Browsing tag: teeth

Ask a vet online-‘I have an 8 year old Maltipoo who has had teeth and gum problems for the last 4 years.’

Question from Mary Collins O’Hara:

I have an 8year old Maltipoo who has had teeth and gum problem for the last 4years. He had 8teeth pulled, including some teeth on the bottom front, so now he drools all the time and he has the worst breath. I have done several rounds of antibiotics, I brush his teeth but his gums are so tender, he cries. I don’t know what else to do. Please help.

Answer by Shanika Winters

Hi Mary and thank you for your question regarding your dog’s ongoing mouth problem.  An adult dog usually has 42 teeth which are made up of four different types:

12 Incisors which are for nibbling

4 Canines which are for grabbing and puncturing

16 Premolars which are for cutting and shearing

10 Molars which in theory are for grinding up food

Most dogs over the age of 3 years have some form of dental disease, this may be as mild as inflamed gums (gingivitis) and plaque through to infected tooth roots with gum recession.  Along with the functions listed above the teeth help hold the dogs tongue inside its mouth and keep the shape of its mouth by holding the cheek flaps out.  Many dogs cope extremely well after major extractions where they are only left with a few healthy teeth.

The diet may need to be changed so as to make it easier for the dog to eat it, in some cases wet food may be advised. Generally however we recommend some dry food is fed as this helps to keep plaque levels down just by the fact that the food is crunched and scrapes on the surface of the teeth.  There are specially designed dental diets which have fibres in each nugget arranged so as to have maximum scraping effect on the teeth.  As most dog owners are aware not all dogs crunch up their food it is wolfed down rather fast and in such cases dental diets may have little effect on keeping the teeth clean.

You have already mentioned that you are brushing your dog’s teeth, that is an excellent way to keep them clean by slowing down the build up of plaque.  It is important to use tooth paste that is designed for dogs, which is both palatable to them and not high in fluoride as are human toothpastes.  It is also advisable to use specially designed dog tooth brushes, these tend to have a smaller head with a longer handle so it is easier to reach all around the dog’s mouth.  Only light pressure should be applied when cleaning your dog’s teeth, it is easy to be too firm and hurt the gums.

Antibiotics are often used in cases of dental disease to reduce the presence of bacteria in your dog’s mouth.  The bacteria may be present; as part of tooth root infections, attached in the plaque, and even in what appears to be a clean mouth can still contribute to bad breath (halitosis).

Why does my dog have mouth problems?

In order to determine why your dog is drooling, has bad breath and sore gums it is essential that he has a full examination by your vet, there can be underlying diseases that are causing your dog’s symptoms such as poor immunity (ability to heal and fight infection), underactive thyroid gland (Hypothyroidism) and over production of steroid (Cushings disease) to mention a few.  Many of the underlying illnesses can be picked up on blood tests which are done on a sample of your dog’s blood collected by your vet and then sent to a laboratory for analysis.

What can be done to help my dog?

Once your vet has ruled out any underlying diseases, then a close look at your dog’s mouth is necessary, there may be further dental disease needing treatment such as further extractions, sometimes your vet will suggest performing x-rays to check if there are infected tooth roots where the piece of the tooth visible appears healthy.  Some dogs have skin folds around their mouths and these can trap saliva, the skin becomes inflamed, infected and smelly.  The skin folds can be treated by use of antibiotics, trimming the hair from the skin fold and cleaning with an antiseptic solution.

If there is no need for any further dental treatment, then some dogs benefit from the use of antiseptic mouth sprays or drinking water additives to help reduce bacteria levels in the mouth.

Regular courses of antibiotics can be used under the direction of your vet, in some cases this is the only way to keep some dog’s mouths clean and healthy.

So where there are any ongoing dental disease issues it is vital to work with your vet to find the best plan of action to keep your dog happy, healthy and comfortable.  I hope that this has helped to answer your question.

Shanika Winters MRCVS (Online Vet)

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!

Looking after the Older Horse

When I was training as a vet, a 20 year old horse was considered really quite old. Now, however, I regularly find myself working with healthy horses in their late twenties and thirties – even a few that go on into their forties!

That said, horses don’t age uniformly – one may be sprightly and fit at 30, while her paddock mate is really feeling his age at 20, so there’s a lot of variation. The challenge is maintaining them at the best quality of life for as long as possible.

