Heidi Lobprise, DVM, DAVDC, explains the process of determining whether it's necessary to extract strategic teeth in dogs

Lobprise When it's necessary to extract strategic teeth

, Heidi Lobprise, DVM, DAVDC, veterinary dental specialist and senior pet advocate at Southern Veterinary Partners in Boerne, Texas, discussed her recent session, "How to Extract Strategic Teeth in Canine Patients," presented alongside Jessica Johnson, DVM, DAVDC, at the Southwest Veterinary Symposium in late September 2024. 

During the interview, Lobprise explained the reasons why extraction of strategic teeth might be necessary in a patient. She also touched on some concerns pet owners might have over the procedure in older pets with underlying conditions, and ensured them that the procedure can be life-changing.

: So, we certainly look at the tooth, the amount of damage that's there, whether it's a broken tooth with an open canal, or if it has periodontal disease that's taken out some of the bone around that tooth, making it unstable. Usually, when we look at periodontal disease greater than 50% we're going to talk about extracting. And if we have a tooth that has a compromised pulp, either the pulp canal is open or it's discolored, and we know the pulp is dead, then that means either extraction or root canal. And for various reasons, access to a diplomate who can do a root canal, even the cost, that can make a difference. 

Even beyond the tooth, though, we look at the patient. So, most of these dental conditions cause chronic inflammation in the pet, not just the infection, but the chronic inflammation, and this really impacts our systemic health. So, if we have an older pet that has cardiac disease or renal disease, or anything like that, I would rather extract the tooth and get rid of that chronic inflammation infection and make the pet healthier, versus doing fancy periodontal work or root canal just to preserve the tooth itself.

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Heidi Lobprise, DVM, DAVDC, explains how to determine whether it's necessary to extract strategic teeth in dogs, and the benefits of doing so

When it's necessary to extract strategic canine teeth

Antimicrobial stewardship is a major topic in both veterinary and human medicine. Recommendations for treatment of common types of infections have changed as new data become available. During a session at the 

 in Atlantic City, Mark Acierno, DVM, MBA, DACVIM, professor and associate dean at Midwestern University College of Veterinary Medicine in Glendale, Arizona, discussed updated recommendations for managing urinary tract infections (UTIs) in dogs and cats.

Although urine was once thought to be sterile, new analyses have found numerous bacterial and fungal species exist in both human and animal urine. This has led to new definitions, which “are important due to good antimicrobial stewardship,” Acierno said, including the following:

Bacteriuria: presence of bacteria in the urine

Subclinical bacteriuria: bacteriuria in the absence of clinical signs of UTI

UTI or bacterial cystitis: bacteriuria in the presence of clinical signs, including hematuria, pollakiuria, stranguria, and/or dysuria

“Treatment of subclinical bacteriuria is not indicated for humans, dogs, or cats,” Acierno said. Up to 12% of healthy dogs and 13% of healthy cats have subclinical bacteriuria.

 Even if pyuria is present along with bacteriuria, antibiotic therapy is not recommended in the absence of clinical signs of cystitis.

In veterinary medicine, UTIs occur more commonly in female dogs compared to males because of differences in anatomy. “Cats rarely have UTIs because of their cleanliness and [high] osmolarity,” Acierno said, noting that the vast majority (>95%) of cats with feline lower urinary tract disease (FLUTD) do not have bacterial cystitis. Further workup and culture are always indicated in cases of feline UTIs.

Sporadic UTIs occur less than 3 times in 1 year or less than 2 times in a 6-month period. Ideally, urine cultures should be performed, though empirical treatment is reasonable in these cases. Nonsteroidal Anti-inflammatory Drugs (NSAIDs) can help to decrease clinical signs of cystitis pending culture results.

Amoxicillin, amoxicillin and clavulanate potassium (Clavamox; Zoetis), and trimethoprim and sulfamethoxazole (Tribrissen [TMS]; Jurox) for 3 to 5 days are the top empirical recommendations because they concentrate well in the urine.

