Should a dog of 8 years of age receive anesthesia for a dental cleaning if the liver values are elevated -( possible cushings, not yet ruled out)
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Should a dog of 8 years of age receive anesthesia for a dental cleaning if the liver values are elevated -( possible cushings, not yet ruled out)
Thank You
Yes, if the enzyme elevations are only moderately elevated and only due to cushing’s disease. Unchecked dental disease can create another health dilemma for a pet if left unchecked such as discomfort, pain, and internal disease. However, I also perform pre and postfeeding bile acid levels to evaluate the liver function prior to anesthesia in these patients. Has cushing’s disease been definitively diagnosed in this patient? For anesthesia, bloodwork the day of the procedure is mandatory along with a protocol that does not utilize drugs metabolized primarily by the liver. An I.V. catheter and supportive fluid therapy would be mandatory for this patient while under anesthesia. Preanesthetic antibiotics may also be considered.
Hope that helps!
Joc Rawls, DVM
Banfield Pet Hospital
Peoria, AZ
If the dental treatment is needed, anesthesia is not as big a concern as untreated dental disease.
Phillip McHugh, DVM
Park Veterinary Hospital
Durham, NC
It depends upon the condition of the mouth. If there is lots of infection and tartar in the mouth, get it done. High liver values usually don’t mean anesthesia problems unless the bilirubin is high also. With Cushings, the ALT (SGPT) is usually about 5-10x as high as the high end of the normal ranger—it is usually Cushings when it is that high. Cushings doesn’t necessarily have to be treated unless you are seeing obvious signs of that condition. I generally recommend to go ahead and have the teeth cleaned due the infection that may be present. Antibiotic therapy is advised if your pet is immune-compromised for there is much infection present.
Larry Baker, DVM
The Northgate Pet Clinic
Decatur, IL
I would never use anesthesia in a dog or cat with elevated liver enzymes. Need to find the cause firstly, and then either use milk thistle or other antioxidants to bring the values down to normal. The most common reasons for elevated liver enzymes (with no other symptoms) are: excessive use of flea and tick products, environmental toxins, mold toxins in the food, chemicals in the food, dietary imbalances, and liver cancer.
Ihor Basko, DVM
All Creatures Great & Small
Kapaa, HI
You may want to invest in an non-anesthesia dental cleaning instead.
There must be one in your area.
Dyanna McCain, DIHom DVetHom
Holistic Animal Healing
Los Angeles, CA
I need more details about how to anesthetize patients with elevated liver enzymes to releive an urgent biliary obstruction.