Dog Teeth Cleaning Heart Murmur
Edward R. Forte
October 13, 2021
Bags & Cleaning Supplies
Recently, I was asked if a pet with a heart murmur can have a dental cleaning.A "murmur" is an abnormal sound that we hear when we listen to the heart with a stethoscope.But a dog or cat with a heart murmur may sound like "lub-swish-dub".Also, just like in people, sometimes a murmur can be "innocent", which means the blood may be flowing differently through the heart, but not because of a diseased heart.Sometimes there can be an abnormality in the heart causing the murmur, but the heart still functions normally.Once we know the cause of the murmur, we can determine if any medication is indicated to keep the heart healthy, and if the heart is healthy enough for anesthesia.If he does have "heart disease" causing his murmur, does that mean he cannot undergo anesthesia for his dental cleaning?But heart disease does increase the risks associated with anesthesia, which means that extra precautions must be taken to ensure his safety during the procedure and during the post-anesthesia period.So, selecting an appropriate anesthetic drug protocol to balance all of the potential negative cardiac effects is essential to minimize the stress on the heart. .
Is My Dog Too Old for a Dental Cleaning?
Is my dog too old for a dental cleaning?Even so, anesthesia can sound scary—and if your old dog is in need of a dental cleaning, you may be worried about some of the risks that might be involved.If your dog has never had a dental cleaning done and now he is considered a senior, consider that he has likely accumulated a great amount of tartar on his teeth and under his gums."Old age is not a disease," remark many veterinarians, and no dog is "too old" for anesthesia as long as the dog is healthy—but what about old dogs who are sick or too frail to undergo anesthesia but have severe dental problems?"You do need to weigh that possibility against the risk of anesthesia in an older dog," points out veterinarian Dr.I have seen many cases where an old dog has severe infection in its mouth and gums, we do a dental cleaning, extract infected teeth, and put the pet on antibiotics.So is your dog too old for a dental cleaning?While a dental cleaning done on a 12-year-old dog may be more risky compared to a dental cleaning done on, say, a five-year-old dog, there are several things that can be done to reduce the risks for complications.Here are some questions that you may want to ask.Will my dog have blood work done prior to the procedure?If your dog has swollen gums and signs of periodontal disease or perhaps an abscess, your vet may consider putting him on some antibiotics prior to the dental procedure so to decrease the amount of bacteria traveling from the mouth.Will my dog's mouth be x-rayed?While an x-ray of the problem tooth makes sense, a full mouth x-ray may be a better choice considering that dogs may have problems in other teeth that can be seen only through an x-ray.Question: My 9 year old dog has a heart murmur.Is it safe to have her teeth cleaned?Answer: Whether a procedure is "safe" is a relatively difficult question to answer even if you ask your vet.All procedures requiring anesthesia have some level of risk, but in some cases, the risks may be higher or lower.If the teeth are very diseased, there is dental pain and there is a need for extraction/extractions then, than this may be needed more, although in some older dogs with health conditions that puts them at risk, antibiotic pulse therapy can be an option (dog goes on the antibiotic for a week, and then off for 3 weeks).In dogs with very advanced dental disease and not too severe murmurs, the benefit may outweigh the risks also considering that bad teeth can affect the heart as well.Question: How much does it cost to have a senior dog's teeth cleaned?I can provide you with a rough estimate based on what I paid when my senior dog had his dental cleaning done at 8 years old.His cleaning was $324.00 but then he needed an extraction $250 and x-rays ($150), so it all came down to around $600.Question: What is the cost of a thorough dental cleaning with X-rays, blood work, and extractions?Is it safe to get dental cleaning?He has had blood work , x rays done, he has a enlarge probate, kidney problems, will it be ok to do this.?Is it safe to go under anesthesia for a teeth cleaning?Adrienne Farricelli (author) on August 28, 2019:.Erin30, thank you for sharing your story about your dog undergoing dental cleaning and extractions.We never had any issues with his dental cleanings in the past and he was fine.This time we discovered ahead of the cleaning he had a foul-smelling mouth and painful tooth - so we knew they'd find something while he was under anesthesia.After the procedure his mouth was very swollen and he was given antibiotics for two weeks.He was still on antibiotics when he spiked a very high fever and couldn't lift his neck.I think dogs who show any