To do so, we need to consider three things:

• Work and exercise
• Preventative health (worming, dental care etc)
• Disease management and medication

I’ll deal with these in sequence, although really they are of course all interconnected.

Work and Exercise

PerryI’d like to introduce Perry, a horse I’ve known for many, many years. Born in 1986, by 2002 Perry was a successful Eventer, competing on the Affiliated circuit, and usually well up in the places. However, by then he was starting to slow up a bit, and his then-owner decided it was time to reduce his workload. He was struggling in particular with the dressage and show jumping, so they sold him on to a friend of mine as a Pony Club horse for Tetrathlon. All he had to do was carry his (fairly novice) rider round a cross country course – the phase he enjoyed the most anyway. Relieved of the need to work in an outline, or in collection, he flourished at Tetrathlon, going on to compete at the National Championships.
Of course, in time, his low-grade arthritis (which I’ll talk about more later) meant that he was struggling with the cross country requirements, and he moved into a semi-retirement as a hack. He’d seen it all, done it all, and was as close to 100% in traffic, tractors and low flying aircraft as any horse could be.
For most horses, as long as they can work, they want to – generally (and there are always exceptions!), it isn’t in a horse’s best interests to take him out of work one day and retire him to a field. A gradual wind-down over several years is kinder, and helps to keep him interested and alert.
So, by changing career, Perry had an extra five years of competition, and then many more years of useful work – simply because his various owners were wise enough not to over face him, but to play to his strengths.

Preventative Health

I’ve talked before about the importance of regular dental work – in the older horse, it is doubly important. As the horse ages, his teeth undergo a number of changes. Although it appears that teeth grow constantly, that is in fact an illusion – the adult teeth are pretty much a fixed length, but most of the tooth is hidden away within the gums (the reserve crown). As the tooth is worn down by chewing, more of this reserve is extruded (which is, by the way, the basis of ageing horses by dentition). However, sooner or later, this reserve is expended, and the teeth “cup out”, becoming small, loosely held, concave structures, of limited use for chewing. Good, regular dental care can help delay the onset, and can help the horse to manage as the teeth cup out. Remember, as long as there are a few pairs of teeth in occlusion (i.e. Facing each other), the horse can still chew, he’ll just be very slow about it! In my experience, teeth generally start to cup out about 30-35 years of age, but it depends on their dental history – more use and wear and tear means the teeth are ground down faster.
Worming is also inceasingly important in the older horse, simply because although they may have higher immunity to worms (this is still debated, but does seem likely), they also have less reserves to cope if they have a heavy infestation. The spring is a particularly risky time, as sometimes large numbers of small redworms can emerge all at once, causing massive gut wall damage. It is important to make sure that at some point over the winter, you use a wormer that is active against hibernating (hypobiotic) worm larvae – currently, the only wormers on the market that have this activity are a full 5 day course of Panacur, and (reportedly) Equest.

Foot care is always important, as older horses can suffer some terrible hoof capsule problems if left untreated.

I always recommend that people keep up vaccinating their horses, even if they’re not competing or going out. Equine influenza probably isn’t essential in a stay-at-home horse or pony (although they can still contract it if they’re in contact with a younger friend who does go out and do), but Tetanus vaccination is essential. Just because a horse is old doesn’t mean you can stop vaccinating, because tetanus kills horses of any age just as easily. It’s also a really useful opportunity to have a general “MOT” and get your vet to check the horse over thoroughly, to detect and problems before they become too serious.

Disease Management

Although many horses lead a long and healthy life, the probability is that as they enter old age, they will suffer from one or more “chronic diseases”. These are generally low-level conditions, and in the older horse are usually manageable rather than curable. Probably the most common are arthritis and Cushing’s disease, but malabsorbtion diseases and some tumours aren’t that uncommon either.

The key factor is managing the disease in such a way that the horse doesn’t suffer from the symptoms, and is able to keep up as much work as possible, for as long as possible.

