Beginner's Guide to Brushing Your Dog's Teeth

The AVMA sponsors National Pet Dental Month every February to spotlight the importance of dental care to your pet's health and well-being.  Bad breath, drooling, dropping food, or difficulty eating are all clues of more advanced dental problems that you may notice at home.  Your veterinarian may detect other signs, e.g. gingivitis, chipped tooth, loose tooth, tooth resorption, and treat them before they lead to more serious problems.

A comprehensive oral health assessment, cleaning and treatment (e.g. extractions) under general anesthesia may be recommended for your pet.  After the cleaning, a good home dental care program is important to maintain that fresh breath and oral health. As with behavioral issues, preventing dental health problems is one of the more difficult subject for veterinarians and their teams to tackle because it relies on you, the caregivers, to do the work at home.  Showing you how to brush your dog's teeth is also not something that can easily and effectively be done in a brief exam room visit.  Below are a series of very short videos we did with Elaine almost 3 years ago on how to start brushing your dog's teeth.  Click anywhere on the pictures to start/stop the videos.

Beginner's Guide to Brushing Your Dog's Teeth: Step 1: Handling Her Mouth.

A video posted by The Family Vet (@thefamilyvet) on Feb 13, 2014 at 12:13pm PST

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Beginner's Guide to Brushing Your Dog's Teeth, Step 2: Touching Her Teeth.

A video posted by The Family Vet (@thefamilyvet) on Feb 18, 2014 at 12:36pm PST

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Beginner's Guide to Brushing Your Pet's Teeth, Step 3: Adding Toothpaste. #pets #teeth

A video posted by The Family Vet (@thefamilyvet) on Feb 21, 2014 at 2:01pm PST

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Beginner's Guide to Brushing Your Pet's Teeth, Step 4: Transitioning to a Toothbrush. #pets #dentalcare

A video posted by The Family Vet (@thefamilyvet) on Feb 28, 2014 at 10:49am PST

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Brushing Your Dog's Teeth: Holding Technique A. #pets #teeth

A video posted by The Family Vet (@thefamilyvet) on Mar 4, 2014 at 12:23pm PST

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Brushing Your Dog's Teeth: Holding Technique B. #pets #teeth

A video posted by The Family Vet (@thefamilyvet) on Mar 4, 2014 at 12:33pm PST

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Beginner's Guide to Brushing Your Pet's Teeth, Step 5: Toothbrush Readiness Test. #pets #teeth

A video posted by The Family Vet (@thefamilyvet) on Mar 11, 2014 at 12:33pm PDT

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Restraining or holding your pet for the brushing depends on her size and willingness to sit still.  Some pets do better sitting with their back to you; others like Elaine, do better facing you.

Beginner's Guide to Brushing Your Dog's Teeth, Step 6: Introducing the Toothbrush. #pets #teeth #dentalcare

A video posted by The Family Vet (@thefamilyvet) on Mar 11, 2014 at 12:45pm PDT

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The amount of time it takes for your pet to get used to having her teeth brushed depends on how much handling she already gets and how consistent you are with the routine.  It is like developing any habit --- consistency, rewards, and patience.  For complete beginners, pets who have not even had their mouths handled at home before, we usually suggest at least a week of daily practice for each step.  Most people give up or fail because they rush and expect to be brushing their pet's teeth after a few days.  Move on to the next step only when you can safely and repeatedly do each exercise.  Yes, that means it may take a month before you actually brushes her teeth but by then, dental care would be part of her daily routine, not a feared procedure that you have to force on her.

Sweet Elaine was not the most trainable dog.  It's embarrassing but I think it took us almost 6 months before I was able to brush her teeth.  I started then gave up when it seemed she would never learn to sit still for the brushing.  We then did 10-15 seconds sessions and eventually worked our way up to actual brushing.  I'm sure it will not take 6 months for you and your pet, but don't expect it to happen overnight either.

If you are currently not brushing your pet's teeth daily, give it a try.  It is a much overlooked practice that not only improve her health and prevent bad breath but, like daily walks, also strengthen the bond between you and her.

Elaine is getting her daily teeth brushing.

A video posted by The Family Vet (@thefamilyvet) on Oct 26, 2013 at 6:11pm PDT

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Lessons from Pet Loss

I lost five of my pets in the past 2 years.  I said pets to make it easier for me to write this but those who have lost a pet know, they were more than pets, they were family and each had a special place in my life and heart.

