My Annie, 15 1/2 pheochromocytoma - Annie is now an angel running free

[frijole]

Looking for any advice or experience... took my young one Annie, she's 14 to the vet today for teeth cleaning. She has awful teeth - always has. I have been worried that she had cushings because of increase in hunger, inability to jump on couch, big tummy on a skinny dog... so I had the full blood panel done and a thyroid test.

Vet called to say she is hypothyroid. Says bloodwork was fine. Said she had an extreme heart murmur and he is doing a chest xray. He also recommended either removing her upper canine teeth or I return every 6 mos. I just couldn't have them removed. She's my baby...

I will pick her up after work... any thoughts or questions re her issues? This is new to me (except the hypothyroidism). Thanks guys.

Kim

[Squirt's Mom]

Hi Kim,

Bless your hearts. I know you are worried sick about your sweet Annie and all I can contribute is what I know about the teeth/heart connection...which ain't much!

Decaying teeth in a human's mouth, if left unattended, will cause a lot of pain and present the very real probability of a myriad of nasty consequences in the body...including heart problems. This holds true for pups, too. I'm NOT saying the heart murmur is a result of her teeth...they can be caused by several things, or can be idiopathic. But if Annie's canines are decaying, they could lead to other heart issues on top of the murmur.

I know you don't want to remove them, but our babies' canines are designed for defense and stabbing & holding prey (or treats!). Since our companion animals don't have to hunt for their food, that purpose for those teeth is greatly lessened. If a pup is in an environment in which they aren't required to defend themselves, then that purpose, too, is diminished. If her teeth don't improve with the bi-yearly dentals, then you might want to give this more thought. Just my 2 cents worth.

Here is a link I found that has some good info on the canine heart and the problems it can have, including murmurs.

http://www.dogaware.com/specific.html#heart

From there I found this link that has some info on murmurs:

http://www.vetgo.com/cardio/concepts/concindx.php#sect2

You're a great mom, Kim.... Annie knows you are going to take very good care of her just as we do.

Hugs,
Leslie and the girls

[SasAndYunah]

Hi Kim,

I have to agree with Leslie about the canine teeth. Infected gums and teeth aren't just a problem of the mouth. The heart, kidneys, intestinal tract and even joints may become infected. The tartar and any infected areas of the mouth contain a multitude of bacteria that can "spread" to other parts of the body. I would strongly advise you to have them removed. Also because with each dental cleaning done (every 6 months) she will need an anti biotics treatment to prevent the bacteria entering the bloodstream and causing more problems. If you have the canines removed and try to keep the remaining teeth as clean as possible, that will also spare her the "constant" anti biotic treatments. Do note that if you decide to have her canines removed to make sure she will start anti biotics a couple of days before the dental surgery, this is really important.

About the heart murmur, did your vet mention wich grade it was? While heart murmurs can have several causes, in older dogs it is usually because of a leaking valve.
In the case of a heart murmur, an ultrasound is the most usefull. An ultrasound exam allows visualization of the heart valves, which allows accurate confirmation that the valve is the problem and the amount of reflux blood flow through the valve is measurable which is useful information. Furthermore, an ultrasound exam can help to rule out causes of heart murmurs in which the damage to the valves is due to a cause such as cancer or bacterial infection of the heart lining that would not show up using X-rays or ECG. Cardiomyopathy is usually identifiable on ultrasound exam as well and this is an important "rule-out" in many cases of heart failure. But for such an ultrasound you would need to see a cardiologist and probably need a refferal.

X-rays are more useful in helping to determine how serious the effect of the murmur is then in assessing the type of murmur. But a vet should have a pretty good idea of what kind of murmur is present based on the type of sound it makes and the location of the sound when listening to the heart. Especially in older dogs since most of them are valve failures. Often, using X-rays to determine when the heart is enlarging and when fluid accumulation in the lungs (pulmonary oedema) is beginning to occur is enough to make treatment decisions for the dog. In many ways it is not as accurate as an ultrasound exam but accurate enough to allow successful management of the heart problems associated with murmurs in many dogs.

Having had a miniature poodle with heart murmer (due to a leaking valve indeed) I first had the ultrasound done because it gives such valuable information and after that, managed his condition through x-rays if needed.