Arthritis is perhaps the commonest condition of older horses, and those that aren’t so old. In most cases, it is due to simple wear and tear on the joint surfaces. The harder a horse has worked, the more rapid the onset of arthritic changes. It’s often the case that, initially, a horse will have trouble working in an outline, and perhaps with show jumps, but hacking and cross country, with it’s more open jumping style, is less of a problem. This of course was exactly the case with Perry. Managing arthritis is a lot more than just monitoring exercise, however – nowadays, we no longer need to just accept “a bit of stiffness” in the older horse. It’s often best to use several different strategies. I generally recommend a combination of joint supplementation (feed supplements such as Cosequin and Newmarket Joint Supplement are the most popular, while injectables like Adequan are more expensive but possibly more effective) with analgesics (bute and/or Danilon, usually) as required. Although painkillers like bute don’t address the underlying disease, they reduce the inflammation and associated pain. Although there can be side effects, it really isn’t fair to put a horse through the pain and discomfort of arthritis without some pain relief; if side effects are a particular concern, Danilon has a much lower risk, although it seems to be a little less effective. Its usually best to start out using bute only as required, and then build up the dose as necessary. Perry, for example, started using bute about 10 years ago, but just a sachet or so immediately after a competition. As he’s got older, he uses more, and at the moment he’s on an average of 4-5 sachets a week – enough to keep him comfortable (and galloping round his paddock like a yearling!).

Cushing’s disease (hyperadrenocorticism) is most common in older horses, and is caused by a micro-tumour in the pituitary gland. This results in an excess of circulating cortisol (a stress hormone), that causes the characteristic symptoms of abnormal fat pads (typically over the eyes and as saddle-packs), excessive drinking and urination, and increasing susceptibility to minor infections and laminitis. Ironically, the “classic” shaggy coat of the Cushingoid horse isn’t entirely due to cortisol – the presence of a tumour in the pituitary causes a malfunction in the part of the brain that controls body temperature, causing retention of a winter coat for longer. Cushing’s isn’t curable in horses, but symptoms can be partially controlled by management (regular clipping, diet and exercise control and remedial shoeing), or largely eliminated with some medications – Cyproheptadine (Periactin) may be of some use; however, Pergolide (Prascend) is highly effective, and is licensed for the treatment of Cushing’s.

Gut problems of one sort or another are also more common in older horses – these may be malabsorbtion issues, caused by thickening of the gut wall, or an increased susceptibility to colic. This may be due to a diffuse Lymphoma (a cancer of the white blood cells) which is the commonest tumour of older horses. In these cases, the key is to feed a highly digestible, high feed value ration, possibly with a probiotic to enhance digestion.

Tooth loss is also a problem in the older horse – as I discussed earlier, eventually the teeth “cup out”, at which point there’s little more that can be done, dentally. The next phase is that the tooth falls out, leaving naked gums. I remember once doing a regular tooth rasping on a 38 year old mare – I put a hand in to have a feel around, and four teeth fell out in my palm… (she actually did better once the teeth were out than she had in months!). An edentulous (toothless) horse needs a soft, ultra-high fibre diet; typically a mash made from fibre pellets or pencils. Horses can live healthily for quite some time on such a diet – however, once your horse has reached this stage, it is probably time to consider how long you can fairly keep him going.

If you can stay on top of all these points, you have every chance of keeping your older horse going for a long, healthy life – as Perry has had, and indeed continues to have.

If you are worried about any symptoms your horse or pony is showing, please talk to your vet or check how urgent the problem may be by using our Interactive Equine Symptom Guide written by expert equine vets.

How can you tell if your pet is in pain?

Domino-sleeping
It seems a simple enough task, to be able to tell when your pet is in pain but actually it can be a lot harder than you think. Animals have been programmed over millions of years of evolution to hide when they are sore or in discomfort, otherwise predators and competitors would pick up on the signs and target them. So, as owners, we need to be vigilant to quite subtle changes in our pet’s behaviour that could indicate they are in pain, and ensure they don’t suffer in silence.

Depression

Most of us assume that if an animal is in pain they will cry out or whine but actually the opposite is true. Chronic (low grade and continual) pain is very depressing and often animals learn to cope with it and show few outward signs of a problem, other than maybe being quieter than normal or sleeping more. The problem with is that this sort of pain is common in older pets, for example with arthritis, and this is what we expect them to do anyway. However, even in excruciating pain our pets can be very quiet and withdrawn. I once saw a cat with a very badly broken leg who had managed to drag himself home, curl up in his basket and was so calm his owner didn’t think he was in any discomfort, until she saw the x-rays! Often with this type of pain, it is not until you give your pet some pain killers, and see the difference in their behaviour, that you realise how sore they were in the first place.