signs of dental disease before going in for their cleanings need to be on preventative antibiotics beforehand and owners need to ensure vet who is cleaning teeth has experience with dental cleanings and tooth extraction.His teeth are getting plaque again and he needs another cleaning - but no more extractions will be allowed and rest assured I'll be sure he's on antibiotics beforehand.Her teeth are in need of cleaning.Given such condition, I really do not think anesthetic and even anti biotic would be good for his body yet her tooth and gum are really bad till beyond discribed.Adrienne Farricelli (author) on September 23, 2018:.tootsie is 16 and is in need of teeth cleaning... she is scheduled for cleaning in a.m.this will be her 4 cleaning, and still she gets infections.My 10 year old Maltese desperately needs her teeth cleaned.She has a heart murmur and Liver problems.. I’ve tried to clean her teeth but she doesn’t let me and also some of them are moving in the front and has wholes deep inside on the top,u can see it.What do I do ?We really debated it, but I’m very glad I did it.So it was the least I could do.My 12 year old Maltese desperately needs her teeth cleaned again.she is a rescue and I have had her 8 years....she has a heart murmur and is very neurotic.Adrienne Farricelli (author) on December 31, 2017:.I have a 15 year old toy poodle who has had her teeth cleaned every year.I have a 9 year old chihuahua and he has very bad teeth.I got him when i was young and was never told you had to brush dog's teeth.I don't care for excuses and I know it's my fault so I saved up alot of money for the to be expenses.Can i still get dental work done if I have all his papers and id or do I have to bring my parents?I know this sounds weird but I love my dog and my parents don't I just want to get this procedure done fast and I'd rather take the risk because his quality of life is not good at this point.Adrienne Farricelli (author) on March 15, 2017:.Adrienne Farricelli (author) on March 07, 2017:.This is a very important hub for Dog owners like me.
Is There a Relationship Between my Dog's Dental & Heart Diseases
In addition, chronic valvular heart disease is the most common source of murmurs and heart failure in small-breed dogs.It has been well documented that some people with periodontal disease are at risk for infections of the mitral valve after dental work, causing heart failure and, in severe cases, the need for valve replacement surgery.The mitral valve is commonly affected and patients with a history rheumatic fever are advised by the American Heart Association to use prophylactic antibiotics before undergoing procedures such as dental work, which could result in bacteremia that may lead to infective endocarditis (IE).Given the incidence of dental disease and the prevalence of mitral endocardiosis in dogs, it is easy to see a connection between dogs and humans.Endocardiosis--Chronic degeneration of the valve tissue that is an acquired malformation related to age.It is non-inflammatory in nature and can lead to heart failure.Polyarthritis is a common condition in patients with IE as an inflammatory response in the connective joint tissue.Chronic myxomatous valvular degeneration, or valvular endocardiosis, is by far the most common source of murmurs in small-breed dogs.It is estimated that up to 75% of dogs with signs of congestive heart failure have mitral endocardiosis.2 The cavalier King Charles spaniel is known to develop the condition much earlier in life, typically by 5 or 6 years of age.There is marked degeneration of the connective tissue of the mitral apparatus (leaflets and chordae tendineae), leading to regurgitation of the valve during systole.Currently, no evidence shows that this condition is infective and related to bacteremia from any source.Although this case recognizes the temporal relationship between dental prophylaxis and the onset of IE, it acknowledges that the findings should not be applied broadly to all dogs because this is the only reported case.Bacteremia has been shown to occur in two-thirds of dogs after dental prophylaxis, even with the use of prophylactic penicillin.3 In patients with chronic periodontal disease, this shower of bacteria can be constant.Research has demonstrated that the severity of dental disease is related to histopathologic changes of the kidneys, liver, and lungs.1 Although histopathologic evaluation of heart tissue showed myocardial degeneration and inflammation related to the degree of dental disease, evidence of causation of mitral valve endocardiosis was lacking.However, research does show that dogs with sub-aortic stenosis have a higher risk of developing IE, and bacteremia could lead to disease.2,4 The connection between dental bacteremia and heart disease does not appear to be linked to mitral endocardiosis but rather to endocarditis.Sub-aortic stenosis is a congenital defect of the heart that causes narrowing of the