Taking a bite out of dental disease


A conversation with Dr. Santiago Peralta, veterinary dentist, oral surgeon, and
new Lecturer in the Department of Clinical Sciences’ Section of Dentistry.

What path led you to your new position?

I grew up and studied in Colombia, South America, and graduated with a veterinary degree from La Salle University in 1999. In Botoga I worked in private practice for seven years and became interested in dentistry and oral surgery. As my interest grew, I decided to pursue further study in this specialty and completed a 3-year residency in veterinary dentistry at UC Davis between 2006-2009. Returning home, I resumed private practice until coming to Cornell in Summer 2011.

What will you offer as part of the dentistry service?

We offer state of the art dental and oral care for animal patients. Our service deals with small and large animals, and my focus will be small animals, mostly dogs and cats. I also have experience with exotic pets such as rabbits, chinchillas, and guinea pigs, as well as zoo animals including tigers, hyenas, orangutans, and more.

Our most common dental treatments deal with periodontal disease (gum disease), the most prevalent disease of animals.  Other advanced dental procedures we offer include endodontics (root canals) to fractured teeth, orthodontics to correct bite abnormalities, oral surgery following facial trauma or to remove tumors.

What innovations do you bring to CUHA?

I’ve helped move our service from hand instrumentation techniques to more precise rotary root canal instrumentation techniques that provide more reliable results, higher success rates, and lower anesthesia times. These newer techniques come together with safer and more effective materials that allow success rates of therapy similar to that seen in humans.

Do you have research plans?

My main research interest involves tooth resorption, a common cat and dog disease in which the teeth degrade and disappear. Nobody has figured out why, and that is a question I’d like to pursue. I am also interested in research concerning oral tumors and oral radiology.

What do you like about your job so far?

I like the academic culture, and the opportunity to provide real clinical instruction. Interacting with students and other specialists offers a stimulating educational environment where everyone has something to learn. The opportunity to help out the community, clients, and local veterinarians is very rewarding.

Why is dentistry important and how can owners help?

Dental disease can lead not only to oral discomfort and pain, but can dramatically affect the general health of an animal. It can cause inflammation and infection that can spread to other organs or turn the blood toxic through permanent bacterial infection. Pets may stop eating, bleed from the mouth, and show discomfort.

Animals are very stoic in nature; they are good at hiding pain. Owners underestimate dental disease and often don’t realize their pets are suffering from it until it’s too late. Owners can help by bringing pets in for yearly routine oral exams, yearly or biyearly professional dental treatment. Toothbrushing is the only way to prevent periodontal disease. Just like in humans, it should be done every day.

Oral hygiene is very important for pets, and the magnitude of disease is difficult to appreciate until after treatment. The improvement in a pet’s demeanor following treatment can be amazing to see.



New MRI machine brings CUHA to the forefront of medical imaging

CUHA has upgraded its Magnetic Resonance Imaging (MRI) capability, offering unprecedented opportunities for advanced medical imaging. As part of the Janet L. Swanson Imaging Suite, the MRI and the recently installed 16-slice Aquilion LB CT scanner mark a huge leap forward in the Hospital’s clinical and research capacities, continuing CUHA’s commitment to innovation.

New System Features
The 1.5T Toshiba Vantage Atlas MRI scanner employs a high-field magnet capable of scanning any animal up to the size of a large dog, some large farm animals, and the limbs or heads of horses. A moveable table allows an anesthetized horse to be brought close enough to the magnet to scan those parts that can be pulled into the bore. Most veterinary colleges have similar systems though this model has the latest software and hardware available at 1.5T field strength. It is a “work-horse” scanner in the human imaging field.
“The exceptional detail and clarity of the image quality make it easier to diagnose more accurately,” says Dr. Peter Scrivani, radiologist at CUHA’s imaging department. “We are able to get more information about the patient’s health and disease status during the same length of examination, because the image acquisition time is shorter and the new scanner has additional functionality. The extended clinical applications offer a major advancement. We expect to use the machine mostly for neuroimaging and musculoskeletal imaging, and there is potential for thoracic or abdominal applications.”

