Professional dental cleaning in dogs: clinical routines among Swedish veterinarians and veterinary nurses

BACKGROUND

Dental disease is very common in dogs and veterinary professional dental cleaning and examination, together with daily dental home care, is the foundation for good dental health. To our knowledge, no previous study has investigated professional dental cleaning routines in small animal veterinary practice. A validated questionnaire survey was distributed to all veterinarians and veterinary nurses with registered e-mail addresses in the Swedish national registry (veterinarians; n = 3657, veterinary nurses; n = 1650). Response rates were 32% for veterinarians (V) and 38% for veterinary nurses (VN).

RESULTS

In total, 73% (V)/96% (VN) of respondents reported that professional dental cleaning was performed at their work place under general anesthesia, and 27% (V)/18% (VN) that dental cleaning was performed under sedation. Of the respondents, 43% (V)/96% (VN) considered regular dental cleaning under general anesthesia fairly or very important, and 49% (V)/47% (VN) stated that it was sometimes important for good dental health in dogs. A majority of respondents, 84% (V)/97% (VN), reported that dental extractions were performed at their clinic, and 72% (V)/90% (VN) had access to dental radiography equipment.

CONCLUSION

A majority of Swedish veterinarians and veterinary nurses perform professional dental cleaning under general anesthesia with access to dental radiography equipment, in accordance with national and international recommendations. However, a considerable proportion of professional dental cleanings were performed under sedation only, and extractions performed without access to dental radiography equipment were common, suggesting several areas of improvement in the routines in Swedish veterinary clinics and hospitals. Our results clearly indicate the need for improved educational efforts to increase the awareness among veterinary health professionals regarding guidelines and official recommendations in canine dental care.

Dog Owners' Perspectives on Canine Dental Health-A Questionnaire Study in Sweden

Periodontal disease is one of the most common diseases affecting dogs, with a reported prevalence of at least 80% in dogs over 3 years of age. However, there is a lack of studies regarding dog owners' assessment of their dog's dental health, and whether they perceive clinical signs often associated with periodontal disease, i.e., dental calculus, halitosis or mobile or lost teeth. A validated questionnaire survey was distributed to all Swedish dog owners with email addresses in the national registry (n = 209,263). The response rate was 32%. The survey questions concerned opinions and practices regarding canine dental health, including assessment of dental health parameters and dog owners' ability to examine their dog's mouth. A construct (α = 0.76) was used to investigate dog owners' assessed symptoms of their dog's dental health in relation to background factors. Half of the respondents rated their dog's dental health as very good. However, one in four dog owners experienced difficulties when inspecting the dog's teeth. The most common reason for this difficulty was stated to be an uncooperative dog. Almost half of the dog owners reported halitosis to some degree in their dog, and almost four in ten owners reported dental calculus. One in eight dogs had been previously anesthetized for dental cleaning, and one in 12 dogs had experienced problems with gum disease, according to the owners. Owners' assessment varied significantly with the dog's age, weight, breed, breed group, sex, and concurrent disease. Owner-related factors that influenced the assessment of the dog's dental health were age, gender, education, county (urban/rural), and whether they were breeders or not. Dog owners with smaller dogs, older dogs and certain breeds predisposed to periodontal disease assessed their dog's dental health as worse than their counterparts, which is in agreement with previously reported higher prevalence of dental disease in these groups. This indicates that dog owners are able to perform relative assessment of their dog's dental health status. Our results also highlight the need for routine professional assessment of periodontal health, as well as education of dog owners and training of dogs to accept dental care procedures.

Dental home care in dogs - a questionnaire study among Swedish dog owners, veterinarians and veterinary nurses

Background

Periodontal disease remains one of the dog’s most common health issues, even though it is largely preventable by tooth brushing. Implementation of daily tooth brushing would not only improve animal welfare, but also reduce veterinary costs for the owner. There is a paucity of studies investigating attitudes, opinions and practices of dog owners, veterinarians, and veterinary nurses regarding preventative dental home care in dogs. The objective of this study was to investigate these parameters in Sweden, thereby providing a basis for improved prophylactic strategies.