Acierno acknowledged that many veterinarians are nervous to use TMS because of known adverse effects such as keratoconjunctivitis. However, these adverse effects are rarely seen with such a short course of medication.

Rechecking patients with sporadic UTIs is not indicated unless clinical signs do not resolve. This includes rechecking urinalysis and culture.

A UTI is considered recurrent when it occurs more than 3 times in 1 year or more than twice in a 6-month period. Recurrence can occur for 3 reasons:

Relapse, due to the presence of a bacterial reservoir in the body

Reinfection, which often occurs in the presence of immunosuppression

Refractory, which may be due to poor medication compliance or the presence of a biofilm that protects microorganisms.

Recurrent UTIs require further workup to determine the reason for recurrence and best treatment plan. First, a thorough physical examination that includes direct observation of the patient’s urination and conformation of external genitalia. A common cause for recurrent UTIs is hooded vulvas, which respond well to surgical correction. Acierno recommended checking the fur around the vulva for urinary staining, which can indicate urine is being trapped.

Next, other underlying conditions, such as endocrine disease, should be ruled out with lab work, including a complete blood count, chemistry panel, and urinalysis. Culture and sensitivity on a sample obtained by cystocentesis is indicated in cases of recurrent UTIs.

Imaging is performed to assess for stones, neoplasia, and other anatomical abnormalities in the lower urinary tract. Radiographs can be used, but even a boarded radiologist will miss as many as 27% of uroliths. Ultrasound is preferred as it has a lower false negative rate of only 6%.

 The final step in the workup of recurrent UTIs is cystoscopy, according to Acierno’s presentation.

Once treatment is started based on results of culture and sensitivity, a culture should be obtained 1 week into treatment to confirm efficacy. As long as this culture is negative, treatment should be continued for a total of 4 weeks. An additional culture should be obtained 1 week after treatment to ensure full resolution.

Acierno noted that there are many adjunctive treatment options that have been proposed for these cases, such as probiotics or cranberry extracts, though evidence for their use in dogs is low. New therapies are under investigation.

Acierno noted that although UTIs are much less common in male dogs, it is important to assess the prostate for intact males with UTIs. This is best done by ultrasound. Cytology and culture of the prostatic fluid is ideal, but culture samples should be submitted as tissue samples to get accurate results. When the prostate is involved, treatment is needed for 4 to 6 weeks. fluoroquinolones, TMS, and macrolides are preferred due to excellent tissue penetration.

Although urine was once thought to be sterile, new data show that some animals have normal bacterial flora in their urine. This changes how the presence of bacteriuria should be interpreted and treated. Only patients with bacteriuria and clinical signs of urinary tract infection should be treated with antibiotics. While culture is ideal, empirical treatment is appropriate in cases of sporadic UTIs. Recurrent UTIs require further evaluation and longer treatment courses.

, is a 2013 graduate of the University of Pennsylvania, a practicing veterinarian, a freelance speaker and an author, based in western Pennsylvania. She is passionate about mentorship, spectrum of care, education, and addressing common sources of stress for veterinary teams and recent graduates. Outside of clinical practice, Boatright is actively involved in organized veterinary medicine at the state and national levels.

Acierno M. Making sense of the new UTI antimicrobial recommendations. Presented at Fetch Coastal 2024: Atlantic City, NJ. October 13, 2024.

Weese JS, Blondeau J, Boothe D, et al. International society for companion animal infectious diseases (ISCAID) guidelines for the diagnosis and management of bacterial urinary tract infections in dogs and cats. 

. 2019;247:8-25. doi:10.1016/j.tvjl.2019.02.008. 

https://www.sciencedirect.com/science/article/pii/S109002331830460X?via%3Dihub

Articles

Veterinarians should become familiar with new definitions and recommendations for managing urinary tract infections in dogs and cats to promote antimicrobial stewardship.

