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Dental health is a critical part of your pet’s health because it can be associated with other health problems and oral pain. Unfortunately, our pets often do not show signs of discomfort until there is significant dental disease. This is because our pets do not understand that if they demonstrate pain, someone will identify it and have it assessed and ultimately fixed. They only understand that if they stop eating, they will not survive. 

To accurately assess your pet’s dental health, routine oral examinations are necessary. This allows us to evaluate:

- plaque and tartar accumulation

- gingivitis (gum redness)

- abnormalities with occlusion (which can affect chewing habits and cause soft tissue damage in abnormal)

- identify possible missing teeth (x-rays are needed to confirm if teeth are missing – unerupted teeth still located below the gumline can contribute to the development of locally destructive bone cysts in the jaw)

- identify any retained baby teeth or “extra” adult teeth

- assess the gum tissue and oral cavity for any masses or abnormal tissue growth

Once a preliminary oral health assessment is performed, our veterinarians can determine if a more detailed evaluation is needed. A detailed oral exam, including intra-oral dental radiographs (x-rays), under general anaesthesia is the only way we can accurately assess our pet’s for periodontal disease (as 2/3s of the tooth is located under the gumline). 

Once this comprehensive assessment is complete, our veterinarians will discuss any concerns that they have with you and formulate a treatment plan which may include an oral hygiene procedure (ultrasonic scaling of the teeth above and below the gumline (we are only able to remove accumulated plaque under the gingival margin), hand-scaling (into crevices and occlusal pits), polishing (to smooth the surface of the enamel – as plaque accumulates more quickly on a roughened surface), fluoride treatment, or oral surgery to address teeth affected by periodontal disease, resorptive lesions or fractures with pulp damage. 

Referral to a veterinary dental specialist may be recommended depending on the severity of your pet’s dental disease or if certain dental conditions are noted on the preliminary oral health examination. 

Home care dental plans are an important part of maintaining a healthy mouth. There are several diets, water additives, tooth brushes/pastes and dental chews that can be helpful for your pet. It is important to look for the Veterinary Oral Health Council (VOHC) seal of approval on these products – this lets us know that these products have been tested to be safe and effective for your pet. 

"But what about anesthesia-free dental cleaning?" 

To the naked eye, anesthesia-free dental cleaning (AFDC) may seem like the perfect option, it is cheaper, quicker, and doesn't involve the risks of anesthesia! But, nothing is ever as it seems. You may see AFDC services offered at local groomers and pet stores for a fraction of the price than what is offered at a veterinary clinic. So what is the difference?

- How is AFDC performed? Your pet will be wrapped tightly in a towel or blanket so they are physically unable to move. Additionally, the person doing the "cleaning" may pin them down using their legs. This causes extreme stress and anxiety in our pets and will likely produce a fear of future restraint. Your pet will struggle which will cause them to use stronger restraint and possibly injury.  

- What is involved in a AFDC? The person performing the procedure will use extremely sharp tools to remove tartar and plaque from your pets teeth.  Dental tartar is firmly adhered to the surface of the teeth. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.  These tools will leave the tooth surface extremely scratched and rough which will promote future tartar and plaque build up.  Professional dental scaling includes scaling the surfaces of the teeth both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the subgingival space between the gum and the root), where periodontal disease is active.  Access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet’s health, and provides a false sense of accomplishment. The effect of a AFDC is purely cosmetic.  A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed. Dental radiographs are not completed during AFDC,  since 60% of a tooth is below the gumline, problems such as retained roots, root fractures, and periodontal disease only can be detected on radiographs. Without X-rays, many dental problems go undiagnosed and untreated.  A thorough dental exam and X-rays may reveal problems requiring immediate action that can't be treated without anesthesia. If your pet already is anesthetized, problems can be addressed immediately so he returns to you with a healthy mouth.

WSAVA (World Small Animal Veterinary Association) commented on AFDC in an published article in July 2020. The article read:  

Veterinary organizations worldwide agree that performing dental procedures without anaesthesia, referred to in this document as Anaesthesia Free Dentistry (AFD) but occasionally known as non-anaesthetic dentistry or natural dentistry, is not medically beneficial. Animal welfare scientists maintain that preventable and predictable pain, stress, and anxiety should be addressed during veterinary care for both moral and ethical reasons. Effective evaluation of periodontal health requires thorough periodontal probing. 

