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The Gums - Window to the Heart
Dr. Michael Rumore
Lake Seminole Animal Hospital
Everyone should regularly look in their dog’s mouth, and this does not mean a dental exam. While we have all learned how dental disease can lead to bacteria in the bloodstream, or septicemia, and cause everything from kidney and spinal diseases to poor birth weights, there is much more in your dog’s mouth then teeth. For this segment we will focus on the “window to the heart”- the gums.
In Traditional Chinese medicine, tongue and gum color is an indicator of general body and organ health. In western medicine, while we don’t rely quite so heavily on the oral mucous membranes, they do tell a significant story. The moist tissue in the mouth is one of the few places we can “see” blood. The gums in the average dog are light to medium pink, and this pink is from the large amount of blood relatively near the surface. This is why a dog that is anemic will begin to turn pale. Dogs that are jaundiced, or have a yellow pigment in their blood often secondary to liver problems, will have a yellow tinge. Blue gums are a severe lack of oxygen- oxygen turns the hemoglobin pigment in the blood cells a red color. This oxygen is also why arteries, which carry oxygen rich blood, are often bright red, and veins are darker to almost blue. The veins are returning the “used” oxygen-poor blood to the heart and lungs for re-oxygenation.  Bright red gums can be from carbon monoxide poisoning, which affects the hemoglobin by binding sites needed for oxygen.
Beyond readily seeing the color of the blood, gums also give us window to cardiovascular health through the Capillary Refill Time, or CRT. This simple test involves pressing on the gums until they blanche, or turn white. By releasing the press, the tissue should return to its normal pink state within 2 seconds. Longer is an indication of the heart having trouble moving blood properly through the cardiovascular system. This can happen in heart failure, or sometimes shock. “Shock” occurs when there is a sudden drop in blood pressure, which leads to the body tissues getting an inadequate blood, and consequently oxygen, supply. This lack of oxygen can lead to unconsciousness and potential organ failure.
The CRT is vitally important in trauma assessment. Many times we have seen what appears to be a healthy, normal animal after a trauma- they are wagging their tail and walking around as though nothing happened. When we check their capillary refill time, we see a prolonged time of 4 or 5 seconds, and then realize that while they may appear normal, they are approaching a severe cardiovascular collapse, and potentially death, unless corrective action is taken quickly. There may have been a ruptured spleen, a twist of the bowel, or some other severe, superficially unapparent disaster. All dog owners should practice the CRT on their own pets- look to see what normal looks like. Knowing that “something is wrong” and taking quick action can buy valuable time in an emergency. Learning how to open that “window to the heart” and looking in could save your dogs life.