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Dental cleaning for a senior dog

EllyJ

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Pumpkin
16 year old Neutered M, Maltese/Lhasa Apso mix
14 lbs
Freeze Dried raw + kibble (will try transitioning to raw again soon)
Hasn't been vaccinated much (mostly just rabies). He got a triple rabies vaccination a couple of months ago
Low exposure to medication, including flea meds and heartworm meds
Overall good health throughout life, no major issues. A couple of UTI's (wears diaper).
Bad teeth (probably stage 4; a couple have fallen out)


Should I get his teeth cleaned? He's very spry for his age (nobody can believe he's 16), but he does have worsening mobility issues, and he has that leftover respiratory symptom (posted about in the Medical Diseases forum), which is basically a "snort" when he takes deep breaths and when he moves sometimes. This came on after a weeklong bout of Kennel Cough (?) after we started going to the dog park a few months ago.

I don't know if he's in pain from his teeth. That's the only reason I'd get them cleaned. Surgery would be around $2000. He loves me, he follows me everywhere, he's spry as hell, but I wonder if his velcro-ness is a sign of pain. Also, when I bend down to engage with him sometimes when he's resting, I could tell he's not that great. He might be in a low-level amount of pain. I don't know.

Any advice would be appreciated.

Thanks,
Elly

@Dr. Jeff @Dr. Christina @Dr. Sara
 
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Dr. Jeff

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Hey Elly!
Bad teeth (probably stage 4;

Should I get his teeth cleaned?
I would, yes.

He'll feel better and you may see some kidney, liver and mobility improvement (as there is more cellular energy available from having clean teeth, his other systems can work better).
 

GinnyW

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I'd love to see him on some decent, species-appropriate food - raw or mostly, varied, including meats, veggies, good oils, probiotics, etc. Even agt this stage of his life you can do miracles with appropriate nutrition.

I'll bet you see a different dog, once his teeth are no longer bothering him and his diet is helping.
 

EllyJ

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Hey Elly!

I would, yes.

He'll feel better and you may see some kidney, liver and mobility improvement (as there is more cellular energy available from having clean teeth, his other systems can work better).

Hey Elly!

I would, yes.

He'll feel better and you may see some kidney, liver and mobility improvement (as there is more cellular energy available from having clean teeth, his other systems can work better).
Thank you. BTW, no comment on the other thread (re his "cough")? TIA
 

EllyJ

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I'd love to see him on some decent, species-appropriate food - raw or mostly, varied, including meats, veggies, good oils, probiotics, etc. Even agt this stage of his life you can do miracles with appropriate nutrition.

I'll bet you see a different dog, once his teeth are no longer bothering him and his diet is helping.
Tried that twice. The first time, there was too much going on, and this second time.....oh my gosh. He kept leaving half-eaten bowls on the floor, which I'd have to pick up. I kept worrying about cross-contamination in the refrigerator and the constant cooking, sourcing, and costs(!); it just wasn't for us. I was like a dog butler. I've got my own stuff going on, thank you very much!

And it didn't transform his behavior like I thought. He was the same dog. And we tried it for a few weeks.
 

Dr. Jeff

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no comment on the other thread (re his "cough")?
Did you ask any specific questions in it? If you did, I apologize if I missed them.

For the sake of time, it's super helpful if you can share the link to this thread (or any thread you'd like me to comment on).

Thanks!
 

EllyJ

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Thx!
 
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EllyJ

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Ok, went to vet yesterday. Vet was leaning toward not doing a cleaning. He said he'd probably need a lot of teeth pulled and has high liver numbers. Said he might have a liver tumor and recommended doing some testing before we jump into a cleaning. (A Radiograph and Ultrasound. ) Also said he has a yeast infection and possible bladder stones. (Recommended a Urinalysis.)

(Will attach recent bloodwork results)

Should we get those tests?

I found a good homeopathic vet, but her first available appointment is two weeks out. Do you think that's too long to wait? She wouldn't be able to diagnose a tumor. Do you think that's a reasonable possibility, or was he being histrionic? Should I give him something like Milk Thistle in the meantime?


