Q: My dog was recently diagnosed with a heart murmur but also has dental disease. Is it safe for her to undergo a dental cleaning?
A: Dental disease has a profound impact on the health of our pets and in some cases can severely affect their quality of life. Dental disease can cause significant pain and infection and can result in decrease in appetite, excessive salivation, bleeding from the gums, and systemic infection. The bacteria causing infections in the mouth readily pass into the blood stream and into the rest of the body.
This chronic exposure to bacteria takes a toll on the internal organs leading to chronic inflammation and possible systemic infections. Treating dental disease is extremely important and is essential in keeping your pet healthy. It is even more important to maintain good oral health in animals that have concurrent medical conditions as they are more susceptible to infections and secondary complications from dental disease.
There is some discussion as to the benefit of light dental cleaning without anesthesia to try and avoid an anesthetic procedure. Unfortunately, dental cleaning without anesthesia does not allow for a thorough oral exam and underlying dental disease can potentially be missed. It also does not allow for dental extractions if needed. It can be useful for very light cleaning if your pet tolerates the procedure but if the dental disease is anything other than mild it is highly recommended that the dental cleaning be performed under full anesthesia.
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The anesthesia that is used in animals these days is highly controlled and the animals are closely monitored, so anesthesia related deaths have decreased significantly with newer anesthesia protocols. Also, when an animal has concurrent organ dysfunction such as a heart murmur we take extra precautions to ensure the safety of the animal when undergoing an anesthetic procedure. An animal with a heart murmur and dental disease is at high risk of bacterial endocarditis (a bacterial infection of the heart) and it is even more important to address any underlying dental disease in these animals.
Typically, we place these animals on antibiotics prior to the dental cleaning to protect the heart from the bacteria in the blood stream. If your animal has a heart murmur as well as dental disease, it is highly recommended to pursue a dental cleaning under the supervision of a veterinarian.
Q: My cat started to drool and have difficulty eating and my veterinarian told me that she has a condition called stomatitis and needs to have all her teeth removed. This seems so extreme. What is the cause of this disease and why do we have to remove all her teeth?
A: Stomatitis is a very painful condition that results in oral inflammation and ulceration in a cat’s mouth. The pain can be severe enough that most cats will stop eating and exhibit oral discomfort.
The cause of the inflammation can be due to multiple issues such as dental disease, infectious disease, or oral trauma. However, the most common reason for this condition is an anti-immune reaction to the cat’s own teeth!
For some unknown reason, cats will become allergic to the enamel on their teeth and will create an inflammatory response to them. You can medically treat this condition with steroids, which are anti-inflammatory medications, and antibiotics if there is dental disease. But if this is an auto-immune reaction to the teeth then the only way to fix the problem is to remove all the teeth.
Once the teeth are removed the source of the problem is gone and the tissues should heal. Since any tooth can be a source of the reaction it is important to remove all the teeth or there will be residual issues in the mouth.
Surprisingly, cats can do great with no teeth and can still eat and drink with no problems. Removing the pain by removing the teeth is life changing for a cat that is suffering from this condition.
dr Julianne Miller is a Flagstaff veterinarian. You can be reached at email@example.com
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