left ventricular outflow tract which is the area just inferior to the aortic valve.The more narrow the area, the higher the velocity.As blood is ejected from the heart through the stenosis it impacts the aortic valve at increased velocity, thereby damaging the surface of the valve.Dogs with any degree of sub-aortic stenosis are at risk of developing IE.IE is an infection of the valves or interior surfaces of the heart.A system of major and minor criteria and definitions of likelihood has been developed to aid in diagnosis.Blood cultures and echocardiography are key diagnostic criteria.Echocardiography is an excellent tool to help achieve a definitive diagnosis of valvular disease.Vegetative lesions can sometimes be seen attached to a cardiac valve but if the vegetation is small discrete visual clues may be lacking.Cardiac arrhythmias are also occasionally seen in dogs with IE, some of which can be life-threatening.Even though the prevalence of periodontitis and heart murmurs is high in veterinary medicine, there appears to be no substantial link between poor dental hygiene in dogs and chronic valvular degeneration.IE is a rare but potentially deadly condition that can be caused by bacteremia associated with dental prophylaxis.Dogs with sub-aortic stenosis have been shown to be at higher risk of developing IE when exposed to bacteremia.Prophylactic antibiotic therapy for all patients with murmurs undergoing dental treatment is controversial.Diagnostic criteria for the diagnosis of infective endocarditis in dogs and cats.4.a.b. Positive blood cultures in the absence of diskospondylitis or obvious sepsis:.c. The recent onset of a diastolic heart murmur or evidence of more than trivial aortic regurgitation on a Doppler echocardiographic examination in the absence of sub-aortic stenosis or annuloaortic ectasia.Criteria for the diagnosis of infective endocarditis in dogs and cats.4.No pathologic evidence of infective endocarditis.
Heart Murmurs in Dogs
Pathologic heart murmurs can be caused by a structural problem within the heart (i.e., cardiac disease), or can be due to a problem that is 'extracardiac' (i.e., not caused by heart disease).What is an innocent or physiologic heart murmur?In general, a physiologic or innocent heart murmur will have a low intensity (usually Grade I-II out of VI), and does not cause any symptoms or clinical signs.The most common cause of an acquired heart murmur in the dog is 'mitral insufficiency' (also called 'mitral regurgitation'), a condition in which the mitral valve becomes thickened and begins leaking (see our handout 'Mitral Valve Disease in Dogs') - mitral insufficiency tends to be more common in small breed dogs.In most cases, a heart murmur is detected when your veterinarian listens to your dog’s heart with a stethoscope.If your pet is still a young puppy and the murmur is of low intensity, your veterinarian may recommend a re-examination in a few weeks time to track whether the murmur has decreased in intensity or disappeared, indicating that it was likely an innocent murmur.Similarly, if your adult dog appears to be extremely stressed at the time of a routine health examination and the murmur is of low intensity, your veterinarian may recommend a re-evaluation at a later time when the dog is calmer.A dog with a heart murmur that is caused by a structural heart disease or an extracardiac problem will generally have some symptoms or clinical signs that can be attributed to the disease.During a physical examination, if your veterinarian detects an abnormal rhythm to the heartbeat, or finds that your dog has weak pulses or irregular pulses, it will be more likely that the murmur is caused by an underlying problem.If your veterinarian determines or suspects that the heart murmur is caused by structural heart disease or an extracardiac problem, further diagnostic testing will be recommended.Depending on what other clinical signs are present in your dog, your veterinarian will usually recommend X-rays, an electrocardiogram, or an ultrasound examination of the heart (an echocardiogram).A Doppler examination is a specialized type of echocardiogram in which the speed and direction of blood flow can be measured across the heart valves and in the heart chambers.Heart murmurs are simply abnormal heart sounds caused by turbulent blood flow, and treatment depends upon the underlying cause of the heart murmur or the turbulent blood flow.If the murmur is caused by extracardiac disease or a functional problem that can be treated, the murmur may resolve over time.The long-term prognosis for a dog with a murmur caused by congenital heart disease is extremely variable, depending on the specific type of defect that is present; if the defect can be surgically corrected the prognosis is very good. .
Can Pets With Heart Murmurs Have Dental ...
Any comments on this site are not intended to be a substitute for professional medical advice, diagnosis, or treatment. .