Methods

Validated questionnaire surveys were distributed to all Swedish dog owners (n = 209,263), veterinarians (n = 3657) and veterinary nurses (n = 1650) with e-mail addresses in the national registry. The response rates were 32% for dog owners and veterinarians, and 38% for veterinary nurses. The survey questions concerned attitudes, opinions and practices regarding dental home care, including whether dog owners received information concerning dental home care or not, and if this information resulted in implementation.

Results

Attitudes, opinions and practices regarding dental home care are presented for Swedish dog owners, veterinarians, and veterinary nurses. A fundamental finding was that the absolute majority of Swedish dog owners do not perform adequate prophylactic dental home care. Considerable discrepancies were identified in the opinions of veterinary health practitioners and dog owners regarding attitudes towards dental home care and conveying of information. Several areas for improvement in the communication between dog owners and veterinary health practitioners concerning dental home care were identified.

Conclusion

Our results illustrates the need for validated methods to increase dog owner compliance with dental home care recommendations. We also see a need of further education, regarding canine dental home care, among veterinarians, veterinary nurses, and dog owners. The results from this unique study constitute an important foundation for future development of prophylactic strategies, with the ultimate goal to improve dental health, and thereby animal welfare, in dogs.

Investigating the Probability of Response Bias in Owner-Perceived Pain Assessment in Dogs With Osteoarthritis

Owners' ability to recognize signs of chronic pain in dogs undergoing pharmacologic and nonpharmacologic pain interventions during a period of physical rehabilitation is not known. This study aimed to compare dogs with and without chronic pain, and to assess the relationship between explanatory factors, including the probability of owners' response bias induced by pharmacologic and nonpharmacologic pain intervention, and chronic pain in dogs with osteoarthritis (OA). Seventy-one dogs with OA were included in this observational study. Owner-perceived pain interference was measured by Canine Brief Pain Inventory (CBPI) and owner-perceived pain behavior was assessed using Helsinki Chronic Pain Index. A dichotomous variable of Helsinki Chronic Pain Index was used in regression analysis to investigate the association between chronic pain and explanatory factors (body condition, anti-inflammatory medication, animal physiotherapy consultation once or more and owners' perception of pain interfering). Seventy-five percent of the dogs had ongoing anti-inflammatory medication, 51% of were overweight and 45% had a physiotherapy consultation. Higher levels of overt pain behaviors were reported in items addressing activities. Body condition, physiotherapy consultation and medication were not associated with chronic pain. Odds ratio (OR) and 95% confidence intervals of OR for the CBPI were 1.74 (1.23-2.47) and significantly associated with chronic pain. The adjusted OR of the CBPI did not differ from the crude OR. Owner-perceived pain behavior was not confounded by the dogs' medication. Results indicated that CBPI was not mediated by the medication. The CBPI pain interference score was not associated with response bias and may be used as clinical outcome measure of chronic pain and pain-related disability in dogs with OA along a period of physical rehabilitation comprising pharmacologic and nonpharmacologic pain interventions.

Development and validation of two questionnaires: Dental home care and dental health in Swedish dogs

BACKGROUND

Dental disease is one of the most common health problems in dogs. However, no studies have investigated the attitudes, opinions and practices of dog owners, veterinarians and veterinary nurses regarding dental health and preventative dental home care in dogs. The objective of this study was therefore to develop and validate questionnaires for this purpose, in accordance with survey methodology guidelines.

METHODS

Questionnaire items were determined based on the authors' academic knowledge and clinical experience, and modified throughout the validation process. Several measures were taken to reduce sampling, coverage, measurement and non-response errors. Content validity was assessed by Subject-Matter Experts (SME) and cognitive interviews were conducted in accordance with the "think-aloud protocol". Non-response analysis was performed using several methods.

