July 23, 2025 • 28 mins
In this episode of Paws, Reflect & Heal, Dr. Rocco Mele and I delve into the critical yet often overlooked topic of dental health in pets. We discuss common dental issues faced by dogs and cats, the progression of periodontal disease, and the unique challenges in feline dental health. We really want to emphasize the importance of early detection, proper dental hygiene, and veterinary intervention. We also address common myths surrounding dental care, the role of inflammation, and preventive measures that pet owners can take to ensure their pets maintain healthy teeth and gums.
Main Takeaways
- Dental care is just as important as diet and exercise.
- Periodontal disease is the most common dental issue in pets.
- Inflammation is a key factor in dental disease progression.
- Brushing pets' teeth is the most effective preventive measure.
- Gentle dentistry often fails to address underlying issues.
- Anesthesia is necessary for thorough dental cleanings.
Chapters
00:00 Introduction to Pet Dental Health
02:20 Common Dental Issues in Dogs and Cats
05:09 Understanding Periodontal Disease
07:53 Retained Baby Teeth and Fractured Teeth
10:11 Unique Challenges in Feline Dental Health
12:53 Stomatitis: Causes and Treatments
15:33 Prevention and Management of Dental Issues
18:24 The Importance of Anesthesia in Dental Procedures
20:59 Debunking Dental Myths
24:29 Conclusion and Final Thoughts
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_01 (00:00):
And he says, Oh, I I see you do veterinary dentistry.
I want to ask you a question.
I said, Okay, go ahead.
Well, the endodontist is workingon me.
And he was a he was a dentist,an endodontist.
He says, I have a dog thatfractured his tooth.
Is that painful for that dog?
And I thought to myself, whatkind of question is that?
I says, absolutely it's painful.
(00:20):
I couldn't believe he was askingme the question.
SPEAKER_00 (00:28):
Welcome to Pause, Reflect, and Heal.
I'm Dr.
Randy Aronson.
In this episode, we're going totake the deep dive into a
subject that I know perplexesmost of my clients.
And it's a shame because if morepet parents knew more about how
to keep their pets' teeth andgums healthy, everyone would
benefit.
Sadly, when it comes to ourpets' health, dental care is
(00:48):
often overlooked.
But I want to stress that it'severy bit as important as good
diet or regular exercise.
In fact, dental and gum diseaseare among the most common health
issues affecting both dogs andcats.
And most would be avoided withreally some good preventative
measures.
In dogs, periodontal diseasetops the list, followed by
issues like broken teeth, toothrot abscesses, and retained baby
(01:12):
teeth, especially in smallerbreeds.
Cats have their own unique setof challenges, including painful
tooth resorption, widespreadgingostomatitis, aggressive oral
cancers like squamous cell.
So with early detection, properdental hygiene, and
veterinarian, most of theseissues can be managed, and as
they said before, preventative.
(01:33):
This is a hugely importanttopic, and we're gonna you're
gonna learn a lot in this show.
So make sure you stay tuned.
I'm gonna bring in with us agreat friend, Dr.
Rocco Mele, to make this happen.
He's very special guest andreally second to none in the pet
dental world.
Dr.
Mele, welcome to the show,buddy.
SPEAKER_01 (01:51):
Thank you, Randy.
Really happy to be here.
Thanks a lot.
SPEAKER_00 (01:54):
Uh before we start, I just want to ask a favor of
our listeners.
If you like our podcast, you canhit the subscribe button.
Give us a like if you'rewatching on YouTube, and if
you're on the podcast apps suchas Apple or Spotify, please
follow us.
Um your comments are alwayswelcome, no matter what
platform.
And lastly, follow me onInstagram at Dr.
(02:15):
RandyPetvet.
Thanks for your support.
Rocco, let's let's talk about umsome general questions.
So um what do you think youryour most common dental or gum
diseases that you're seeing indogs and cats?
And a little bit of differencebetween the two species, if we
could.
SPEAKER_01 (02:32):
Usually the the most common thing that I see, and
that we see, I think, indentistry, is uh periodontal
disease.
Very common in both species, uh,more in dogs, I think, than
cats.
Cats have their unique problems,that's for sure.
But periodontal disease, we alsosee a lot of trauma, fractured
teeth, uh, oromaxillofacialtrauma from uh accidents,
(02:54):
congenital issues.
We always see malocclusion,missing teeth, retained baby
teeth.
And there's also something thatwe we see more often than not is
uh is oral cancer anymore.
We see a lot of oral cancers, uhbenign and malignant.
So I I guess uh at the top ofthe list, periodontal disease
would be would be the mostcommon thing that we deal with.
(03:14):
Uh we deal with others too, butthat's the most common.
SPEAKER_00 (03:17):
So let me ask you a question on that.
Um you know, it's so common inpets.
In your view, what do youactually think is happening in
the pet's mouth when thisdevelops?
Like tell us how thatprogression happens.
SPEAKER_01 (03:28):
Um you know, what happens is uh it starts with
just I don't know the exactcause, quite honestly.
Some people genetically there'sa problem, sometimes people say
diet.
I I really just don't know.
All I know is that when itstarts, it starts with uh plaque
in the mouth or any type ofinflammation.
Inflammation is the realproblem.
(03:49):
And if left unchecked, then theinflammation it just progresses.
It progresses to periodontaldisease, different grades of
periodontal disease.
And also, we see with dogs thatthat have uh chronic chronic
oral problems, if you do labwork and you do blood work,
you're always getting anelevation in total protein,
globulins, and so on.
(04:11):
And that's a real problem.
That's a killer.
When you have inflammationanywhere in your body, you you
get that inflammatory process,it starts.
And then the the periodontalissues just progress from simple
grade one to grade four.
And at grade four, there's justbasically no saving of teeth.
It's just a horrible problem.
SPEAKER_00 (04:28):
And you know, um, I tell my clients a lot, and I
know I've heard you say thistoo, uh, the problem with
periodontal disease is this ishappening underneath the gum
line where many times we can'tsee what's going on.
And, you know, we get thesecases that come to us where
people have done dentals withoutum dental radiographs.
And it's like, you know, in myworld, in your world, it's
(04:50):
almost malpractice nowadays notto look for that because I I was
told it's about 40 or 50 percentof the disease going on in their
mouth is all is oftenperiodontal or more for that
matter.
Uh but we can't often see it.
Is that correct?
SPEAKER_01 (05:04):
That is correct.
And I mean, especially uh withwith problems in cats, sometimes
the the mouth in cats can lookso normal.
And without dental radiographs,you can't pick up anything.
And uh, you know, it it's amatter you need to take dental
x-rays.
Years ago, you know, 50 yearsago when we when I started this,
dentistry was unbelievable.
You wouldn't believe what we didin dentistry.
(05:26):
But nowadays, um the the dentalx-rays really pinpoint a lot of
disease processes.
And uh the way we do it here iswhen we take a patient in, we we
once we get them anesthetized,and then we take our dental
x-rays and start the cleaning.
That's when I call them and Igive them the final diagnosis,
treatment plan, and so on.
But the x-rays tell us tell usquite a bit.
(05:47):
Sometimes when the dogs come in,you can smell them when they
walk in the door, and we knowsomething's going on, and uh we
know there's a periodontalproblem.
