Hiya

My Cavalier King Charles spaniel is nearly 12 years old, he has had a grade 3 heart murmour for a few years and is on Vetmedin and Vivitonin. He is pretty bright and lively and has just lost quite a bit of weight, going from about 13kg to 10.6kg (on a vet supervised diet). He doesn't show any heart symptoms such as coughing at the moment.

He has really bad teeth and today at his check-up I asked about getting them cleaned up, the vet said this would be a good idea as his gingivitis could cause infection leading to heart complications later on. But he said the general anaesthetic carried a risk, but wouldn't be drawn at all on this except to say there is no way of knowing and he might have a heart attack and die. He wouldn't tell me how likely it was or anything. Just said it was up to me to decide.

I don't know what to do!

I know that even if the odds were one in 50, Louis could still be that one in 50. But maybe they are worse at one in two.

I also don't know how long Louis might live without the teeth cleaning; if he will only live another 6 months to a year then I am not sure it's worth the risk of the GA, but if he might live another 3 or 4 years, then we ought to risk getting it done.

Has anyone any comments or advice please? I'd be particularly interested to hear from any cav owners or owners of dogs with heart murmours.

Thanks!

Well I have a 14 years and 7 months old Cavalier who has had a grade 6 murmur for the past 7 years. So to me a grade 3 is nothing. My Rufus has terrible teeth, he stinks, they are rotten, he finds it hard to eat (not that it stops him!!) but of course there is no way on earth we can put him under GA to sort his teeth out. Had his heart only been a grade 3 with no symptoms I am fairly certain I would have gone for it. Now Rufus' teeth have been bad for a few years so not sure if that gives you any indication at all? Obviously there will always BE a risk, there are never any guarantees, but if it was my dog, I would do it. In fact a few months ago I heard of a cavalier with a grade 5 who went through it as there were some teeth that were so bad it was a case of sort them out or put the dog to sleep -that dog came through it.

Thanks for your reply Marianne!

I think we are erring towards doing it, because if Louis lives with his heart murmur another 3 years, his teeth are going to be in a right state by then! It's so difficult because of the GA risk, but that is only really going to get worse with time, so the sooner the better in some ways.

How does Rufus manage with his murmur, is he still quite lively or does it slow him down a bit? 14 is a great age!

Cheers
Alex

I think you have to weigh up the pro and cons are his teeth causing him discomfort or is it more your discomfort with his bad breath , can he eat drink etc: if he has discomfort trouble eating , would he have a better quality of life , how would you feel if he didnt survive the anaesthetic etc
Does he have good health apart from the murnur steady on his feet, no toilet problems etc then I would get a second opinion from another vet then decide.

Hi Starryeyes, thanks for your reply.

Some of his teeth are rotten so may be hurting, and there is a health risk from possible infection developing. He eats more slowly too because of it. So I think his quality of life would be slightly improved.

Obviously if he didn't survive the GA I would be gutted and blame myself. But if he dies in 6 months from complications of his infected gums I will wish I had had his teeth cleaned up now. Argh.

Yes he is in good health apart from arthritis, he is steady on his feet etc.

Good idea re second opinion, how would I arrange that, would I tell my own vet? How to find a good one, are there specialists in this area (anaesthetics) I wonder?

Cheers
Alex

My friend had a dental op done on her 13 year old CKCS under GA to remove all but the four canines, he has a grade 3 murmur and came through with no problems.
He now has his Bonios smashed up with a hammer but is much brighter and happier now it's been done.

It's all about quality of life not quantity and a mouthful of bad teeth and inflamed gums cant be the best of things to live with.
Besides, the vet's point about gingival bacterial infections leading to the risk of bacterial endocarditis, is a real one and well documented.

Hi tooolz thanks for your comments, great to hear about your friend's dog and yes you are right on quality of life. It was just a bit nonplussed at the vet's "take it or leave it", unhelpful attitude so it is great to hear real life tales on here, even if there is no guarantee that Louis will be ok. Funny about having to have bonios smashed up with a hammer!

Cheers
Alex

Alex I suspect your vet want the decision to be entirely yours so that he cant be blamed......... 'Blame culture' is probably the bane of his life.

I know, it's frustrating though not to have him say a vague idea or opinion! A relative had cancer last year and the consultant told him he had to decide for himself how to be treated, even though the consultant was the expert in cancer! My cat died while under the vet's care last June and I haven't sued him/blamed him for that so I wish he felt able to be a bit more upfront with me. Oh well, rant over, like you say it is the culture we live in.