Updates in management of urinary tract infections in small animal medicine

The FDA recently shared a reminder to veterinarians that using aspirin to treat pyrexia and pain in lactating dairy cattle is prohibited, as there are no aspirin products for use in cattle that are approved by the federal agency.

Some dairy farms are using a nonsteroidal anti-inflammatory drug to treat cattle affected by highly pathogenic avian influenza, specifically type A H5N1, according to an American Veterinary Medical Association (AVMA) report that cited communication from the American Association of Bovine Practitioners (AABP) to its members.

The FDA announcement came in a “Dear Veterinarian” letter, where the agency stated that using unapproved drugs in food-producing species for any off-label purpose is prohibited. According to the FDA, there are safe and effective FDA-approved products for controlling pyrexia and pain in lactating dairy cattle. These products have established milk and meat withdrawal periods. In every FDA-approved animal product, one of the following statements can be found on its label

“Approved by FDA under NADA # XXX-XXX” (for brand name animal drugs)

“Approved by FDA under ANADA # XXX-XXX” (for generic animal drugs)

According to the AVMA, flunixin meglumine is the sole FDA-approved medication for managing pyrexia linked to bovine respiratory disease and endotoxemia, and to control inflammation in lactating dairy cattle.

Off-label drug use in food-producing animals

The Animal Medicinal Drug Use Clarification Act allows veterinarians to prescribe certain FDA-approved human or animal drugs to food-producing animals under defined conditions. These conditions include that no suitable approved animal drug exists for the intended purpose, unless a veterinarian determines, with a valid veterinarian-client-patient relationship, that the approved drug is clinically ineffective for its purpose.

Moreover, before prescribing an approved animal or human drug for extra-label use in food animals, the veterinarian must conduct a thorough diagnosis, establish extended withdrawal periods for food products, maintain animal identity, and ensure compliance with withdrawal timelines. For approved human drug use, the use must be medically justified, and precautions must be taken to prevent treated animals from entering the human food supply if safety scientific information is unavailable.

Currently, Vazalore (PLx Pharma) is the only FDA-approved human aspirin available. There are other human aspirin products that are sold as an over-the-counter monograph. However, the monograph did not receive FDA approval, making their extra-label use illegal. “Given the impracticality of dosing cattle with a sufficient amount of the approved human product, the FDA understands that veterinarians and dairy farmers may instead be using unapproved aspirin products that are not legally marketed,” wrote the FDA in its announcement.

 “The extra-label use of unapproved drug products in food-producing species is prohibited.”

“Veterinarians and dairy farmers should stop use of unapproved aspirin in lactating dairy cattle and use FDA-approved products to control pyrexia and pain,” the FDA continued.

 “In the event that animals have already been treated with aspirin, veterinarians should use their scientific expertise and available resources to set protective and extended milk and meat withdrawal periods for treated animals.”

Dear Veterinarian Letter regarding use of aspirin products in lactating dairy cattle. News release. US Food and Drug Administration. October 11, 2024. 

https://www.fda.gov/animal-veterinary/product-safety-information/dear-veterinarian-letter-regarding-use-aspirin-products-lactating-dairy-cattle

FDA warns against use of unapproved aspirin in lactating dairy cattle. News release. American Veterinary Medical Association. October 23, 2024. Accessed October 25, 2024. 

https://www.avma.org/news/fda-warns-against-use-unapproved-aspirin-lactating-dairy-cattle?utm_source=delivra&utm_medium=email&utm_campaign=todays-headlines-news

Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA). US Food and Drug Administration. Accessed October 25, 2024. 

https://www.fda.gov/animal-veterinary/guidance-regulations/animal-medicinal-drug-use-clarification-act-1994-amduca#animals

Vazalore is currently the only FDA-approved human aspirin that may be used in food-producing animals under certain conditions

FDA: Off-label use of aspirin in lactating dairy cattle is prohibited

Daniel Flinchbaugh (left), Penn Facilities and Real Estate Services assistant landscape planner  and Nick Tanner(right), Penn undergraduate, with a nearly finished bat box in the Weitzman School of Design Fabrication Lab (image courtesy of John Donges/University of Pennsylvania School of Veterinary Medicine)

To help support the local bat populations in the Philadelphia area, the University of Pennsylvania School of Veterinary Medicine (Penn Vet) Wildlife Futures Program (WFP) are facilitating the design and building of a collection of wooden bat boxes. The boxes will be installed in campus parks to help support the needs and health of bats.