With medication, watching his weight and diet, and watching his excercise levels, he lived another 4.5 years and passed away at the age of 16

Best of luck to you and Annie,

Saskia and Yunah

[lulusmom]

Hi Kim,

I don't have a lot to add because Leslie and Saskia did an excellent job of presenting my case. If, as you say, Annie has always had dental problems, then you may want to rethink your decision. Depending on the severity of the heart murmur some vets won't do any type of surgery. If your vet thinks Annie can handle the dental procedure now, then I wouldn't wait as their is no guarantee that the heart condition won't worsen and surgery would be a much bigger risk at that point. So her tongue may fall out of her mouth without the support of canines? Mine does that all the time.

[frijole]

You guys are great. I had to make a decision before I posted about the canine teeth because she was already there and bloodwork done. I promise to do it in 6 mos. Re the chest xray vs sonogram... I will talk to him when I pick her up. So there are different "grades"? Like high, medium, low or are there names? I am so ignorant... at work and can't read the links... just sneaking this out while I can.

There are no IMS physicians in my entire state. Yep. Closest is a 6 hour drive each way. There is a new program where K State docs drive to Omaha monthly or so but I'm not sure of their services. I'll figure it out. This one is my youngest.

Thanks guys.. I'll check in later. Kim

[BestBuddy]

Hi Kim,

Like the others have said, bad teeth are better out than in. Buddy had to have one of his canines out and it was the best thing we did, no more pain and constant cleaning to try and save it. We left it too long and it had infected and gone through the gum to the nose so we then had to deal with an oral/nasal fistula. We battled trying to save the tooth for over twelve months and when we finally had it done it was amazing how quickly he bounced back even better than before.

Jenny

[Harley PoMMom]

Hi Kim,

Heart murmurs are classified as follows: Grade I—the lowest intensity murmur that can be heard, typically detected only while auscultation is performed in a quiet room; Grade II—a faint murmur, easily audible, and restricted to a localized area; Grade III—a murmur immediately audible when auscultation begins; Grade IV—a loud murmur immediately heard at the beginning of auscultation but not accompanied by a thrill; Grade V—a very loud murmur with a palpable thrill, the loudest murmur that is still inaudible when the stethoscope is just removed from the chest wall; or Grade VI—an extremely loud murmur that can be heard when the stethoscope is just removed from the chest wall.

This came from:
http://www.merckvetmanual.com/mvm/in...m/bc/11203.htm

Lori

[mytil]

Hey Kim,

Sorry I am late in the game here but I am glad they will be taken out. And I am sorry to hear about the murmur

Big (((((hugs))))) to Annie
Keep us posted.
T.

[StarDeb55]

Kim, Harley has had a grade 3 murmur for the past few years. It doesn't seem to be getting worse,. He has no symptoms such as coughing or lethargy, ( I sometimes wish he was a little more lethargic!) It has not prevented him from having dentals done.

I won't add anything about the dental, & the problems that untreated periodontal disease can cause in the rest of the body as everyone else has pretty much covered it.

debbie

[frijole]

Update....he graded it a 3 on a scale of 1 to 5. Slight enlargement. No fluids in the lungs. Does not feel we need to treat with medicine at this time.

He used a product called ProSeal on the canines to help seal them up. I appreciate your input on the canine removal.. I had already told him to keep them for now when I posted here. I knew I could have them removed in the future but I couldn't put them back and I had to get your advice first! We will do it next time. I feel so sorry for the little gal. She lost 16 teeth at the age of 7... Me thinks her parents wore dentures.

Dang I left with photocopies but didn't end up with the T4 test copy. 2 pills a day. He said she should feel much better after a few days on this so she must have had a solid diagnosis.. dang can't believe I don't have that.

Blood panel was all normal except for ALP which was at 233 (normal is 0-140)... said that was most likely due to the teeth.

She came running to me and had a big grin on her face so I felt much better. She may be 14 but she is my youngest... I wasn't ready for it. None of us ever are, are we?

She ate Haley's fish oil tablet tonight as well as her own and I didn't scold her. Thanks all. What would I do without you? Big hugs of gratitude.