I had my 14 year old boys teeth done almost a year ago. He has chronic renal failure and the vet feared the bacteria from his teeth was compounding the problem. However, the vet would not do the operation until such time as we had an improved blood test. When that came, my Vet said they were now happy to carry out the procedure (keeping the anaesthesia as light and short as possible) and, although with any GA there is a risk, they felt the benefits outweighed the risk.
My vet always uses the "if this was my dog, I would.....". I find that an extremely helpful attitude and often helps me to decide what course of action I should take.
I would be really annoyed if my vet was unable to offer me an opinion or idea....that's what I pay them for!

How does Rufus manage with his murmur, is he still quite lively or does it slow him down a bit? 14 is a great age!

He's very slow now but then again I think he'd be even with a good heart, at this age. When he was diagnosed aged 7 at first I kept him quiet. THAT nearly killed him, he was so bored and depressed. So I started letting him do whatever he wanted to, and have stuck to that. I'd rather he dropped dead of a heart attack doing something he enjoyed, than died slowly being bored. When he was 9 he went back to training classes and passed his Good Citizen Gold test. When he was 10 I bought a Papillon puppy and he REALLY brought Rufus to life. There have since been two more Papillons arriving and I swear they keep him going. He's blind, he's deaf, he's had several strokes, he falls over a lot, he's incontinent, he's had a few major seizures -all sounds bad but he still goes for his walks (not daily, though -when HE wants to), still actually leaps up into the air when the food is on the go, still gets really excited when anyone comes home or visitors arrive. If nothing exciting is happening he sleeps an awful lot, but all in all he has a happy life, he's always cheerful. Turn your back for a split second and he will run off with whatever food there is around -a few times an entire baguette for instance LOL. I think his excuse is he can't hear so how would he know we said no?

it just sounds to me your vet covering his backside.

This is a lovely bit he sounds a character, and I think he'll keep going and going.
He also sounds full of fun, I especially like the food pinching bit !! Keep on trucking Rufus!

Hi colliecrew thanks for your reply, I have now had another appointment with a different vet and she said we ought to do it as long as his bloods are ok, since his teeth are quite bad. She also said he should be fine, it's just that the GA always has a risk and more so with dogs with heart probs. I was glad she was able to give me some guidance; like you say it 's part of what we pay for!

Marianne Rufus sounds very similar to Louis, I wonder if they are just typical cavvies! He likes to sleep a lot but still gets excited about food and training and stuff. He is always cheerful too! Louis has also disgraced me with food stealing in the past and famously drunk Uncle Alan's tea when we were visiting their house about 10 years ago; he bent down to get his cup and Louis was sat licking his lips and the cup was empty! Hope Rufus is continuing to thrive

I take it you have had Louis' teeth done by now, but I thought I'd reply as I'm making the same decision.

I have a Cav that was graded as Grade 5/6 when she was 7.  I think the indecision was based on how wound up she got in the vets waiting room!  3 weeks after the diagnosis she was struck down with pyometra.  She has a horrific and long story, but the short version is after me taking her to be put to sleep THREE times (the most stressful time of my life) the pyometra went untreated by the vet for 2 weeks.  I snapped and took her out of the surgery on a drip and drove for 4 hours to the vets I had used growing up.  At this point she had lost over a third of her body weight (she was in show condition to start with) and couldn't even hold her head up.  I just wanted her suffering- and he was suffering badly, to be over.  My family vet was so horrified by the previous vets reatment, and so impressed that she was still fighting, that he offered to spay her, and if her heart gave in she would know no more about it than having the injection to put he to sleep.

That was 2 years ago.  It has been a long hard fight, she is now known as 'the pill box', she is addicted to her vetmedin and does backflips to get her next 'fix'!  She is now fighting fit and still goes on an hours off lead walk a day.  As said in above posts I believe she is only alive because her heart is being made to work.  I dont push her, if she chases one to many seagulls we go home early much to my Kooikers disgust.

The point is she was a dog that wasn't just on deaths door, but half way through it, Grade 5/6 murmour, major op and still made it.

My dilemma is she made it through once, I'm pretty sure twice is pushing it.  Her teeth are getting really bad, but she is still eating chews without problems.  I think its something I have to seriously think about over the next 6 months.