Performing a thorough and accurate probing on all surfaces of the tooth, especially the caudal teeth and all lingual/palatal surfaces, on a typical awake animal is exceedingly challenging, and therefore likely to be inaccurate. Challenges include animal head movement, tongue interference, and difficulty for visualization. While this may be a procedure that creates minimal pain and stress in healthy individuals, probing diseased tissues such as resorptive lesions elicits a significant and predictable pain response. Determining which animals will experience pain on probing is rarely accurate based upon visual cues, and as such, a practitioner has little accurate information before probing to ensure the process will not be painful or stressful to the patient.

Individuals performing a dental procedure without anaesthetic cannot conduct radiological examination of the subgingival anatomy, which in Tier Three countries is considered an essential procedure for thorough evaluation. Without effective evaluation of the supra- and subgingival areas, meaningful treatment cannot be delivered to the patient. As a result, removal of supragingival tartar and polishing of the visible surfaces of the teeth may lead to a cosmetically improved oral cavity, but persistent infectious, inflammatory, and/or painful conditions not recognized or identified remain untreated. Therefore, not only is the procedure essentially ineffective for relieving pain and infection present, it often results in a false sense of security for the owner and lead to delays in appropriate professional care.

This directly opposes the welfare benefits and improvements to quality of life, that are at the centre of these guidelines. Additionally, stress or discomfort incurred during this time-consuming cosmetic procedure are wholly avoidable when a reasonable alternative 

is utilized (appropriate anaesthesia), and indefensible from a medical and ethical standpoint. As such, the World Small Animal Veterinary Association strongly objects to the practice of veterinary dental procedures without appropriate anaesthesia, as it is inadequate and provides a substandard level of care which may be misleading to the pet owner.

Caring for a pet with a terminal illness, chronic discomfort or mobility changes can be difficult, both emotionally and physically. Our veterinarians and support team are here to help you with decisions regarding home-care, medications and alternative therapies, environmental/home modifications and to explain all available options for your pet. 

When palliative care is unlikely to provide your pet with a good quality of life or you have made the decision say goodbye to him/her in the most peaceful way we can, we are here to walk you through the process. 

We have a comfort room at our hospital to provide our clients and their pets with privacy and a sense of “home” for quality of life consultations or euthanasia. Our goal is to ensure that we make this incredibly hard time peaceful and comfortable for both you and your pet.. 

Gateway Pet Memorial provides our after-care services, including cremation or burial at a pet cemetery. You can visit their website to learn more about their services and memorial options including urns, pawprints and jewellery, www.gatewaypetmemorial.com.  PearTree Impressions pawprints are also available as a memorial keepsake of your pet. See their beautiful craftsmanship here www.peartreeimpressions.com.

Our technician Becky can be available for bereavement counseling for you and your family should you need some assistance with the loss of your beloved pet. Alternatively you can also reach out to the Pet Loss Support Hotline at info@ontariopetloss.org or 240-389-8047. 

There are different veterinarians in the area that do house calls for end of life care. Their information can be found below. 

Avery Mobile Vet 519-806-7387 www.averymobilevetservices.com

Caledon Vaughan Mobile 416-894-3871 www.cvhousevet.com

Coulter Mobile Vet 705-309-2956 www.heartwithwings.net

Owner History
The first part of any visit to our office is the collection of what we call the pet’s history.  This is a question and answer period between owner and veterinarian that establishes specific concerns about the kitten’s health or behaviour at home.  In addition to ensuring the kitten is not showing any signs of illness (vomiting, diarrhea, coughing, sneezing, skin infections, fleas, etc.) this is your opportunity to voice any concerns you have and to ask questions.

Common questions to expect from the veterinarian may include:

• Where the kitten came from
• Previous veterinary visits/medical care (vaccinations, parasite screening, parasite treatment/prevention)
• Health problems of parents or littermates
• Diet (brand, kibble, canned), amount fed, frequency of feeding, treats
• Litter training and environmental enrichment for indoor cats
• Contact with other animals (what kinds), wildlife, children, elderly, immunocompromized individuals
• Lifestyle – indoor vs outdoor

Many new cat owners are surprised by the amount of time we spend talking at the beginning of each appointment.  Asking these questions is critical in determining if your kitten is displaying any early signs of illness or behavioural issues and whether he/she may be carrying diseases or parasites that could affect the health of your family or other pets.  They also help us determine your kitten’s individual risk level for getting infectious and parasitic diseases, allowing us to choose the vaccinations and parasite preventions that are best suited for your kitten.

