Dental disease shouldn't be ignored

Early in my career an 18 year old mixed breed dog named Peanut presented for an exam with several clinical signs consistent with Cognitive Dysfunction Syndrome (CDS) including not greeting the owner, not wanting to go on walks and would stare into space. On exam, severe periodontal disease was noted and after a thorough diagnostic work-up it was decided to proceed with treatment for the oral disease. Treatment was somewhat risky as it necessitated anesthesia, but most of the dog’s teeth were extracted due to the extent of disease.

Two days later I received a phone call from the Peanut’s owner and she was absolutely ecstatic and amazed about what a different dog she had. The signs that were thought to be from CDS - all gone! She was greeting, wanting to go on walks and very bright and alert - things she hadn’t seen in Peanut in years. It was a profound lesson for me in the importance of addressing the whole patient in achieving an accurate diagnosis. In this case, Peanut’s mouth was so painful, what we thought was CDS was not. If not for addressing the source of pain, she would have suffered in pain so much longer.