Worried over upcoming dental for my senior with severe CT and potential heart murmur

[PILOTthePuppy]

Happy New Year everyone!

Pilot turned 14 back in September and has progressive collapsing trachea, very early stages of heart issues, severe luxating patella, and is mostly blind.

He's been getting chronic bronchitis and nasal congestion for the last few months. It's been controlled mostly with Hydrocodone, Temaril-P, and Clavamox one week a month for the last few months.

He has not had a dental since he was 8 because he had breathing issues afterwards due to early stages of CT and then eventually contracted severe pancreatitis from what I think was a steroid shot to calm down his breathing issue.

I made a consult appointment a few weeks ago with a board certified dentist in my area as I suspected part of his nasal issues are teeth related. She looked in his mouth and said his back molars were caked with heavy tartar and recommended I proceed with the dental if the bloodwork and other tests came back OK. She said she would do it if were her dog.

We ran the senior blood panel, performed radiographs, and have an updated echocardiogram scheduled early next week. All test have come back with nothing unexpected. The radiographs showed his CT in his lower airway, and slight heart enlargement on the left side, but the dentist did not seemed too concerned. She has a plan to increase his medications one week prior to surgery to make sure his cough is controlled as much as possible, and then continue that for a few days after surgery.

I'm very worried that I'm going to end up killing him with this procedure based on his previous experience when he was 8.

I know if I leave him be that his teeth are likely going to end up making his heart situation or other organs even worse.

Has anyone been in a similar situation with a very senior pup? I'm starting to worry more and more that I'm making a mistake, but it seems like I have no choice now. Any thoughts would be appreciated!

He's scheduled for January 19th.

[ladyjane]

This is a tough call and ultimately is your decision. No one can really advise you. I can only tell you what I would do or not do and I would not have a dental done on my 14 year old pup with the health issues you are speaking of, especially if the meds I was giving him were helping him. You mentioned he had pancreatitis and you felt it was due to prednisone. Are you aware that anesthesia can sometimes also cause pancreatitis?

I once did a dental on a 16 year old yorkie and she did ok after the dental, but was dead 3 months later from renal disease. We knew she had it but I was afraid the dental issues would hasten her death. In the end, I don't know which did, the dental issues or the anesthesia, but the bottom line, she was gone and I promised myself I would never again do a dental on a senior pup with health issues.

I had two yorkies pass this past year from renal disease. They were siblings and were 15 years old. They both had dog food that caused the renal issues. They needed dentals about a year before their death. My vet did not recommend it and said that IF the teeth started causing a problem, then she would give antibiotics.

I personally think it is unlikely the breathing issues are related to his teeth. Dogs with collapsing trachea are more prone to upper respiratory disease/infections. If he were mine, I would treat the symptoms. This is pretty late in the game to be treating the teeth. If he were 9 or 10 it would probably be more reasonable. This, of course is just my opinion.

The nasal congestion .... I had a pretty sickly little guy who was treated with neo-poly-dex eye drops for it (a drop daily in each nasal cavity). At first I was skeptical but it truly helped him! You might want to ask your vet about that. I don't think it would be contraindicated because he is on Temeril P but your vet could advise on that. Sounds like you are doing all the right stuff for the bronchitis. Another thing you might want to ask your vet about is Lomotil for his CT. A lot of the specialists are using this first for CT and it really does help in some dogs. I have a foster right now who is on it and it is helping him.

PLEASE understand that my thoughts on a dental are just that.....MY thoughts. At the end of the day, you are the one who must do what you think is best for Pilot.

I will keep you in my thoughts and prayers. Please keep us posted on your boy.

[PILOTthePuppy]

Originally Posted by ladyjane

This is a tough call and ultimately is your decision. No one can really advise you. I can only tell you what I would do or not do and I would not have a dental done on my 14 year old pup with the health issues you are speaking of, especially if the meds I was giving him were helping him. You mentioned he had pancreatitis and you felt it was due to prednisone. Are you aware that anesthesia can sometimes also cause pancreatitis?

