What makes a happy canine mouth? Breedwatch 2016 presentation

Simone Kirby, Dentistry Lecturer from the RVC spoke about canine dentition at today’s Breedwatch Education Day.

This talk began with an overview of the anatomy and normal occlusion of the dog’s mouth, from birth to adulthood. Simone talked about common malocclusions, and explored the difference between merely cosmetic issues and more serious conditions.

Puppies are born without teeth; primary dentition erupts at 3-4 weeks and is completed by 2-3 months. Puppies have 28 teeth. Adult teeth start to come through between 3-7 months – incisors come first, canines erupt at 4-5 months and there will be mixed dentition during the changeover period.

Normal dentition is a scissor bite and full adult dentition is 42 teeth. In general, malocclusions should be treated as a cause of pain.

Cosmetic variations are not an issue from a medical perspective, compared with dogs intended for showing, where Breed Standards will be quite specific about requirements and faults. Some breeds have malocclusions as part of the Breed Standard, e.g Brachycephalic breeds.

Simone discussed a particular example of base narrow canine teeth where lower canines impinge on the upper palate. This is often painful. It may be combined with a short lower jaw.
Anecdotally, many breeds are pre-disposed to this. Often there may be just one puppy in a litter. Not much data is available on breed prevalence.
Treatment includes extraction, crown shortening + vital pulp treatment. Braces (orthodontics) are rarely used in dogs as they can be difficult to retain unless a puppy is calm. Any such treatment should be reported to the KC.

Periodontal disease was the next topic to be discussed: It is very common amongst all dogs; however certain skull shapes predispose some dogs more to this than others.

Tooth crowding:
You find premolar crowding if the jaw is too short or incisor crowding if the jaw is too narrow. Both can result in periodontal pockets on the root  that sits in the palate.

Primary teeth not coming out:
– crowding causes pockets where food gets stuck and invites disease
– persistent baby teeth can cause malocclusion of adult teeth
Persistent primary teeth are more common in small breeds such as the Chihuahua and Yorkshire Terriers.

Periodontal disease:

70% of dogs over 3 years are affected to some degree. This includes infection of the jaw bone. It is multi-factorial, related to bacteria in plaque, oral hygiene, nutritional deficiencies, genetics and stress.
With gum recession and heavy tartar coverage, the tooth root becomes mobile. This is not always recognised by owners.

Is tartar removal enough? Probably not; you can miss disease under the gum-line. Vets really need to probe under the gum line and use x-rays under GA. X-rays will identify periodontal pockets.
Treatment includes extractions, scale/polish, pocket treatments, Prevention – daily tooth brushing is the gold standard.

Prevention – daily tooth brushing is the gold standard.

Simone noted that it can be difficult to brush teeth in pugs and other brachy breeds. As a veterinary dentist, she would welcome seeing longer muzzles in these breeds.

Finally, she discussed trauma to teeth: The incidence is higher in younger dogs, due to their extremely playful nature, but can affect any age group. There was a brief overview on the treatment of fractured teeth, and strategies of risk-reduction when choosing toys for your dog.

Toy breeds have specific jaw fracture risk. Jaw and bone size have shrunk in these breeds, but their teeth are the same size as in larger dogs. This results in a thinner jaw bone and the jaw bone can become weak with periodontal disease. The risk is greater in lower jaw bones.

Larger head and muzzle size would help increase jaw bone height. It is unlikely that we would be able to breed for smaller teeth. These breeds need meticulous oral care from puppy age. An anti-plaque drinking water additive and annual dental checks are also recommended.

Dental trauma:
Tooth fractures are more common in younger dogs. Canines fracture due to play behaviours. Premolar and molar fractures are usually caused by chewing sticks, bones, nylon toys, antlers and cow hooves.

Untreated, they  can result in an abscess. Extraction or root canal treatment is required.
Blunt trauma – “pink tooth” – can cause bleeding inside the pulp. The pulp then dies off and needs the same treatment as an open fracture.

Abrasion – slow wear: Tennis balls are the number 1 culprit, but any toys on the beach are also problematic due to the presence of sand. Abrasion trauma is mild in many dogs, but more common in terrier-types.