But um that that's it.
The dental x-rays have to betaken.
I don't see how anybody canpractice dentistry at a level or
an advanced level without that.
SPEAKER_00 (06:04):
Yep, I absolutely agree.
You know, um I have a number ofpodcasts about in removing
inflammation from the body, andI'm really a very strong
proponent of working onmicrobiome and diet uh to get a
lot of that inflammation out.
And I think it really helps ourdental world also, and it's
really coming.
You know, microbiome is uh, youknow, the biome is the eighth
(06:25):
organ in human medicinenowadays.
It's become so important, andthey're isolating individual
bacteria and fungus thatbasically can be corrected to
prevent some of these things.
So I think we're gonna see abig, big upturn in in a lot of
this.
And as people get away from someof the really high-processed
foods and those kinds of things,inflammation starts to wane, and
(06:46):
we're we're much, much betteroff when it comes to the mouth,
I think.
SPEAKER_01 (06:49):
Yeah, inflammation, Rand, as you say, is something
it's I call it a slow killer.
It's just the organ failure,weight loss, fatigue, muscle
wasting.
It's just a chronic, chronicproblem caused by so many
things, heart valvular problems,and so on.
SPEAKER_00 (07:03):
So um let's go to the dog for just a second.
And in the dog-specific problem,we see a fair amount of retained
baby teeth in a lot of smallbreeds often.
You know, how serious that isthis?
And what when should parents acton this, Rocco?
SPEAKER_01 (07:17):
Uh it is common.
We see it occasionally in cats,but more often in in little
dogs.
And the what the the thing thatI use, uh, if I see when I
examine a dog, no matter whatage, eight weeks, twelve weeks,
sixteen weeks old, if we if wesee them in, uh if I see two
teeth in one area, likeespecially in the canine area,
if we see an adult tooth and ababy tooth, it's very important
(07:38):
to get those to get those takencare of.
And usually we extract thoseteeth right away to prevent
certain things.
And we prevent um orthodonticproblems, malocclusions, and
also when the two teeth are inthe same area, you get a lot of
debris in there, a lot of hair,a lot of food, and it just sits
in there.
And what happens when it sits inthere?
Inflammation, periol problems,and it gets worse and worse and
(08:01):
worse, that's for sure.
So it is very important to getit taken care of.
SPEAKER_00 (08:05):
Um I wanted to ask you about um in dogs uh
fractures in the teeth.
Um, your thoughts on on this,and also people ask about like
chewing bones, antlers, hardtoys.
Um are fractures something yousee often?
SPEAKER_01 (08:19):
We see fractures a lot, a lot, and especially in
the dogs that that have that areon hard toys, chew bones, things
like that.
One of the most common fractureswe see with chewing like that is
the upper fourth premolarfracture.
You get a slab fracture, causesa real problem in dogs if left
untreated.
Um trauma, we see a lot oftrauma, which will fracture
(08:42):
canines uh and left untreatedcan be a real problem.
But um certainly fractures are abig part of practice, that's for
sure.
SPEAKER_00 (08:50):
Um in the cat, let's go to the cat for just a second.
And um we did talk about toothresorption, it's a you know as a
condition that's unique to them.
Um can you explain what it isand why it's so tricky to catch
early?
SPEAKER_01 (09:02):
We see it a lot in cats.
I think probably I don't know,70% of cats have this problem.
And many times it's obvious whenyou examine the kitty, you can
you can see the crown isfractured off, there's only one
piece of crown left, a lot ofinflammatory disease at the
gums.
Every once in a while you'll seenormal teeth, and you'll see
just small areas of inflammatoryprocess taking place, especially
(09:25):
at the premolars on themandible.
And if you're not if you're not,if you don't know what you're
looking at, you can just missthese and just rule them off as
just a little bit of somegingivitis.
But every time I see somethinglike that, there is an
indication of the resorptiveproblem taking place.
And this is where the wholetooth, uh inside of the tooth,
is being eaten away.
(09:46):
And we're not at a crownfracture yet, but yet as time
progresses, the roots become soweak and and disintegrate
basically that the crown willfracture off and you won't have
a tooth there, and you'll thinkit's just an area of missing
tooth.
But then the problem lies underthe gum line when the roots
start to uh just becomefragmented and ankylosed.
SPEAKER_00 (10:04):
Yeah, typically what's your what what's your
solution in that situation forthat cat?
SPEAKER_01 (10:09):
Uh, you know, the people try just, you know,
they'll help them out a littlebit, but the the the treatment
of choice certainly is issurgical extraction.
And surgical extractions with uhresorptive lesion, no matter
what teeth, are getting into adifficult area.
I mean, these are these aredifficult surgical extractions.
They're not easy, especially ifthe if if you have a normal
(10:31):
tooth that's fractured and youhave healthy roots, relatively
easy to extract the tooth, nomatter what tooth it is.
But boy, when they're diseasedand you cause that much
inflammatory disease in the gumline, that much problem under
the gum line, the fracturesbecome really tough because you
have to do gingival flaps toapproach the tooth, remove some
of the bone, the buckle bonearound those roots, and then you
(10:52):
have to take those roots outbasically in fragments.
And then to close that area, thetissue is so friable that it's a
very, very difficult job to do.
So it it is it is quite a dealto do.
But the extraction usually worksvery, very well.
As opposed to stomatitissometime when you have to do uh
extractions, then you don't getthe results that you get, I
(11:13):
think, in something like uhresorctive lesions.
SPEAKER_00 (11:15):
Sounds great.
Let's go to stomatitis becauseum tell our listeners what that
is, and um talk about like umyou know, basically, you know,
possible causes, um, and thenyou know your treatment for
something like that.
SPEAKER_01 (11:31):
Uh basically stomatitis, we see a lot in
cats, and it's not it's not uhthe kind of prognosis that we
see in other uh other issues.
But bottom line is what happensis the the cat is allergic to
basically the plaque on theteeth.
It's an overactive immunesystem, they're allergic to the
(11:52):
plaque, and it can cause realsevere uh inflammatory disease.
Um other things that can causeit are certainly caleesi virus,
herpes virus, FIV, differentthings like that that affect our
immune system.
But once it starts, it can getreally very severe.
And the only treatment for thatis either full mouth extraction
or partial mouth extraction.
SPEAKER_00 (12:13):
Yeah, and that um as as one who has done a few of
those, but I know you've doneway more, it's it can be a real
bear, to tell you the truth.
SPEAKER_01 (12:22):
It's it it is amazing.
When you when you start to seethe when you start to see those,
you get frustrated a lot.
That's for darn sure.
And because usually full mouthextractions, especially with a
with a diseased mouth, uhinflamed mouth, is is a
time-consuming thing.
But uh many times when we getall those teeth out of there, we
(12:42):
can get a pretty decent uh uhprognosis from it.
But believe me, there's nohundred percent on those.
Sometimes we we will get 80percent, sometimes 90%,
sometimes 20%.
And then the the ones that wehave 20%, and what we have to
try to do is medically help themalong every once in a while with
medication.
But it is it it's probably oneof the most serious problems
that we can see.
Very difficult, very frustratingto deal with.
