Periodontal Disease: The #1 Medical Problem of Today’s Pets

After being housebound for several days, consuming more junk food, and exercising less, it is time to get back to my regular routine. It is so easy to make excuses due to the cold and sleet. So often the same “mindset” occurs when it comes to caring for the teeth of pets. It is well known by most pet owners that bad breath is associated with dental disease. It is less known is that most expect their pets to stop eating with oral pain. In fact, lack of appetite is one of the last signs to be seen in oral infections. Once an owner flips their pet’s lip, it is often surprising the changes found in mouth: redness, odor, infection, and even tumors.

WHAT IS PERIODONTAL DISEASE? WHAT PERCENTAGE OF PETS HAVE IT?

Periodontal disease is the inflammation of the teeth’s supporting structures: ligaments, gums, and jaw bones. This encompasses approximately 60% of the tooth below the gum line.  Left unchecked, it has an adverse effect on a pet’s quality of life.  About  70 to 80% of pets by the age of 3 develop signs of it. 

WHAT REALLY IS DOGGIE BREATH?

Halitosis is mainly the by-product of bacterial pockets trapped below the gum line. 

WHY DO PET DENTALS NEED TO BE PERFORMED UNDER GENERAL ANESTHESIA?

Dental radiographs & dental cleanings cannot safely or ethically be performed on awake animals. Up to 42% of cats and 27% of dogs will have significant periodontal disease revealed in dental radiographs; yet the teeth above the gum line will appear normal.  Anesthesia alleviates pain during dental cleanings, allows probing of the teeth, and intubation protects aspiration of debri and water into the lungs.

WHAT PERCENTAGE OF PETS NEED AN ANNUAL, ANESTHETIC DENTAL Cleaning?

It is estimated to be 85%.

HOW DOES PERIODONTAL DISEASE DEVELOP?

 The lack of brushing or abrasive chewing leads to sticky plaque accumulation on a pet’s teeth. In 72 hours, bacterium encased in plaque evolves into hard tartar on the tooth surface (that cannot be removed by routine brushing). Tartar subsequently irritates the lining tissues around the teeth leading to inflammation, infection, and eventual destruction/detachment of the tooth from the gum tissue and jaw bone. 

IS THERE A CERTIFICATION PROGRAM FOR VETERINARY DENTAL PRODUCTS?

Ye,s the Veterinary Oral Health Council (VOHC.org) assesses home dental products. Pet owners should look for the VOHC seal on veterinary products to ascertain efficacy and safety. Approved products include dental chews, prophy pastes, diets, water treatments, and gels. 

WHAT ARE THE TOP 5 TOOLS & TECHNIQUES FOR ORAL HOME CARE?

1. TOOTH BRUSHING: DAILY PREFERRED

2. ANTISEPTIC SOLUTIONS

3. CHEW-BASED TREATS & DIET

4. BARRIER SEALANTS

5. WATER ADDITIVES

NAME SOME COMMON MISCONCEPTIONS OF PERIODONTAL DENTAL DISEASE

1. The amount of tartar on the teeth is an accurate benchmark of periodontal disease. FALSE!  It is more important to evaluate the gum tissue both visually and also radiographically. 

2. Gum color is first sign of gum disease. FALSE! Actually gum bleeding is noted more commonly when slightly irritated. 

3. Oral exams are all that are needed to determine gum disease. FALSE! In fact, radiographs and probing depth of gum pockets while sedated are key criteria. 

4. Only loose teeth need to be extracted (removed). FALSE! The key criteria are radiographically, those with deep pockets or abscessed roots (even if tooth is attached) need to be extracted as they indicate potentially serious infection. 

LEFT UNTREATED, WHAT ARE SOME OF THE MORE COMMON CONSEQUENCES OF DENTAL DISEASE?

Oral pus/pain, holes between the sinuses and the mouth, jaw bone fractures, heart valve disease, liver & kidney failure, and even untimely passing are sadly potential consequences to infected mouths.  

WHAT IS MOST COMMON COMMENT OF CLIENTS AT THE POST DENTAL RECHECK?

They comment their pets seem happier and more playful. 

Photo of Kepley, courtesy of Rick and Chris Vandenberg 

Betsy Sigmon DVM, Diplomate ABVP, canine & feline

Creature Comforts Animal Hospital

Cary, NC

Reverse Aging: A Potential, New Fountain of Youth Drug

To celebrate our Valentine’s Day Anniversary, my husband and I recently went to Florida and to the Miami Boat Show. I have to admit I was blown away by the expensive, million dollar plus cigarette boats that were pure testosterone-driven, ego trips for some financially successful people. When I asked a salesman how individuals from the Middle East picked up their boats from a factory in Missouri, his deadpan answer was “with a cargo plane." One individual had wanted to give a boat to a friend in Dubai as a surprise. 

I am sure my youthfulness would have picked up speed driving one of these fast boats. 