Lameness

A very common sign of leg pain, from pulled muscles to arthritis, is limping. Other than this the pet can seem quite well and cheerful, and often won’t respond to the leg being moved about or felt, which can lead to their owners thinking they aren’t in any pain, when nothing could be further from the truth! Lameness is a very common problem and if it lasts more than 24 hours (even if it is intermittent) the pet should always be checked over by a vet.

Smelly Breath

All pets have smelly breath to some degree (!) but halitosis can often be the only sign, without looking in their mouths, which some pets are reluctant to let their owners do, of painful teeth problems. Often people assume if their pet is eating then they aren’t in any dental pain but this isn’t the case, as an animal’s drive to eat will always overcome any soreness. In fact, if a pet does stop eating because of mouth pain, it is likely to be excruciating and will have been there for some time. Other signs of mouth pain include tartar build up on the teeth and swollen gums. If you are concerned, most vets run free dental clinics, so give them a ring and pop along.

Weight Loss
Bunnies

Our smaller pets, like rabbits and guinea pigs, are even better than cats and dogs at hiding when they are sore because, as prey animals, if they show any signs of being ill, they will be quickly singled out by predators. So their owners have to be even more vigilant to spot problems. In fact, it is not uncommon for these pets to be brought into our clinics close to death, their owners distraught that they have missed signs of a problem or thinking they have fallen ill very quickly, when it is more likely they have been poorly for a while but have managed to hide their symptoms. However, one thing which always happens if these animals are in pain or poorly is that they will lose weight, even if they appear to be eating normally. So, weighing your small pets regularly is a great way of monitoring them and any changes in a downward direction should always be taken seriously.

Our pets can’t speak for themselves and in many cases are too brave for their own good; trying to pretend that everything is fine when in fact they are in pain and suffering. So, all good owners should be alert to the small changes that could indicate a big problem and make sure they get them treatment they need and deserve.

If you are worried that your pet may be in pain, please contact your vet. If any other symptoms are present why not check the urgency of the problem by using our Interactive Symptom Guide?

Tooth Care for Horses

Jack_in_StableI’ve been thinking about teeth this week – horses’ teeth in particular. That’s partly because my own horses are due for a dental check up, but also because there’s been a report in one of my journals that really made me think how much dental work has moved on in the last ten or fifteen years!

When I was training as a vet, an equine “tooth check” mainly involved grabbing the tongue, having a quick feel round, then rasping away at anything that felt sharp. If you were properly equipped, you’d use a gag (aka a dental speculum); if not, many vets were happy to work around the horse’s tongue and teeth.

Nowadays, that sort of cursory examination really isn’t good enough in many cases. There are a lot of very well trained and experienced vets, as well as good equine dental technicians (EDTs) who would probably need a sit down if they saw some of the things that were commonplace not that long ago!

We also have many more “paraprofessionals” now – EDTs who have a variety of qualifications, and there seem to be fewer quacks out there than there used to be. That said, if you’re asking an EDT to do your horse’s teeth, check out their qualification first: if something goes wrong, some insurance companies won’t pay out if the EDT isn’t registered with the BAEDT (British Association of Equine Dental Technicians).

For a start, a proper tooth check up needs to include a clinical examination of the horse – is he losing weight? Are there any lumps or bumps on her head that might indicate a tooth root problem? How well are his intestines working to digest his food? It’s also true that it is not possible to do a full mouth exam without a gag of some sort. If you’re brave enough, yes you can feel the outside edges of the teeth by running your hand up, but anyone who thinks that holding a horse’s tongue will stop them biting your fingers has either been very lucky, or hasn’t tried it! A gag really is essential so you can examine the inner surfaces of the teeth, and also so you can have a look at the mouth. Although you can learn a lot from feeling, there are some conditions that are easier to detect and evaluate by sight, using a head lamp or a pen torch to have a good look around the mouth.

Now, of course, we have to consider the horse himself. In my experience, about 1 in 3 horses aren’t safe even to examine without some degree of sedation. Yes, you can often get away with it – but once you’ve put a gag in, you’ve effectively given the horse a lethal weapon. He doesn’t have to turn his head that far or that fast to knock someone out, or worse. I’ve only had this happen once while I was working on a horse, but that’s enough for me to be very certain I don’t want anyone else to be injured.

Of course, only a vet can legally prescribe sedatives to a horse, so in many cases, this is where EDTs have to call in backup. And please note, I’ve found that ACP (e.g. sedalin) barely takes the edge off a nervous horse; for dental work, injectable sedatives are preferable.

