Hale Veterinary Clinic

03/10/2025

Virtual anesthesia symposium from NAVAS! It has awesome anesthesia talks every year and is free!

It’s time, everyone! Our Symposium is rolling registration out again! Go to our webpage for more info 🩺

03/05/2025

🦷 We always tell people that an awake examination only gives us limited information, and we cannot finalise the treatment plan until we have their pets anesthetised, take whole mouth intraoral radiographs, and do more detailed examination of all teeth. There is no exception, even for a board-certified veterinary dentist’s pet.

🐈 Dr. Hamilton‘s cat Bucky was just in recently for his routine COHAT. Nothing looked alarming during the awake exam except some gingivitis associated with 104, so we were hoping that all he needed was scaling and polishing. However, once he was anesthetised, had whole mouth radiographs, and a more detailed exam, we found subtle tooth resorption at the distal aspect of 307 and lingual aspect of 407! Those mandibular 07s! Both teeth required extraction to prevent pain.

🔍 Similar ‘surprises’ also happened to our RVT Stella’s cat Cheech and RVT Kim’s cat Ivy. In fact, we find unexpected issues in our patients’ mouths on an almost daily basis. This is why a thorough examination under anesthesia with whole mouth radiographs cannot be replaced by a quick peek into a wiggly pet’s mouth when they are awake.

02/28/2025

😺 We think free cardboard boxes from Costco work great for shy kitties! Odysseus loves this butter box (maybe it smells like butter?) ❤
Have a great weekend everyone! If you are heading to Costco this weekend, don't forget to pick up some nice boxes for your kitty patients!

02/19/2025

More free CE!

💻 Decision Making in Dentistry: It’s Not Always Easy 🦷✨

Sponsored by ANTECH Diagnostics

Join us for a complimentary VETgirl–Antech webinar featuring Dr. Marika Constantaras, DAVDC, as she dives into the complexities of clinical dental decision-making. In this 1-hour session, Dr. Constantaras will review various oral pathologies, imaging findings, and challenging clinical scenarios, offering practical guidelines to develop effective management plans. Whether you’re tackling tricky dental cases or refreshing your diagnostic approach, this webinar is a must-watch!

⏰ February 19, 2025, from 8:00 - 9:00 PM ET / 5:00 - 6:00 PM PT
📚 1 hour of RACE-approved CE credit
👥 Speaker: Dr. Marika Constantaras, DAVDC
💰 Cost: FREE to all, thanks to Antech Diagnostics!

🔗 https://vetgirlontherun.com/webinars/february-19-2025-decision-making-in-dentistry-its-not-always-easy/

02/14/2025

🦷 In dogs, gingival enlargement (GE) is a common finding in certain genetically predisposed breeds such as Boxers, or it can be a response to certain medications such as cyclosporine. In cats, it is commonly seen with juvenile-onset gingivitis/periodontitis. While many will call this excess gingival growth “gingival hyperplasia (GH)”, this is a histologic diagnosis that cannot be made without histopathology, therefore the term “gingival enlargement” should be used until histology tells us otherwise.

🤔 Why is gingival enlargement a problem? It forms pseudo-pockets around the teeth, which trap hair, food, plaque, calculus and other debris. This predisposes affected teeth to periodontal disease. In some cases, the enlargement can become very big and affect normal chewing, which is uncomfortable for the patient. Therefore, surgical removal of the enlargement (gingivectomy or gingivoplasty) is required. If it is thought to be medication-related, the medication should be discontinued.

👉 However, Gingival enlargement may recur in genetically predisposed dogs or juvenile gingivitis-affected cats. Stringent oral home care such as daily brushing and using VOHC-approve products is required to slow or delay the recurrence.

02/08/2025

😺 Not teeth related, but who doesn’t wanna know everything about cats! Thanks to International Cat Care for this kitty fun fact! It’s called ‘Henry’s pocket’ ❤️

02/02/2025

📚Free CE on anesthesia monitors!

01/30/2025

😃 Do you know our RVT Stella speaks Mandarin? If you are referring a client who prefers communication in Mandarin, simply add a note on their referral form and Stella will be more than happy to talk to them and answer their questions.

🤳 Stella also made a clinic WeChat account for clients who prefer to communicate through WeChat. We have also started a client-oriented clinic Red Note page in Chinese if they would like to know more about us and veterinary dentistry!

01/27/2025

😱 If you Google ‘maxillectomy in dogs’ (please don’t), there are some horrifying photos of dogs missing half of their face. When pet owners hear that their dog has an oral tumor and requires surgical removal, the idea that their dog might look like that scares them away from surgery. However, depending on the location, size, and type of tumor, most patients look the same after oral mass removal.