Avoiding dental trauma – advice…

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It’s a Big Problem – genetic and other causes of canine obesity

Dr Eleanor Raffan from Cambridge University spoke at today’s KC Breedwatch Education Day on the subject of canine obesity. Here’s my summary of her presentation.

Obesity is a big problem – pet obesity is in the news. Health problems resulting from obesity include:

  • Joint problems
  • Breathing in Brachycepahlics
  • Cancer (in people, obesity is now a bigger cause of cancer than smoking)
  • Obese dogs die younger.In one study, fat Labradors died 2 years earlier than lean ones
  • Worse quality of life
  • Interestingly, there is little evidence that diabetes is linked with canine obesity, unlike in people

In the overall canine population, obesity is far more significant as a health issue than low prevalence genetic issues. (We know this from the VetCompass project)

Simplistically, the causes of obesity are too much food and not enough exercise. This is simplistic but important from a management point of view. We have to remember that most of dogs’ evolution was in a resource-scarce environment, so biologically, it makes sense to lay down fat (energy) for when food is scarce.

The genetics of obesity:

Eleanor conducted research into Labradors, a breed commonly found to be obese. She identified the POMC mutation in overweight dogs – dogs with 1 copy of the mutation weighed more than those with 2 copies and this explained most of the variation in weight. The presence of the mutation also correlated with dogs’ food motivation.
The POMC mutation interrupts the leptin pathway, which regulates appetite, so dogs with the mutation don’t know when to stop eating!

pomc_mutation75% of Labradors are wildtype but this was as low as 20% in Guide Dogs. Temperament and “trainability” are the main drivers for selection of assistance dogs, and “positive reinforcement” with food reward is a mainstay of puppy training. Eleanor, therefore hypothesised that dogs carrying the POMC deletion may be more likely to be selected as assistance dogs.

The POMC mutation also exists in Flatcoated Retrievers, a breed not normally associated with obesity. Interestingly, Golden Retrievers don’t have the POMC mutation. The observations of these two breeds were particularly interesting for today’s audience who felt FCRs were generally not considered to be overweight in the show ring, in contrast to some GRs, which can be overweight.

So, we do need to recognise that an obsession with eating and consequent tendency to become obese is hard-wired into some dogs’ genes.

Prevention:

Owners should establish good feeding habits with puppies – bonding can be done without food. Give fewer treats (a mid-sized Dentastix contains 75 calories).
Dry foods are very calorie-dense. they taste and smell good, so are very attractive to dogs. It can be useful to switch from bowls to feeding in a Kong throughout the day. This keeps greedy dogs happy.

Establish good exercise habits. I recently shared information on a Canadian study of owners which showed 26% had no intention to exercise their dog at all, 33% were “failed intenders” and only 40% were active intenders (people who said they would walk their dogs and actually did so). It’s no good saying “I intend to walk my dog”; you actually have to take them out every day!

How to cope with an obese dog:

Vet weigh-loss diets are typically high in protein and fibre, both of which sends signals to the brain to say the dog is full. These are expensive.

Download a copy of the Body Condition Score chart and regularly assess your dog. A “healthy weight” is a BCS of 4-5 (out of 9).

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Get help from your vet; many run obesity clinics.

Messages for judges:

Dogs could look “right” but may actually be fat. Judges must feel the dog’s body and assess whether or not its “shape” is actually caused by it being fat.

I resisted the temptation to comment on the fact that very few Miniature Dachshunds would be likely to be fat in the show ring. Judges weigh them and exhibitors know the correct size and body condition required. In contrast, it is obvious even from the ringside that some Standards are “well-covered” and in soft condition as well as being over the desired size specified in our Breed Standard.

Follow Eleanor on Twitter @GOdogsproject.