RESULTS

Constructs were identified using exploratory factor analysis and two predefined constructs from the dog owner questionnaire were confirmed "Dog owners' attitudes towards brushing their dog's teeth" (Cronbach's α = 0.86) and "Dog owners' assessment of their dog's dental health" (α = 0.76). Additionally, exploratory factor analysis identified three potential constructs. In the veterinary health practitioner questionnaire, two constructs were identified: "Veterinary health practitioners' attitudes towards dental chews and dental feed" (α = 0.78) and "Veterinary health practitioners' attitudes and opinions on dental problems and dental cleaning" (α = 0.73). Non-response analysis showed a higher proportion of women in the sample of dog owners and veterinarians compared to the target populations. Veterinarians in the sample were also younger. In contrast, gender and age distributions in veterinary nurses did not differ between sample and target.

CONCLUSION

The validation presented in this work showed that the developed questionnaires could be used as accurate and reliable tools for measuring attitudes and practices regarding dental home care in dogs among Swedish dog owners, veterinarians and veterinary nurses.

Head and pelvic vertical displacement in dogs with induced swinging limb lameness: an experimental study

Background

Swinging limb lameness is defined as a motion disturbance ascribed to a limb in swing phase. Little is known about its biomechanics in dogs, particularly about the body motions that accompany it, such as vertical head and pelvic motion asymmetry. The aim of this study was to describe the changes in vertical head and pelvic motion asymmetry in dogs with induced swinging limb motion disturbance, mimicking a swinging limb lameness. Fore- and hind-limb lameness was induced in ten sound dogs by placing a weight (200 g) proximal to the carpus or tarsus, respectively. Marker-based motion capture by eight infrared light emitting video cameras recorded the dogs when trotting on a treadmill. Body symmetry parameters were calculated, including differences between the two highest positions of the head (HDmax) and pelvis (PDmax) and between the two lowest positions of the head (HDmin) and pelvis (PDmin), with a value of zero indicating perfect symmetry.

Results

Induction of swinging forelimb lameness showed significant changes in HDmax (median and range: sound 1.3 mm [− 4.7 to 3.1], in the left side − 28.5 mm [− 61.2 to − 17.9] and in the right side 20.1 mm [− 4.4 to 47.5]) and, induction of swinging hind limb lameness showed significant changes in PDmax (sound 2.7 mm [− 7.4 to 7.2], in the left side − 10.9 mm [− 22.4 to 0.5] and in the right side 8.6 mm [− 3 to 30]), as well as an increased hip movement asymmetry (sound 1.6 mm [− 8.6 to 19.9], in the left side − 18.1 mm [− 36.7 to 5.4] and in the right side 15 mm [− 20.7 to 32.1]) (P < 0.05).

Conclusions

Induced swinging fore- and hind limb lameness resulted in significant increased asymmetry of the maximal vertical displacement movement of the head and pelvis, due to decreased lifting of the head in forelimb lameness and of the pelvis in hind limb lameness. The results suggest that asymmetry of the maximal vertical displacement of the head and pelvis (i.e. lifting) is a key lameness sign to evaluate during examination of swinging limb lameness.

Psychometric evaluation of the canine brief pain inventory in a Swedish sample of dogs with pain related to osteoarthritis

BACKGROUND

To evaluate intervention, implement evidence-based practice and enhance the welfare of dogs with naturally occurring osteoarthritis (OA), access to valid, reliable and clinically relevant outcome measures is crucial for researchers, veterinarians and rehabilitation practitioners. The objectives of the present study were to translate and evaluate psychometric properties, in terms of internal consistency and construct validity, of the owner-reported measure canine brief pain inventory (CBPI) in a Swedish sample of dogs with pain related to OA.

