4078.. An old poodle loses weight and is hunched. Periodontitis, Kidney and Liver Disorder

HOOK
Have you ever suffered from toothaches? You feel a very painful sensation when you drink cold water or eat food. You need a dentist. Animals can't talk and may show different signs.



In one of my unusual signs, a Miniature Bull Terrier in 2008 had frequent seizures (3 images BELOW) for a few months as he jogged with his master.  Only after my extraction of the loose and decayed teeth did he live a normal life without fits!  He was able to continue his daily jog and the owner was very happy. 

This is a rare case of seizures caused by dental disease. Your older dog or cat will have bad breath, eat lesser amount of the dry food or eat just soft food. A common sign is weight loss (image) and moving his head away to prevent you examining his mouth. 

A TYPICAL CASE
In Feb this year, the owner of this 14-year-old male neutered poodle would want just vaccination for his dog every year as diseases like distemper, parvovirus and leptospirosis are still present in some dogs in Singapore. He would decline dental work and blood tests. A quickie vaccination and go home. 

Lethargic, scrawny and protruding spinal backbone

Weight loss and bad breath

"Your old dog is scrawnier this year," I told him. "His backbone spines are protruding. He is hunched as if he has abdominal pain. "He moves his head away when I try to open his mouth to examine his teeth and gums," I continued. "This is a sign of severe oral pain as he has been eating less every day."

Mr Tan got the news that his dog suffered from kidney and liver disorder (blood test results) after a blood test. 


"When can you do the dental work so that your dog can eat without mouth pain and put on weight?" I phoned Mr Tan as he did not phone us for any advices after knowing the blood test results.

"I know he has liver and kidney disorders as shown in his blood test," he said. "Will he die under general anaesthetic during dental work?"

"No vet can guarantee there will be no anaethestic risk," I explained to him. "Your dog has a strong normal heart and lungs. From my experience, if I use only isoflurane gas anaethesia and no IV sedation and have no deaths from this method. "

Mr Tan gave his consent. The dog had 4 bad teeth extracted and was awake within 5 minutes at the end of gas anaesthesia. My assistant opened his mouth and showed Mr Tan the white teeth. The dog has no objection to his mouth being opened this time. A special therapeutic diet called Hills K/D needs to be fed as it is formulated for liver and kidney disease. The dog should now gain weight and live longer with a good quality of life.   

ANAESTHESIA AND DENTAL WORK (video)

CONCLUSION
IT IS IMPORTANT FOR THE VET TO FOLLOW UP AS THE OLD DOG NEEDS HELP. The owner can then ask questions about the anaesthesia and be well informed of the risks. If he is assured of the chances of success, he will permit his dog to be given dental work. 

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IMAGES TO BE USED 

Most dogs with bad teeth and gum infections will eat little as in the following case. The dog becomes very thin. He does not want his mouth to be opened, a sign of painful mouth as in this case study

Losing weight. One reason is oral pain due to dental disease.

This male neutered 14-year-old poodle came for his annual vaccination every year. I showed the protruding spinal backbone which stood out above the back. The dog washunched as if he was having abdominal pain (image).
He moved his head sideways and upwards as he objected to his mouth being opened by me - a sign of oral pain. Bad breath wafted from his mouth. The back teeth were encrusted with solid brown tartar.

BLOOD TEST
Abnormally high ALT, high urea and creatinine levels suggestive of a liver and kidney disorders.
Polydipsia (drinks a lot more) and polyuria (pees a lot more) are present, indicating liver and kidney disorders. A therapeutic diet, Hills K/D is recommended for such patients.

Lethargic, very thin and drinks a lot

Came for yearly vaccination. Now 14 years old.
Needed dental work. 

Thick tartar on teeth and inflamed gums indicating chronic gingivitis

MINIMISE ANAESTHETIC RISKS

Isoflurane gas at 3%. No sedatives IM or IV. This method is safer as it reduces the risk of death due to respiratory depression.  0.5 ml of furosemide IV given as the some lung sounds were present and the dog had a history of "asthmatic" attack occasionally.

VIDEO OF TOA PAYOH VETS OPERATING ROOM

Before dental work - Thick tartar and chronic gingivitis

White" teeth. One decayed tooth extracted (arrow)

TIPS AND ADVICES

1.  He should be eating healthier diet. The Hills prescription diet is formulated for patients with  kidney and liver disorders.   

The dog will be reviewed every 6 monthly.

2. During annual vaccinations, some owners do not want dental work to lower the veterinary costs.
Early detection of dental disease, liver and kidney orders would enable the dog to live a longer life.

3.  The dog recovers fast from gas anaesthesia (video footage) and the owner is pleased with the "white" teeth.

VIDEO