From left to right: Elaine, Kobi, Lana, Sariah, and Xander.

The 3 cats, Lana, Xander, and Sariah, were littermates abandoned in a grocery bag in our waiting room in September 1998.  They were only several days old, eyes not yet opened and umbilical cord stumps still present.  They were too young to be adopted out and rescue groups were unable to take them in until they were older and eating on their own.  One-year out of vet school, I had worked with cats but had never been owned by one.  Dr. Grant, the owner of the practice at the time, was generous and allowed me to take care of the kittens until they were old enough to be adopted out.  For the next 4 weeks, those kittens were never far from my side. They were nursed back to health, bottle-fed or tube-fed, until they were old enough to eat on their own. 

Never having had the pleasure of living with cats before, I was quickly introduced to the joy of kitten antics -- and how to care for them.  Oh, I was well trained in the medical aspect of kitten care --- deworming, vaccination, flea control, what to feed them, how often and how much, etc. --- all that were learned in vet school.  But everything else, from how to hold the 3-ounce squirming bundle in the palm of one hand, stabilizing his head between your thumb and index finger, while the other hand passes a feeding tube down his esophagus, to how to stimulate him to defecate and urinate, all that and more could only be learned through experience.  And those 3 kittens gave me a crash course in newborn and kitten care that have served me well over the years.

I do not know if I ever really seriously planned to adopt them out.  I think everyone in the clinic and at home knew those kittens were not going anywhere but we continued to joke about it.  Years later, I recall telling a client that I was still trying to find a home for them.  Right :)

Just as they taught me about kitten care, they continued to educate me in the art of feline medicine.

Sweet Lana was the first to depart, succumbing to kidney failure in September 2014.  Regal Xander followed 6 months later in March, heart failure.  And aloof Sariah 9 months later, in December 2015.  Even near the end, they each taught me how to traverse that difficult path of knowing when to let go.  Both Lana and Xander took a sudden decline and more-or-less helped me make the euthanasia decision.  Petite Sariah was a fighter and had rallied over the years through inflammatory bowel disease, hyperthyroidism, arthritis, and intestinal lymphoma.  She was stubborn and hung on but, as she withered down to under 5 pounds, I was reminded that the kindest loving decision made at the right time and for the right reasons, can still hurt and bring doubt to any of us.

In my mind, I know how fortunate I was to have had them in my life for almost 18 years.  In my heart though, I wish I could have had more.

Kobi was a Toy Poodle that my mom took in when her co-worker was unable to keep him.  He was my mom's dog but he soon made it clear that he was mine whenever I visit or stay over.  I have since believed that my mom secretly taught Kobi to be attached to me so that I would feel motivated to visit more often.  Messages of her missing me soon became "Kobi misses you" and "Kobi is looking for you."  Over the years, he conspired with my mom to show me how things are often not as I learned in school.  To this day, I imagine he took great pleasure in being the vet's dog that needs to be sedated for nail trims.  Thanks to Kobi, I learned all the different ways of training dogs to accept nail trims -- and how to be humble and sympathetic to families with uncooperative pets.

He was not quite 16 years old when we had to say good-bye to him in the end of May 2016, just five months after losing Sariah.

Less than a month later, I had to say good-bye yet once again.

It is not true that losing loved ones get easier with experience.  If it was true, the series of loss in the past 2 years would have prepared me for Elaine's death.  Prior to their loss, I had also lost other pets that were also dear to me --- my family of Chihuahuas got me through vet school, big aggressive diabetic Tyson taught me that kindness from a human touch can turn even a mean Rottweiler into a trusting soul, Panacea reminded me that cancer does what cancer wants, and Sammie taught me the tough lesson that sometimes we have more regrets from hanging on too long than from letting go too soon. 

Past loss may have taught me coping mechanisms and how to deal with grief and loss.  But it does not make it any easier.

Losing so many pets in succession also made me realize that the amount of grief I feel with each loss is not necessarily a reflection of how much love I had for that pet.  Grieving more for one does not mean I loved her more than any of the others.  The grief and how I deal with the loss and sadness may have more to do with what was happening during the time a particular pet was in my life.  In some ways, pets are the physical embodiment of my emotions and feelings --- my hopes and dreams, my experiences and memories.  And when I lost pets that had a strong presence in my life, I used to fear that I would also lose those memories, that I would forget the way loving that pet made me feel.