Physical Examination
A thorough physical examination is the most important part of each kitten visit.  The most common question many kitten owners ask is why a full physical examination is necessary at every visit.  The reason for this is similar to why your child needs to have an examination at every vaccination appointment – to ensure that his/her growth and development are progressing normally and to address any health concerns early, hopefully avoiding permanent health problems.  Another important reason is that we are often administering vaccinations and/or additional medications during these appointments, which can only be administered to healthy kittens.  Administering a vaccination to a kitten that is sick or fighting an infection (even if they are not showing signs of illness at home) is not safe and can result in serious health consequences.  A thorough physical examination is the only way to ensure the kitten is healthy enough to receive these treatments.  Although every veterinarian has a slightly different technique and style for examining each pet, there are some key areas that should always be assessed during the physical examination:

• General attitude and behaviour assessment – Overall impression of the kitten’s mental alertness (normal kittens should be bright, alert and inquisitive, providing it is not nap time) and attitude towards new people (normal kittens should be friendly and curious).
• Oral Cavity/Dental examination – Assessing the colour of the gums (pale gums or bright red gums can be indications of illness), bite/occlusion and dental anatomy (overbite/underbite or malposition of baby teeth that may interfere with normal eating behaviour), cleft palate and damaged/loose baby teeth that could be painful or lead to infection. We will also discuss safe toys and how to care for your cats’s teeth as it grows.
• Ophthalmic (eye) examination – Examine the eyelids, conjunctiva/sclera (soft tissues surrounding the eyeball), and the eye itself including the external surface and internal structures of the eye (cornea, anterior chamber, lens, iris and retina).  We are looking for signs of trauma, infection, and anatomical malformations , underdeveloped eyes, abnormally rotated eyes, retinal abnormalities, congenital blindness.
• Ear/Otoscopic examination – Signs of excessive wax/dirt accumulation, foreign material within the ear canal (hair, foreign material, etc), ear mites, other external parasites , infections or malformations of the ear canal.
• Lymph nodes – These paired, soft tissue structures are part of the immune system in the body. They act like surveillance in the body for infections and also help to fight these infections by making white blood cells. We will palpate all the superficial (peripheral) lymph node looking for asymmetry or enlargement that could indicate an area of infection or inflammation.
• Hair coat assessment – Assessment of hair coat quality (a sign of overall health), evidence of skin infections, external parasites (fleas, mange, lice, ticks), or fungal infections.  We evaluate areas that could be concerning in certain breeds  and discuss home care to maintain a healthy coat and prevent infections (how often to bathe, required grooming, etc).  We examine the nails and foot pads and demonstrate how to safely trim his/her nails.
• Thoracic auscultation (listening to the heart and lungs with a stethoscope) – Assessing for heart murmurs or arrhythmias while feeling the kittens’s pulse to assess his/her cardiovascular health and blood pressure.  We listen to the puppy’s lungs and upper airway, evaluating for any areas of dullness, crackles or wheezes that could indicate pneumonia, upper airway infection, and fluid accumulation within the lungs or free fluid within the chest.  We look for anatomical abnormalities that could affect the kittens’s ability to breathe normally.
• Abdominal palpation – We palpate the kitten’s abdomen looking for signs of pain, abnormal gas accumulation or distensions that could indicate internal parasites or intestinal obstruction.  We palpate the kidneys, bladder, liver and spleen looking for signs of enlarged, underdeveloped, or missing internal organs.  We assess the integrity of the body wall and umbilical region to ensure the kitten is free from congenital hernias (which could require surgical repair).
• Musculoskeletal Examination – We assess the kitten’s body weight and size and determine if his/her current daily food intake is appropriate.  We evaluate the kittens’s conformation and evaluate developmental/growth abnormalities (abnormally rotated limbs, abnormal laxity in the joints, etc).  We look for pain or sensitivity that could indicate a trauma, infection or inflammation.
• Genitalia – We examine the kitten’s external genitalia to ensure that there are no congenital abnormalities (undescended testicles, malformations of the penis/vulva, malformations of the anus, etc).
• Neurological examination – We examine the kitten’s mental awareness, gait and reflexes looking for neurological deficits that could indicate central nervous system infections, congenital malformation of the skull/brain, toxin ingestion, or juvenile epilepsy.

Vaccinations
Core vaccinations are required at 8, 12 and 16 weeks of age.  A single vaccination does not provide protection to your kitten with the exception of the rabies vaccine.  This means that your kitten needs to have at least 2 vaccinations, administered three to six weeks apart, in order for his/her immune system to produce enough antibodies to protect against infectious diseases.