Reposting his stats for convenience's sake:

Pumpkin
16-year-old Neutered M, Maltese/Lhasa Apso mix
14 lbs
Freeze Dried raw + high-quality kibble
Overall good health throughout life, with no significant issues. A couple of UTIs (wears a diaper). He had a wound on his genitals that was hard to heal about two years ago, so he had surgery. (Vet also suspected cancer. No cancer.)
Hasn't been vaccinated much (mostly just rabies). He got a triple rabies vaccination a couple of months ago.
Low exposure to medication, including flea meds and heartworm meds.
Some eye cloudiness
Acupressure and crystal healing for a couple of years now. Regular exercise.
Bad teeth (probably stage 4; a couple have fallen out)
BEAM: It's hard to quantify. He's got some issues he needs to work on for sure: restlessness, arthritis, sore throat, liver, but he's spry. The vet said his heart was good.

@Dr. Jeff @Dr. Christina @Dr. Jean Hofve
 

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Dr. Jean Hofve

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Rotten teeth are painful, and constantly spew bacteria into the blood, stressing organs and possibly seeding infections in liver, kidneys, heart, etc. So yes, I'd recommend doing the dental work needed. He will feel SO much better! I've worked on many cats who started playing like kittens, jumping up, better appetite... bad teeth are a horrible drag on health. Make sure the vet is using safe anesthesia, fluids, post-op pain meds, thoroughly monitoring during surgery, etc. It costs the big $$ but worth it!
 

EllyJ

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Rotten teeth are painful, and constantly spew bacteria into the blood, stressing organs and possibly seeding infections in liver, kidneys, heart, etc. So yes, I'd recommend doing the dental work needed. He will feel SO much better! I've worked on many cats who started playing like kittens, jumping up, better appetite... bad teeth are a horrible drag on health. Make sure the vet is using safe anesthesia, fluids, post-op pain meds, thoroughly monitoring during surgery, etc. It costs the big $$ but worth it!
Ok. He said that one route is to give him antibiotics for the dental pain (I'd do homeopathy, instead), but that's still not an ideal solution, huh? Do you have any comments on the Radiograph and Ultrasound?
 

Dr. Jeff

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Should we get those tests?
Yes, if it is feasible for you.
Do you think that's too long to wait?
No, you can do any diagnostic testing in the meantime. That way you'll have more data to share with the vet homeopath.
Should I give him something like Milk Thistle in the meantime?
Yes, that's a great idea! And perhaps also some DMG (dimethylglycine) or TMG. Check out:



 

DayshaG

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Rotten teeth are painful, and constantly spew bacteria into the blood, stressing organs and possibly seeding infections in liver, kidneys, heart, etc. So yes, I'd recommend doing the dental work needed. He will feel SO much better! I've worked on many cats who started playing like kittens, jumping up, better appetite... bad teeth are a horrible drag on health. Make sure the vet is using safe anesthesia, fluids, post-op pain meds, thoroughly monitoring during surgery, etc. It costs the big $$ but worth it!
@Dr. Jean Hofve speaking of dental cleanings for older cats, I've shared about Bella with kidney issues but her sister Maya (13 yrs 9 mos) is going to get her teeth cleaned and possible extractions in Jan (old hat for us). Her blood values are completely normal for her age. Always a risk going under anesthesia as they get older I hear, but I have confidence in the vet and team performing it. But with Bella, with her blooming kidney issues over time, I am taking her for a physical exam next month as well, but to a more local vet that will hopefully reduce some of the anxiety that is exacerbated with a longer trip to her long-time vet (45 min drive one way it was). I have noticed she has been scratching at her mouth on the right side (Both cats have had routine dentals and extractions over the years under anesthesia) for a while now, and think she may be suggested to have a dental in Jan. I will try and get her blood drawn 1st of course so we can see her values. What are your feelings about doing the dental work on a senior cat with underlying conditions with the kidneys?
 

Dr. Jean Hofve

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As long as appropriate monitoring and sufficient fluids are used, preferably with propofol as the anesthetic (but gases like isoflurane or sevoflurane are okay), there really isn't an increased risk. I've done dentals on cats as old as 20 years, and while we didn't have the ideal set-up, they did fine. Keeping the cat warm and hydrated are key, so ask how they accomplish that.
 

Dr. Jean Hofve

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Reading backwards through the thread... I see I missed something!

Antibiotics are not painkillers. Buprenorphine at the least is required for extractions, for a few days. Antibiotics are very rarely necessary, and they disrupt the microbiome so badly I don't recommend them.