(13:05):
Medication, antibiotics,steroids can help the kitty,
pain medication can help them,but it doesn't make it go away.
SPEAKER_00 (13:12):
And you know, it's funny, um, recently, again,
because I've been working a lotwith microbiome and cats, um
when we um identify how out ofwhack some of these dysbiosises
are, that you know, themicrobiome is messed up, and we
correct that on whether it's afood sensitivity or uh a
microbiome problem, these catsdefinitely get better.
(13:32):
I mean, we definitely can helpthem along the way after someone
like yourself has has dealt withthem too.
So it makes it nice because nowwe're having some newer tools uh
in the mouth, you know, throughthe gut, you know, which is
really interesting.
SPEAKER_01 (13:45):
Well, I'll be uh I'll be definitely calling you
for some of that.
That's for sure, some of thatknowledge.
I wanted to ask you one thing.
What do you think about uh youknow, vitamin vitamin D is
really important, inflammatory,it decreases.
What do you think aboutsupplementing vitamin D for some
of these patients?
SPEAKER_00 (14:02):
I think it's huge.
And you know what?
It's amazing you mentioned thatbecause on our microbiome tests,
we get a D level.
And um I will tell you that ninetimes out of ten, it's low.
And so we use a fair amount ofum um oral liquid vitamin D for
cats, especially in the food.
(14:23):
Um, and we then look at levelsagain and we can get them up,
and things get better once we dothat because it's it's hugely
important in this.
You're absolutely right.
SPEAKER_01 (14:31):
Well, I tell you, in in human, I work with a lot of
human oral surgeons doing thisthing, and when when they do
these types of implants anddifferent types of major
surgery, they're always checkingvitamin D levels.
They find if it's like you said,low, the healing is very slow, a
lot of failure takes place, anduh they always do them on the
human patients.
I try to do them on some of myanimal patients, but we found
(14:53):
that at that time we were tryingto do with vitamin D levels very
expensive to do.
And and most owners just don'twant to go through that.
SPEAKER_00 (15:00):
VDI labs now makes a really nice blood vitamin D
level test that is not crazyexpensive.
It's very it can be veryaffordable.
So we've been using them a lotbecause they're spot on with
their microbiome stuff, as isour animal biome that we use,
but um really really helpfulwith the vitamin D levels when
(15:21):
we get those back.
SPEAKER_01 (15:22):
I'm gonna get that in from later later on after
we're all finished andeverything.
I'll get you some uh text andget some of that information
from you.
That'd be great.
SPEAKER_00 (15:29):
Absolutely, absolutely.
Let let's let's move a littlebit to uh prevention and
management because um you know Iknow both of our jobs would be
so much easier if people wouldwould do this and do a little
bit of uh prevention.
So let's talk about some of theways the parents can help with
gum disease, you know, um uh youknow, whether it's uh a brush or
(15:53):
shoes or you know, kind of youryour favorite scenarios in this
in this world.
And then I I do have to ask youabout some of the oral stuff
that's available.
SPEAKER_01 (16:02):
You know, the one of the main things is um certainly
we have to we have to uh educateour clients.
And I don't think that's beingdone a lot.
I think when I see clients comein, we do mostly all referrals
anymore.
And every time I see a client,we also we go through a uh a
lengthy talk about what'shappening, trying to let them
(16:26):
know what's going on.
We do a lot of show and tell, alot of skeletons, just to show
them what happened so thatthey're aware of different
things going on in the mouth.
Most clients will come in andthey're not aware of anything
happening in the mouth.
We see referrals coming in fromuh outside veterinarians that
send them in for, well, this isthe this is the history, needs
one uh one extraction.
(16:46):
We see the patient and you openthe mouth, and I gotta tell them
that we got a little bit morethan one extraction.
So that's kind of a difficultthing, but but uh uh talking to
the client about what'shappening in the mouth, number
one, is very important.
Um, brushing is probably thegold standard if you can do it
in dogs and cats.
(17:07):
And what I recommend is I don't,well, whatever they like,
brushes, finger brushes.
I really like to use just a uhswab, a three by three swab, or
not a swab, you can even use agauze pad with a little water.
Just rubbing the teeth in yourmouth, rubbing the teeth will
remove the plaque.
The more you do it, if you keepthe plaque off the teeth, you're
(17:27):
gonna really help preventcalculus, that's for sure.
Um dental chews, I think, arereally uh are really good.
Um water additives.
I I just I don't know exactlyhow how they work.
I think brushing is the mostimportant thing.
But but people like specialdiets too.
There are dental diets that theyuse that that seem to be made in
a way, they're very porous andthey help clean the teeth out a
(17:48):
little bit.
But brushing, brushing,brushing, if you can, is the
best thing.
It doesn't have to be perfect.
You just put it around yourfinger.
You don't have to do the palatalside or the lingual side of the
tooth, just the outside of thetooth to keep the to keep the uh
plaque off.
SPEAKER_00 (18:02):
And I, you know, you know, I and I know you've done
this also, I start working withmy puppy and kitten clients
right at initial vaccinationtime to get them used to this,
you know, even just startingputting your finger in your
mouth, their mouth with theflavored paste, let's say.
Um I know a lot of my clientsuse bake use baking soda on that
gauze because if it's a littlebit abrasive.
(18:25):
Um but you know, if you couldstart slowly acclimating your
dog, your your puppy or kittento this, you're gonna be in a
great place as they get older.
Because if you don't do thisearly, it makes it that much
harder later on, as you and Iboth know.
SPEAKER_01 (18:41):
It it it does.
I mean, I I think you're rightexactly right.
If you start early, do it quick.
And usually they'll they'll kindof look away or kind of repel a
brush or something like thatcoming in the mouth.
Not all.
Some pay some patients will takethe brush really nice, but uh I
find that getting your finger inthere with a little pad on it
really does the job.
SPEAKER_00 (19:00):
Yep, yep.
Um so a couple things that Iwanted to mention just for our
clients, just as a littlebackground, is you know, some of
the things that people can missum with their animal's uh you
know, mouth is you know, lookingfor things like bad breath,
drooling, uh difficulty eating,pawing at the mouth, uh visor
visible tartar or red swollengums, and of course the tooth
(19:24):
loss.
So, you know, people kind ofkeep their eyes open for some of
this.
It can it can really be a huge,uh, huge benefit to tell your
veterinarian or or seekveterinary care as media as
media as you you knowimmediately as you can to get
that remedied uh when whenpossible.
So I know a lot of people um askthe question, and I'm gonna
really be strong about this, andI I I know you'll probably back
(19:47):
me up on this.
And they ask about gentledentistry versus
anesthesia-related uh options.
And I want to tell people thatgentle dentistry in my world is
anything but gentle.
Uh these animals need to be helddown, sometimes scraped with a
tartar scraper, uh, micropitting the enamel, causing more
(20:10):
problems, uh, and never getunder the gum line because it's
impossible to do that.
You and I both know you can'tadequately do that without some
anesthesia.
So, you know, people say, well,you know, I can have this done.
And I had a client, you'll lovethis, just two weeks ago, they
came to see me, had a gentledentistry done in California by
a veterinary technician, um, washere visiting its um look, I'm
(20:36):
looking at its mouth, and it hadthe worst pyrrhea and the worst
halitosis I've seen in a longtime.