The mother’s milk contains antibodies that provide the kitten with protection against diseases. When the puppy stops nursing, these antibodies start to decline and the puppy is no longer protected. This occurs around 6-8 weeks of age which is why we administer the first vaccination at this age.

BUT, there is a risk that this first vaccination will not be protective if the kitten still has a certain level of antibodies from the mother in his/her system. Unfortunately, we do not have a way of knowing if this first vaccination is effective or not. This is why the second vaccination is administered at 10-12 weeks of age.

The final vaccination is administered at 14-16 weeks of age because this is when the kitten’s immune system is primed to form antibodies against specific diseases. This vaccination “boosts” the immune system which then forms a memory response allowing it to fight these diseases if exposed to them.

We recommend that all kittens receive vaccinations against Feline Rhinotracheitis-Calici-Panleukopenia, Feline Leukemia and, rabies.

Internal Parasite Treatment and Prevention
Most kittens are infected with internal parasites.  They can be transmitted to the kitten before birth while it is developing in the mother’s uterus.  They can be passed to the kitten in the mother’s milk while others can be ingested as the kitten explores its world by licking, chewing on and biting things.  Many internal parasites are passed in the stool as microscopic eggs and are not visible with the naked eye. A stool analysis is important for all kittens to screen for internal parasites that could make the kitten sick and negatively affect its growth and development.  Some parasites can be transmitted from kittens/cats to humans.  Children are at an increased risk for infection with internal parasites because they don’t always wash their hands before eating or touching their mouths.  A number of internal parasites carried by cats can cause very serious and, in some cases, life-threatening disease in humans, so it is CRITICAL to have your kitten checked for internal parasites as soon as possible after adoption (ideally before introducing it to children or other household pets).  The Canadian Parasite Prevention Council recommends all kittens receive parasite prevention at least once a month from 8 weeks of age to 6 months of age.

External Parasite Treatment and Prevention
Fleas, ear mites and lice are all more common in kittens than in adult cats.  External parasites can cause discomfort, secondary skin/ear infections and can spread serious diseases.  Heavy infestations with fleas can cause life threatening blood loss/anemia in young kittens.  If parasites are seen during the physical examination the appropriate medication will be administered to resolve the infection and prevent spread to other pets and family members.  If no external parasites are identified during the examination, a topical medication will be administered that will prevent your kitten from acquiring fleas, lice and ear mites for 30 days after application.

Sterilization – Spay/Neuter
We recommend spaying or neutering all cats not intended for breeding.  This eliminates the risk of unwanted pregnancies and reduces the risk of specific cancers.  Spaying a female cat eliminates the risk of uterine and ovarian cancer and, if performed prior to the second heat cycle, reduces the risk of mammary (breast) cancer by approximately 97%.  Neutering male cats eliminates the risk of testicular cancer and reduces the risk of prostate disease and other testosterone-related disorders such as perineal cysts, glandular hyperplasia (stud tail).

Historically we recommended that all kittens be spayed or neutered at 6 months of age if they were not intended for breeding or showing in conformation classes.

Many people express concern that their cat will become overweight or lazy if they are spayed or neutered.  Weight gain is a valid concern as we know that sterilization will result in a decrease in metabolic rate.  We monitor all our kittens for several months after sterilization with no-charge weight checks and body condition assessments to ensure they are not gaining weight too rapidly, allowing us to intervene before a weight problem arises. It is uncommon for energy level to change after sterilization.

Our veterinarians and technicians understand that every pet is an individual and that there is not a “one-size fits all” diet. We will work with you to develop a nutritional plan that is best for your pet. 

Nutritional referrals are available upon request. We can also provide you with recipes and supplement balancers (through Hilary Watson’s complete and balanced cookbook or BalanceIt.com) if traditional commercial diets are not the best option for them. 

Pet obesity is a rising concern in our patients with over 1/3 of all cats and dogs being obese in North America. If your pet is suffering from being overweight or obese, our team can provide you and your pet with a healthy weight plan including:

- diet type,

- feeding amounts, 

- exercise plan,

- weight re-assessment visits 

Obese Pets
We work with you to develop an individual feeding and exercise plan to help your pet feel their best. Our staff are trained to take key body measurements on cats and dogs to determine their individual body fat percentage. This helps us to make adjustments to their diets to help them maintain an ideal body condition.  By working towards and maintaining a healthy high body fat percentage we can help reduce the health risks associated with obesity.