🐶 For example, this is a 7-year-old MN Chihuahua mix with an oral mass affecting the rostral maxilla, which appears to arise from the incisive papilla. Dr. Hamilton performed an excisional biopsy with 5.0mm attempted margins. The histopathology confirmed the diagnosis of a plasma cell tumor, which is expected to be curative with complete surgical excision. His owner was a little worried that he would look different after his surgery, but as in the photos below, he looks just the same post-op!

🔍Of course, early detection and treatment before the mass grows too big is always preferred to minimize the extent of surgery required. This makes routine oral examination by your veterinarian critical. Pet owners are also encouraged to check their pet's mouth between vet visits so an oral mass will be detected sooner.

01/22/2025

🦷 Have you heard about feline Patellar and Dental Anomaly Syndrome (PADS, formerly known as “feline knees and teeth syndrome”)? It is a congenital bone disease of cats characterized by atraumatic bone fractures (most commonly the patella), persistent deciduous teeth, and impacted permanent teeth.

🐱 Moo, a 5 yr old DSH had the classic presentation of this condition and was first referred to us in 2023, with a history of hind limb lameness and draining tracts from the left mandibles. While conventional wisdom would suggest removing all the persistent deciduous and unerupted teeth, the more recent recommendations suggest only extracting the teeth exhibiting periodontal or endodontic disease (including persistent deciduous teeth), or if associated with areas of osteomyelitis. Given that these cats are prone to developing osteomyelitis following oral surgery (due to their underlying bone abnormalities), it is recommended to monitor patients radiographically for the development of dentigerous cysts associated with unerupted teeth before electing to extract them. In 2023, Dr. Hamilton extracted Moo’s fractured persistent deciduous maxillary canines and his left caudal mandibular teeth as the left mandible was affected by extensive osteomyelitis. Following extraction of the roots of the unerupted 307 and 308, the left mandibular bone was debrided using a diamond bur until it readily bled (indicating that the bone was somewhat healthy). Moo healed uneventfully following that procedure and the draining tracts associated with the left mandible subsequently resolved.

😺 When we saw Moo recently for his reevaluation, fortunately, everything looked stable! There has been no progression of periodontitis and no development of endodontic disease. His left mandible still looks abnormal radiographically; however, it has improved since his initial presentation. A professional cleaning was performed both above and below the gumline. To prevent periodontal disease and subsequent extraction, Moo requires stringent oral home care in the form of daily brushing and the use of VOHC-approved products, as well as annual professional cleanings with intra-oral radiographs.

01/08/2025

🩺 Feline Chronic Gingivostomatitis is one of the few oral conditions that require extended monitoring and management following surgical treatment. The Stomatitis Disease Activity Index (SDAI) is an excellent tool to monitor disease progression and assess a patient’s response to treatment.

📃 The SDAI was originally developed by Dr. Jamie Anderson. It includes the owner’s evaluation of the patient’s quality of life at home and the veterinarian’s evaluation of the level of oral inflammation. The version we use was extrapolated from a paper published by Dr. Milinda J Lommer in JVD in 2013. We have it printed and laminated to be reused for each FCGS recheck. We have the owner circle the score on the owner evaluation side and Dr. Hamilton fills out the veterinarian evaluation side after examination. A total score is calculated, and all scores are recorded in patient files to track their progress.

🐱 The case example below is Cheetah, a 9-year-old FS DSH with FCGS. We have done 3 rechecks for her since her whole mouth extraction surgery. The inflammation in her mouth persisted during the first 2 rechecks but greatly improved when we saw her last week. Her SDAI scores continue to improve, and we will see her again in 8-10 weeks for another recheck.

👉 If you would like to use our version for your patients, feel free to save the images in the comment section.
👉 For a comprehensive review of the management of FCGS - https://journals.sagepub.com/doi/10.1177/1098612X231186834?icid=int.sj-abstract.citing-articles.7
👉 The authors of this review also created a modified score that includes objective criteria which can be downloaded here -
https://journals.sagepub.com/doi/suppl/10.1177/1098612X231186834/suppl_file/sj-pdf-1-jfm-10.1177_1098612x231186834.pdf

12/30/2024

🤔 What happens if a malocclusion is left untreated? When a malocclusion is not functional, meaning there is an abnormal tooth-to-tooth or tooth-to-soft tissue contact, timely treatment is required before it becomes a bigger problem.

🐶 Jax is a 6-year-old GSD who was referred for assessment and management of chronic epistaxis. The nasal discharge was dribbling on the floor and being sneezed onto furniture, so his family had to spend a lot of time cleaning up after him daily. Upon evaluation, Jax had a severe class II malocclusion, and the epistaxis was the result of one of the two large oronasal fistulae caused by the traumatic contact from his mandibular canine teeth. 104 had a palatal periodontal pocket depth of 8mm and 204 had a pocket depth of 18mm! That must be very painful! Both teeth were extracted, the fistulae debrided, nasal cavity flushed, gross debris removed, and the fistulae closed in a tension-free manner. His mandibular canine teeth were treated with crown reduction with vital pulpotomy to alleviate the traumatic contact.

