Skip to content

Surgery Concerns

Katie
Guest

Hello –

My dog Henry, age 13 Shih-Poo, was first diagnosed with IMHA in 2019. He currently remains on 1/4 mycophenalate 500mg daily and 1 50 mg Atopica daily. During an X-Ray for something else, multiple bladder stones were discovered. He has no clinical symptoms and does not have a UTI. There are upwards of 20 stones in a clump, the largest appearing to be about 3 mm. Because bladder stones can turn into an emergency if they move into the urethra, surgery is recommended.

At the same time, his teeth are very much starting to bother him. He rubs his face frequently. One of his teeth near the front looks infected, and I know it needs to be addressed.

I am terrified that he will not survive surgery or that it will spark an IMHA episode again.

Should I request a dental and the bladder stones be completed at the same time or would that be too much on his body? Is it wise to proceed with the bladder stones first when they are currently not causing him or any problems or should we attempt a dental first? Will he survive either of these
procedures being on immunosuppressants or should I wean him off of them first?

As you can see I am spiraling with anxiety. Any advice would be appreciated for me and Henry.

Thank you!

Details
Vally
Keymaster

Hi Katie and Henry – Welcome.

I honestly don’t know. If the tooth looks infected, then that in itself is not a good thing and can start things again.

What are Henry’s bloods like? What is his PCV.

I had a growth on Bingo’s back removed. I was absolutely terrified, but he came through it fine. At that stage, he was only on a small maintenance dose of prednisone.

I understand how worried you are. The surgery for the stones sounds major. Is Henry under a specialist? Who would be doing the surgery?

I’ve emailed Patrice, the site owner, to get her imput. She is very knowledgeable about all this.

Regards, Vally

Details
Katie
Guest

Hi Vally. Thank you for your response.

Henry’s blood work is relatively normal. His last PCV was 45. It usually hovers between 40 and 46 depending on the day. He runs a high platelet count which is most likely due to the cyclosporine. Other than that, everything is normal.

Henry is seeing an internal medicine doctor for the bladder stones surgery and an anesthesiologist will be there as well. They are able to do it laparoscopically and that is scheduled for March 10.

I began inquiring about dentals last summer when I noticed he had bleeding gums after eating but was advised against it both by his general vet and his IMHA doctor. The general vet was concerned because at the time he was on Plavix (he is not anymore) and the IMHA doctor was concerned because of the amount of bacteria that can be released during the procedure as well as the antibiotics that are typically used. I spoke with his IMHA doctor recently and he said that if it was a quality of life issue, I may have to decide to move forward. Henry seems happy. He is eating and drinking normally. But I can’t imagine an abscess tooth isn’t causing him pain.

Anyway, thank you for reading.

Katie.

Details
Katie
Guest

Hi Vally –

Was there ever any follow up with Patrice about my questions? I’d love some advice.

Thank you!
Katie.

Details
Vally
Keymaster

Hi Katie, I’m so sorry, I thought I had posted a reply on her behalf as I remember she quickly emailed me. I’ve just gone through emails and found this. I should have passed this on to you. Again, I’m so sorry…

This is what Patrice said:

“13 is old even for a small dog. Anesthesia is harder on old and tiny dogs. There are senior protocols that are less risky, so the vet must be experienced.

If this were me i would do a complete cbc chem screen to evaluate. Then, if all is fairly good i would only do the teeth first, but making sure hes been on antibiotics prior to surgery. I would locate a board certified diplomate veterinary surgeon to perform the surgery. Let them determine how risky this is with him on these drugs. He may want to adjust them before surgery.

Teeth can be full of bacteria and that is infamous for releasing dangerous levels in the blood causing sepsis.

The stones are common in some male dogs and there are various drugs and diets that can help prevent new instances. But if there are no symptoms right now, just get on those treatments.”

Vally

Details
Viewing 5 posts - 1 through 5 (of 5 total)
Reply To: Surgery Concerns
Your information: