Everyone in general practice (GP) has their favorite types of appointments. For me, it’s the preventive care appointments, especially when they really are preventive. In theory, these should be pretty low-stress appointments for everyone because the pet is (supposed to be) well. You shouldn’t feel too rushed because there isn’t a major problem you need to solve and correct right then and there, you shouldn’t need multiple technicians to get x-rays, blood work, fluids, injections, etc going, and in 30 minutes, you should have time to discuss your exam findings and recommendations and not finish the appointment feeling like you missed giving some vital piece of information or forgot to mention something because there was just so much to convey. (That’s, of course, not always how it works out for one reason or another, but that’s the vision I have in my head for these types of appointments. A larger than normal number of “well” visits these days seem to come in with a laundry list of ailments or concerns that have been saved up for anywhere from 6 weeks to 6 months.)
When I’m doing these appointments, even when the owner says they have, “no concerns,” there are typically two things that I feel I have to address with more patients than not. I don’t always mind repeating myself, but some days, I wish I just had a recording of myself to play because I get tired of giving the same news and subsequent advice. Those two things are: “Your pet has tartar build-up on his teeth; you should really be thinking about a dental procedure under general anesthesia,” and “Your pet has gained some weight and should ideally be [insert number of pounds] lighter.” There are also two things that make me very sad in general practice: dental extractions and old, overweight dogs that are really struggling to get around (or cats with owners that don’t realize their pets are painful, despite behavior changes at home that indicate they are).
Dental extractions sometimes just can’t be avoided, even with the best home care. I don’t know how to prevent resorptive lesions or stomatitis in cats. I wish I did because these are painful conditions for our cats and require extraction of affected teeth. I once went to dental continuing education where the lecturer told us that she was often asked how to not break teeth in cats during extraction. Her only advice: don’t do dental procedures in cats. That is obviously not an option for some of us, myself included. Aside from these aforementioned feline oral conditions, dogs sometimes manage to break their teeth just being dogs, and many small breeds, unfortunately, just have terrible dental genetics. I half jokingly say that I only want to do dental procedures on dogs over 40 lbs because they tend to need less extractions, and when they do, there’s usually room to work comfortably in their mouths.
As for all of those chubby pets out there, I admit that I have a hard time wrapping my head around what (and the amount) some of these guys must be eating each day to weigh what they do. My dogs eat a decent amount of food. (Rook gets 3 cups of his dog food daily, and Magic gets 3 1/2 cups daily, plus they both get cheese on every walk, fresh fruit and veggies every Monday morning when I make up a big batch of food for Elliot and Felix, occasional last bites of whatever we’re eating and various treats, including a fully stuffed Kong with treats and peanut butter after their baths every other weekend. Rook also shares lunch with my receptionists every Friday.) You know what my dogs are not? Overweight. Rook is pretty consistently 56 lbs with a very nicely apparent waist and easily felt ribs, and Magic is typically between 63-65 lbs with a perfect “tuck” before her back legs and also easily felt ribs. So what is everyone feeding their dogs?! I really think people lie to me, either intentionally or because they just forget (or in some cases really don’t know) about all of the “extras.”
I had a client a couple of years back with an adult Golden Retriever that had plumped up a little and was having some mobility concerns. I always tell people that the two best things you can do for a dog (or cat) with arthritis or other orthopedic concerns are 1. good weight management and 2. keeping them as active as they are comfortable being. This client worked hard to get their dog to lose a few pounds, and when I commented on his weight loss and how good he looked, the client got very excited and went on to tell me how much a difference they noticed in their dog since his weight loss- he was happier, more active and playful, more like the puppy he once was, all without requiring medication. I wished that I could record them as a testimonial to play for literally everyone else.
I currently have an obese feline patient who had 3-4 asthma flare ups in a year requiring courses of steroids to get things controlled for him. He lost several pounds in the early fall (and was subsequently diagnosed with diabetes, which is a whole separate issue that may also be weight-related… and/or steroid-related) and has not had any asthma flare ups since the weight loss. Perhaps it’s coincidence since we’re early into this phase of his life, but so far, the weight loss has seemingly helped one problem he was struggling with regularly.
Here are the things I want everyone to know:
- Please brush your pets’ teeth at least 3 times a week if they’ll allow it, as this is the best thing you can do for their oral health at home and prolong the time before they end up on someone’s dental table. At the very least, try to look in their mouths now and then because there is a lot of disease in there, even at relatively young ages. I have, in fact, had pets with very bad dental disease have procedures with multiple extractions, and the owners do come back and say that they had no idea how it was affecting their pet until after the procedure- they had a different animal once they recovered from surgery.
- If I tell you that your pet needs an extraction (or more), I am NOT saying so to make more money or to give myself something to do. I absolutely HATE extracting teeth. Ask any of my colleagues. My favorite dental days are the ones when none of my patients need any extractions. I could clean tartar off of teeth all day, but I really do want those teeth to stay in your pet’s mouth. (I’m also waiting for cats to evolve to not have teeth, but I don’t think that’s happening in my lifetime, unfortunately for me.)
- Don’t let your pets get fat. They do not (in most cases) feed themselves. They have studies that show that overweight Labradors live on average close to two years less than normal weight Labradors. Food does not necessarily equal love.
- If I point out that your pet is heavy, I am not trying to shame anyone. I really just want your pet to be able to live its best possible life. That’s not going to happen if it has trouble standing up and walking or pants every time it shifts its position.
- Just for good measure: please, please, please remember to give your pet its preventatives! I’m not recommending that you poison your dog or cat. I just don’t want them to contract heartworm disease (see November 2021’s post about my sister’s dog, Nina) or come in with a fever of unknown origin or a sudden anemia that stems from either a tick or flea-born disease. Yes, your cat that sits with you on the porch or explores the garden every morning for 15 minutes could be at risk.Yes, even your indoor cat could be at risk if you have a dog or happen to track some fleas in on your clothing. I never had Rickie on a flea preventative until one jumped on me in my car, at which point I panicked because if they’re in my car, they’re also in my house. It’s also not usually cold enough for long enough here in the mid-Atlantic for fleas and ticks to be completely eliminated in the winter, and I have absolutely seen a mosquito in February.
There you have it, for anyone that ever wondered, the three things that come up most often in a wellness visit when the owner has nothing they want to bring up. Occasionally, people do come in wanting to talk about those things. Although most people that do are already doing a pretty good job maintaining their pets at a healthy weight and staying on top of their dental health by scheduling regular cleanings and x-rays and brushing their pets’ teeth.
“Health is not valued till sickness comes.” ~ Thomas Fuller