RESULTS

Twenty-one owners of clinically sound dogs and 58 owners of dogs with pain related to OA were included in this observational and cross-sectional study. After being translated according to the guidelines for patient-reported outcome measures, the CBPI was completed by the canine owners. Construct validity was assessed by confirmatory factor analysis, by repeating the principal component analysis and by assessing for differences between clinically sound dogs and dogs with pain related to OA. Internal consistency was estimated by Cronbach's α. Confirmatory factor analysis was not able to confirm the factor-structure models tested in our sample. Principal component analysis showed a two-component structure, pain severity and pain interference of function. Two components accounted for 76.8% of the total variance, suggesting an acceptable fit of a two-component structure. The ratings from the clinically sound dogs differed from OA dogs and showed significantly lower CBPI total sum. Cronbach's α was 0.94 for the total CBPI, 0.91 for the pain severity and 0.91 for the pain interference of function.

CONCLUSIONS

The results indicate that the translated version of the CBPI is valid for use in the Swedish language. The findings suggest satisfying psychometric properties in terms of high internal consistencies and ability to discriminate clinically sound dogs from OA dogs. However, based on the confirmatory factor analysis, the original factor structure in the CBPI is not ideally suited to measure pain related to OA in our sample and the hypothesis of the presented two-factor structure was rejected. Further research needs to be conducted to determine whether the original psychometric results from CBPI can be replicated across different target groups and particularly with larger sample size.

Kinematic and spatiotemporal assessment of habituation to treadmill walking in Labrador retrievers

Background

This study investigated differences in kinematic and spatiotemporal variables in Labrador retrievers during introduction to treadmill walking, with the aim to determine the time required for them to become habituated. Twenty-five healthy, treadmill-naive Labrador retrievers participated in the study. The total angular displacement of the carpus, elbow, tarsus and stifle, as well as stride time and stance duration were calculated from the 3-D tracking of skin mounted reflective markers recorded with 6 infrared light emitting video cameras at 240 Hz. The measurements were done at two walking speeds, 0.78 and 0.96 m/s, in six sessions on the treadmill during two consecutive days.

Results

With a 1–2 min acclimatization period following each treadmill speed change, mean values of the study variables were significantly different from the last training session mainly in the first session on the first day. However, between-stride variability was significantly larger for at least one variable even in the fourth session for the slower walking speed, and in the fifth session for the higher walking speed.

Conclusions

The results show the importance of proper pre-training of dogs in locomotion studies at walk using a treadmill, and the need to consider not only variable mean values but also between-stride variability, in order to ensure that dogs are sufficiently accustomed to allow collection of reliable data.

Comparison of Polar® RS800CX heart rate monitor and electrocardiogram for measuring inter-beat intervals in healthy dogs

The aim of the present study was to assess the criterion validity, relative reliability and level of agreement of Polar® RS800CX heart rate monitor measuring inter-beat intervals (IBIs), compared to simultaneously recorded electrocardiogram (ECG) in dogs.

METHODS

Five continuous minutes of simultaneously recorded IBIs from Polar® RS800CX and Cardiostore ECG in 11 adult healthy dogs maintaining standing position were analyzed. Polar® data was statistically compared to ECG data to assess for systematic differences between the methods. Three different methods for handling missing IBI data were used. Criterion validities were calculated by intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). Relative reliabilities and levels of agreement were calculated by ICCs and the Bland and Altman analysis for repeated measurements per subject.

RESULTS

Correlation coefficients between IBI data from ECG and Polar® RS800CX varied between 0.73 and 0.84 depending on how missing values were handled. Polar® was over- and underestimating IBI data compared to ECG. The mean difference in log transformed (base10) IBI data was 0.8%, and 93.2% of the values were within the limits of agreement. Internally excluding three subjects presenting IBI series containing more than 5% erroneous IBIs resulted in ICCs between 0.97 and 0.99. Bland and Altman analysis (n=8) showed mean difference was 1.8ms, and 98.5% of the IBI values were plotted inside limits of agreement.