According to the organizational release, Penn Vet’s WFP is working in collaboration with Penn Sustainability and Penn Facilities and Real Estate Services to combat the population decline within the urban ecosystem of Philadelphia by providing these bats with a safe breeding environment. Five wooden boxes, that can fit up to 200 bats each, were created at the Weitzman School of Design Fabrication Lab and will be placed through the campus to give these bats a place for breeding, maternity roosting, and hibernation.

“Bats are so ecologically important. They eat mosquitoes and insects that negatively impact agricultural production, and several bat species worldwide serve as important pollinators,” explained Julie Ellis, BS, MS, PhD, co-director of the WFP.

 “But in urban ecosystems, bats often do not have access to safe places to form breeding colonies and raise their young. As a result, they end up living in buildings or in the attics of people’s houses, from which they are usually quickly evicted. Our bat boxes are designed to mimic tree habitat and support the daily needs and overall health of bats.”

Because of white-nose syndrome (WNS), a fungal disease that is killing bats in North America,

 the bat population in Pennsylvania has been on a sharp decline since 2008. WNS presents as white fuzz on the face of bats, giving it its name, and affects hibernating bats. For little brown bats like those in Philadelphia, their population has declined more than 90% leading to it becoming an endangered species.

In the springtime, bats arrive back in Philadelphia to mate and reproduce before moving to a different geographical area through the year. For this fall, Kaskey Park will be home to a portion of the bat boxes and several boxes will then be installed in Penn Park early 2025. These locations were selected because they are located on the established bat migratory pathway along the Schuylkill River. In spring 2025, the local bat population will gain access to the new maternity spaces to birth and raise their young. 

Ware C. Penn Vet’s Wildlife Futures Program launches habitat initiative for Philadelphia bats | Penn Today. Penn Today. Published October 22, 2024. Accessed October 25, 2024. 

https://penntoday.upenn.edu/news/penn-vets-wildlife-futures-program-launches-habitat-initiative-philadelphia-bats

What Is White-nose Syndrome? White Nose Syndrome Response Team. Published 2019. Accessed October 25, 2024. 

https://www.whitenosesyndrome.org/static-page/what-is-white-nose-syndrome

The initiative out of University of Pennsylvania will develop bat boxes to support the daily ends and health of bats

Bat habitat initiative to launch in Philadelphia 

Rats have long been a ubiquitous part of life in New York, New York (NYC). They thrive in dense urban environments, taking advantage of readily available food in garbage and shelter in subway tunnels, parks, and vacant lots. Their presence is not just an inconvenience but a significant public health risk.

Rats are prolific breeders. One pair can potentially produce 15,000 descendants in a year, and they are known carriers of diseases like leptospirosis and salmonella, with their waste contaminating food sources.

 Efforts to control the population have largely focused on eradication through lethal means, but these methods have proven to be temporary solutions. According to exterminators and pest control experts, rats are intelligent, adaptable creatures that quickly learn to avoid traps and poisons, leading to persistent infestations.

Traditional methods of rat control, such as snap traps, glue boards, and poisons, are ineffective in the long run and also raise ethical concerns. These methods often cause rats to die slow and painful deaths, sparking criticism from animal rights organizations and lawmakers who argue for more humane approaches. Glue traps, for example, can also catch small animals like birds and squirrels, leaving them to die from dehydration or starvation. Rat poison, on the other hand, causes internal bleeding, leading to a prolonged and painful death.

Recently, the idea of using birth control to curb the rat population has gained renewed attention. Contraceptives offer a more humane, ethical, and potentially effective solution to managing a city's rat problem compared to traditional methods such as poisons and traps.

