Fractured Teeth Always Merit A Trip To The Veterinarian

Teeth are amazingly strong! Nevertheless, when you consider that teeth are essential tools for your cat or dog, used not only for eating but for playing and picking things up, it’s not surprising that veterinarians routinely see broken teeth in their patients.

“All types of dogs and cats can fracture teeth. Cats are more likely to have injured teeth as a result of trauma, while dogs often cause damage chewing during play,” explains Dr. Katherine Kling, a veterinarian at the University of Illinois Veterinary Teaching Hospital in Urbana who is pursuing board certification in dentistry. (When teeth are damaged due to trauma, such as bite wounds or being hit by a car, the teeth are generally treated after more serious problems, like jaw fractures, have been addressed.)



According to Dr. Kling, commonly fractured teeth include the fang-like canine teeth in dogs and cats (yes, cats have canine teeth!) and the carnassial teeth in dogs. The carnassial teeth are the largest teeth in your pet’s mouth, paired top and bottom toward the back of the mouth; these teeth evolved in many carnivore species to shear the flesh off prey.

Dr. Kling categorizes broken teeth as complicated and uncomplicated fractures. Either way, the problem should be promptly evaluated by a veterinarian to save the tooth, in some cases, and to ensure that the pet is not in pain, in all cases.

“A complicated fracture occurs when the crown of the tooth is fractured and the pulp is exposed,” she says. “If there is not intervention, the tooth will die.”

Uncomplicated fractures do not involve the pulp (the part of the tooth that supplies nutrients to the tooth) and may heal. However, it is important to understand that fractured teeth can be quite painful and always merit a prompt visit to the veterinarian.



Dr. Kling explains “If you notice a complicated fracture right away, there is a chance that the tooth can be saved through vital pulp therapy.”



Vital pulp therapy is generally performed by a veterinary dentist, like Dr. Kling. The procedure involves removing about four millimetres of the exposed pulp — the live tissue inside the tooth — and medicating the remaining pulp to help support new dentin as it forms. Dentin is a bonelike substance that lies below the tooth enamel; dentin is produced throughout the life of the tooth. To successfully restore viability of a tooth, vital pulp therapy must be performed immediately following the damage.



If time has elapsed since the tooth was damaged, two options remain for a tooth with a complicated fracture: a root canal or extraction of the tooth. Your veterinarian can help you decide between these two therapies.

During a root canal, all of the pulp is removed from the tooth and replaced with a substance that allows the tooth to function comfortably without the risk of infection or pain. If surgical extraction of the tooth is chosen, animals typically live happily with fewer teeth.

“A painful tooth is providing no benefit to a pet and it is likely to cause problems,” says Dr. Kling. “Most animals eat much more comfortably once the painful tooth is removed.”

Uncomplicated fractures usually do not need an aggressive intervention, but should still be seen by a veterinarian. While there is a lower risk of the tooth dying, the tooth may be sensitive. Additionally, the tooth may need some restoration or smoothing of jagged edges to ensure that it does not cause problems for the pet.



Even if your pet is young enough that the fractured tooth will eventually fall out and be replaced by the adult tooth, a veterinarian needs to evaluate the problem

“Since permanent teeth are very close to their deciduous counterparts, pulp exposure on a baby tooth can result in damage to the bud of the permanent tooth below,” warns Dr. Kling.

While tooth fractures cannot always be avoided, choosing appropriate toys can help prevent fractured teeth in dogs that like to chew. Soft rubber or stuffed toys are much safer than hard plastic toys, antlers or bones.

“Dental issues are sometimes overlooked because they are not life limiting, but they are most definitely quality-of-life limiting, so it is important to include dentistry in your pet’s care,” says Dr. Kling. “We are fortunate to have the knowledge and resources to help provide our pets with comfortable and healthy mouths.”

“Dental issues are sometimes overlooked because they are not life limiting, but they are most definitely quality-of-life limiting, so it is important to include dentistry in your pet’s care,” says Dr. Kling. “We are fortunate to have the knowledge and resources to help provide our pets with comfortable and healthy mouths.”


