Barnum, my Bouvier service dog, recently underwent oral surgery. The veterinary dentist gave me very stern instructions that I was to brush the injured area in Barnum’s mouth every day, starting the day after surgery. She had been considering extracting one of Barnum’s upper canine teeth which was damaged on the inner side and in the surrounding gums, but she decided to spare it for now pending a good recovery in the weeks following surgery. And she said the recovery would have a great deal to do with my capability in brushing the right spot on a consistent basis.
I tend to be kind of a perfectionist/worrier/overachiever where my dog’s health is concerned, so what I heard was, “If you don’t brush exactly all the right parts of Barnum’s mouth every day, perfectly, starting right this very instant, I will yank out his tooth.”
Thus, on Wednesday, the day after Barnum’s surgery, I set out to brush Barnum’s traumatized left tooth and gums. Even though so far he was not actually letting me touch his mouth.
Even when we were just lying in bed, relaxing, every time I moved my hand toward his muzzle to try to get a peek, he moved his head away. I worked on this with him by moving my hand toward his mouth and rewarding him with a treat for not withdrawing. He got extra treats for moving toward my hand. We had progressed to him letting me touch the fur on his muzzle — as long as I didn’t touch the left side of his mouth. But the time had now come for the prescribed brushing, and I was determined to do it, no matter what.
I took him to our “grooming station,” which is my coffee table that I keep in my bathroom so I can slide it in front of the toilet and groom him whenever it’s convenient. I call this “toilet training.” It’s one of the things that I do, as a severely fatigued and chronically ill person, to get necessary dog grooming things done while conserving energy.
As a result of long and diligent effort on my part, Barnum has a very solid positive reinforcement history with sitting on this table. He is used to being groomed there and getting rewarded handsomely for it.
I got out my three dog toothbrushes and my three tubes of dog toothpaste and examined each one, trying to decide which would be the most enticing and/or the least painful.
I don’t normally have three dog toothbrushes or three tubes of dog toothpaste, but I was worried that the bristles on my old toothbrushes had gotten too worn so I bought a new one at the vet’s (even though they don’t have the brand
I like Barnum likes) and a new tube of toothpaste because they said it was beef flavored and I used to have beef-flavored toothpaste that Gadget adored.
The kind I usually use is Petrodex poultry-flavored toothpaste (the tube on the left above), which all my dogs have liked, but which they are not as wild about as they were when I used to be able to find liver-flavored or beef-flavored toothpaste.
Unfortunately, the veterinary dental practice seems to favor CET brand toothpaste and toothbrushes, and while I’m sure they are very healthy and medically recommended, I think CET has a different concept of “beef” than I do, or more importantly, than dogs do. I let Barnum taste the new CET “beef-flavored” toothpaste (pictured above, right). Barnum was not a fan. It did not smell like beef or actually like anything (note to people with MCS: this is probably the most MCS-safe dog toothpaste I’ve found so far).
Why didn’t I use the Petrodex beef-flavored toothpaste that I dug out of my box of dog health supplies just for this special occasion? I tried to. Then I discovered it was so old that it had expired and had gotten all hard and crusty and could not even be squeezed out. (So I put it away again for the next special occasion. No, I’m kidding, I threw it out, which is why it’s not pictured above.)
In case you’re wondering why I had a disgustingly old tube of dog toothpaste, it’s because after I bought it the first time I discovered that the beef-flavored Petrodex came in horribly wasteful, expensive packaging — a big plastic pump where you get less than three ounces of toothpaste but you pay the same price as you do for a regular tube with 12 ounces or whatever. So I guess I was saving it for a special occasion and then forgot that I had it. (Let this be a lesson to you: Wear the fancy underwear you’ve been saving for a special occasion. The occasion may never happen, or if it does, it might be so far into the future that the underwear has expired and gotten crusty and become impossible to squeeze out of the tube.) However, as you can see from the picture above (center), Petrodex is now making a regular-sized tube of beef-flavored toothpaste, which we will try out today.
Anynoodle, I got Barnum up on the grooming table and tried every possible combination of toothbrushes and toothpaste, and what I discovered was this: Barnum liked the old brand of toothpaste (Petrodex poultry) the best and I like his old toothbrush (Triple-Pet EZdog) the best, although it did need to be replaced because the bristles were getting worn.
I also discovered that while he was willing to let me brush most parts of his mouth (if he was offered sufficiently high-value treats), he did not appreciate it when I pried his mouth open and scraped a scratchy old toothbrush against the infected open wound inside his mouth. No, he did not sit there compliantly for that. (Would you?) He flailed his head around trying to get away from my tool of torture.
