Q: All species can have an increasing amount of health issues develop as they age and one of our dogs, a Bichon that is now 13, is no exception. She has a few different things going on. Last year she had a heart murmur that our vet called a Grade 3 and she also had rotting teeth and several growths on her body. Our vet suggested that she should first have her heart disease evaluated before considering dental work but due to financial constraints and after accepting some risk, we proceeded with a dental and growth removals. She had several teeth extracted and she did fine.
Now, one year later, her heart murmur has gotten more severe and remaining teeth are loose and rotting. Our vet now insists on having a veterinary cardiologist assessing the Grade 4-5 murmur before doing anything further. What should we do? Will the dental disease possibly lead to other complications?
We love our little dog but given all that is going on and her age, is there any benefit to proceeding now?
A: As you point out, all species can have various health issues that develop with advancing age and your dog is no different. Even if she did not have any cardiac disease going on, there is always risk involved when any patient undergoes anesthesia for any procedure, including dentistry. I think that you and your dog were lucky last year in working with a Grade 3 heart murmur and proceeding with dental extractions and growth removals.
Some veterinarians will not accept the risk of subjecting an animal to a procedure without following steps like bloodwork and a cardiac assessment. If your veterinarian was willing to accept that risk and you signed off on a consent and release form last year that was for them to decide.
It seems as if this year, there is added risk and I trust that your veterinarian is doing what they feel is safest and in the best interest of your dog. Only you can decide what to do next. My suggestion would be to see if you can afford the added expense of a cardiac workup by a cardiologist, have that done, and then address removing those loose rotting teeth.
They can be painful but also add the possible risk of having harmful bacteria enter the bloodstream through the oral cavity, which can lead to additional cardiac issues such as bacterial endocarditis. Pre-operative antibiotics may be needed as well as the probable need for cardiac medication for the murmur and advancing cardiac disease.
While I believe there is significant risk to your dog, the benefits of proceeding with the proper steps can be worthwhile. Good luck!
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.