Endocarditis in Dogs
In many cases, endocarditis affects a heart valve that has already been damaged.Affected dogs show vague signs of illness, such as weight loss and lethargy.They may develop signs related to the spread of bacteria throughout their body, such as lameness and joint pain.Dogs may develop signs of heart failure, such as a cough, exercise intolerance, and weakness.You may also notice that your dog has shortness of breath or difficulty breathing.Blood pressure abnormalities are also often associated with endocarditis; in some cases, these abnormalities may be dramatic enough that your veterinarian can detect them when assessing your dog's hindlimb pulses.(including a complete blood cell count and serum biochemistry) may show abnormalities consistent with endocarditis or other infection.Infectious disease testing, including blood cultures and tests for specific pathogens, may be used to help determine what agent is involved in endocarditis.If your dog has multiple findings consistent with endocarditis, this suggests a high likelihood of the condition and warrants treatment.Dogs are monitored throughout treatment, with chest X-rays, blood tests, and additional heart testing as indicated. .
Addressing Anesthesia Concerns ...
Advances in veterinary medicine, nutrition and quality of life contribute to dogs living longer today than ever before.Not surprisingly, older dogs are increasingly vulnerable to diseases that may require anesthesia as part of the treatment process.Oftentimes, older dogs have significant underlying diseases that complicate their ability to be anesthetized with a good outcome.Older dogs also are prone to hypothermia, or dangerously low body temperature, which slows their metabolism and recovery from anesthesia.“Drug protocols and dosages should be carefully monitored to prevent an overdose or prolonged recovery.If a heart murmur is detected, chest radiography or cardiac ultrasound may be necessary.“I think most owners value the importance of these pretests in helping to ensure their dog receives safe anesthesia.”.Just as in people with cancer, dogs have good and bad days during the course of treatment.Vigilant monitoring during anesthesia is the best defense against potential problems in older dogs.“Early intervention and correction of problems before there are permanent consequences is possible with vigilant monitoring,” Dr.“Cancer treatment has pushed the limits of how much older patients are anesthetized,” Dr.Some of these cases may only be treated one time on an as-needed basis to help manage the pain.”.These specialists often work in private veterinary practices and provide consultation services as well. .
15-Year old pomeranian with severe periodontal disease
Like many smaller breeds with complicating factors such as his advanced age and heart disease, the health of his teeth had deteriorated.Brigden often says “age is not a disease” and by approaching anesthesia cautiously and with a thorough pre-anesthetic workup, we can successfully treat severe oral disease in our older patients. .
5 Scary Consequences of Neglecting Your Dog's Teeth
You may already know that not taking care of your dog’s teeth can lead to periodontal disease, a condition that results in bleeding gums, bad breath, and ultimately tooth loss.But did you know that poor oral hygiene is also linked to other health issues in dogs, including diabetes and heart disease, and it can even lead to a broken jaw.And because dogs are experts at hiding pain, you may not even realize there’s a problem.“Periodontal disease starts under the gumline with a substance called plaque, which is made up of bacteria,” explains Dr.Reducing inflammation by treating periodontal disease can have a profound impact on a dog’s health because “it decreases the amount of work the body has to do to fight this infection,” says Dr.The heart and liver are especially prone to developing inflammation from dental disease.While it can be tough to determine cause and effect, “we know there’s an association because they so often occur together,” she says.Jason Nicholas, chief medical officer at Preventive Vet, based in Portland, Oregon.Inflammation and infection decrease the body’s sensitivity to insulin, a primary hormone involved in blood-sugar regulation, he adds.We all have seen dogs ‘inhaling’ hard food without chewing,” says Dr.Stanley Blazejewski, a board-certified veterinary dentist at VRC Specialty Hospital in Malvern, Pennsylvania.“Most pets continue with their daily routine and it is not until we have the opportunity to address the fractured canine or wiggly molar that families will notice a difference in their pet," Dr.Poor oral hygiene can lead to a broken jaw in dogs, especially smaller breeds with disproportionately large teeth, such as Chihuahuas, Lhasa Apsos, Maltese, and Shih Tzus, Dr.Gwenn Schamberger, a board-certified veterinary dentist with WVRC Emergency & Specialty Pet Care in Waukesha, Wisconsin.“But I do see this, and it is serious and very painful—it can be very difficult to get the fracture to heal appropriately—because the bone is not healthy bone,” Dr.“However, in many cases, jaws that fracture due to periodontal disease present an extra challenge due to the lack of good quality bone in the area as well as lack of teeth.”.Taking caring of your dog’s oral hygiene is about much more than clean teeth and fresh breath, Dr. .
Why Antibiotics Before a Cleaning Appointment
Some forms of these conditions may be affected by the stress of dental procedures or certain electrical equipment used in the office.Bacteria normally present in your mouth can sometimes spread to other places in your body as a result of certain dental procedures. .