At this point I was filled with panic that if I didn’t brush that spot right then, the veterinary dentist was going to yank that tooth out, imminently. So I went after that spot again, and Barnum tried to get away again. (To both of our credit, Barnum’s only resistance was flailing his head around to try to get the sore spot away from the brush; he didn’t growl or snap or even jump off the grooming table, which is only about a foot off the ground and which he was not leashed to).
I felt terrible. It seemed to me that all I had accomplished was hurting Barnum and confirming him in the belief that letting me touch his mouth was dangerous. I was worried that I was undoing all the years of handling training we’d done before. But what to do? The vet had said I needed to brush that area every day.
I realized that a big part of the problem was that I was approaching the situation in a state of panic, letting my emotions run rampant and not thinking clearly about training strategy. I told myself that if Barnum’s mouth needed two or three days to heal, that would probably not be the difference between him losing the tooth or not. Meanwhile, I could do things to make the task easier. I decided to “go back to kindergarten” where handling was concerned and treat him like a wild animal, clicking and treating for every small movement I made toward his mouth. I could also make sure to use lots of really high-value treats when he was on the grooming table and I brushed the other parts of his mouth. This would ensure that tooth brushing and the grooming table were not “poisoned” in his mind.
But I was still uncertain about my plan. I talked to my friend Eileen (who is a training geek blogger like me), discussing ideas with her, and then she talked to her friend Marge (an awesome trainer with a very entertaining YouTube channel), and with their help, I arrived at a plan:
1. Do lots of handling training with Barnum where I make it like a game. I touch a part of him and click and treat if he stays still. Some of the touching will be his mouth, but some will be other spots, so he’ll never know where the next touch will be, and that will help take some of the focus and anxiety off his mouth and make it more like a game. Once I started doing this, I allowed him to move body parts toward my hands and gave extra-good treats for that.
2. Use the grooming table for all his grooming, including toothbrushing, EXCEPT the ouchy parts of his mouth. Use very high-value treats and a very high rate of reinforcement for all activities on the grooming table, especially toothbrushing.
3. I would make the ouchy-spot brushing completely different from all the other toothbrushing (which should prevent “poisoning” all our other grooming and handling). For “ouchy brushing” I would use a different brush, a different toothpaste, and we would do it in a completely separate area of the house — preferably an area that we rarely use. I chose the living room couch. I use the CET toothpaste — because I figure I might as well get some use out of it — and the long-handled, soft-bristled CET toothbrush, because that design is actually ideal for the way I do this: I open his mouth on the right side and then reach the toothbrush through his mouth to scrub the inside of the left canine tooth and gum.
4. Right before I do any ouchy brushing I would give Barnum a warning word so he would feel like he has some control and awareness over what’s happening. My warning word is, “Ouch.”
5. I would use ridiculously high-value treats when brushing the ouchy spot — I chose canned cat food — which I gave him WITHOUT using a marker each time I brushed the sore spot. I was just going for classical conditioning — pairing the wildly reinforcing wet cat food with the process of brushing that tooth — and not wanting to have to worry about timing a marker to a behavior.
6. I realized I did have some control over how much the brushing hurt because the vet had given me pain medication for Barnum, which I dispensed as needed. I decided he needed it before I brushed that area! Thus, I timed the ouchy brushing for at least one hour after I gave Barnum his pain medication.
7. I decided I also needed to take my own pain medication at least one hour before I embarked on the ouchy brushing! After all, it is much easier to think straight, be patient, and reach the parts I need to reach if my own pain level is not skyhigh.
This plan has worked really well so far. I give him some good treats to get him sitting on the couch, and I put the bowl with the cat food in it right next to him to give him something to focus on. I put on nitrile gloves because things can get very messy. (The first day I put on a different brand of gloves from what I normally use, and Barnum wouldn’t touch even the really high-value treats. I realized he hated the smell of the gloves. I ditched them, and everything went fine from there.)
I started using this new protocol on Thursday and have used it everyday since. Each day that we’ve done it, it has gotten easier.
Note: Because I can’t type with my hands and because it’s harder to use Dragon with my speech impairment, it’s taken me five days to write this post. I had considered trying to include a video of me doing the “ouch” toothbrushing protocol, but I decided to just get this posted, finally. However, if there’s interest in seeing me brushing the painful area and Barnum’s mouth, let me know and I’ll make the video. (Actually, the good news is, I don’t think that area is painful anymore, so I will probably soon transition to brushing that area at the same time as the rest of his mouth.)