Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - my dog needs a dental

My dog "Katie" started this dreaded disease 11 months to date and is on Cyclosporine 10mg twice a week and nothing else. She is 12 yrs old and she needs a dental very bad with about 4 teeth pulled. Anyone here ever had a dental done? I am really afraid she may relapse. I have an appt with a veterinary dentist Tuesday to see what his opinion is. I would like someone to tell me maybe if i should give her Pred a few days before or Cyclo maybe everyday for a few days before and after. I have no idea what to do or if he even knows. My regular vet won't touch her because of the anestesia. Any help would be appreciated. Thank you.

Lynn Florida

find someone who does not put them under, especially at her age. there are plenty of people who clean teeth without using anesthesia that would be the most important thing i would think.

josh california

Wylie who is 11 had her spleen removed 2 months ago and came through the anethesia with flying colors. Now Jake my 11 year old lab had 3 molars pulled in January and was in a lot of pain and groggy for the first few days. Here Wylie had major surgery and I picked her up after 24 hours and you would never had thought she had surgery. Jake was in the same amount of time and we could barely get him home, I was worried. I dont know if it was the pain meds or what so I would be concerned. I know they had difficulity getting the teeth out. I think he was in surgery for over 2 hours. Because he also had eye surgery and he was fine with the anethesia so I really think it was the teeth pulling that gave him so much grief But what to you do, Wylie also has a bad fang they have been wanting to pull but didnt want to do it with the spleen, because they call anything with the teeth dirty surgery. and dont want to do it with a clean surgery like the spleen. And now having seen what Jake whent thru with his teeth pulling, I dont want to have that fang pulled because its just as invasive as when Jake had his molars pulled. Laurie

Laurie CA

I want to elaborate more. When Jake had his tteth pulled my vet got pulled to an emergency and had his other vet do it. She is young so I dont know if she had the experience under her belt to handle Jakes teeth because I do know my vet had to be called in. So I think seeing a dental specialized is a good idea. Again as for the anasthesia. I discussed this at length with my vet and he assure med he was only using very little and for as short as possible. She was standing up and eating abut 4 hours after her splenectomy. So discuess with the dental vet if he has experience with AIHA. what the scope of the surgery would entail and minimal anasthesia Laurie

Laurie CA

oh wow, i just realized you said she needed TEETH PULLED!!! i thought you just meant a teeth cleaning, i apologize for not reading more closely :/

josh california

The real danger of any kind of dental surgery, for humans as well as dogs, is the release of potentially dangerous bacteria into the body. Folks who have had heart surgeries for instance are required to take prophylactic antibiotics prior to any dental surgeries. If these teeth that need to be removed are in pockets full of bacteria the risks could be very high for bacterial infections. Also, being on immunosuppressive medications like cyclosporine further compromises the immune system. Now, anesthesia does certainly have it's dangers, but Laurie is right that vets do use less dangerous meds now, in most cases. Chance had to have a little biopsy a few months ago and Dr. C assured me that she could bag him without real problems. He was fine. He was also fine when they removed his spleen a year ago on a "mix." He recovered in about an hour and was eager to get up and pee after that. He walked to the car to go home! Certainly not all dogs experience the same ease. Talk with the vet about prophylactic antibiotics prior to any absolutely necessary tooth extraction. Patrice

Patrice NYS

Thank you all. I talked on the phone to the dental vet specialist today and he is going to talk to a vet he knows at U of Florida that is an internist. He said he would use NO drugs just ISO gas and mask her down. She is 5# and these teeth are very loose so probably will just fall out if he pulls alittle. No drilling, etc. Next week after he talks to him and also to my Internal medicine vet he will look at Katies teeth. He did say I could be there and hold her and he will try first to pull them with no gas. At least he is willing to try that. I am able to brush her teeth and get most of the tartar off. I would like a good dental but if all we can do is get the teeth pulled, that is the most important. I will ask about the antibiotics first. Are there some that she should NOT take? I read somewhere sulfa drugs were bad and there were a few more. Lynn

Lynn Florida

Lynn, Stay away from any poteniated sulfominides. Dr. Dodds recommends either Clavamox or Baytril for antibiotitcs. Penny

Penny Lytle Creek Calif

I would ask about the cyclosporine. Patrice mentioned cylcosporine, I did not know it was an immune suppresent. When Wylie had her surgery, the vet wanted her off prednizone for 2 weeks before, so we did a fast weaning off so she was pretty clear and then she went back on right after her surgery so something to definately ask about. I think antibiotics is a must (my personal opinion) for any kind of dental work . Lynn, regarding antibiotics, this is just my experience , Wylie had many possible factors to her cause of AIHA and one was the amoxxilicin family. she was put on a different antibiotic and I dont remember the name. So I would ask about the cyclosporine, again I have no clue but ask. Wylies hematoctrit was 40 at surgery down to 34 and now up 38-40 range, good luck Laurie

Laurie CA

Lynn, Lindy, age 10, was on Azathioprine 25 mg eod last year and had to have 12 teeth pulled! As for anasthesia, she had a very light dose. When I went to pick her up she was her usual perky self. My only request was that she not be given any nsaids. They did not give her any antibiotics and her specialist was okay with that. She did fine and this year had another cleaning and now has two loose molars. She doesn't have enough teeth left to chew on rawhide treats, so that has me worried. Anyway, I wish Katie the best getting through this dental ordeal! Let us know how she does. Nancy and Lindy

Nancy CO

Thank you all for your comments. I contacted Dr. Dobbs and she told me NOT to give antibiotics unless there is a high WBC on the blood work and to use only ISO as the gas with no other drugs.Katies bloodwork came back with her PCV at 39% which I am very happy about. Everything else is in normal range except the T4( thyroid) is .7 which is alittle low. Does anyone have a problem with thyroid? When she was very sick last year her T4 was .2 and the specialist said it goes with the disease and not to treat her. She has been at 1.4 until now.Going to see the dentist today so hope he will say yes to Katies dental. Lynn

Lynn Florida

Lynn, Over the years I have seen lots and lots of dogs who have AIHA/IMHA who also have low thyroid function or hypothyroidism including my own Meisha. We did treat Meisha for her low thyroid function and so have most of those others. If you read the Success Stories at the Meisha's Hope AIHA/IMHA Web site: http://www.cloudnet.com/~jdickson/successstories.htm you will see that many of these dogs are on thyroid medication. The Textbook of Veterinary Internal Medicine says and I quote: "The association of IMHA with other immune disorders including hypothyroidism and immune mediated thrombocytopenia (ITP) lends support to the hypothesis of general immune disturbance” end of quote.

Joanne MN

I just called the vet and they requested the lab to do a free-T4 with the serum from yesterday. They said that test will give us a better idea if the thryoid is really a problem? thanks. Lynn

Lynn Florida

Lynn, My non-IMHA dog suffers from hypothyroidism. It was diagnosed after he began having seizures. Thought it was epilepsy, but ultimately it came down to hypothyroidism. You are wise in treating prior to seizures. Ann Marie

Ann Marie FL

Lynn- if her thyroid results came back wacked then you might want to mention it to dr. dodds because she is a big advocate for making sure those levels stay intact... she might suggest putting katie on SOLOXINE which will help in that area. My sway has been on it for almost 7-8 months now.

josh california

This thread was discussed between 17/07/2008 and 22/07/2008

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