Elaine was brought to our clinic on her birth day, February 14, 2002.  Her umbilical cord was not even dry yet.  It was fitting that it was Valentine's Day for she wormed her way into my heart and never left.  Maybe one day, I will tell her story.  Suffice it to say that I am a better human being, and definitely a better veterinarian for having had her in my life.

Another day at the clinic: baby Elaine with Dr. Tran working in the background, 2002.

She was such a huge part of my life.  I learned so much about myself, some lessons I rather not have had but know they were necessary for my personal growth.  Even in death, she helped me realize that I had nothing to fear about losing loved ones -- that the influences she had on my life do not end with her death.  The lessons she and all my other pets have taught me are part of who I am now.  And in some ways, how I affect others in my life will reflect their influence so the fruits of their existence outlast their physical presence in my life.

Dr. Tran and Elaine, July 2003.

It is comforting to look at it that way. I think I used to grieve and fear their loss because it seemed what we shared was lost forever.  I still grieve for them but I no longer fear losing them as much.  I may have lost their physical presence but I can never lose what we shared.  That lives on in me and, if I'm lucky, in the lives I touch, both in and out of the clinic.

-tnt

Clinic Insights, Summer 2016

As many of you have found out, 7 year employee Elisabeth has moved to another state to be with her partner. We will greatly miss Elisabeth – not only was her care and tireless work an asset to our facility, we will be miss her as we she was part of our family. When we first hired her 7 years ago, she was shy and unsure of herself; through the years she learned the ins and outs of how to succeed at a busy, sometimes difficult workplace. Most importantly, she left us confident that she can succeed at whatever she sets her mind to. We wish her the best of luck and look forward to seeing her now and again.

Celebrating goodbyes and new opportunities, from right to left: Elias, John, Elisabeth and Dr. Tran

Elisabeth’s departure has resulted in some changes; naturally, everyone in the facility will take on a larger role. Elias will take on most of the “front staff” duties; this means you may get a voicemail answering service more often than we would like during our business hours. Five year employee John will provide additional assistance with pharmacy and treatments.  We are depending on our clients' understanding for the adjustments that we will all make.  We are also changing some protocols including appointment periods accordingly and other "behind the stage" changes to make the adjustment easier. Our philosophy remains the same: to assure every client that comes in that we are committed to promoting their companion animals’ health and well-being.

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Seemingly continuous postage rate increases (along with what seemed to be worsening delivery problems) along with clients' shift towards email and electronic notices have caused us to shift towards electronic reminder cards for patients, away from the old postage cards. We encourage clients to provide us with an email address (and to notify us when it changes) so that we can email your companions’ postcard reminders.  For those of you without an email address, postcards will continue to be mailed out during the later half of the month.

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Some of you may know, we lost one of our own, Elaine, on June 23rd. Elaine was the heart and soul of our clinic. Whenever things weren’t as we would like them to be, she was there to remind us that things weren't so bad. And even when everything was okay she made them better. Her interminable happy attitude is familiar to any dog owner, but the funny quirks that made her her (being afraid of cats, playing games to have her daily teeth brushing, completely happy living in small quarters, etc.) were familiar only to us. Elaine taught all of us here many life lessons that will stay with us for the rest of our lives. I suppose this is the greatest gift she could have possibly given us, and she has done that. Elaine you are in our hearts, forever. We miss you greatly.

Elias' son and Elaine, circa 2002

Elaine, 2015

Change is inevitable, but this doesn’t make it any easier. That said, we remain confident that as we continue to learn about ourselves, about people, about animals, about having to say goodbye and about eternal bonds, we will continue to become better health care providers. An ancient Chinese proverb states "When the winds of change blow, some people build walls and others build windmills." We'll build windmills.

Elaine, May 17, 2016

February 14, 2016

Saturday was one of those days that reminded me of how fortunate and blessed I am to live the life I do.  I know I have the love and support of my family, the respect and dedication from our team, and the trust and loyalty from our clients but it is not often that all three come together like a glorious colorful painting in front of my eyes.

Even though our clinic closes at 5 pm on Saturday, our last client did not leave with her pet until after 7:30 pm.  Our staff did not lock the clinic doors until almost 8 pm.  Nevertheless, worried or tired, everyone left with a satisfied smile.