And I go, how long ago was thisdone?
And she told me, and I said, youknow, what's happened is they
basically got off some of thecalculus and maybe some of the
plaque from the outside of thetooth, but never addressed the
(20:57):
gum line.
You know, we caught we talkabout this micro pitting that
these things can cause wherebacteria can actually attract
more.
And this poor animal was interrible shape.
Um, elevated white cell count,like you said, elevated total
protein and globulins, um, andobviously required a full mouth,
dental procedure, a number ofextractions with it.
(21:18):
So um, you know, I I warn peopleabout these anesthesia-free
cleanings, they're they're justa they're a ripoff, quite
honestly, and in my world don'treally do anything for our pets.
SPEAKER_01 (21:30):
I think that's 100% right.
I think all you do with uhgentle cleaning or whatever
they're calling it now, it'svery traumatic to the pet.
Very traumatic.
And usually when you havecalculus on there, especially a
large amount of calculus, youthink you could knock off with a
probe or anything like that, acurette.
Um, there's something going onunder the gum line or even into
(21:53):
the into the root area of thetooth.
So to do something like that,it's it's a disservice.
You're you're missing so much.
Unfortunately, we have toanesthetize, give a general
anesthetic to all our patientsto do proper x-rays and proper
cleanings because we do a lot ofcleaning up under the gun.
And what happens to the calculusthat's on the lingual side, it's
on the uh palatal side, that youcan't deal with that, you just
(22:13):
knock it off the buccal area.
Um so I agree 100%.
I I think it's a disservice tothe to the patient and the
client.
SPEAKER_00 (22:21):
And I want to remind our listeners also that uh Rocco
and I have been around longenough to see anesthesia really
evolve.
And we're at a point, you know,at Paw's Veterinary Center where
every single body function isbeing monitored during that
procedure.
That the anesthetic gases thatwe use are incredibly safe, and
(22:41):
when we turn them off, theanimals typically wake up.
But we also do a lot ofpre-operative work, whether we
get EKG blood pressure, likeheart enzyme like BNP, or just
general blood work, to knowwe're really backing our bet on
these cases.
And thank God we don't loseanimals under anesthesia.
It's it I know it's a huge mythfor people to worry about this,
(23:03):
and and you know, don't get mewrong, anesthesia is always uh a
risk, but we've minimized thatto such a great degree.
Uh, I'm so thrilled to be ableto do these things and have our
animals, even a 10-year-oldheart patient, do great with
these procedures.
SPEAKER_01 (23:18):
I think so, and we we we do the same.
Certainly, a careful history isvery important to see what's
been going on with the patient.
And before we do any procedure,we're doing some complete lab
work.
If we see any indication on ouruh examination or history that
there might be something elsehappening, we focus in on
special types of thyroid tests,different types of tests that we
(23:40):
want to uh pick up before we dothe procedure.
So that's number one.
The when I do surgery, I alwayshave an assistant and we always
have another technician thatthat is very uh knowledgeable in
anesthesia, watching theanesthesia so that the person
that's helping me doesn't haveto do the anesthesia.
We're taking monitor every five,ten minutes.
So, and like you said, Rand, wehave IV fluids, monitoring
(24:03):
system, blood pressure going onall the time.
Um and the medications that weuse, the type of uh gaseous
anesthetics and the pre-medsthat we use are are very, very
safe.
Most of the ones that I use, ifyou have a you can wake them up
very, very quickly.
Um the other thing that I foundthat's pretty interesting.
I I don't know I don't I don'tknow what this is about, but I
see a lot of patients referredin, and the first thing we hear
(24:25):
is uh my dog or cat has amurmur, has a heart problem.
And I I'll tell you, certainly,the way I do it is we check the
animal if there's no clinicalsigns, we don't have any uh
fluid in the chest, anycoughing, very healthy, the uh
lab work looks normal.
One of the things that I'venoticed is, and I tell them you
(24:46):
you get no guarantees on thesethings, of course, but the the
patients that I do that havehard murmurs with no clinical
signs, dogs or cats, do one, doso well, so well.
In fact, they do better thansome of the normal patients that
we have.
I have no I don't understandthat.
I just don't know why that is,but they do extremely well.
(25:08):
They're perfect through thehole.
The other patients that we have,we're monitoring.
Sometimes we have to bring theblood pressure up a little bit,
down a little bit, we have tobring the heart rate up a little
bit.
So these patients, nothing.
Nothing.
SPEAKER_00 (25:20):
Yep, yep.
And what people need to alsounderstand is many of these
murmurs are caused by bacteriathat has come from the mouth,
attached to the mouth, leafletsin the heart, and cause an
endocardiosis where theybasically have these murmurs to
start with.
SPEAKER_01 (25:36):
Absolutely.
Absolutely.
That that's just like in people,same thing, absolutely.
SPEAKER_00 (25:40):
So to kind of wrap this up, and and I can't I can't
thank you enough for being sogracious with your time, Dr.
Murley.
Um, do you have like one dentalhealth myth you wish that every
pet parent understood?
Like something that would beoverriding for you uh to
reiterate to our listeners.
SPEAKER_01 (25:58):
Yeah, I had uh I saw that question on there, and I
put I wrote down some things.
Wait a minute.
Yeah, help myths.
One of the common things thatthat we see is dental disease is
not painful.
It's uh it's it's somethingnormal, the dogs can handle it
just fine.
(26:18):
Uh fractured teeth are notpainful, fracture down into the
pulps, not painful,malocclusions, not painful.
Um and uh when the dog theyalways ask me, well, here's
what's going on.
We've got a real real problemhere, but my dog is still
eating.
He's still eating, and you'd besurprised the mouse that we see,
horrible mouse, the patient isstill eating, and the owner
(26:40):
stinks doing really fine.
But one thing that I've noticedis, and I always tell the
owners, once we're finished withthe procedure, no matter what
the procedure is, especiallyperiol problems, uh you'll have
a different pet in about threedays.
And then at two weeks, you won'tbelieve how healthy the pet is,
or how they feel.
They feel very good.
That's my that's that's the whatI've seen.
Absolutely.
SPEAKER_00 (27:00):
Absolutely.
I can't tell you how many timeswe've gone in and done uh you
know a dental prophylaxis, adental procedure, um, whether
there was you know extractionsor not.
And um people come back, youknow, for like a two-week
recheck and they're going, thisdog is a completely different
dog.
I mean, I can't believe I didn'tknow you know that this dog was
(27:21):
really having a problem.
SPEAKER_01 (27:22):
Let me tell you a story.
I was sitting in a uhendodontist office.
I was getting my uh a root canaldone.
I was getting a root canal done.
And we do those too.
But I was getting a root canaldone.
Right.
And one one of the associatescame in and he says, Oh, I I see
you do veterinary dentistry.
I wanted to ask you a question.
I said, Okay, go ahead.
Well, the while the endodontistis working on me.
(27:42):
And he was a he was a dentist,an endodontist.
He says, I have a dog thatfractured his tooth.
Is that painful for that dog?
And I thought to myself, whatkind of question is that?
I says, Absolutely, it'spainful.