I once did a dental on a 16 year old yorkie and she did ok after the dental, but was dead 3 months later from renal disease. We knew she had it but I was afraid the dental issues would hasten her death. In the end, I don't know which did, the dental issues or the anesthesia, but the bottom line, she was gone and I promised myself I would never again do a dental on a senior pup with health issues.

I had two yorkies pass this past year from renal disease. They were siblings and were 15 years old. They both had dog food that caused the renal issues. They needed dentals about a year before their death. My vet did not recommend it and said that IF the teeth started causing a problem, then she would give antibiotics.

I personally think it is unlikely the breathing issues are related to his teeth. Dogs with collapsing trachea are more prone to upper respiratory disease/infections. If he were mine, I would treat the symptoms. This is pretty late in the game to be treating the teeth. If he were 9 or 10 it would probably be more reasonable. This, of course is just my opinion.

The nasal congestion .... I had a pretty sickly little guy who was treated with neo-poly-dex eye drops for it (a drop daily in each nasal cavity). At first I was skeptical but it truly helped him! You might want to ask your vet about that. I don't think it would be contraindicated because he is on Temeril P but your vet could advise on that. Sounds like you are doing all the right stuff for the bronchitis. Another thing you might want to ask your vet about is Lomotil for his CT. A lot of the specialists are using this first for CT and it really does help in some dogs. I have a foster right now who is on it and it is helping him.

PLEASE understand that my thoughts on a dental are just that.....MY thoughts. At the end of the day, you are the one who must do what you think is best for Pilot.

I will keep you in my thoughts and prayers. Please keep us posted on your boy.

Thank you ladyjane for your thoughts on this. It's an extremely tough call indeed. His back teeth are very bad, so it's very likely to accelerate some sort of organ failure at some point. This this was a last ditch effort to improve what I can in his quality of life, assuming he recovers and survives.

We started going down the antibiotic route but what leaned me towards doing it were many success stories I've read around the internet, including a CT group I follow. I also just completed a dental on his brother who is almost 13 back in November, but he doesn't have as many health issues as Pilot.

I thought may be the shot of dexamethasone caused his pancreatitis not prednisone, he taking a low dosage of this now with Temaril-P. It's very possible the anesthesia cause as you stated.

I'll make an update regardless of the outcome, thank you again.

[ladyjane]

Originally Posted by PILOTthePuppy

Thank you ladyjane for your thoughts on this. It's an extremely tough call indeed. His back teeth are very bad, so it's very likely to accelerate some sort of organ failure at some point. This this was a last ditch effort to improve what I can in his quality of life, assuming he recovers and survives.

We started going down the antibiotic route but what leaned me towards doing it were many success stories I've read around the internet, including a CT group I follow. I also just completed a dental on his brother who is almost 13 back in November, but he doesn't have as many health issues as Pilot.

I thought may be the shot of dexamethasone caused his pancreatitis not prednisone, he taking a low dosage of this now with Temaril-P. It's very possible the anesthesia cause as you stated.

I'll make an update regardless of the outcome, thank you again.

It could turn out very well. It's too bad we cannot rely on something like a crystal ball.
I will watch for an update. Best wishes to you and him.

[PILOTthePuppy]

Originally Posted by ladyjane

It could turn out very well. It's too bad we cannot rely on something like a crystal ball.
I will watch for an update. Best wishes to you and him.

Hi ladyjane, as promised here is the update for Pilot.

He went into surgery at 9 AM this morning. Once he was under, it was found that he has advanced periodontal disease in all remaining teeth, 15 in total. There was also an oral mass found in his mouth. They performed the full mouth extraction and mass removal in about 2 hours which was uneventful.

However, once they went to remove the breathing tube, problems arose pretty quickly, which I figured may happen based on his underlying medical conditions. He quickly went into respiratory distress, so they reinserted the breathing tube and gave him a steroid shot (which might have given him pancreatitis in the past).

It was then recommended we move him over to ICU and put him on IV drip with butorphanol and oxygen through his nasal passages and then reattempt to remove the breathing tube after waiting several hours.