14 year old Elaine

The Family Vet is a very small practice comprising of myself, Dr. T-na Tran, and our three assistants, Elias, Elisabeth, and John.  We see patients by appointments only and weekends tend to fill up ahead of time.  But as we all know, pets do not get sick on schedule.  When a client calls with a sick pet, we try to work our schedule so that we can care for as many as we are able without significantly compromising the quality of our services.  When we do not have any open appointments or if the openings are not acceptable to the clients, we offer to have them leave the pets with us for the day.  We tend to these day-stay patients in between our scheduled appointments and contact the clients to discuss the care and treatment as needed.  The length of the day stay varies with the day’s appointment and whether scheduled appointments are on time or if any are cancelled/rescheduled.  Some stays are 3-4 hours but most stay the whole day, or past closing time, if we have a full schedule.

Some of our clients have known us for almost 20 years and have no qualms about leaving their companions with us.  But for the newer clients, it is asking a lot of them to leave their pets with us for the day ---whether it is the stress to the geriatric cat who has never been away from home except for the vet visits or the hyper barking puppy that may not quiet down regardless of our various tricks.  Yet, they would leave their pets in our care if we asked them because they know that we would encourage them to go elsewhere (e.g. another local practice or the emergency clinic) if that was better for their loved ones.

In many ways, the clients who do not get upset at us but, on our recommendation, take their pets either to the emergency clinic or another local practice show even more trust in us.  They trust that we would gladly see them if we could safely do so.  They trust that we know their pets well enough to know when it would be better for the pets to be seen elsewhere.  They trust that the health and well-being of their pets are of the highest importance to us and we would find ways to help their pets even if it means sending “business” elsewhere.

This trust is priceless.  I am forever grateful that we were able to cultivate that rapport with our clients over the years.  We strive to build on that trust and safeguard it whenever possible.  It is to that end that we intermittently stop accepting new clients to our practice.  We want to be able to be there for the current clients and patients in our care.  Limiting the influx of new clients allow our small team to provide quality personal care for our current patients.  Even though clients may not like going elsewhere when we recommend that option, they know it would be better for their pets.  They understand that we have done what we could to improve our availability to our current patients, even if it meant going against business advisors by not accepting new clients.

Not only am I fortunate to have that trust and support from our clients, I am also blessed to have a team of awesome compassionate people who share my vision and work just as hard as I do to deliver the type of care to our patients that we would want for our own families.  I am not unaware of how difficult it can be to work in a practice where team members are asked to go the extra miles for the sake of client and patient care, not for bonus points or revenue incentives.  Somehow we managed to keep a core team of dedicated professionals who see The Family Vet not as just a workplace but also as a second family.  We would not be able to provide the personal care that we do here at The Family Vet without the skills and commitment from Elias, Elisabeth and John.  Thank you, guys!

Going-on-17 years old Sully                   

Speaking of second family, there would be no such thing if I did not have the most understanding and supportive “first” family.  On this particular Saturday, my family was out celebrating the Lunar New Year at the festivals in Orange County.  As with so many family outings over the years, I missed it as we did not finish at the clinic until way late.  Other than being worried that I was working too much, my family had always loved and supported me in my chosen profession.  They may tease that I spend more time with my second family than with my real family but, ultimately, they would do what they could to help me – whether it is my mother caring for the beautiful orchids or my brother-in-law’s computer tips.

And that is how, on this St. Valentine’s Day, I am reminded of how much love and caring there may be in our lives.  We just have to look past the traditional romantic love to appreciate the many other types of love that fill our lives.  Without a doubt, my life is better for being on the receiving end of the love, trust, respect, support, and loyalty from my family, our clients, and our team here at The Family Vet.

And of course, I cannot forget Sully and our birthday girl, Elaine.

Thank you all.  Hope your Valentine’s Day was as you had hoped it to be.

T-na Tran, DVM

Cats at The Met

If you’re like me you just don't have enough cats in your life. You have them at home, (I’m fortunate enough to have them at work too), but you need more. Lucky for us the Metropolitan Museum of Art (“The Met”) has a solution. If you use Chrome Browser for Windows PC’s simply install the free Chrome Browser add-on located here http://t.co/I7NwEw1zIa. Now you'll be able to viewing The Met’s collection of art featuring cats from across their vast art collection by simply opening up a new tab on your web browser! That’s right, just open a new tab on your web browser and be treated to beautiful art that features a cat. For fans of art and cats it’s the cat’s meow!

I tried it and found it quite the distraction. That The Met took the time to provide artist information and art date makes it additionally wonderful. Here are screenshots of the first 5 tabs we opened:

The Met's Chrome Browser extension is educational, fun and free. Highly recommended.