I couldn't believe he was askingme the question.
But anyway, that's that's afunny thing.
SPEAKER_00 (27:59):
I Rocco, you're the best man.
SPEAKER_01 (28:02):
Thank you for having me.
I I really appreciate it.
There's nothing more that Ienjoy more than talking to you
and uh also discussing all thesethings, these dentistry things.
But I am going to contact youabout some of that, uh, some of
those tests and everything thatyou do.
I'd I'd really like to startdoing some of that.
SPEAKER_00 (28:19):
Absolutely.
Anytime you know that, justreach out and we'll we'll
communicate off of this and andI'll get that stuff to you.
SPEAKER_01 (28:24):
Okay.
Thanks, Rand.
And he says, Oh, I I see you do veterinary dentistry.
I want to ask you a question.
I said, Okay, go ahead.
Well, the endodontist is workingon me.
And he was a he was a dentist,an endodontist.
He says, I have a dog thatfractured his tooth.
Is that painful for that dog?
And I thought to myself, whatkind of question is that?
I says, absolutely it's painful.
(00:20):
I couldn't believe he was askingme the question.
SPEAKER_00 (00:28):
Welcome to Pause, Reflect, and Heal.
I'm Dr.
Randy Aronson.
In this episode, we're going totake the deep dive into a
subject that I know perplexesmost of my clients.
And it's a shame because if morepet parents knew more about how
to keep their pets' teeth andgums healthy, everyone would
benefit.
Sadly, when it comes to ourpets' health, dental care is
(00:48):
often overlooked.
But I want to stress that it'severy bit as important as good
diet or regular exercise.
In fact, dental and gum diseaseare among the most common health
issues affecting both dogs andcats.
And most would be avoided withreally some good preventative
measures.
In dogs, periodontal diseasetops the list, followed by
issues like broken teeth, toothrot abscesses, and retained baby
(01:12):
teeth, especially in smallerbreeds.
Cats have their own unique setof challenges, including painful
tooth resorption, widespreadgingostomatitis, aggressive oral
cancers like squamous cell.
So with early detection, properdental hygiene, and
veterinarian, most of theseissues can be managed, and as
they said before, preventative.
(01:33):
This is a hugely importanttopic, and we're gonna you're
gonna learn a lot in this show.
So make sure you stay tuned.
I'm gonna bring in with us agreat friend, Dr.
Rocco Mele, to make this happen.
He's very special guest andreally second to none in the pet
dental world.
Dr.
Mele, welcome to the show,buddy.
SPEAKER_01 (01:51):
Thank you, Randy.
Really happy to be here.
Thanks a lot.
SPEAKER_00 (01:54):
Uh before we start, I just want to ask a favor of
our listeners.
If you like our podcast, you canhit the subscribe button.
Give us a like if you'rewatching on YouTube, and if
you're on the podcast apps suchas Apple or Spotify, please
follow us.
Um your comments are alwayswelcome, no matter what
platform.
And lastly, follow me onInstagram at Dr.
(02:15):
RandyPetvet.
Thanks for your support.
Rocco, let's let's talk about umsome general questions.
So um what do you think youryour most common dental or gum
diseases that you're seeing indogs and cats?
And a little bit of differencebetween the two species, if we
could.
SPEAKER_01 (02:32):
Usually the the most common thing that I see, and
that we see, I think, indentistry, is uh periodontal
disease.
Very common in both species, uh,more in dogs, I think, than
cats.
Cats have their unique problems,that's for sure.
But periodontal disease, we alsosee a lot of trauma, fractured
teeth, uh, oromaxillofacialtrauma from uh accidents,
(02:54):
congenital issues.
We always see malocclusion,missing teeth, retained baby
teeth.
And there's also something thatwe we see more often than not is
uh is oral cancer anymore.
We see a lot of oral cancers, uhbenign and malignant.
So I I guess uh at the top ofthe list, periodontal disease
would be would be the mostcommon thing that we deal with.
(03:14):
Uh we deal with others too, butthat's the most common.
SPEAKER_00 (03:17):
So let me ask you a question on that.
Um you know, it's so common inpets.
In your view, what do youactually think is happening in
the pet's mouth when thisdevelops?
Like tell us how thatprogression happens.
SPEAKER_01 (03:28):
Um you know, what happens is uh it starts with
just I don't know the exactcause, quite honestly.
Some people genetically there'sa problem, sometimes people say
diet.
I I really just don't know.
All I know is that when itstarts, it starts with uh plaque
in the mouth or any type ofinflammation.
Inflammation is the realproblem.
(03:49):
And if left unchecked, then theinflammation it just progresses.
It progresses to periodontaldisease, different grades of
periodontal disease.
And also, we see with dogs thatthat have uh chronic chronic
oral problems, if you do labwork and you do blood work,
you're always getting anelevation in total protein,
globulins, and so on.
(04:11):
And that's a real problem.
That's a killer.
When you have inflammationanywhere in your body, you you
get that inflammatory process,it starts.
And then the the periodontalissues just progress from simple
grade one to grade four.
And at grade four, there's justbasically no saving of teeth.
It's just a horrible problem.
SPEAKER_00 (04:28):
And you know, um, I tell my clients a lot, and I
know I've heard you say thistoo, uh, the problem with
periodontal disease is this ishappening underneath the gum
line where many times we can'tsee what's going on.
And, you know, we get thesecases that come to us where
people have done dentals withoutum dental radiographs.
And it's like, you know, in myworld, in your world, it's
(04:50):
almost malpractice nowadays notto look for that because I I was
told it's about 40 or 50 percentof the disease going on in their
mouth is all is oftenperiodontal or more for that
matter.
Uh but we can't often see it.
Is that correct?
SPEAKER_01 (05:04):
That is correct.
And I mean, especially uh withwith problems in cats, sometimes
the the mouth in cats can lookso normal.
And without dental radiographs,you can't pick up anything.
And uh, you know, it it's amatter you need to take dental
x-rays.
Years ago, you know, 50 yearsago when we when I started this,
dentistry was unbelievable.
You wouldn't believe what we didin dentistry.
(05:26):
But nowadays, um the the dentalx-rays really pinpoint a lot of
disease processes.
And uh the way we do it here iswhen we take a patient in, we we
once we get them anesthetized,and then we take our dental
x-rays and start the cleaning.
That's when I call them and Igive them the final diagnosis,
treatment plan, and so on.
But the x-rays tell us tell usquite a bit.
(05:47):
Sometimes when the dogs come in,you can smell them when they
walk in the door, and we knowsomething's going on, and uh we
know there's a periodontalproblem.
But um that that's it.
The dental x-rays have to betaken.
I don't see how anybody canpractice dentistry at a level or
an advanced level without that.
SPEAKER_00 (06:04):
Yep, I absolutely agree.
You know, um I have a number ofpodcasts about in removing
inflammation from the body, andI'm really a very strong
proponent of working onmicrobiome and diet uh to get a
lot of that inflammation out.
And I think it really helps ourdental world also, and it's
really coming.
You know, microbiome is uh, youknow, the biome is the eighth
(06:25):
organ in human medicinenowadays.
It's become so important, andthey're isolating individual
bacteria and fungus thatbasically can be corrected to
prevent some of these things.