🥰 When Jax returned for his two-week post-op recheck, his surgery sites were healing well. His family said Jax is now happy and full of energy, and there is no more nasal discharge, so they are all enjoying this holiday season!

👉 For more information on malocclusion - https://www.haleveterinaryclinic.ca/site/educational-material-veterinary-guelph/2024/03/21/malocclusions

12/24/2024

🎁 Miss Froya wants us to remind everyone to check over your pet’s holiday gifts and make sure nothing can break their teeth!

🦴 Froya received a yak cheese chew as a gift from their family friend. She loved chewing on it until it caused fractures and abrasion to many of her teeth! Two of her teeth had near-pulp exposure and one had periapical lucencies on radiographs, indicating apical periodontitis. These two teeth were extracted, and three other teeth were treated with odontoplasty and application of a bonded sealant. Froya does not want other pups to go through the same thing this holiday season. Check out the link below for the knee-cap rule!
https://www.haleveterinaryclinic.ca/site/educational-material-veterinary-guelph/2024/03/18/the-knee-cap-rule-endodontics

12/20/2024

🎄 We will be closed on December 25th, 26th 2024, and January 1st, 2025.
💖 Our team withes everyone happy holidays and enjoy your time with your family and furry friends!

👉 If you have a dental emergency when we are closed, please contact your local veterinary emergency clinic.
👉 If your pet just had surgery with us before the holiday and you have any questions or concerns, please leave a voicemail on our after-hour number stated on the discharge statement or respond to the email Dr. Hamilton sent you post-op. If this is urgent, please get in touch with your local veterinary emergency clinic immediately.
👉 If you would like to cancel a booked appointment, please call us and leave a message so we can inform the clients on our cancellation list.
👉 If you would like to arrange a referral/visit, please go to our website to fill out a referral form - https://www.haleveterinaryclinic.ca/site/home

12/06/2024

🐱 Like many cats, Nico loves canned food. However, he had a cleft palate so when he ate canned food, it went up into his nose. As you can imagine, it was not comfortable, and he also had chronic nasal discharge as a result.

🩺 Nico was referred to us for repair of his cleft palate and extractions of many teeth affected by tooth resorption. Dr. Hamilton performed a Von Langenbeck procedure to facilitate the closure of the defect without tension and extracted teeth which were affected by tooth resorption.

😸 2 weeks after Nico’s surgery, he was back for a recheck and all his surgery sites were healing well including his palate! His owner told us Nico has been eating canned food without issue for the first time in years!

👉 For more information on Von Langenbeck procedure and cleft palate repair - https://www.veterinarypracticenews.com/how-to-treat-the-congenital-cleft-palate/

12/02/2024

🐱 Most cats have 30 teeth. Alexi the 3-year-old Russian Blue had 32! These two extra teeth were causing some issues for him.

😿 Alexi’s owner noticed that sometimes he struggles with wet food, which seems to get stuck in the back of his mouth. This behaviour prompted a visit to his veterinarian and a subsequent referral to us. Although nothing looks alarming at first, close examination and intra-oral radiographs under general anesthesia revealed a supernumerary 108 and 208 hiding on the palatal side of their normal counterparts, resulting in crowding and predisposing these teeth to periodontal disease. These two teeth were also in the area where the mandibular molar should rest when the mouth is closed and may have been impeding the complete closure of his mouth. Extraction of these supernumerary teeth was required. The 208 (SN) is partially erupted and one cusp is beneath the normal 208, making extraction challenging, but the surgery all went well, with extraction confirmed radiographically and cruciate suture placed across the extraction site to facilitate healing.

😸 Recently, Alexi was back for his two-week post-op recheck. Now he is able to close his mouth and eat wet food without issue!

11/12/2024

🤔 Do you notice anything abnormal about this patient’s teeth on radiographs?

🦷 This is a 7-year-old MN Maltese mix. He was referred to us for the assessment and management of his periodontal disease. Upon closer examination and intra-oral radiographs, all his teeth have a brown colouration, and in all teeth but his mandibular first molars, the pulp has been obliterated, with no perceivable root canals evident. These clinical signs suggest that he might have a rare condition known as dentin dysplasia (also referred to as Dentinogenesis imperfecta), whereby there has been abnormal dentin deposition in the teeth due to a genetic abnormality. Histopathology is required for a definitive diagnosis of this condition. Dogs with generalized dentin dysplasia usually present with diffuse radiographic pulp abnormality (shape, width and opacity of the pulp chamber) and tooth discolouration, which does not necessarily indicate loss of vitality. Without other pathologic findings, these teeth generally do well long-term without treatment. In the first patient’s case, his mandibular first molars had periapical lucencies, and periapical granulomas were identified following extractions. Both these teeth were extracted along with some teeth affected by advanced periodontal disease, tooth resorption and retained tooth roots.