaling, polishing and extracting teeth, dentistry for animals is becoming more sophisticated all the time and there are specialists available to deal with the most complex cases.

Regular examination of your pet’s mouth, both at home and in the surgery, is important in spotting problems early and planning the right treatment. As well as dental disease this can also help with early detection of mouth and throat tumours, which are not uncommon. Ideally the mouth should be examined at least once every 6 months.

A week or two after a dental procedure, when everything is healed, is a great time to start brushing teeth again, or for the first time if it wasn’t started as a puppy/kitten. If unsure about the brushing technique, ask your vet or nurse for advice or a demonstration.

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Epulis: a gum problem seen mainly in boxers.

Tilly aged 1 year and Martha aged nearly 11

Tilly aged 1 year and Martha aged nearly 11

Although I love dogs of all shapes, sizes and breeds, I do have a bit of a soft spot for boxers. We have owned one or more for over 20 years.

Personality-wise, you might describe the boxer as a mixture of boisterousness, joyfulness, fearlessness, even brainlessness, but with a huge enthusiasm for everything about life.

All breeds have certain conditions to which they are pre-disposed, that is, more likely to suffer from than their friends of other breeds. One such condition in boxers is epulis, a lumpy overgrowth of gum tissue. Other breeds can get epulis, but not as commonly as in boxers.

Epulis is a benign growth of the gum tissue, which begins as small bumps on the gums and continues to grow, sometimes becoming cauliflower-like and almost enveloping some of the teeth. Unlike a malignant growth, it does not spread to other areas of the body. It can cause problems when the growths become large and when food and bacteria become trapped in the crevices, causing infection, a bad smell and sometimes bleeding. Sometimes the centre of the growth will become quite solid and almost bone-like.

Removal may be necessary if it is extensive or causing these problems. It is carried out under general anaesthetic to prevent pain and to allow access to all the affected areas of the mouth. The growths are simply cut away, either with a surgical blade, or more commonly, by thermocautery or electrocautery. These techniques seal blood vessels as they cut and so prevent bleeding. Thermocautery uses heat to do this, and electrocautery uses an electric current running through the cutting instrument.

Pain relief is usually given after the procedure and any infection will be treated with antibiotics. Examination under a microscope of the removed tissue (histopathology) may be advisable as it can be difficult to distinguish from other types of mouth tumour with the naked eye.

The condition is likely to re-occur given time. Martha, for example, has had two anaesthetics in her life for the removal of epulis, and each time she has also had some minor dental work done. She currently has a lovely full set of nearly-pearly-white teeth and healthy gums.

Jenny Sheriff BVM&S  MRCVS

If you are concerned that your dog may have an epulis you should consult your vet for advice. Use the interactive symptom guide if you are unsure how urgently you need an appointment.

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