So I think we're gonna see abig, big upturn in in a lot of
this.
And as people get away from someof the really high-processed
foods and those kinds of things,inflammation starts to wane, and
(06:46):
we're we're much, much betteroff when it comes to the mouth,
I think.
SPEAKER_01 (06:49):
Yeah, inflammation, Rand, as you say, is something
it's I call it a slow killer.
It's just the organ failure,weight loss, fatigue, muscle
wasting.
It's just a chronic, chronicproblem caused by so many
things, heart valvular problems,and so on.
SPEAKER_00 (07:03):
So um let's go to the dog for just a second.
And in the dog-specific problem,we see a fair amount of retained
baby teeth in a lot of smallbreeds often.
You know, how serious that isthis?
And what when should parents acton this, Rocco?
SPEAKER_01 (07:17):
Uh it is common.
We see it occasionally in cats,but more often in in little
dogs.
And the what the the thing thatI use, uh, if I see when I
examine a dog, no matter whatage, eight weeks, twelve weeks,
sixteen weeks old, if we if wesee them in, uh if I see two
teeth in one area, likeespecially in the canine area,
if we see an adult tooth and ababy tooth, it's very important
(07:38):
to get those to get those takencare of.
And usually we extract thoseteeth right away to prevent
certain things.
And we prevent um orthodonticproblems, malocclusions, and
also when the two teeth are inthe same area, you get a lot of
debris in there, a lot of hair,a lot of food, and it just sits
in there.
And what happens when it sits inthere?
Inflammation, periol problems,and it gets worse and worse and
(08:01):
worse, that's for sure.
So it is very important to getit taken care of.
SPEAKER_00 (08:05):
Um I wanted to ask you about um in dogs uh
fractures in the teeth.
Um, your thoughts on on this,and also people ask about like
chewing bones, antlers, hardtoys.
Um are fractures something yousee often?
SPEAKER_01 (08:19):
We see fractures a lot, a lot, and especially in
the dogs that that have that areon hard toys, chew bones, things
like that.
One of the most common fractureswe see with chewing like that is
the upper fourth premolarfracture.
You get a slab fracture, causesa real problem in dogs if left
untreated.
Um trauma, we see a lot oftrauma, which will fracture
(08:42):
canines uh and left untreatedcan be a real problem.
But um certainly fractures are abig part of practice, that's for
sure.
SPEAKER_00 (08:50):
Um in the cat, let's go to the cat for just a second.
And um we did talk about toothresorption, it's a you know as a
condition that's unique to them.
Um can you explain what it isand why it's so tricky to catch
early?
SPEAKER_01 (09:02):
We see it a lot in cats.
I think probably I don't know,70% of cats have this problem.
And many times it's obvious whenyou examine the kitty, you can
you can see the crown isfractured off, there's only one
piece of crown left, a lot ofinflammatory disease at the
gums.
Every once in a while you'll seenormal teeth, and you'll see
just small areas of inflammatoryprocess taking place, especially
(09:25):
at the premolars on themandible.
And if you're not if you're not,if you don't know what you're
looking at, you can just missthese and just rule them off as
just a little bit of somegingivitis.
But every time I see somethinglike that, there is an
indication of the resorptiveproblem taking place.
And this is where the wholetooth, uh inside of the tooth,
is being eaten away.
(09:46):
And we're not at a crownfracture yet, but yet as time
progresses, the roots become soweak and and disintegrate
basically that the crown willfracture off and you won't have
a tooth there, and you'll thinkit's just an area of missing
tooth.
But then the problem lies underthe gum line when the roots
start to uh just becomefragmented and ankylosed.
SPEAKER_00 (10:04):
Yeah, typically what's your what what's your
solution in that situation forthat cat?
SPEAKER_01 (10:09):
Uh, you know, the people try just, you know,
they'll help them out a littlebit, but the the the treatment
of choice certainly is issurgical extraction.
And surgical extractions with uhresorptive lesion, no matter
what teeth, are getting into adifficult area.
I mean, these are these aredifficult surgical extractions.
They're not easy, especially ifthe if if you have a normal
(10:31):
tooth that's fractured and youhave healthy roots, relatively
easy to extract the tooth, nomatter what tooth it is.
But boy, when they're diseasedand you cause that much
inflammatory disease in the gumline, that much problem under
the gum line, the fracturesbecome really tough because you
have to do gingival flaps toapproach the tooth, remove some
of the bone, the buckle bonearound those roots, and then you
(10:52):
have to take those roots outbasically in fragments.
And then to close that area, thetissue is so friable that it's a
very, very difficult job to do.
So it it is it is quite a dealto do.
But the extraction usually worksvery, very well.
As opposed to stomatitissometime when you have to do uh
extractions, then you don't getthe results that you get, I
(11:13):
think, in something like uhresorctive lesions.
SPEAKER_00 (11:15):
Sounds great.
Let's go to stomatitis becauseum tell our listeners what that
is, and um talk about like umyou know, basically, you know,
possible causes, um, and thenyou know your treatment for
something like that.
SPEAKER_01 (11:31):
Uh basically stomatitis, we see a lot in
cats, and it's not it's not uhthe kind of prognosis that we
see in other uh other issues.
But bottom line is what happensis the the cat is allergic to
basically the plaque on theteeth.
It's an overactive immunesystem, they're allergic to the
(11:52):
plaque, and it can cause realsevere uh inflammatory disease.
Um other things that can causeit are certainly caleesi virus,
herpes virus, FIV, differentthings like that that affect our
immune system.
But once it starts, it can getreally very severe.
And the only treatment for thatis either full mouth extraction
or partial mouth extraction.
SPEAKER_00 (12:13):
Yeah, and that um as as one who has done a few of
those, but I know you've doneway more, it's it can be a real
bear, to tell you the truth.
SPEAKER_01 (12:22):
It's it it is amazing.
When you when you start to seethe when you start to see those,
you get frustrated a lot.
That's for darn sure.
And because usually full mouthextractions, especially with a
with a diseased mouth, uhinflamed mouth, is is a
time-consuming thing.
But uh many times when we getall those teeth out of there, we
(12:42):
can get a pretty decent uh uhprognosis from it.
But believe me, there's nohundred percent on those.
Sometimes we we will get 80percent, sometimes 90%,
sometimes 20%.
And then the the ones that wehave 20%, and what we have to
try to do is medically help themalong every once in a while with
medication.
But it is it it's probably oneof the most serious problems
that we can see.
Very difficult, very frustratingto deal with.
(13:05):
Medication, antibiotics,steroids can help the kitty,
pain medication can help them,but it doesn't make it go away.
SPEAKER_00 (13:12):
And you know, it's funny, um, recently, again,
because I've been working a lotwith microbiome and cats, um
when we um identify how out ofwhack some of these dysbiosises
are, that you know, themicrobiome is messed up, and we
correct that on whether it's afood sensitivity or uh a
microbiome problem, these catsdefinitely get better.
(13:32):
I mean, we definitely can helpthem along the way after someone
like yourself has has dealt withthem too.
So it makes it nice because nowwe're having some newer tools uh
in the mouth, you know, throughthe gut, you know, which is
really interesting.
