Old guy with bad teeth

Question
Hi, i got my dog, buddy, almost two years now when he was 13 from the
humane society. He is a English springer spaniel and is just full of life still.
(except that he sleeps a lot). He had really bad teeth and gums when i got
him
and i took him back to the vets there and asked what i needed to do about it.
since he was so old and had a heart murmur they suggested not to take him
to
the vet dentist because of going under for him in his condition could kill him.
so i went home and did the best i could and scraped off the black junk and
tartar build up and brushed his teeth and so on. it hasn't gotten near as bad
as it was before but there is still some tartar build up that has come back and
he does have rotten teeth that he had from the beginning that needed to be
taken out that haven't. can those teeth be pulled out without him under. he is
a calm dog and lets you groom him and brush him while he just lays there
and enjoys it. Also i have notice his gums swelling up in odd shaped bumps. I
am worried that he might have some tooth disease but not sure if i want to
risk his life to fix it as he is getting older. he has no problem eating. is this
something that could be causing him lots of discomfort? last vet visit was a
few months ago or so and he got medication for his Arthritis in his legs but it
didn't' seem like there was nothing else i could do
and the vet just told me he was old .. ... is there anything i can do so that he
can enjoy the rest of his life now in better comfort?

Answer
Hi Leah,

It sounds  like you've done an excellent job is getting your dog's bad teeth under control, but it's now at a point where he needs more care that you can provide.

A cardiologist is the best person to evaluate your dog's heart murmur, and would be able to tell you if your dog can undergo oral surgery.
Even though he has a heart murmur, it still may be possible to do surgery, if he passes pre-surgery tests. A pre-anesthetic examination and labwork are likely to uncover any hidden problems that may impact on anesthesia such as kidney disease or diabetes that are more common in older dogs. As long as the exam and tests seem normal there should be no significant increase in risk in anesthetizing an older patient.

Vets can operate on a dog with a heart murmur as long as the dog's physical condition is satisfactory overall. If there are signs of problems related to the heart murmur, such as stunted growth, coughing, breathing difficulties, tiring easily, etc. then the vet would be less willing to operate.

To make a decision for a dental work, you need to weigh risk versus benefit. Is there significant disease-not just tartar-that warrants an anesthetic? Does a tooth need to be pulled? Surgery performed? If a time-consuming procedure such as a root canal is being considered, I think it's appropriate to consider a shorter procedure such as extraction instead of keeping the dog under anesthesia longer to save a tooth that it can live without.

To provide an extra measure of safety during the anesthesia, your veterinarian can use drugs that are short acting or reversible, and place an intravenous catheter prior to anesthesia so that emergency drugs can be administered without delay should the dog have an adverse reaction.

Or, your dog may be able to be treated under a local, rather than a general anesthetic. Talking to the veterinary dentist is a reasonable next step.

If your dog is eating well, then his tooth disease probably isn't causing much pain. I couldn't guess at what the bumps you described are, that's something else you should take up with either your regular vet, or a veterinary dentist.

Getting medication for your dog's Arthritis was a good thing, you sound apologetic about it. Elderly dogs are better off receiving medication that restore mobility and relieve pain, than they would be not receiving medication. While no drug, not even aspirin is without possible side effects, you have to weigh quality of life issues against the possibility of side effects.

Trying to keep extra salt out of the your dog's diet would be helpful in managing the heart murmur.

You can ask your vet about using diet supplements that help protect joint cartilage. Two popular supplements are Cosequin and Glyco-flex. They consist of glucosamine and purified chondroitin sulfate, major building blocks of cartilage. Cosequin and Glyco-flex are "neutraceuticals", meaning they're dietary supplements or food additives that do not require FDA approval. Many people swear by them. Your vet can suggest a brand and correct dose. You should use these supplements along with the pain medication. These supplements need to be given daily, and can take over a month before (and if) you see results. If you stop giving the supplements, the joints will start to degenerate again.
Other supplements to reduce inflammation are fatty acid supplements containing high levels of Omega-3 fatty acids, such as Omega-3 Gel Caps

There are many anecdotal reports on the use of acupuncture in treating musculoskeletal disorders in dogs. Pain from hip dysplasia and arthritis are a common reasons for acupuncture referrals.
You can locate a Veterinary Acupuncturist here:
http://www.ivas.org/member_search.cfm
http://www.aava.org/pub/directory_links_public.html

If your dog has trouble walking or getting to his feet, there is a special leash especially made for arthritic dogs:
http://www.dogshealth.com/large_item.php?sku=BOTUPL01

If your dog is overweight, reducing his weight is the single most important thing you can do to help relieve joint pain. Keeping your dog warm in the winter, and having a soft but supportive orthopedic dog bed are also important.

I hope I've been a help.
Best of luck,

Patti