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Dr. Scarlett
Dr. Scarlett, Dog Veterinarian
Category: Dog
Satisfied Customers: 4110
Experience:  I am a practicing small animal veterinarian with 18 years experience.
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My 12.5 year old Scottiedog has developed really smelly breath!!!

Resolved Question:

My 12.5 year old Scottiedog has developed really smelly breath!!! We are aware he has raised liver enzymes - discovered 3 year years ago on routine pre-op screening for dental work. Checked two years later - still raised but no worse than first tests. No hepatic or renal symptomatology. So not convinced it is gastric in origin... I am guessing the cause maybe dental and/or gum disease but realise to get a look an anaesthetic would be needed. That scares me ... He is elderly but still active - engaged - loves his food - I fear the anasthaetic... But would the vet recommend that course of action in an elderly dog? Is there anything else I can do ?
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Scarlett replied 3 years ago.

Dr. Scarlett :

Hi,

Dr. Scarlett :

Older dogs can develop benign nodules in their liver that can cause the liver enzymes to increase a bit. Dental disease can also cause elevations. So if other testing to rule out things like Cushing's disease, diabetes, etc were all normal, I wouldn't be too worried about anesthesia.

Dr. Scarlett :

Dental disease, and all the bacteria that gets into the blood stream, can cause a dog to feel pretty poorly. So you do need to weigh that possibliity against the risk of anesthesia in an older dog.

Dr. Scarlett :

But 12.5 yrs in a Scottie isn't extremely old. If Archie is otherwise doing well, I would certainly recommend a dental cleaning if he needed it. I would do pre-anesthetic bloodwork to recheck the liver as well as look at kidneys, complete blood count, electrolytes, etc. I give all my patients under anesthesia IV fluids during the procedure to keep them from getting dehydrated. Depending on his mouth, I might start him on antibiotics prior to the dental procedure, to decrease the amount of bacteria.

Dr. Scarlett :

The other thing about those liver enzymes--Scotties are known to have higher alkaline phosphatase values normally than other dogs. So Archie's liver may be perfectly normal!

Customer: As a nurse - and in my heart - I think I know what I need to do - and stop putting if off because of this anasthaetic fear!!! All the time my little companion is to all intents and purposes OK .. I suppose I am reluctant to be the instigator of possibly losing him prematurely by my action! It will be bad enough when his time comes without the guilt of thinking I am the cause. But common sense tells me that to do nothing is equally putting him at risk!! I appreciate vocalising this issue with you - it has helped me to hear your relative unconcern re: anasthaesia in the older dog - I think I need to trust our vet's skills!!!! I understand your standpoint on the issue and he would need bloods done which would further inform the decision ... Poor chap - he hates the vets - and the groomer - he gets really nervous!!!!
Customer: Yes ... After my initial 'OMG - he's got raised liver enzymes
Customer: Sorry- pressed wrong button!! I was going to say -after the initial worry - I did some internet research and came up with some fascinating studies and literature on Scotties and their liver enzymes!!! Which was reassuring to say the least!!!
Dr. Scarlett :

Yes, I had one Scottie patient with deplorable teeth. I diagnosed him with a stomatitis and managed it with chronic metronidazole antibiotics and the occasional teeth cleaning. The owner also brushed his teeth daily, which helped. But his liver enzymes were always high, prompting me to do some research. So I suspect Archie is just a normal Scottie!

Dr. Scarlett :

You might ask your vet about giving him something like alprazolam prior to the vet visit (or groomers) to help decrease his anxiety.

Customer: Bless you!!! Unfortunately I have not been a good 'Scottie Mum' re teeth cleaning - I have tried but he wins every time
Customer: Oh! Goodness - done it again - pressed the return key!! He came into my life as a 9 month old rescue - and I had never had a dog before - consequently - he rules me with a rod of iron!!!! I suspect he will have to have a few out too - which won't help me get into his mouth in the future!!!
Customer: Never thought to ask for medication - mind you the vet has seen how shakey he gets when we go and not suggested giving him anything ...but he does it when we shower/bath him too!! Guessing he's just anti being interfered with!!! But I don't like to see him so tremorous - I will explore with our vet ...
Dr. Scarlett :

If he has overall anxiety, I would ask about using something daily/long-term--maybe prozac or similar.

Customer: Hmm!! But in every other way he is quite an assertive - if stubborn - character named by our neighbours as King Archie for his ponderous and regal bearing!!!
Dr. Scarlett :

Well, they can be both assertive and have anxiety. Scotties are a stubborn lot! At least worth discussing with your vet. Maybe see how the alprazolam does short-term and if that seems to help him overall. You can always start on something long-term.

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