SPEAKER_01 (13:45):
Well, I'll be uh I'll be definitely calling you
for some of that.
That's for sure, some of thatknowledge.
I wanted to ask you one thing.
What do you think about uh youknow, vitamin vitamin D is
really important, inflammatory,it decreases.
What do you think aboutsupplementing vitamin D for some
of these patients?
SPEAKER_00 (14:02):
I think it's huge.
And you know what?
It's amazing you mentioned thatbecause on our microbiome tests,
we get a D level.
And um I will tell you that ninetimes out of ten, it's low.
And so we use a fair amount ofum um oral liquid vitamin D for
cats, especially in the food.
(14:23):
Um, and we then look at levelsagain and we can get them up,
and things get better once we dothat because it's it's hugely
important in this.
You're absolutely right.
SPEAKER_01 (14:31):
Well, I tell you, in in human, I work with a lot of
human oral surgeons doing thisthing, and when when they do
these types of implants anddifferent types of major
surgery, they're always checkingvitamin D levels.
They find if it's like you said,low, the healing is very slow, a
lot of failure takes place, anduh they always do them on the
human patients.
I try to do them on some of myanimal patients, but we found
(14:53):
that at that time we were tryingto do with vitamin D levels very
expensive to do.
And and most owners just don'twant to go through that.
SPEAKER_00 (15:00):
VDI labs now makes a really nice blood vitamin D
level test that is not crazyexpensive.
It's very it can be veryaffordable.
So we've been using them a lotbecause they're spot on with
their microbiome stuff, as isour animal biome that we use,
but um really really helpfulwith the vitamin D levels when
(15:21):
we get those back.
SPEAKER_01 (15:22):
I'm gonna get that in from later later on after
we're all finished andeverything.
I'll get you some uh text andget some of that information
from you.
That'd be great.
SPEAKER_00 (15:29):
Absolutely, absolutely.
Let let's let's move a littlebit to uh prevention and
management because um you know Iknow both of our jobs would be
so much easier if people wouldwould do this and do a little
bit of uh prevention.
So let's talk about some of theways the parents can help with
gum disease, you know, um uh youknow, whether it's uh a brush or
(15:53):
shoes or you know, kind of youryour favorite scenarios in this
in this world.
And then I I do have to ask youabout some of the oral stuff
that's available.
SPEAKER_01 (16:02):
You know, the one of the main things is um certainly
we have to we have to uh educateour clients.
And I don't think that's beingdone a lot.
I think when I see clients comein, we do mostly all referrals
anymore.
And every time I see a client,we also we go through a uh a
lengthy talk about what'shappening, trying to let them
(16:26):
know what's going on.
We do a lot of show and tell, alot of skeletons, just to show
them what happened so thatthey're aware of different
things going on in the mouth.
Most clients will come in andthey're not aware of anything
happening in the mouth.
We see referrals coming in fromuh outside veterinarians that
send them in for, well, this isthe this is the history, needs
one uh one extraction.
(16:46):
We see the patient and you openthe mouth, and I gotta tell them
that we got a little bit morethan one extraction.
So that's kind of a difficultthing, but but uh uh talking to
the client about what'shappening in the mouth, number
one, is very important.
Um, brushing is probably thegold standard if you can do it
in dogs and cats.
(17:07):
And what I recommend is I don't,well, whatever they like,
brushes, finger brushes.
I really like to use just a uhswab, a three by three swab, or
not a swab, you can even use agauze pad with a little water.
Just rubbing the teeth in yourmouth, rubbing the teeth will
remove the plaque.
The more you do it, if you keepthe plaque off the teeth, you're
(17:27):
gonna really help preventcalculus, that's for sure.
Um dental chews, I think, arereally uh are really good.
Um water additives.
I I just I don't know exactlyhow how they work.
I think brushing is the mostimportant thing.
But but people like specialdiets too.
There are dental diets that theyuse that that seem to be made in
a way, they're very porous andthey help clean the teeth out a
(17:48):
little bit.
But brushing, brushing,brushing, if you can, is the
best thing.
It doesn't have to be perfect.
You just put it around yourfinger.
You don't have to do the palatalside or the lingual side of the
tooth, just the outside of thetooth to keep the to keep the uh
plaque off.
SPEAKER_00 (18:02):
And I, you know, you know, I and I know you've done
this also, I start working withmy puppy and kitten clients
right at initial vaccinationtime to get them used to this,
you know, even just startingputting your finger in your
mouth, their mouth with theflavored paste, let's say.
Um I know a lot of my clientsuse bake use baking soda on that
gauze because if it's a littlebit abrasive.
(18:25):
Um but you know, if you couldstart slowly acclimating your
dog, your your puppy or kittento this, you're gonna be in a
great place as they get older.
Because if you don't do thisearly, it makes it that much
harder later on, as you and Iboth know.
SPEAKER_01 (18:41):
It it it does.
I mean, I I think you're rightexactly right.
If you start early, do it quick.
And usually they'll they'll kindof look away or kind of repel a
brush or something like thatcoming in the mouth.
Not all.
Some pay some patients will takethe brush really nice, but uh I
find that getting your finger inthere with a little pad on it
really does the job.
SPEAKER_00 (19:00):
Yep, yep.
Um so a couple things that Iwanted to mention just for our
clients, just as a littlebackground, is you know, some of
the things that people can missum with their animal's uh you
know, mouth is you know, lookingfor things like bad breath,
drooling, uh difficulty eating,pawing at the mouth, uh visor
visible tartar or red swollengums, and of course the tooth
(19:24):
loss.
So, you know, people kind ofkeep their eyes open for some of
this.
It can it can really be a huge,uh, huge benefit to tell your
veterinarian or or seekveterinary care as media as
media as you you knowimmediately as you can to get
that remedied uh when whenpossible.
So I know a lot of people um askthe question, and I'm gonna
really be strong about this, andI I I know you'll probably back
(19:47):
me up on this.
And they ask about gentledentistry versus
anesthesia-related uh options.
And I want to tell people thatgentle dentistry in my world is
anything but gentle.
Uh these animals need to be helddown, sometimes scraped with a
tartar scraper, uh, micropitting the enamel, causing more
(20:10):
problems, uh, and never getunder the gum line because it's
impossible to do that.
You and I both know you can'tadequately do that without some
anesthesia.
So, you know, people say, well,you know, I can have this done.
And I had a client, you'll lovethis, just two weeks ago, they
came to see me, had a gentledentistry done in California by
a veterinary technician, um, washere visiting its um look, I'm
(20:36):
looking at its mouth, and it hadthe worst pyrrhea and the worst
halitosis I've seen in a longtime.
And I go, how long ago was thisdone?
And she told me, and I said, youknow, what's happened is they
basically got off some of thecalculus and maybe some of the
plaque from the outside of thetooth, but never addressed the
(20:57):
gum line.
You know, we caught we talkabout this micro pitting that
these things can cause wherebacteria can actually attract
more.
And this poor animal was interrible shape.
Um, elevated white cell count,like you said, elevated total
protein and globulins, um, andobviously required a full mouth,
dental procedure, a number ofextractions with it.
(21:18):
So um, you know, I I warn peopleabout these anesthesia-free
cleanings, they're they're justa they're a ripoff, quite
honestly, and in my world don'treally do anything for our pets.
SPEAKER_01 (21:30):
I think that's 100% right.
I think all you do with uhgentle cleaning or whatever
they're calling it now, it'svery traumatic to the pet.
Very traumatic.
And usually when you havecalculus on there, especially a
large amount of calculus, youthink you could knock off with a
probe or anything like that, acurette.
Um, there's something going onunder the gum line or even into
(21:53):
the into the root area of thetooth.
So to do something like that,it's it's a disservice.
You're you're missing so much.
Unfortunately, we have toanesthetize, give a general
anesthetic to all our patientsto do proper x-rays and proper
cleanings because we do a lot ofcleaning up under the gun.
And what happens to the calculusthat's on the lingual side, it's
on the uh palatal side, that youcan't deal with that, you just
(22:13):
knock it off the buccal area.
Um so I agree 100%.
I I think it's a disservice tothe to the patient and the
client.
SPEAKER_00 (22:21):
And I want to remind our listeners also that uh Rocco
and I have been around longenough to see anesthesia really
evolve.
And we're at a point, you know,at Paw's Veterinary Center where
every single body function isbeing monitored during that
procedure.
That the anesthetic gases thatwe use are incredibly safe, and
(22:41):
when we turn them off, theanimals typically wake up.
But we also do a lot ofpre-operative work, whether we
get EKG blood pressure, likeheart enzyme like BNP, or just
general blood work, to knowwe're really backing our bet on
these cases.
And thank God we don't loseanimals under anesthesia.
It's it I know it's a huge mythfor people to worry about this,
(23:03):
and and you know, don't get mewrong, anesthesia is always uh a
risk, but we've minimized thatto such a great degree.
Uh, I'm so thrilled to be ableto do these things and have our
animals, even a 10-year-oldheart patient, do great with
these procedures.
SPEAKER_01 (23:18):
I think so, and we we we do the same.
Certainly, a careful history isvery important to see what's
been going on with the patient.
And before we do any procedure,we're doing some complete lab
work.
If we see any indication on ouruh examination or history that
there might be something elsehappening, we focus in on
special types of thyroid tests,different types of tests that we
(23:40):
want to uh pick up before we dothe procedure.
So that's number one.
The when I do surgery, I alwayshave an assistant and we always
have another technician thatthat is very uh knowledgeable in
anesthesia, watching theanesthesia so that the person
that's helping me doesn't haveto do the anesthesia.
We're taking monitor every five,ten minutes.
So, and like you said, Rand, wehave IV fluids, monitoring
(24:03):
system, blood pressure going onall the time.
Um and the medications that weuse, the type of uh gaseous
anesthetics and the pre-medsthat we use are are very, very
safe.
Most of the ones that I use, ifyou have a you can wake them up
very, very quickly.
Um the other thing that I foundthat's pretty interesting.
I I don't know I don't I don'tknow what this is about, but I
see a lot of patients referredin, and the first thing we hear
(24:25):
is uh my dog or cat has amurmur, has a heart problem.
And I I'll tell you, certainly,the way I do it is we check the
animal if there's no clinicalsigns, we don't have any uh
fluid in the chest, anycoughing, very healthy, the uh
lab work looks normal.
One of the things that I'venoticed is, and I tell them you
(24:46):
you get no guarantees on thesethings, of course, but the the
patients that I do that havehard murmurs with no clinical
signs, dogs or cats, do one, doso well, so well.
In fact, they do better thansome of the normal patients that
we have.
I have no I don't understandthat.
I just don't know why that is,but they do extremely well.
(25:08):
They're perfect through thehole.
The other patients that we have,we're monitoring.
Sometimes we have to bring theblood pressure up a little bit,
down a little bit, we have tobring the heart rate up a little
bit.
So these patients, nothing.
Nothing.
SPEAKER_00 (25:20):
Yep, yep.
And what people need to alsounderstand is many of these
murmurs are caused by bacteriathat has come from the mouth,
attached to the mouth, leafletsin the heart, and cause an
endocardiosis where theybasically have these murmurs to
start with.
SPEAKER_01 (25:36):
Absolutely.
Absolutely.
That that's just like in people,same thing, absolutely.
SPEAKER_00 (25:40):
So to kind of wrap this up, and and I can't I can't
thank you enough for being sogracious with your time, Dr.
Murley.
Um, do you have like one dentalhealth myth you wish that every
pet parent understood?
Like something that would beoverriding for you uh to
reiterate to our listeners.
SPEAKER_01 (25:58):
Yeah, I had uh I saw that question on there, and I
put I wrote down some things.
Wait a minute.
Yeah, help myths.
One of the common things thatthat we see is dental disease is
not painful.
It's uh it's it's somethingnormal, the dogs can handle it
just fine.
(26:18):
Uh fractured teeth are notpainful, fracture down into the
pulps, not painful,malocclusions, not painful.
Um and uh when the dog theyalways ask me, well, here's
what's going on.
We've got a real real problemhere, but my dog is still
eating.
He's still eating, and you'd besurprised the mouse that we see,
horrible mouse, the patient isstill eating, and the owner
(26:40):
stinks doing really fine.
But one thing that I've noticedis, and I always tell the
owners, once we're finished withthe procedure, no matter what
the procedure is, especiallyperiol problems, uh you'll have
a different pet in about threedays.
And then at two weeks, you won'tbelieve how healthy the pet is,
or how they feel.
They feel very good.
That's my that's that's the whatI've seen.
Absolutely.
SPEAKER_00 (27:00):
Absolutely.
I can't tell you how many timeswe've gone in and done uh you
know a dental prophylaxis, adental procedure, um, whether
there was you know extractionsor not.
And um people come back, youknow, for like a two-week
recheck and they're going, thisdog is a completely different
dog.
I mean, I can't believe I didn'tknow you know that this dog was
(27:21):
really having a problem.
SPEAKER_01 (27:22):
Let me tell you a story.
I was sitting in a uhendodontist office.
I was getting my uh a root canaldone.
I was getting a root canal done.
And we do those too.
But I was getting a root canaldone.
Right.
And one one of the associatescame in and he says, Oh, I I see
you do veterinary dentistry.
I wanted to ask you a question.
I said, Okay, go ahead.
Well, the while the endodontistis working on me.
(27:42):
And he was a he was a dentist,an endodontist.
He says, I have a dog thatfractured his tooth.
Is that painful for that dog?
And I thought to myself, whatkind of question is that?
I says, Absolutely, it'spainful.
I couldn't believe he was askingme the question.
But anyway, that's that's afunny thing.
SPEAKER_00 (27:59):
I Rocco, you're the best man.
SPEAKER_01 (28:02):
Thank you for having me.
I I really appreciate it.
There's nothing more that Ienjoy more than talking to you
and uh also discussing all thesethings, these dentistry things.
But I am going to contact youabout some of that, uh, some of
those tests and everything thatyou do.
I'd I'd really like to startdoing some of that.
SPEAKER_00 (28:19):
Absolutely.
Anytime you know that, justreach out and we'll we'll
communicate off of this and andI'll get that stuff to you.
SPEAKER_01 (28:24):
Okay.
Thanks, Rand.
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