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Our Dogs “Best of Health” article: Show me the data and I will show you some insights and solutions

Best of HealthMost readers will probably remember me writing about the Dachshund Breed Council’s 2015 Breed Survey: DachsLife 2015. The aim of the survey was very specific – to identify any lifestyle factors that contributed to the risk of back disease (IVDD). The original survey design was done in conjunction with Rowena Packer and her colleagues at the Royal Veterinary College (RVC). We deliberately involved them in the design because we had ambitions to gather lots of data that could be used to build on Rowena’s earlier work on the conformational risk factors associated with IVDD. In 2013, Rowena published her paper “How long and low can you go?” which showed that the longer a Dachshund’s body, the higher was its risk of IVDD. This clearly had implications for breeders and judges, but we also wanted to explore what owners could do.

After we had reported our results, we handed the data over to Rowena to work her magic with the more sophisticated statistical analysis tools she has available. Now, we have just published that further level of analysis in the peer-reviewed journal of Canine Genetics and Epidemiology.

One of the great things about this journal, which is sponsored by the Kennel Club, is that all the articles are Open Access. I strongly believe that sharing data and making the results of scientific studies widely available is key to making progress with any sort of improvement. So, not only can readers read the full text of our paper, but they can also access the anonymised source data. Anyone can repeat our analysis and interrogate the data further.

“Without data, you’re just another person with an opinion” (Dr. Deming)

As soon as data, research and analysis are put into the public domain, people can begin to make informed decisions.

Of course, the data and analysis may well challenge existing preconceptions and urban myths. Our Dachshund analysis was no different. Conventional wisdom would have you believe that allowing your Dachshund to jump on/off furniture, or to run up and down stairs is potentially bad for their backs. The analysis actually showed the reverse; those dogs who were allowed to do those things had a lower odds of having IVDD.

We do have to be careful to remember that correlation does not imply causation and we point out in the paper that there may be a danger of “reverse causation” with some of the results. For example, it may be that dogs whose backs have herniated were subsequently not allowed to jump on/off furniture or go up/down stairs. The missing data is “when” did those activities start/stop in relation to the herniation. We can, however, find other studies which also showed that this sort of activity reduced the risk of IVDD. The practical advice for owners arising from the activity/exercise findings is that keeping your Dachshund fit and active is one way to reduce the risks of IVDD. It’s common sense and any reasonable person would expect a fit, well-muscled dog to be able to lead a normal lifestyle coping with furniture and stairs.

Another surprise from our analysis was that neutered/spayed Dachshunds had an increased odds of IVDD compared with entire dogs. In this case, we can be more confident that it is not a case of reverse causation (e.g. dogs with IVDD were subsequently neutered) because we know the age of neutering and the age of IVDD diagnosis. Indeed, we found that the younger a dog was neutered, the higher its odds of IVDD. This finding should not surprise us in light of numerous other studies in dogs (and people) that challenge the claimed health benefits of neutering.

This finding is going to be a hard one to sell to many vets who still seem keen to encourage new puppy owners to book their dog in to be spayed/neutered as soon as possible after its vaccinations or before 6 months of age. However, in this emerging age of evidence-based veterinary medicine, vets will, I suspect, find some of their prejudices and biases challenged.

Big data gives you big insights

One of the interesting challenges when the paper was peer-reviewed was around biases in the data. The survey participants were self-selecting, they were willing to “own up” to health issues in their dogs, they may have been keen to “make a point”. They all responded via the internet in an online survey, so there may have been demographic biases in the respondent population.

Our argument was that, if you have large volumes of data, these sorts of bias are less significant. We had over 2000 responses and looked at more than 50 variables in the lifestyle factors. The VetCompass project is similar; with literally millions of case reports from first opinion veterinary practices, the volume of data permits deep insights to be obtained with high statistical confidence.

Of course, we have to remember that epidemiological studies draw conclusions about populations, not individual dogs. Inevitably, there will be owners whose personal experience differs from the findings at population level. In our case, there will be comments like “my dog jumped off the chair and ended up paralysed” or “my dog was fit and well-muscled, but still had IVDD”.

Those individual cases are entirely to be expected and do not diminish the advice we are able to give owners based on population-level insights. We know that, fundamentally, IVDD has a strong genetic component and is highly heritable. Nevertheless, if every owner adopted the good lifestyle choices we have been able to identify, I am convinced that it would make some inroads into the risks of IVDD. I’ve written previously about Dave Brailsford’s 1% Principle: lots of small changes can aggregate to make a significant difference.