CONCLUSION

This study showed that Polar® systematically biased recorded IBI series and that it was fundamental to detect measurement errors. For Polar® RS800CX heart rate monitor to be used interchangeably to ECG, by showing excellent criterion validity and reliable IBI measures in group and individual samples, only less than 5% of artifacts could be accepted.

Kinematic and temporospatial assessment of habituation of Labrador retrievers to treadmill trotting

This study investigated differences in kinematic and temporospatial variables in treadmill-naïve dogs when introduced to treadmill trotting and the time required to for them to become habituated to the treadmill. Twenty-four healthy Labrador retrievers, with an age range of 22-36 months and with no history of orthopaedic disease, were included in the study. A motion capture system registered kinematic variables of the carpus, elbow, tarsus and stifle, along with stride time and stance duration, at 240 Hz. Six sessions, each lasting 8-10 min, walking and trotting on the treadmill were performed with each dog, with three sessions on each of two consecutive days. The between-stride variability of total angular displacement of the carpus, elbow, stifle and tarsus, as well as the stride and stance time, was higher during the day 1 trotting sessions than in the last session of day 2. These stabilised to non-significant levels before the second session on the second day of measurements and thus habituation was achieved.

Soft tissue artifact in canine kinematic gait analysis

OBJECTIVE

To investigate, noninvasively, the soft tissue artifact (STA) in canine kinematic gait analysis.

STUDY DESIGN

Experimental study.

ANIMALS

Labrador retrievers (n = 4).

METHODS

Kinematic study: Reflective markers were glued to the skin over bony landmarks, with the distance between 2 markers representing the length of the underlying scapula, humerus, ulna, femur, and crus. The distance between these markers (marker distance [MD]) was measured with infrared cameras while the dogs stood still or walked on a treadmill. Fluoroscopy study: Radiopaque markers were glued on the skin over the spinous process of the L6 vertebra and the stifle to allow fluoroscopic observation of the markers and underlying skeletal segments while the dogs walked on the treadmill. The position of the markers was compared with the position of the underlying skeletal segments during different phases of the step cycle.

RESULTS

Kinematic study: Significant differences were found between MD during standing and walking for all bones investigated. Mean percentage differences in MD ranged from -18% to +6%. Fluoroscopy study: Significant displacements relative to the bony landmarks were found ranging from 0.4 to 1.2 cm.

CONCLUSIONS

Analysis of the motion of skeletal structures with the use of markers attached to the skin showed that the skin moves relative to underlying skeletal structures. When working with a 3-D motion-capture system using skin markers, researchers should be aware that the STA could significantly influence their results.

Relationships between fore- and hindlimb ground reaction force and hoof deceleration patterns in trotting horses

REASONS FOR PERFORMING STUDY

The transmission of shockwaves following hoof impact is proposed to be one major source of stress to the limb. In the forelimb, there are indications that the period of horizontal deceleration of the hoof is related to the attenuation of shockwaves. In the hindlimb, information about the hoof deceleration has been lacking.

OBJECTIVE

To compare hoof deceleration patterns between the fore- and hindlimbs.

METHODS

Seven Standardbreds were trotted by hand over a force plate covered with sand, with triaxial accelerometers mounted on the fore and hind hooves. Variables representative of decelerations (first 2 main vertical deceleration peaks; characteristic minimum and maximum values in the craniocaudal deceleration; hoof braking time) and ground reaction forces (vertical loading rates; maximum and the following local minimum of the craniocaudal force) of the initial part of the stance phase, and the differences between individual fore- and hindlimb time and amplitude variables were used for statistical analyses.

RESULTS

Force plate data showed significantly greater vertical loading rate (mean +/- s.d. 6.5 +/- 5.9 N/sec) and horizontal loads (190.4 +/- 110.2 N) in the forelimb than the hindlimb, but the parameters from accelerometer data showed no significant differences.

