Do heart problems mean the dog can’t be treated under anesthesia for dental pain?

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Q. I rescued an 11-year-old cavalier King Charles spaniel with dental issues. Her breath would melt glass…real bad. But more than that, I cannot brush her teeth or approach her mouth at all. Although her appetite remains good and she seems generally happy, when I go to touch her mouth to take care of her or get a look at her teeth, she cries out in pain (but never tries to bite me). I have tried all the over-the-counter remedies to no avail. Is there any alternative to get her mouth healthy again? I have taken Lady to two different veterinarians, and both said putting her under anesthesia for dental work is out of the question because she has an enlarged heart and progressive heart failure that is too far along to provide anesthesia safely. Any light you can shed on this would be greatly appreciated.

Ed Taylor
Merritt Island, Florida

Dear Mr. Taylor,

You are an astute friend to your dog to observe that she seems to be in pain despite still having an appetite and eating well. According to Your Dog editorial board member and board-certified veterinary dentist Bonnie Shope, DVM, “people often mistakenly think that dogs must not be enduring pain if they are eating. This is not true. You and I would still be hungry and want to eat, even with a toothache!”

Dr. Shope also says that while you have taken your dog to see two veterinarians, you might want to consult a veterinary cardiologist. “Consulting with a cardiologist to evaluate the stage of heart disease informs us of the risk and guides us in developing the safest anesthesia protocols,” she notes. “It is rare that a cardiologist absolutely does not recommend using anesthesia to treat a pet suffering from advanced dental disease.”

Seeing a veterinary dentist for surgery under anesthesia is the ideal solution.On the off chance that a board-certified veterinary cardiologist does rule out anesthesia for Lady, a veterinary dentist still has tools in her arsenal that can ratchet down pain far better than over-the-counter remedies. She may prescribe non-steroidal anti-inflammatory pain medication, a narcotic, or another medication based on the diagnosis, which could be anything from a cracked tooth or tooth abscess to an oral tumor.

Please keep us posted as you go forward. We feel confident that with the proper professional help, your dog can enjoy her life more comfortably.

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