Scanner Facility
Summer renovations at the Hospital ensured that the MRI can be operated with optimal efficiency and safety. The control room provides easy viewing of the scanner and patient and connects to a fully equipped anesthesia room for small animals. Equine anesthetic induction and recovery stalls are adjacent to the scan room. A large door at the back of the exam room opens directly to the large animal hospital, making it easy to accommodate imaging needs for equine and other large animals. A full complement of MRI-compatible monitoring equipment keeps anesthetized patients stable throughout the exam.

Available Services
The Toshiba MR and CT scanners comprise the Janet L. Swanson Imaging Suite and are now operational and available for CUHA patients by referral. Small animal MR scans are available daily. Horse scanning is progressing and protocols are under development. Veterinarians who would like to discuss the use of these modalities for their patients are welcome to contact the Imaging Section at the CUHA for advice and referral information. Please call 253-3060 for appointments or -3241 to have a radiologist consultation.

Diagnosis on the run

Athletes of all kinds use exercise machines to evaluate and improve performance, but it’s a rare machine that can handle the world’s largest and fastest athletes. Horse trainers and referring veterinarians can bring race horses to Cornell’s Equine Performance Testing Clinic, where a horse-sized treadmill, an array of examination equipment, and a team of seasoned technicians and surgeons work together to evaluate the performance of equine athletes. The Clinic’s treadmill can bring horses to racing speeds of up to 40mph while allowing veterinarians to examine patients under the same strain they experience on a race track, revealing problems that may otherwise be difficult to diagnose. Since its inception in 1989, the Clinic has run over one thousand horses in a safe, weatherproof indoor environment, using the treadmill as a diagnostic tool to find causes of poor performance and determine better ways of treating them.

The Clinic is equipped to examine a wide variety of problems, including upper and lower respiratory disease, neurological issues, high-speed lameness and orthopedic problems using flexion tests and gait analysis, and cardiac abnormalities such as arrhythmia using EKG, blood gas analysis, and exercising ultrasound. Upper respiratory problems comprise the bulk of cases, including issues such as pharyngeal collapse, palate displacement, laryngeal paralysis, and epiglottal entrapment. Video endoscopy can examine the upper respiratory tract while a horse is running. Sound spectrograms can reveal acoustic abnormalities during inspiration and expiration, and airway pressure determination and airflow analysis may indicate airway obstructions during exercise.

An internist, a cardiologist, and several technicians and equine surgeons comprise the Clinic’s team, which has found that the majority of upper airway problems can be managed with surgery if diagnosed early. Headed by Dr. Norm Ducharme and Dr. Jon Cheetham, the group investigates ways to diagnose diseases more accurately while expanding the toolbox of techniques for their treatment. Several projects have had immediate clinical impact, while others may have future applications in human medicine.

Research Highlights:

–Laryngeal tie-forward treatment: a widely-used surgical procedure developed at the Clinic in 2001 to treat palate displacement with an effectiveness of 80-85%.

Cornell Collar: an external device developed at the Clinic and patented by Cornell, providing a non-surgical alternative treatment for soft palate displacement.

Laryngeal Pace-Maker: an electrical implant placed into the muscle or around the nerve to stimulate the muscle to open the laryngeal cartilage (aretynoid) during exercise.

In addition to major innovations, the Clinic’s research has made improvements in several existing equine surgical procedures including laryngeal tie-back, suture replacement, bone cement, and post-surgery stabilization methods. The recently developed laryngeal pacemaker device is currently being tested on race-horses in Europe for regulatory approval, and investigations are underway for possible applications to humans with laryngeal paralysis or transplants.

The Equine Performance Clinic works in partnership with local veterinarians to understand problems with horses and how their clients want to address them. Horses have come from as near as New York’s Equine Alley and as far as Ohio for performance evaluation and diagnosis. If you would like to schedule an evaluation, contact the Clinic or visit the website for more information.