The contraceptive being piloted in NYC is 4-vinylcyclohexene diepoxide (VCD), an EPA-registered

 product that has shown promise in reducing rat populations in other cities. VCD (ContraPest; SenesTech) works by targeting the reproductive systems of both male and female rats. In female rats, the contraceptive disrupts ovarian function, making it difficult for them to conceive. In male rats, it interferes with sperm production, reducing their fertility.

 The contraceptive pellets, made from fat and salt, are more appealing to rats than digging through trash.

 The hope is that by reducing the reproductive capacity of the rat population, the overall number of rats will decrease over time.

Recent research has explored the use of fertility control in 

(the black rat), specifically focusing on the combination of quinestrol and levonorgestrel. Investigators captured live black rats and fed them bait with varying hormone concentrations to assess fertility impacts. The researcher monitored the rats for bait acceptance, physiological changes, and reproductive outcomes.

Results from this study indicated that the physiological impact on reproductive organs was evident, particularly in females, where uterine edema (inflammation and swelling) was observed. In males, the baits led to a reduction in the weight of sex organs and a decline in sperm motility and count.

One key finding was that the fertility control baits effectively reduced pregnancy rates in females. When females consumed the baits containing the contraceptive, none of them became pregnant, regardless of whether the male partner had also consumed the bait. This suggests that the treatment had a direct and significant effect on female fertility, making it a promising option for population control in 

Despite the promise of contraceptives, challenges and criticisms exist. Some pest control experts argue that while birth control may reduce the population, it is not a silver bullet. Rats are highly adaptable and intelligent creatures, and there is a concern that they may eventually learn to avoid the contraceptive pellets, just as they have learned to avoid traps and poisons. Additionally, the use of contraceptives requires constant monitoring and maintenance to ensure that the pellets are being consumed and are effective.1

Another potential issue is the cost and logistics of implementing a widespread birth control program. Distributing contraceptive pellets across a city as large and densely populated as New York would require significant resources and coordination. The question of whether the contraceptive method will be as effective in all areas of the city remains, given the different environmental conditions and rat behaviors in various neighborhoods.

Despite these challenges, contraceptives like VCD offer a more humane and potentially effective solution compared to traditional methods. Although factors such as rat adaptability and logistics still pose hurdles, fertility control shows promise for long-term, ethical population management.

Ava Landry is a 2026 PharmD candidate at the University of Connecticut in Storrs, where she is studying veterinary pharmacy.

Fitzsimmons EG. The next frontier in New York’s war on rats: birth control. 

. April 10, 2024. Accessed October 5, 2024. https://www.nytimes.com/2024/04/10/nyregion/nyc-rat-contraception-birth-control.html?unlocked_article_code=1.O04.fIxb.9o4oxNJtSjPh&smid=url-share.

ContraPest approved for general use in New York State. News release. SenesTech. February 6, 2023. Accessed October 25, 2024. https://www.prnewswire.com/news-releases/contrapest-approved-for-general-use-in-new-york-state-301739051.html

Khan M, Attanasio C. To lower its rat population, NYC considers birth control as a humane option. PBS. April 14, 2024. Accessed October 5, 2024. https://www.pbs.org/newshour/science/to-lower-its-rat-population-nyc-considers-birth-control-as-a-humane-option.

Selemani M, Makundi RH, Massawe AW, Mhamphi G, Mulungu LS, Belmain SR. Impact of contraceptive hormones on the reproductive potential of male and female commensal black rats (Rattus rattus). 

. 2022;17(6):991-1001. doi:10.1111/1749-4877.12563

New York City is piloting a program to reduce breeding with an oral birth control pellet

Managing rat populations with hormonal interventions 

What flavors, textures, and kibble size and shapes do cats and dogs like when it comes to their food? In her session, “Palatability in Pet Food: A Blend of Science and Practice,” presented at the Fetch dvm360 Conference in Atlantic City, New Jersey, Vicky Ograin, MBA, RVT, VTS, scientific communication senior specialist for Hill's Pet Nutrition, talked about canine and feline food preferences, as well as tips for transitioning these animals to therapeutic foods.