CONCLUSIONS

No significant difference was found in the hoof deceleration, but the deceleration curves displayed a common pattern that described in detail the kinematics of the fore and hind hooves during the initial period of hoof braking.

POTENTIAL RELEVANCE

These results contribute to further knowledge about the characteristics of these potential risk factors in the development of subchondral bone damage in the horse. Further studies are required on the influence of hoof braking pattern at higher speed, different shoeing and ground surfaces with different properties.

Influence of draw reins on ground reaction forces at the trot

According to riding texts, draw reins are supposed to support increased collection. This has not been measured objectively. Therefore, the objective of this study was to determine whether a horse ridden with draw reins would relatively increase weightbearing of the hindquarters while worked with the draw reins compared to a normal rein. Ground reaction forces were measured in 8 horses at the slow trot over a force plate in 3 different experimental set-ups: 1) riding with only a draw rein (DR); 2) riding with the combination of a normal and a draw rein (NR-DR) and 3) riding with a normal rein (NR). Horses ridden with NR-DR showed significant higher vertical impulse in the hindlimb compared to riding both with only DR and only NR. Several significant differences were also seen in the horizontal force. It is concluded that draw reins, when used correctly, together with a normal rein, achieve the desired result of shifting the weight of the horse caudally. This was not the case when the draw rein was used alone. It is important that trainers, as well as veterinarians, recommending draw reins in a rehabilitation programme, know about these possible effects.

In vivo transmission of impact shock waves in the distal forelimb of the horse

There is a high prevalence of lameness among Standardbred trotters, most commonly caused by noninfectious joint diseases, mainly related to training and competition. In this context, impact-related shock waves transmitted through the skeleton and joints have been proposed to be one important factor in the development of osteoarthritis. The aim of the present study was to investigate the characteristic pattern of the events immediately following first contact, with a focus on the in vivo transmission of impact shock waves in the distal forelimb. Two horses were trotted by hand over a force plate. Recordings of 3-D kinematics of the distal forelimb were carried out by use of a 240 Hz video system. Tri-axial accelerometer data were collected from a bone-mounted accelerometer on the midlateral side of the third metacarpal bone (McIII) and from another accelerometer attached to the lateral side of the hoof. Force plate and accelerometer data were sampled at 4.8 kHz using a 16-bit A/D-converter, synchronised with the kinematic data. The results indicate that the time lapse of the horizontal retardation of the hoof is an important factor in the attenuation of the impact. A shorter period of hoof braking showed higher amplitudes in the longitudinal retardation of McIII and a more rapid oscillation. This makes all parameters that affect the horizontal hoof braking potentially important to the orthopaedic health of the horse.

Nerve block and intra-articular anaesthesia of the forelimb in the sound horse

Nerve blocks and intra-articular anaesthesia are used extensively as routine methods in lameness evaluation. The method is based on the assumption that the technique itself does not change the movement pattern. The aim of this study was to carry out a quantitative kinematic study to confirm or reject the hypothesis that high palmar digital nerve block (HPDN) and intra-articular fetlock joint anaesthesia (IAF) influence significantly the movement pattern of the horse. Seven Standardbred horses trotting at 4.5 m/s were recorded at 240 Hz on a treadmill before and after anaesthesia by use of a ProReflex video system. Time variables, segment and joint angles were calculated. The high palmar digital nerve block (HPDN) resulted in a longer stance time and caused a greater fetlock joint angle range and greater maximal pastern joint angle. No systematic differences in time and angle variables were observed after intra-articular fetlock joint anaesthesia (IAF). In conclusion, HPDN but not IAF affects locomotor pattern in sound horses. Distal limb proprioception is important in normal movement, while fetlock intra-articular proprioception is apparently not. Interpretation of the effect of HPDN in lame individuals should incorporate more variables than maximal overextension of the fetlock joint.