The second attempt to remove the breathing tube was successful, and he is now breathing on his own, still a bit noisy but he's breathing on his own least.

He will remain in ICU for the remaining of the night.

Had I not gone through the surgery, the dentist said he was at very high risk of fracturing his jaw and tooth abscess in the near future. The oral mass would have also not have been found and might of grown to block his airway.

At this point, I think he still has an uphill battle but at least he's breathing on his own now.

[ladyjane]

Originally Posted by PILOTthePuppy

Hi ladyjane, as promised here is the update for Pilot.

He went into surgery at 9 AM this morning. Once he was under, it was found that he has advanced periodontal disease in all remaining teeth, 15 in total. There was also an oral mass found in his mouth. They performed the full mouth extraction and mass removal in about 2 hours which was uneventful.

However, once they went to remove the breathing tube, problems arose pretty quickly, which I figured may happen based on his underlying medical conditions. He quickly went into respiratory distress, so they reinserted the breathing tube and gave him a steroid shot (which might have given him pancreatitis in the past).

It was then recommended we move him over to ICU and put him on IV drip with butorphanol and oxygen through his nasal passages and then reattempt to remove the breathing tube after waiting several hours.

The second attempt to remove the breathing tube was successful, and he is now breathing on his own, still a bit noisy but he's breathing on his own least.

He will remain in ICU for the remaining of the night.

Had I not gone through the surgery, the dentist said he was at very high risk of fracturing his jaw and tooth abscess in the near future. The oral mass would have also not have been found and might of grown to block his airway.

At this point, I think he still has an uphill battle but at least he's breathing on his own now.

Just seeing this. I hope little Pilot is doing better this morning. Shooting prayers up now.

Thank you for updating.

[PILOTthePuppy]

Originally Posted by ladyjane

Just seeing this. I hope little Pilot is doing better this morning. Shooting prayers up now.

Thank you for updating.

Hi ladyjane,

Pilot is quite the fighter. He was able to stabilize overnight and his breathing continued to improve. He was able eat two small low fat GI meals this morning, which was very encouraging. The ER vet said he was doing amazing well and he’ll be discharged this afternoon.

He’s on the road to recovery and I’m praying that pancreatitis doesn’t rear it’s ugly head from all the drugs and anesthesia.

I also spoke with the internal medicine doctor and they’ll be giving me a dosage recommendation to get Lomotil filled through my normal vet.

Thank you for the continued prayers and good thoughts. I’ll update again soon.

[ladyjane]

Originally Posted by PILOTthePuppy

Hi ladyjane,

Pilot is quite the fighter. He was able to stabilize overnight and his breathing continued to improve. He was able eat two small low fat GI meals this morning, which was very encouraging. The ER vet said he was doing amazing well and he’ll be discharged this afternoon.

He’s on the road to recovery and I’m praying that pancreatitis doesn’t rear it’s ugly head from all the drugs and anesthesia.

I also spoke with the internal medicine doctor and they’ll be giving me a dosage recommendation to get Lomotil filled through my normal vet.

Thank you for the continued prayers and good thoughts. I’ll update again soon.

Oh!!! I am SO happy to hear this! I know he will be happy to be home and you will be as well.
Keep positive thoughts...he may not have any gi issues. It does not always happen!
This is so wonderful!

[PILOTthePuppy]

Originally Posted by ladyjane

Oh!!! I am SO happy to hear this! I know he will be happy to be home and you will be as well.
Keep positive thoughts...he may not have any gi issues. It does not always happen!
This is so wonderful!

Thank you!

We’re happy he’s back, but it seems his recovery will be slow.

I brought him home and he was super drowsy, wouldn’t really walk around. They gave him some anti anxiety medicine, I suspect it’s partly that. All he wants to do right now is currently sleep. He’s shaking a lot too when not sleeping. Luckily no coughing just a little noise breathing.

His severe luxating patellas seems giving him issues. I’m sure he’s in pain and he’s really holding his back knees together. I tried to get a little Galliprant into his system but he didn’t want to take his little pill pocket.

