My dog has a tooth abscess, heart & kidney failure. What can I do?

Hi there and thank you for using pet coach to address your concern. This is an unfortunate situation. The recommendation would be to remove the tooth but with the concurrent heart disease it makes the decision difficult to put him under anesthesia. I will say, I have placed numerous pets with heart failure under anesthesia that did just fine. This just required an adjustment of the medications and careful attention to the heart monitor to catch any changes early. I would not suggest pulling the tooth at home. I would recommend continuing antibiotics every other month to prevent infection in the mouth. I might also consider speaking with a dental specialist about removing the tooth. Need Dental Specialists deal with many high-risk cases. I would also make sure that you are addressing the discomfort with some kind of anti-inflammatory. If Chico likes playing with toys, I would provide Chico with hard treats or toys to chew on. These Carter objects may help dislodge the already loose tooth. I hope this helps guide you in the right direction. Please do not hesitate to contact me if you have any other questions. I am also available by phone or text based consultation.

I would add that I think it's unlikely for a tooth root abscess to cause the eye to actually pop out (Proptose) however without definitive treatment the problem (the bulging and the infection) are going to get worse. Having that pocket of infection in the gum will likely cause the bacteria to translocate to the bloodstream, where it could cause other problems, including with the heart and the liver. I would consider seeking another opinion, perhaps of a veterinary dentist. I have anesthetized many, many older dogs for tooth removal, and my personal opinion is that removing diseased teeth is necessary. If Enzo has blood work prior to surgery, and possibly even a chest x-ray to check his heart and lungs, in the hands of a qualified veterinarian who is confident with anesthesia and dentistry he will likely do fine. If you don't have the tooth removed, your only other alternative is using antibiotics in a "pulse" fashion, such as 3 weeks on antibiotics, followed by 1 week off. Clindamycin is sometimes used in this fashion, but again, results are suboptimal and the infection within the root pocket will never completely resolve - it may improve, but it won't resolve.

It can be very scary to consider anesthesia in a dog with heart and kidney issues, for sure. But rotten teeth are also a very significant health issue. They become easily infected, and bacteria can get in the blood stream and will stick to areas that aren't functioning normally, like heart valves and kidneys. So by leaving the rotten, loose teeth in the mouth, you are at an increased risk of causing damage to the heart and kidneys. There are many precautions we take when considering anesthesia in these patients, but ultimately we do it to prolong their lives.

I'm sorry to hear that. Giving antibiotics will only be a temporary fix. If she has an abscessed tooth, it is because the tooth is the problem. I'm not sure why your veterinarian thought 8 years was too old, but perhaps Sadie has other medical problems I am not aware of. Antibiotics could temporarily help, but unfortunately, I would suspect once the antibiotics were stopped, it will open back up and start draining again. I recommend trying to save up, or searching online to see if there happens to be a low cost income based clinic in your area, so that the tooth can be removed. Thanks for using Petco Pet Education Center, formerly Petcoach.

I wouldn't say that you can rule out an abscess, on the contrary, if it got better after antibiotic treatment, it's likely to be a tooth abscess. the antibiotic may solve the problem but you cannot know in advance, you need to finish the antibiotic course and wait a few weeks to see if it comes back or not. if it comes back he will need a dental procedure, and by the way he is nowhere too old for anesthesia, a few weeks ago one of my oldest patients, a cat 23 years of age, went through a small procedure under general anesthesia without any issues.

Thanks for using Petco Pet Education Center, formerly Petcoach! This is certainly a somewhat common scenario unfortunately and it is important to make sure that the potential risks do not outweigh the benefits. That is why I can understand your veterinarian's concerns. Your veterinarian could consider a course of doxycycline or clindamycin antibiotic which are commonly used for dental disease as an important component of it is likely due to an infection. Also, it would be important to make sure that you clean her teeth regularly as that is likely going to help as well. Good luck and have a great day!

If Sid does have a tooth root abscess, he will likely need to have the tooth extracted. This will require anesthesia. At the same time, the rest of the teeth can be evaluated and xrayed and then cleaned to prevent or slow the progression of periodontal disease. Antibiotics alone may not be sufficient to resolve the condition. Even though he is a senior pet, a complete physical exam along with blood work will allow your veterinarian to tailor the anesthetic protocol for maximum safety. Medicating Sid without the advice of your veterinarian would not be recommended. Inappropriate antibiotic use may lead to resistant bacteria and may complicate any underlying condition.