Radiography and ultrasound, based on liver enzyme elevations? Seems like overkill. Ultrasound is by far more helpful for soft tissue like liver. IMO abdominal radiographs are pretty worthless.

Intra-operative dental rads are important, though.

Honestly, I think a second opinion is in order.
 

EllyJ

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Reading backwards through the thread... I see I missed something!

Antibiotics are not painkillers. Buprenorphine at the least is required for extractions, for a few days. Antibiotics are very rarely necessary, and they disrupt the microbiome so badly I don't recommend them.

Radiography and ultrasound, based on liver enzyme elevations? Seems like overkill. Ultrasound is by far more helpful for soft tissue like liver. IMO abdominal radiographs are pretty worthless.

Intra-operative dental rads are important, though.

Honestly, I think a second opinion is in order.
Thank you so much. I sensed he was being melodramatic when he suggested that he might have a liver tumor, and therefore, would want to do an ultrasound and radiograph. And it would've been $700, too!

I'm going to get a second opinion. 🙏🙏🙏
 

Dr. Jeff

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Buprenorphine at the least is required for extractions
Chiming in here. My clinical experience is that Arnica dosing pre and post dental often reduces (and sometimes eliminates) the need for Buprenex.

@PattiS, perhaps you can share your recent experience with Rou.
 

EllyJ

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We're moving forward with the dental. His bloodwork was good enough that the vet felt comfortable. She did say he might have early-stage kidney disease, though ("might" because the sample was "potentially diluted", and he questions whether it's really the "high-meat diet" that may be causing the elevated BUN and potassium levels). She recommended a "kidney diet" as per the website, Balance. it. Does anyone recommend that? Also, his SDMA was 17, whereas the range is 0-14. He had kidney issues a couple of years ago, but then I consistently did Kidney 3 (K3) regularly, and in November, his levels were fine. I stopped doing it for a while but I'm starting it up again. He's gonna live to 116 whether I like it or not. We go to the park often, and I love telling people he's that 16 :D No one can believe it, they all comment on how well he's doing. One lady said, "Impressive!" I say he's gonna outlive us all and become the president of some corporation.
 

Dr. Jean Hofve

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I would not be worried about kidneys with those values. BUN does go up on a meat-based diet, although potassium doesn't necessarily so that's something to watch. SDMA is not terribly valuable and that's such a tiny elevation I'd consider it insignificant.

BalanceIT is quite good, but I wouldn't use a kidney diet until BUN is consistently >80, which is about where they become symptomatic.

He probably will outlive us all, but let's not burden him with a darned ol' corporation... maybe instead, a trust fund! 😁
 

EllyJ

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I would not be worried about kidneys with those values. <<Oh, I forgot to mention his BUN was 43!>>BUN does go up on a meat-based diet, although potassium doesn't necessarily so that's something to watch. <<She said it would be due to the kidney issues>> SDMA is not terribly valuable and that's such a tiny elevation I'd consider it insignificant. <<Ok good, thanks.>>

BalanceIT is quite good, but I wouldn't use a kidney diet until BUN is consistently >80, which is about where they become symptomatic. <<Ok good. Yeah, he doesn't seem to have any symptoms. Do you know how long it'll take to get to that point?>>

He probably will outlive us all, but let's not burden him with a darned ol' corporation... maybe instead, a trust fund! 😁<< 😁>>
 

Dr. Jean Hofve

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There are many causes of increased BUN, including pre-renal (dehydration, high-protein diet), renal (actual kidney issue) and post-renal (if for instance there has been a urinary blockage and toxins have built up in the blood).

You *cannot* diagnose kidney disease without:
1. Elevated BUN
2. Elevated Creatiine
3. Low USG (urine specific gravity)

You must have all three to call it kidney disease. Vets see one of them and jump to conclusions--wrongly, most of the time. Drives me bonkers.

There has been research on high-protein diets and bloodwork. High protein does increase BUN because BUN is a breakdown product of.... wait for it.... PROTEIN! :oops:😂

I do a low carb diet myself and my BUN runs high. My doctor is not the least concerned. So there you go.

A BUN of 43 may or may not be significant, what were the creatinine and USG? If a urine test wasn't done, suggest a second opinion as that is not really acceptable. He may not actually *have* kidney disease so not to worry about progression at this point...
 

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