From the University of Illinois UrbanaChampaign College of Veterinary Medicine:

Allergy Shots May Bring Relief To Itchy Dogs


If an allergy is to blame, it probably falls into one of three categories, according to Dr. Scott Miller, who recently completed an internship in small animal dermatology at the University of Illinois Veterinary Teaching Hospital in Urbana. The options are flea allergic dermatitis, food allergies and environmental allergies, also called “atopy” and “atopic dermatitis.”

“Flea allergy is considered the most common allergy affecting dogs, though that varies based on geography,” says Dr. Miller. “For example, fleas do not survive well in the southwest. Environmental allergies are more common there.”

Food allergies are less common. When they do occur, these allergies are most often tied to a specific protein source, such as chicken or beef, rather than to a grain, like corn or rice.



“Immunotherapy, commonly known as ‘allergy shots,’ is one of the oldest and still most-effective treatment options for environmental allergies in dogs,” says Dr. Miller. “It is the only natural way to truly try to change the immune system’s response to allergens, but it requires a long-term commitment on the part of the pet owner.”



Immunotherapy is delivered by a specialist in veterinary dermatology working together with the pet’s general practice veterinarian to ensure continuity of care. Immunotherapy is a good choice for a dog that has not responded well to basic allergy medications or a dog that has frequent, severe allergic signs throughout the year.

“Overall, 60% to 80% of dogs with environmental allergy will respond very well to allergy shots, often eliminating the need for other medications the pet may have been given to control signs,” says Dr. Miller. “Young dogs may respond better to immunotherapy than do older dogs.”

Immunotherapy works by introducing small amounts of what the pet is allergic to and gradually increasing the dose over time, so that the pet builds a tolerance to these allergens. This is most often done via injections under the skin, but in some instances is completed via drops placed under the tongue, usually twice a day. Frequency of shots can vary, but most often they are given every other day initially and then decreased to once or twice weekly.

Immunotherapy must be continued for at least one year before effectiveness can be determined. During this first year, the pet will also take medication to control the allergic signs.



As in human medicine, skin testing is used to identify an individualized formulation of allergens the animal reacts to. The dog is placed under sedation during skin testing. A trained veterinary dermatologist uses tiny needles to introduce small amounts of potential allergens under the skin. The dermatologist then watches for a skin reaction, indicating a positive allergy.

“Skin testing is the gold standard. Blood tests are also available, but reactions in the blood and the skin are not always the same. When investigating symptoms on the skin, we want to go directly to the skin to test reactions,” explains Dr. Miller.

Dr. Miller wants owners to understand that skin testing does not diagnose allergies. Testing is done only in the context of pursuing immunotherapy treatment. In some circumstances, a dog can be allergic yet have normal or negative allergy test results. This does not mean the dog is not allergic. Rather, it means that allergy shots are not a treatment option for that patient.

“After one year of shots, we start to wean the pet off the other allergy medication to see if any improvements have been made to the allergic signs. If there has been no change, we may stop giving shots and choose a different therapy. If the shots appear to be working, they may be continued for life,” explains Dr. Miller.

The goal of immunotherapy is to control the allergies, not to cure them. With proper treatment and owner education, many dogs with allergies can have perfectly normal, happy lives.

If you have questions about allergies and immunotherapy, contact your veterinarian or the veterinary dermatology service at the University of Illinois Veterinary Teaching Hospital.

From Pet Columns at the University of Illinois Urbana-Champaign College of Veterinary Medicine


The heart is essential to the body, regardless of the species. Luckily, when dogs have heart problems, veterinary cardiologists, like Dr. Ryan Fries at the University of Illinois Veterinary Teaching Hospital in Urbana, are able to keep things ticking along.

Pacemakers have been used in human medicine since the early 1960s. In the late 1980s, Dr. David Sisson at the University of Illinois became one of the first veterinary cardiologists to place intravenous pacemakers in canine patients. Currently, the university’s Veterinary Teaching Hospital is the only veterinary facility in the state of Illinois that offers this procedure.