In her lecture, Ograin used the hypothetical example of Pearl, a 15-year-old cat that had been diagnosed with renal disease and was recommended to be put on Hill’s Prescription Diet k/d with Chicken Cat Food. Pearl was 11 lbs, had a body condition score of 2 out of 5, and mild muscle loss, explained Ograin. Pearl had been eating regular food her whole life, and was slightly overweight up until her diagnosis, when she began being “a bit of a picky eater.”

“The other thing to think about with Pearl is: we know that kidney disease can actually affect taste, and so sometimes we have cats or even dogs—but I more think about our cat patients—that have eaten their food their entire lives, and then they're diagnosed with kidney disease, and probably because of the uremia, and [because] they have perhaps…an aversion to that food, [that] maybe they don’t want to eat that food anymore,” explained Ograin, emphasizing that the most important thing with these patients is that they eat.

When transitioning cats like Pearl to a new food, communication with the client is key. “Our owners don't have the medical knowledge that we do,” said Ograin. She explained that clients should be given an explanation as to why their pet has been put on that food. Ograin recommends sending clients an email or text with the diet information, including feeding instructions and palatability tips.

When switching cats to a new food, it is important to do so through a transition. The reason for this is because patients should be given time to get used to the new texture and flavor of the new food. When dealing with a change in texture, the transition can range between 1 week to 2 months. However, transitions are generally made to prevent gastrointestinal (GI) upset, for which the transition will typically last 7 days.

“You can start with 75% of the old [food], 25% of the new [food]. What I usually say [is], if I don't see any GI upset, then I go to the next one: 50%. Usually, you're going to see GI upset in that beginning part, and then we go to 25%/75%,” said Ograin.

In her session, Ograin shared that cats are very particular about the shapes of their food, being very shape-oriented. These animals prefer crunchy, clean kibbles, and do not like crumbs, also referred to as “fines” in the pet food industry.

Transitioning a cat to a different type of kibble than they have been eating, particularly one that is more rounded, can take 1 to 2 months because they need time to adjust to the new texture and shape. With felines who are used to eating dry food and are being introduced to canned food for the first time, patience is key.

Dogs, on the other hand, prefer softer and chewier kibble. Ograin used the analogy of a large, soft Cheeto versus a crunchy Cheeto, explaining that dogs prefer the former. According to Ograin, research has shown that canines—including the smaller breeds— also prefer larger kibble.

“I always recommend putting the bowls side by side, specifically, when you're changing textures,” explained Ograin. She also recommended warming the food up to body temperature.

Oregano can also be added by squeezing it to bring the oils out. However, it’s important to emphasize to the client that it must be 100% oregano; fresh oregano is best, according to Ograin. “I know that sounds silly, but the amount of owners that use Italian seasonings—it has garlic in it. So, you need to make a point of saying it [needs to be] 100% oregano, no garlic allowed,” emphasized Ograin. 

Broth can also be added, ideally low sodium broth. “I tend to go with more low salt, or I make it myself—chicken, beef, fish if you could find a low salt fish one, cats sometimes like that,” said Ograin.

Honey can be used, especially for dogs, although some cats may have a sweet tooth. Ograin recommends mixing a quarter of a teaspoon of honey with water and pouring it over their food.

Lastly, while in the hospital, cats should never be fed the same diet they will be eating at home to avoid creating an aversion to the new diet.

Ograin V. Palatability in Pet Food: A Blend of Science and Practice. Presented at: Fetch dvm360 Conference; October 14-16, 2024; Atlantic City, New Jersey.

Vicky Ograin, MBA, RVT, VTS, explained the types of foods that appeal to pets and offered tips for making food more palatable to these animals in a Fetch dvm360 Conference lecture