Legend has it that Ponce de Leon was searching for the Fountain of Youth in his exploration of Florida in 1513.  It is in that same city, St. Augustine, that Henry Flagler (of Standard Oil) established his first Florida Hotel to enjoy the beauty of the Sunshine State. The Florida legislature (with Flagler funding) helped Flagler divorce his second wife by establishing a new reason: she was declared insane. This was so he could marry Mary Lilly Kenan 11 days later and a startling 38 years younger. He built the beautiful Whitehall in Palm Beach as a  wedding present to her –  a testimonial to his devotion and her wish to live in a marble house.  Unfortunately, youth did not help Flagler. He died 13 years later at the age of 83. He fell down the marble steps, broke his hip, and passed away shortly thereafter. 

With some dog breeds aging approximately 7 years for every 1 human year, clients often ask me what they can do to keep their pets from aging (beyond the standards of exercise, good diets, and weight control.) One recent article reports promising results with the medication, Rapamycin.

WHAT IS RAPAMYCIN? 

Rapamycin, a rare bacterium (bacteria), is the most promising anti-aging drug in decades. It was first isolated by Suren Sehgal in a soil sample at Ayerst Laboratories, a pharmaceutical company in Montreal. It was found on a Canadian medical expedition under a mysterious stone head on Easter Island in the middle of the Pacific Ocean. Besides its anti-fungal properties, the new medication also suppressed the immune system. This lead to its use in organ transplants to reduce rejection with its new manufacturer, Wyeth. Cardiac stents have a coating of the medication on heart stents to reduce rejection and lower the risk of scarring and blocking. 

TELL MORE ABOUT THE ANTI-AGING PROPERTIES, PLEASE!

Novartis pharmaceuticals is eyeing its use to delay the onset of Alzheimer’s disease, cancer, heart disease, and to improve the immune system of elderly patients. Life expectancy in studies was extended by 9 to 40%. 

ARE THERE ANY OTHER DRUGS IN THE WORKS? 

Metformin, taken by millions of human diabetics,  appears to have a 15% decrease in mortality rate. Mimagrumab (Novartis) is a medication intended to reverse muscle loss. 

WHAT OBSTACLES ARE THERE TO DEVELOPING A DRUG THAT IS “ANTI-AGING”? 

The FDA does not consider aging a disease, and thus it will be extremely difficult to approve a medication for such a purpose. In addition, high safety standards would be required for any medication to treat healthy people. 

WHERE ARE THE CLINICAL TRIALS FOR DOGS BEING CONDUCTED?

At the University of Washington researchers are conducting clinical trials on dogs to see if the medication delays heart disease and cancer.

I would like to thank you for your kind words and support of the clinic blog. Please let me know of a subject of interest to you that I may address in future columns. 

Betsy T. Sigmon DVM, Diplomate ABVP, Canine and Feline

Creature Comforts Animal Hospital

Cary, NC

Feline Constipation: Megacolon

As I am writing this, the weekend is now over only after enjoying a lovely brunch with my sister at Waverly Place. My brunch strategy is to first survey the menu and make my main course selection based on my dessert choice and then work backwards. This methodology is a reflection of dinner time in my formative years when everyone asked what was for dessert before we even ate the main meal. My siblings and I then ate the main meal accordingly to save room. My mother, having a master’s degree in human nutrition from Cornell University, was big on healthy eating with the exception of dessert. Then all bets were off the table. 

I think I made a good choice!

When asked what my perfect last meal would be,  without question it would be the dessert buffet at a church social. I would pull up a chair and help myself to EVERYTHING! Unfortunately, there is a price to pay for such gluttony. There certainly is a long list of jokes in our society about feeling full, bloated, and uncomfortable. But for many cats, it is no joking matter to be constipated.

WHAT IS THE PURPOSE OF THE COLON SECTION OF THE INTESTINAL TRACT?

The colon is the section of the intestinal tract from the small intestine to the rectum. It stores poop and removes extra water and salt. It can actually store several weeks worth of stool. Many pets commonly will not have a bowel movement for 1 to 2 days after an anesthetic procedure.   Unfortunately, in other cases, the longer the feces remain in the colon, the more water that is removed which leads to feces becoming very firm and dry. As the colon becomes constipated, this can lead to dilation more than double its normal diameter. This end stage of chronic impaction and extreme dilation is called Megacolon in cats. 

THERE MUST BE MANY CAUSES. WHICH ONES ARE MOST COMMON?

 Many theories abound as to the causes: dry cat food, inactivity, excessive grooming/hair impaction, certain medications, electrolyte imbalance/kidney disease and decrease in water consumption. Anatomical causes include nerve injury, Manx/bob tail spinal cord abnormalities, and fractures/narrowed diameter of the pelvic (hip) canal. are also causes. The majority of Megacolon episodes appear to have an unknown cause (idiopathic).  It is suspected there is a lack of muscle wave (peristalsis) motion of fecal material moving through the colon. 

 ARE THERE SIGNS NOTED BY OWNERS?

Although occasional episodes are not reason for alarm, most cat parents report a decrease of poop in the litter box accompanied by absent, prolonged, or painfully difficult defecation. The passed poop may be dry or hard although some report mucous or soft stool with a bloody tinged that may reflect material being passed around the firmer poop. It often advances to lack of appetite, vomiting and weight loss. Some may appear to have difficulty urinating. 

