30th March 2010, 03:52 PM
Anesthetic Triggers Heart Disease?
Our then 11 year old Cav (Norah) developed heart disease a couple of months after being put out for dental care. This also seems to be the case for many of her litter mates and half brothers and sisters.
Now her younger half brother (now 10) needs dental, some teeth to be removed, and we are scared this will trigger heart disease in him.
Thoughts? is dental disease painful? how would he indicate being in pain?
30th March 2010, 06:15 PM
So sorry to hear you had problems before, and that you understandably have worries now.
I don't think it was the anesthetic that would have caused heart problems although there is a tiny chance that there might have been some contribution in an older dog that became stressed -- have you discussed this with your vet as a cause and effect issue? in fact it might have been more likely that it was the existing dental problem or even the dental work itself and need for dental care that may have contributed to the development of heart disease (see below) but almost certainly there was already an issue there.
However, I think it more likely that the two events are just coincidental -- in other words that the fact that it was discovered that the dog had heart disease in the months following a dental workup had nothing to do with the actual dental workup. Heart disease is the single most common disease in this breed. Almost every Cavalier over age 10 will have mitral valve disease (heart disease) -- sadly, it is endemic in the breed now and half of all cavaliers will already have a murmur by just age 5. So it may well be that the murmur was only picked up at that point but it would be extraordinary if none of these dogs had heart problems before such a good age. There are some better lines for heart health, but even within those most dogs would have a grade one or two murmur by age 9 or 10 or so; it would actually be quite rare for older dogs of that age to have none at all. Had Norah been checked by a cardiologist as opposed to a vet before the murmur was picked up? Most vets will miss early grade murmurs that a cardiologist will quickly pick up. That's why I think perhaps the murmur just wasn't heard even though it was probably already there. Indeed, because heart disease is so prevalent in this breed, the average life expectancy is only about 10 to 11 years.
That said there is a connection between gum disease and heart disease. It is possible that the bacteria from gum disease caused the worsening of heart problems that were already there after the dental work. Because of this slight risk, many vets will put dogs, especially older dogs, on a cycle of antibiotics to treat any bacterial gum disease in the weeks coming up to having dental work done. On the other hand, it could be that the very fact that the dogs needed dental work meant the bacteria had already contributed to heart disease and what you were seeing was the worsening of the heart problems that were connected with gum or teeth problems (it's the same with humans -- it is known that gum disease contributes to heart problems).
Because of the connection between the two, it is important for dogs to maintain good gum and teeth health, so this can be a bit of a chicken and egg situation. For older dogs, vets usually will weigh up the best approach. It is a good idea to have advanced blood tests done for an older dog to consider whether anesthesia is going to be okay -- generally -- it is only considered a risk if the dog already has significant heart problems although in a very small number of dogs a particular type of anesthesia may be riskier.
The best thing to do is to discuss all these issues with your vet. if you haven't had your second Cavalier checked by a cardiologist, it might be a good idea to do that especially as he too is an elderly dog. If nothing else you will have a baseline idea of where your dog stands right now in terms of heart health, which is really advisable for a cavalier of that age.
It is very painful for a dog to tolerate rotting teeth -- exactly the same as you would feel if you had to endure toothache every day. So this is something you will want to have taken care of. It might be a bit reassuring to know that this is a pretty common procedure for older dogs.
In memory: Lucy
31st March 2010, 04:12 AM
thanks for the lengthy response
we had the discussion with the Vet and his view is that there could not be a link. They do a hundred dental procedures under anesthetic each year and they have not seen a risk of this.
my thinking is that the littermates and half siblings from other litters are on the same track, getting teeth trouble and then heart trouble at the same time in the same sequence. The litter owner women ended up becoming firends so they get together occasionally to compare notes.
unless the removal and cleaning of teeth itself sends a bacterial surge to the blood supply and heart, triggering a crisis? Maybe antibiotics would be a good risk mitigation measure as you say? I have heard of humans getting on antibiotics before surgery.
31st March 2010, 04:46 PM
Well, first question that would strike me would be, how old are the other dogs? Consider that one in two of all cavaliers will have heart problems by age 5 -- that means many have murmurs earlier than this, and pretty much 100% will have a murmur by age 10 -- only a very rare exception would not. If these dogs were not cardiologist (not just vet) tested *before* the dental work, than it is highly likely murmurs could have been missed. Vets miss amore than half of early grade murmurs. If all these dogs are older than 5 at the time they are having the dental work, I'd guess it is just a case of the dogs having murmurs that get loud enough to hear within a year of having the dental work, which would likely have been the case whether or not they had dental work. In other words, in human terms you might say people taking arthritis medication found the medications contributed to their needing reading glasses because within months of taking the medication they also needed reading glasses. But both are common older age problems in people and would happen around the same time.
Bacteria from gum disease can contribute to heart problems. There is always a slight risk of exposure to this when a dental is done -- but likewise, if the dental is being done not for basic maintenance but because there are already problems -- eg gum disease and teeth needing to come out -- then the bacteria has already been there and any cut to the mouth from eating say a chew or bone could have introduced it to the bloodstream and caused or contributed to heart problems. The breed is already highly prone to heart problems, so I think either you are seeing
- a coincidence -- and maybe some previously missed existing heart problems as 1 in 2 dogs will have a murmur by age 5 rising to almost 10 in 10 by age 10;
- or the existing gum/teeth problems caused the heart problems to worsen already before the dental was done (that is why dentals are important in the first place)
- or that maybe in the very rare case, bacteria during the dental got into the bloodtsream and worsened an existing heart problem.
I would tend to think the first -- especially if all these dogs are suddenly getting heart problems around the same spread of ages and are closely related. It is just coincidence that they also happened to have what for many owners is an annual event -- a dental. If there were such a high direct risk, dentals wouldn't be done and the risk would be well documented. But they are a regular feature for many breeders and pet owners.
You can ask your vet about giving antibiotics ahead of the dental work. I'd advise taking your fellow to a cardio though given his age if he hasn't had a cardio assessment. A cardio can advise on what to do regarding dentals but also, seeing a cardio is going to be far better in health terms than just about anything else you can do for an elderly dog in a heart-disease prone breed.
Hope that makes sense!
In memory: Lucy