The following are risks associated with obesity:

• Shortened life expectancy
• Diabetes mellitus
• Reduced mobility
• Arthritis
• Increased Physical injury
• Respiratory Disease
• Kidney Disease
• Cancer

If you think your pet may be overweight, please contact us to arrange a body condition assessment. 

 High Energy Pets Some pets lead very active lives and are true athletes. These pets require close nutritional monitoring to help maintain energy levels and muscle mass. 

Regular wellness visits are important for every stage of your pet’s life, so don’t forget to keep your senior pet’s scheduled wellness appointments. We recommend that our senior and geriatric patients see their veterinarian every 6 months. More frequent examinations may be recommended if your pet has specific health concerns. 

If your senior pet is being treated for a medical condition, treatment recommendations can change as a condition progresses. Medication doses or frequency of administration may need to be modified or different medications may need to be considered depending on how your pet is responding to therapy and depending on any changes noted to their organ function based on monitoring blood work and urine testing or x-rays. 

Regular wellness blood work, urinalysis, x-rays and blood pressure monitoring are important for senior pets because these tests allow us to evaluate how your pet’s health is either responding to current management strategies or changing with age.

Your senior pet’s wellness examination is also your chance to have us address any of your questions or concerns about your pet. We welcome your questions and encourage you to be involved in decisions regarding your pet’s health care. During this time we can also suggest environmental modifications to help your pet be their best at home. 

Older pets make wonderful companions, and thanks to advances in veterinary medicine, pets are living longer than ever! You are an important ally in your senior pet’s health care. We are here to help ensure that your pet is safe and happy throughout the “golden years".

Pets can have a wide variety of behavioral issues, from simple housetraining problems to severe anxiety and aggression issues. We are qualified and experienced in diagnosing and addressing behavior problems with an approach that combines skills from veterinary clinical medicine, behavioral medicine, and pet training. Our goals are to help pets and their owners live together comfortably and safely, and to help restore the bond between pets and their families.

Dealing with behavior problems can be frustrating for pet owners. Some pet owners may even blame themselves because their pet seems to have an emotional issue. Although behavior problems can result from emotional trauma or physical mistreatment, in many cases the problem can arise from simple misunderstandings or learned associations that were inadvertently established during training. In addition, several medical conditions can manifest in ways that mimic behavior problems. Scheduling an evaluation with a professional skilled in diagnosing and managing behavioral issues in pets is the first step on the road to resolving the problem. We may even suggest reaching out to a qualified animal behaviourist.

Before you and your pet suffer through one more day of inappropriate behavior, call us. Let’s talk about how we can help.

When a medication is prescribed for your pet, our veterinarians will review his/her medical history and any other medications your pet is currently taking. This ensures that the most appropriate medication is chosen and reduces the risk of any unwanted interactions between different medications. Our team will provide you with information about dosing, frequency of administration, duration of treatment, possible side effects and any necessary monitoring associated with the medications prescribed for your pet. 

The inventory we carry is from safe, reliable sources and is stored under optimal conditions.

Many veterinary products are only sold directly from the manufacturer to the veterinary supplier company. What appears to be the same medication from an online pharmacy may not actually be the product that it says it is and fraudulent products can be very difficult to identify. The manufacturers, and our team, cannot guarantee the safety or efficacy of these medications, nor can we guarantee that hot/cold temperatures will not affect them during shipping.

A wellness examination includes an evaluation of all of your pet’s major organ systems. We’ll use the wellness visit to ask you questions about your pet’s behavior, appetite, exercise habits, and regular activities at home. This is also an excellent time for us to discuss any routine diagnostic testing that may benefit your pet or to recommend any vaccinations that may be due. If your pet seems healthy, a wellness examination is a good opportunity to note any changes, such as weight gain or loss or other subtle changes that may not be evident at home. Sometimes, information obtained during a wellness examination can help detect early signs of illness and address health issues before they progress.

A wellness examination is also your chance to have us address your questions or concerns about your pet. We welcome your questions. No question is too small or too silly, and it is our pleasure to address your concerns. We strive to help you understand your pet’s health considerations, and we encourage you to be involved in decisions regarding your pet’s health care.

Finally, wellness examinations help us establish a relationship with you and your pet. Through your pet’s physical examinations, other wellness procedures, and our consultations with you, we get to know your pet and learn about his or her lifestyle, personality, health risks, home environment, and other important information. We encourage you to use wellness examinations to take an active role in your pet’s health care.