Health Articles

Chronic Dental Disease and Pulse Therapy

by Anne Jones RN, BSNE

 
In reading this information, please note that in Bichons it is important to understand the cause of repetitive urinary tract infections before relying on pulse therapy for treatment.

In talking with veterinarians who see a lot of Bichons in their practices, you will find that they often mention two major health issues in the breed as the reason for return visits to their clinics. Those two problems are allergy/atopy (itchy skin problems) and dental disease. For years we have known that many Bichons start to lose their teeth by age seven and many more have chronic gingivitis, or gum disease. This article focuses on dental disease and related health problems.

Another major health problem in Bichons is the formation of bladder stones. One type, struvite, is caused by infection in the bladder. The other most prevalent type of stone is the calcium oxalate stone and these are from an inherited condition that causes crystals and stones to form. The Minnesota Urolith Center describes the condition as being “associated with complex pathophysiological mechanisms, many of which are still poorly characterized”. In other words, we still are not entirely sure how or why these stones form, though we do know that there is a genetic component. MN Urolith also reported that 58% of stones determined by their lab to be calcium oxalate occurred in six breeds and one of the breeds is Bichons. For this reason, in Bichons it is critical to fully understand what is happening when a Bichon has a bladder infection or forms bladder stones. This issue is addressed in an article at www.bichonhealth.org/HealthInfo/UrinaryStones.htm.

Veterinarians will often deal with chronic gingivitis using a treatment regimen called pulse therapy. What is chronic gingivitis? Gingivitis can be described as inflammation of the gums and it can lead to a systemic infection, or a disease where germs are carried by the blood stream to other parts of the body. It is for this reason that we have to be alert to gum disease in the breed and to carry out routine dental care at home as well as annual or twice a year professional cleaning of the teeth. One common infection seen in dogs with gum disease is urinary tract infection. Germs can also migrate to the major organs and cause kidney, liver and heart disease, among others.

In recent years, a form of treatment for chronic gingivitis has been pulse therapy. Pulse therapy is the administration of antibiotic medication for 5 days out of every month to control infection in the gums before it gets out of hand and causes systemic infection. The antibiotic has to be varied so that germs do not become resistant to any one antibiotic and monthly therapy must continue indefinitely. The teeth still need to be professionally cleaned when possible and everyday care should continue.

While pulse therapy can work to treat chronic gum disease in older Bichons, it is vital that any Bichon with repeated bladder infections be fully assayed to determine the cause of infection and appropriate treatment carried out. To ignore this condition and to assume it is solely related to gum disease may endanger a dog with an inherited form of stone and/or crystal formation. At the same time, pulse therapy may well save the life of an older dog that can no longer be anesthetized to have his teeth cleaned. Routine home care should continue to reduce the tartar buildup that leads to infection. The dog will need to be monitored for other conditions related to the use of antibiotics, such as inflammation of the liver.

If you have a dog with inflamed gums, discuss the condition with your veterinarian so that you can decide together a wise regimen for treating the condition. Pulse therapy may be the answer when combined with other forms of dental care and may be particularly useful for your older Bichon.

Breeders need to pay careful attention to long term history of dental disease and eliminate from their breeding program any Bichons that carry the genes that cause early tooth loss. Breeding for a strong underjaw will help to delay tooth loss and many Bichons have kept full dentition for their entire lives. The causes of gingivitis are complex but tooth loss will occur unless proper mouth structure and bone are present to hold the teeth. The added concern for secondary infections is serious and further cause for careful evaluation of breeding stock.