HOW IS CONSTIPATION TREATED ONCE IT IS DIAGNOSED BY PHYSICAL EXAM ALONG WITH RADIOGRAPHS?

Mild cases are treated with special diets such as Royal Canin fiber responsive cat food following warm water enemas. Other cats do better with low residue, canned diets.  In addition, stool softeners (canned pumpkin, bran cereal, Metamucil, Konsyl, Miralax, Dulcolax) and medications that improve gut motility (pro-kinetic agents) are often prescribed. 

TELL ME MORE ABOUT THE PRO-KINETIC MEDICATIONS AVAILABLE TO ALLEVIATE CONSTIPATION.

Cisapride improves motility of the colon. It was previously used for reflux in humans, including babies. Currently, cisapride can only be obtained from compounding pharmacies. It will not be effective if intestinal nerves have become nonfunctional. Another medication, Tegeserod, works in a similar fashion.  

WHAT OPTIONS ARE RECOMMENDED IF MEDICAL THERAPY FAILS?

Removal of the colon (called a Subtotal Colectomy) is recommended, although many will have persistently soft stools postoperatively. 

Betsy Sigmon DVM, Diplomate ABVP Canine & Feline

Creature Comforts Animal Hospital

Cary, NC

Cognitive Dysfunction: Memory Loss

Upon entry to the Creature Comforts reception area, there is a book case with pictures of various celebrities I have met through the years: Barbara Bush, Tanya Tucker, Betty White, and George Wallace (the comic), to name a few.  There are a few that my clients would like me to forget: Senator John Edwards who I met while on a tour of the US Senate and Bill Cosby who was the entertainment at a veterinary conference where I served on the advisory board. Some images and memories of these individuals are priceless, while others have been demoted and forgotten in dark drawers. 


Memory or Cognitive Function is a hot topic in both pets and people as we age. Acetylcholine and Dopamine are important neurotransmitter chemicals for normal brain function.  In aging there is a reduction in these chemicals as well as blood flow and glucose and oxygen metabolism in the frontal lobes of the brain.

WHAT ARE THE SIGNS OF BRAIN DETERIORATION OR COGNITIVE DYSFUNCTION SYNDROME?

Disorientation, pacing, sleeping most of the time, confusion, and a change in housetraining are among the more common complaints of pet owners. On MRI’s of the brain, brain atrophy (of the frontal /cortical area) and the enlargement of the ventricles is noted in these patients. Additional findings include a decline in blood flow and a decrease in glucose (sugar) and oxygen metabolism. An astounding 28% of dogs aged 11 to 12 years and 68% of dogs aged 15 to 16 years old exhibit this decline. There is actually a commercial web site available for pet owners to measure the cognitive function through a variety of provocative tests www.dognition.com .

ARE THERE SOME BASIC STEPS OWNERS OF OLDER PETS CAN TAKE TO SLOW THIS DECLINE?

Environmental enrichment (mental stimulation), exercise, diets rich in anti-oxidants and medium chain fatty acids, and appropriate medications are good starting points.

WHAT ARE SOME OF THE NUTRIENTS THAT IMPROVE BRAIN FUNCTION & COGNITION?

Omega 3 fatty acids, Arginine(amino acid), Vitamin E (anti-oxidant), B-vitamins, and Medium chain fatty acids (think coconut oil) are among the most common supplements to improve blood flow, nourish the brain, and slow deterioration of brain tissue.  

SEVERAL MEDICATIONS ARE ON THE MARKET FOR SENILTY AND BRAIN DECLINE. WHAT ARE THEY? Note most will take 2 to 3 months to show improvement. 

Anipryl (Segiline/ Pfizer) is approved as a treatment for cognitive dysfunction within 2 months of starting in 77% of patients.

Novifit (S-adenosylmethionine/Virbac,) a natural, nutritional supplement, is an anti-oxidant and is neuroprotective utilized to improve memory and activity. It is best utilized in the early stages of senility.

Anxitane (L-theanine/Virbac), an amino acid protein from green tea leaves, increases GABA levels that works in the brain as a calming agent and increases dopamine that naturally improves attitude while reducing fear. 

Neutricks (Apoaequorin/Quincy Animal Health), a natural supplement derived from jellyfish, shows potential to improve cognitive function in older dogs. 

Senilife (Ginko biloba, Innovet Italia) is a nutritional supplement showing some improvement in activity and interaction of older pets with their environment/families. 

ARE THERE DIETS WITH NUTRIENTS GEARED TO OLDER PETS WITH COGNITIVE ISSUES?

Many of the major pet food manufacturers have mature diets catering towards pets exhibiting brain decline with appropriate nutrients. Hill’s pet food has a brain diet b/d. Purina One Vibrant Maturity 7+ plus formula contains extra medium chain triglycerides.

Betsy T. Sigmon DVM, Diplomate ABVP, canine and feline

Creature Comforts Animal Hospital

Cary, NC