Recently, my dog, Nicki, had extensive oral surgery that took two surgery dates to complete. What started as a broken right carnassial (the huge upper premolar) turned into a mouth full of broken teeth and longstanding pockets of infection. What the two vets and I saw with our eyes was a busted carnassial with two of its three roots exposed. What the X-rays showed, however, were areas of bone deterioration in the jaw and teeth with normal crowns that had broken roots. Nicki had been in a good deal of pain for a long time and I had no clue. She was eating with her normal gusto and chewing hard bones seemingly with no problem. Had she not also broken the tooth we all could see, she would probably still be in pain with a deteriorating jaw and possibly systemic infection.

Nicki can be quite rude to and impatient with other dogs, but she is not “an aggressive dog.” However, without X-rays and surgery, what would her behavior be like in another year with increasing pain that no one could see and she couldn’t tell us about? When another dog growled at her for her rudeness, would she be so stressed from constant pain that she attacked? With her history of redirected fear aggression, would she bite me? Knowing her, I think it’s highly likely that her impatience with dogs in her way would grow from snarkiness into fierce, pain-fueled fighting. It’s also highly likely that the aggressive behavior would not seem sudden and therefore more obvious as a probable medical issue. And then she would be labeled “an aggressive dog.” For a physical problem that can be fixed, but no one can see.

This is one example of why it’s essential to look at the body first in most cases of aggressive behavior. But here’s the rub. Cost aside, even a thorough vet exam with a dental cleaning would not have uncovered the broken and painful roots because most veterinary clinics today don’t have equipment for dental X-rays. If our example dog were already exhibiting aggressive behavior, she would get an all-clear from the vet and the focus would incorrectly be on behavior modification. When the behavior modification failed, what then?

I don’t have a black and white moral to this story. I just want us, as the humans responsible for our dogs, to keep thinking and keep paying close attention to the dogs with whom we share our lives. It’s up to us to keep asking questions about what we see, be mindful of patterns, and, yes, follow our intuition when we know something is wrong that a medical professional has yet to uncover. Especially when we are working on cases of sudden aggressive behavior, we need to keep looking, but not assume that we can see everything with our eyes.

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