While I have focused on Dachshunds and IVDD in this article, I am sure the principles apply more widely:

  • Breed Health Coordinators and their committees should think about the design of their health surveys with a view to carrying out deeper analyses
  • There are many situations where breeds already have lots of data; collecting more or different data is not the solution; we often just need more insight from analysis of existing data
  • The answers lie in the data, but don’t be surprised if some people (owners, vets, breeders) feel challenged or exposed by this, particularly when the results run counter to their perceived wisdom (see my article on Cognitive Dissonance)

Finally, remember “Prejudice is a great time-saver; it enables you to form opinions without having to gather the facts”.

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“Post-truth” – my new favourite word

Oxford Dictionaries this week announced their word of the year to be “Post-truth”. This is a word that questions the concept of facts themselves. It means that objective facts are less influential in shaping public policy than personal beliefs and appeals to emotion.

“It’s not surprising that our choice reflects a year dominated by highly charged political and social discourse,” Casper Grathwohl, Oxford Dictionaries’ president, said in an essay on the company’s website, which cited “the rise of social media as a news source and a growing distrust of facts offered up by the establishment.”

Post-truth derives from the Brexit and Trump campaigns which were both heavily laden with emotional “arguments” and where facts and evidence were largely ignored. It’s also been associated with the phrase “post-truth politics” which seems to be a euphemism for lies or conspiracy theories. It implies that we are living in a world where facts, data and evidence are unimportant or irrelevant.

5s-simulationLast night, I attended the Operational Research Society’s annual lecture and “post-truth” featured in the President’s opening speech. She said that OR Society members have a particularly important role to play in the “post-truth” world. The society is a membership organisation for people from numerate disciplines such as mathematics and statistics who focus their skills on helping organisations make better quality decisions. Despite “only” being a Chemistry graduate, I’m a member because much of my working life is spent looking at data to get a better understanding of problems and to identify insights and solutions.

My second favourite new word which I also discovered this week is “truthiness” which was coined in 2005 and basically means facts that someone wishes to be true, rather than facts known to be true. Truthiness is a one-word summary of a phrase I came across earlier this year: “You are entitled to have your own opinions, but you are not entitled to have your own facts”.

All my friends will know my obsession with data and evidence, which we have used to good effect to help improve the health of Dachshunds. Evidence-based veterinary medicine is an increasingly hot topic and often challenges conventional wisdom about what is the best treatment for an animal.

Look out for my next Our Dogs Best of Health article which is all about the power of data to generate insights and solutions for Dachshund health and welfare problems.

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National Canine Health Testing Week: 21-27 November

NCHTW DachsThe KC has issued a Press Release about National Canine Health Testing Week which is one of the Kennel Club’s annual initiatives to raise awareness of the importance of breeding and buying puppies from appropriately health tested and health screened parents.

During the week, dog breeders and puppy buyers will be provided with information on which health tests and screening schemes may be relevant to their dogs, tools to assist breeders in making health related breeding decisions and information for puppy buyers to ask the right questions before buying a puppy.

Dog owners are being encouraged to take a ‘dog’s eye view’ photograph of their four-legged friends as part of this year’s National Canine Health Testing Week (21st to 27th November). To take a #DogsEyeView photo, the Kennel Club is asking people to take a picture of their dog from behind, with the ears, head or whole body in shot, to show the dog’s view. The photo could be taken low to the ground and should emphasise how a dog sees the world. The dog could be looking at a stunning view, going for a walk through the woods, meeting family and friends or doing an everyday activity. Photos can be funny, serious, or poignant, and should be posted on social media using the hashtags #DogsEyeView and #NCHTW.

This is a good opportunity to take a look at the Breed Council’s recently launched IVDD Screening Programme. If your Dachshund is between 24 and 48 months old, and you plan to breed from him/her, please consider joining the screening programme which is being subsidised by the Health Fund.

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