Once the exam is complete, we need to decide what we’re going to do with whatever we’ve found. Most horses, especially those who are seen regularly, will have a few sharp edges where the tooth has grown into sharp points as part of its daily wear pattern – remember, horses’ teeth grow down from the roots constantly through life, and are worn away by the teeth opposite. If they don’t line up properly side to side, we get sharp edges and points (usually on the outside, by the cheeks, at the top and the inside, by the tongue, at the bottom); if the misalignment is front to back, we get hooks (at the front of the first cheek teeth, usually on the top) and ramps (at the back of the last cheek teeth, usually on the bottom). All of these changes can make it painful or difficult to chew if they are allowed to continue, and sharp edges can cause mouth ulcers. I’m sure everyone knows how painful those can be! It’s even worse if a tooth is missing – the opposite one will grow down into the gap. In severe cases, this can cause “tooth lock”, where the horse is unable to open its mouth because the overgrown tooth has locked into the gap left by the missing one.

If it’s just a matter of sharp edges, or small hooks, these can usually be fixed with a hand rasp; however, if they’re large a power tool may be required. Power tools come in two forms – either a reciprocating power-float, or a rotary dremel are usually used; personally, I prefer a dremel because the blade is guarded so is less likely to damage the soft tissues of the cheeks and tongue. One important thing to remember about power tools is that altough they make the work easier, they do impose some problems of their own. Firstly, it’s very easy to take too much off – I remember once seeing a horse whose owner was very worried because she’d had “the tooth man” (who wasn’t a vet or a qualified EDT) out and then the horse had been unable to eat afterwards. On closer examination, he had managed to power float the teeth as smooth as billiard balls so the mare was no longer able to grind any food. She had to live on porridge and mashes for several months, until the teeth wore in and the grinding ridges reappeared. The second issue is that power tools often generate a lot of heat, and if left applied to the tooth for too long can actually kill the tooth so that it rots and needs to be removed. Some tools have a built in water spray for cooling; otherwise, I only leave the cutting surface on the tooth for a matter of seconds, remove it, apply water if needed, then do a bit more.

Now, once again we need to consider sedation; the more you need to do, the more likely it is that you will need sedation, and personally, I almost always sedate horses if I’m going to use power tools like a dremel. I didn’t always follow this rule, until one day a very calm pony I was working on jumped forward and swallowed the running dremel. Fortunately, all was well in this case, because as I felt the dremel vanish down the pony’s gullet I managed to cut the power, and then retrieve it before it was all gone, but it certainly made me think twice before working on unsedated patients!
In addition, even a quiet power tool makes vibrations that the horse will feel through the bone of his skull. My experience is that it’s a very rare horse that will stand perfectly still and allow you to do a proper job, rather than rush through and say “that’s fine” just before you think the horse is going to start throwing himself around the stable!

There are a number of other problems we come across on regular check ups as well. One of the commonest is misaligned arcades, where one tooth grows out at an odd angle – often straight sideways into the cheek. These require very careful treatment, and often need seeing on a very reglar basis (I had one which needed seeing every 6 weeks a one point).

Another major problem I’ve seen is where there’s a really painful tooth, but nothing obvious on examination. These are often due to tooth root abscesses. Unfortunately, a horse with an abscess like this can’t usually be fixed with a simple course of antibiotics; we need X-rays to see exactly which tooth is involved and how badly, and often we need to remove the tooth. If it’s already pretty wobbly, this can sometimes be done in the field under deep sedation, although it tends to be a lot of physical work to rock it and work it out of its socket. If it isn’t wobbly yet, it usually means the horse needs to come into a hospital facility and have the tooth removed surgically. This can frequently be done under sedation, but occasionally a general anaesthetic is required.

You can find information about other tooth problems that horses can suffer from here: http://www.baedt.com/?c=5386

That said, the vast majority of dental problems I’ve seen can be managed at home, with a good examination, sedation if needed, and then appropriate treatment with either hand or, occasionally, powered tools.

Will I be sedating my horses? One, definitely yes – I have no wish to fight with a 17hh stroppy eventer! The little pony, on the other hand, I’ll see how she feels about it; if I can get away without, I certainly will, but with her there are no guarantees…

If you are worried about your horse’s teeth, talk to your vet or check out any symptoms with our Interactive Horse Symptom Guide to see what to do next.

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.

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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