We took Daisy to the MSPCA Angell-Memorial Hospital Veterinary Dental Clinic today to see one of the two board certfied dentists.
Daisy broke her molar and we wanted to find out the recommended treatment as well as assess her whole mouth as she is now 10 years old and due to very poor breeding has many medical problems including liver disease.
The grounds of the hospital are huge - it's like going to see a family member in a hospital. The place was very clean and the staff very nice, even though we were late due to rain, city traffic and accidents all over the place.
The dentist knew immediately all of Daisy's case - he had certainly done his homework and knew off the top of his head her various blood work results over time. I found him to be extremely knowledgeable about her liver disease, and about various anesthesia that could be used. He knew her medical history just as well as I did. So, right off the bat, I was totally at ease and felt completely comfortable there.
Treatment to remove the tooth is on hold while we repeat her blood work tomorrow and do bile acids testing, since her recent blood work of last week was so far off from her blood work of 3 months prior. Hemolysis was noted by the lab which could account for the readings being off. We just do not know if the blood work is "real" at this time, and because Daisy is doing so great clinically, everyone is perplexed.
As for the her mouth -- the dentist was first impressed that a 10 year old yorkie still had as many teeth as Daisy and that she had no periodontal disease or gum recession. Daisy got a compliment on her teeth and I was commended for good home care -- something that the dentist said was the #1 thing toward good dental health. As for the tooth in question - it must come out, she has a deep slab fracture and the pulp of the tooth is exposed. The tooth is hanging on by a thread of her gums. It could come out on its own, but it would be bloody and could become infected. It will abscess at some point and cause more problems.
We are able to hold off somewhat for the treatment while we get Daisy's blood work repeated, her bile acids information, and also restart her on Marin and Denosyl. The protocol for her pain management during the treatment depends on the liver results, but even if there is no change, they see many higher risk cases than hers and any risks to her will be minimized.
I feel like I can't do better than this for her. I am totally impressed. They do routine dental cleanings for all dogs - ill or well - so if you are in the Boston or New England area, this is the way to go hands down.
I'll keep everyone posted as to treatment and results as we move forward because this has been very interesting and I am certainly happy to share!