In dogs, pacemakers are used both as a life-saving intervention and to improve quality of life.

How Pacemakers Work

“A pacemaker is made up of two parts,” says Dr. Fries. “One part consists of a generator, a lithium battery and a computer chip that we can program to meet the dog’s needs. The other part consists of wires, called leads, that extend from the generator through veins in the neck and are attached to the inside of the heart.”

The pacemaker is activated when the dog’s heart rate slows below the acceptable range set by the veterinarian, generally between 80 and 120 beats per minute. When the pacemaker kicks on, it stimulates contractions of the heart until the heart’s rhythm is reset and can continue on its own.

Cardiologists like Dr. Fries place pacemakers while the dog is under anesthesia. The surgery is most commonly done using minimally invasive techniques. The equipment used is the same that’s used in humans, but the procedure is much more affordable: “The entire procedure typically costs between $3,500 and $4,000, which is consistent with other specialized veterinary procedures,” says Dr. Fries.




How Pacemakers Are Placed

“A small incision is made in the dog’s neck, and the leads are fed through the external jugular vein, the same vein used to draw blood. Once the leads are in, the generator is tucked in the skin and stitched up,” explains Dr. Fries.

These radiographs show the pacemaker in place at the patient’s neck and the leads travelling down to the heart. The patient, Lucy, is shown in the photos on this page.

Fluoroscopy is used to visualize the leads going into the heart so the veterinarian can ensure that the leads are attaching in the right place. Fluoroscopy, a form of real-time radiograph, or X-ray, is also used during a heart catheterization.

“Dogs might benefit from a pacemaker if they have an arrhythmia (abnormal heart rhythm) or a heart rate that is too slow to support the dog in daily activities,” says Dr. Fries. “Some arrhythmias can stop the heart and be life threatening. Other heart conditions may simply impede the dog’s ability to exercise and live a normal life.”

How Pacemakers Help Dogs

A classic presentation of a non-life-threatening heart problem occurs when an otherwise healthy dog suddenly faints while doing routine activities because of reduced blood flow from a slow or irregular heartbeat.

Certain breeds are genetically predisposed to heart abnormalities that can be helped with a pacemaker. Sick sinus syndrome, which affects heart rate, is commonly found in older West Highland White Terriers, Miniature Schnauzers and Cocker Spaniels. English Springer Spaniels are susceptible to a heart condition called atrial standstill.

breed, an advanced atrioventricular (AV) block — a condition in which the impulse that causes contractions in the heart’s atrium is not conveyed appropriately to the ventricle — can be treated with a pacemaker.

“Pacemakers can be a long-term solution and often allow the dog to return to full capacity. If placed early in a dog’s life, the battery may be used enough to wear out. However, the battery can be replaced quite easily,” says Dr. Fries.

Follow-Up Care

A dog with a pacemaker will likely need checkups every six months, alternating visits between a primary care veterinarian and a veterinary cardiologist, according to Dr. Fries. If needed, the settings on the pacemaker can easily be reprogrammed by a veterinarian, who will adjust the computer program by placing a magnet over the skin. No surgery is necessary

Following a month of rest after the surgery, dogs with pacemakers should be ready to resume normal activities. The only thing owners need to do is switch from a collar to a harness to keep pressure off the dog’s neck where the generator is.

“Pacemakers may offer the only treatment option that allows a dog to return to a normal life. We even put them in working animals that return to their jobs,” says Dr. Fries. “They are more common than you would think. There are no outward signs to tell the difference between a dog with or without one!”

If you have questions about pacemakers for dogs, contact your local veterinarian

From Pet Columns, University of Illinois College of Veterinary Medicine:


Prevent the Big Three Pet Parasites

Ticks, fleas and mosquitoes. Nobody wants these bugs on their pets or in their house. But the reasons for keeping these bugs away go beyond just avoiding pests. “Ticks, fleas and mosquitoes are dangerous because they can carry and cause malicious diseases,” explains Dr. Gary Brummet, who heads the small animal primary care service at the University of Illinois Veterinary Teaching Hospital in Urbana and counsels pet owners on preventing pet parasites.