The ER gave us some liquid buprenex for pain, and he’s not really eating yet so I can’t give him his compounded hydrocodone.

I’m hoping the buprenex will help him be out of pain while he mends and I can get him back on another painkiller like hydrocodone or lomotil.

As far as eating, I got him to eat a little pumpkin purée and a tiny bit of cod fish but he really had no interest. They fed him the low fat G/I prescription dog food at the hospital but I don’t have that currently and feed him a home cooked diet since he’s a calcium oxalate stone former.

Any tips or thoughts?

[ladyjane]

Originally Posted by PILOTthePuppy

Thank you!

We’re happy he’s back, but it seems his recovery will be slow.

I brought him home and he was super drowsy, wouldn’t really walk around. They gave him some anti anxiety medicine, I suspect it’s partly that. All he wants to do right now is currently sleep. He’s shaking a lot too when not sleeping. Luckily no coughing just a little noise breathing.

His severe luxating patellas seems giving him issues. I’m sure he’s in pain and he’s really holding his back knees together. I tried to get a little Galliprant into his system but he didn’t want to take his little pill pocket.

The ER gave us some liquid buprenex for pain, and he’s not really eating yet so I can’t give him his compounded hydrocodone.

I’m hoping the buprenex will help him be out of pain while he mends and I can get him back on another painkiller like hydrocodone or lomotil.

As far as eating, I got him to eat a little pumpkin purée and a tiny bit of cod fish but he really had no interest. They fed him the low fat G/I prescription dog food at the hospital but I don’t have that currently and feed him a home cooked diet since he’s a calcium oxalate stone former.

Any tips or thoughts?

Poor guy. Honestly, my guess is the symptoms he is having is due more to the medication. What did they give him for anxiety? The bupranex is an opiate and if you are giving him that, it will definitely make him shaky and drowsy and on top of an anti anxiety med could really zonk him out. I would keep shirts on him if you can and I have also used heating pads on low but for short periods. Be careful not to burn him. I actually made some little packets that I heat in the microwave so I can feel the warmth and then put it under blankets....

I had a list of foods for calcium oxylates ... will see if I can find it. A vet nutritionist had given it to me. In the meantime, I would worry less about that because you want him to eat and heal. I have had success with chicken baby food.....the little jars...

The lomotil is to be used daily for the breathing. I would definitely try to get that in him. I am assuming he is probably taking 1/2 of a tiny tab?? If so, I am sure you can hide it in a bit of cheese or food.

Luxating patellas really do not hurt. That would be extremely rare! I would just focus on the other stuff!!

I will look for that list and I am sending you a message......

[ladyjane]

Oh....another food that is often used for recovery.

They are small cans....

Hill's AD

I have used this in the past and the pups do like it!

https://www.hillspet.com/dog-food/pd...7&gclsrc=3p.ds

[PILOTthePuppy]

Originally Posted by ladyjane

Oh....another food that is often used for recovery.

They are small cans....

Hill's AD

I have used this in the past and the pups do like it!

https://www.hillspet.com/dog-food/pd...7&gclsrc=3p.ds

I got some Hills I/D Low Fat GI canned from the ER vet, he did eat some of that last night.

https://www.hillspet.com/dog-food/pd...-canine-canned

I'm going to contact you back via your personal message you sent. Thank you the support and your responses.

[ladyjane]

Originally Posted by PILOTthePuppy

I got some Hills I/D Low Fat GI canned from the ER vet, he did eat some of that last night.

https://www.hillspet.com/dog-food/pd...-canine-canned

I'm going to contact you back via your personal message you sent. Thank you the support and your responses.

ID is good because of the chance of pancreatitis....I hadn't thought of that.

[maxdog]

My prayers and thoughts are with Pilot.

[PILOTthePuppy]

Originally Posted by maxdog

My prayers and thoughts are with Pilot.

Thank you! Pilot has made a full recovery. I've been speaking with Ladyjane on the side and greatly appreciate her compassion and support.