“Ticks are infamous for their disease-carrying capabilities. They transmit Lyme disease and Rocky Mountain spotted fever and can also pass along protozoa like Cytauxzoonosis and many others,” says Dr. Brummet.
Dogs are extremely susceptible to Rocky Mountain spotted fever, which typically causes fever, vomiting, diarrhea and abdominal pain. When left untreated, Rocky Mountain spotted fever can lead to death.
Cytauxzoonosis is a deadly disease caused by protozoa that affects domestic cats. It begins with nonspecific signs, including lethargy and a poor appetite; the disease will progress to an extremely high fever and death if not treated quickly.
Lyme disease is a bacterial disease that can affect dogs, horses, people and potentially cats. It can cause neurological issues, joint disease and overall lameness. In its most severe forms, it causes renal failure and ultimately death.
In the past this disease was more prevalent in the northeast, but due to increasing deer populations (an ideal tick host) and reforestation providing prime tick habitat, Lyme disease-spreading ticks have increased in number and are becoming more and more prevalent in the Midwest as well as other parts of the country they were not in even just 20 years ago.
This year preventing tick bites is going to be even more relevant as the Centers for Disease Control and Prevention has predicted high tick populations, likely due to the mild winter.
FLEAS TRIGGER ALLERGIES “Fleas may be less known among pet parasites for causing deadly diseases, but are detrimental nonetheless,” says Dr. Brummet. It is not uncommon for dogs with skin allergies to be reacting to a flea infestation, even if they have very few fleas. Fleas also carry tapeworms, which work their way into your pet’s digestive system when the fleas are swallowed while the animal grooms itself.
Additionally, fleas can easily infest a house, which can be very unpleasant. Dr. Brummet says, “Once fleas get in the house, they can be hard to get rid of, so it is easiest to stop them before they start. This means protecting your pets with preventive medication.”
Heartworms are the last of the big three pet parasites most commonly discussed, and they are exactly what their name implies: worms that live in your pet’s heart.
“Heartworms are transmitted by mosquitoes. Any time pets are outside, they are at risk. Heartworms can grow to eight inches in length and can spread from the heart to the lungs,” explains Dr. Brummet.
The signs of a heartworm infestation often start subtly; the animal will begin to tire easily when exercising and may cough. If left untreated, the worms will create such a burden on the heart that the heart cannot perform its job and the animal will die. In cats, heartworms can cause sudden death because there were no discernable signs of disease. “Heartworm can be treated, but the treatment is costly and the animal will likely need to be hospitalized. The course of intramuscular injections used to treat heartworm takes months to complete, and even if the animal survives, it may have lifelong restricted activity because of the damage done to the heart,” Dr. Brummet says.
“Preventive medications are really the best way to combat these parasites and the diseases that accompany them. It is less expensive in the long run and much safer for your pet,” recommends Dr. Brummet.
He notes an added bonus to giving your pet a heartworm preventive: “Heartworm preventives also protect your pet from intestinal parasites that can cause gastrointestinal disease.”
Preventive medications for fleas, ticks and heartworm should ideally be given year round.
“Many owners stop giving medications toward the end of the summer as the weather cools down, but September and October are probably the worst months for flea and tick infestations. At the very least, flea and tick preventive should be given until the second hard frost. Heartworm preventive should be given all year,” cautions Dr. Brummet.
Preventive medications are available in oral and topical forms. Dr. Brummet advises speaking with your veterinarian to choose what is best for your pet.
“Many of these medications are speciesspecific. Using dog products on cats can cause harmful reactions. You should only give the medication to the pet it was prescribed for,” says Dr. Brummet.
If you have questions about fleas, ticks, heartworms or other pet parasites, talk to your veterinarian.
From Pet Columns, University of Illinois College of Veterinary Medicine: