Anesthesia & intubation with laryngeal paralysis

[kudzu]

My girl, Sunita, is 13.5 yo and has laryngeal paralysis. She needs a dental. The dental seems essential to me, still elective but very needed. Somewhere in the back of my head is a caution about intubation in dogs with LP, like it is something to be avoided if at all possible. However, I do not remember why. There are some possible laryngeal related problems, like inflammation, that can occur after intubation. Presumably the consequences of such problem may be worse for a dog with LP. Still those risks seem less worrisome than those posed by not doing the dental work. And I keep reminding myself that intubation itself is actually a treatment for a severe LP crisis.

At her checkup last week, the vet mentioned a dental and immediately said it was okay for LP dogs. (Felt very much like he was reading my mind.) After doing some searching, I do not see anything to contradict this. The risks do not seem to be significantly elevated for LP dogs.  I will add that our first visit to this vet was on an emergency basis during a breathing crisis. They handled everything as well as regular or e-vet and their only a couple miles away. (Had previously avoided this practice but has new owner, vets and staff.) Our regular vet is 30 minutes away and the E-vet 15 mins minimum. Car rides stress Su and at this point the trip to the vet in itself triggers a breathing attack. So we have switched vet practices to have a 5 min ride instead. I know Su needs the dental and really want to believe what this vet is saying, but...  I guess skepticism and worry are my nature.

[greysmom]

No experience with LP, but it seems to me logical that there could be issues of some sort.

I would definitely have an in depth discussion about anesthesia protocols and how this vet plans to administer and monitor for the increased risk with your dog.  I would think malignant hypothermia would have to be something to seriously consider.  You also might talk about a course of antibiotics prior to the procedure to see of that helps at all.  If she wasn't so stressed, an "awake" procedure might be an option, but with how she reacts, putting her under may be the better course.  I would definitely talk about administering something at home prior to leaving for the appointment to keep her stress level as low as possible.

If she really needs a dental, I would probably suggest using a canine dentist rather than just a regular vet, but if you trust the vet you have - and like his answers - you should use him/her.  Because a filthy mouth or infected teeth can cause their own serious problems for our seniors.

[kudzu]

She is currently on antibiotics for a suspected tooth infection. There is a lump under her chin, along jaw line. It’s in an area where one lower tooth sticks out. Tooth has been that way for years, well before a prior dental, but the lump is new. She has a recheck in a week to see how that is doing. Right now the size is unchanged. She very much needs a dental cleaning anyway, but the infection is why I am so concerned. Besides the many other health implications of dental infections, I don’t want my girl to have toothache.

Sunita has been with me 10.5 years, longer than any other dog. She is starting to show her age, but I still hope she will be with us for a good while longer. She is petite & appears rather delicate but is a lot tougher than she looks. 

Getting old ain’t for wimps.

[MP_the4pack]

I had an lp dog. Diagnosed at age 11. We did the tiebacks surgery.  She made it to 15.5.

The intubation thing is that the doctors keep the tube in longer than normal.  The dog is way more awake when they remove it.  That's all. And always careful with vomiting. 

[macoduck]

Has she been put on Doxepin for the LP? Used it here for my one senior LP boy. Worked great but must be given every 12 hours forever.

[BatterseaBrindl]

Doxepin worked great for our Nigel as well.

[cleptogrey]

if you are going to do a dental you may as well do a tie-back. there always is a risk with anesthesia with a dog, especially an older dog. 

[tbhounds]

Intubation isn't the problem its extubation.  Dogs need to almost being chewing on that tube before its pulled.

[Shannon]

Always something to learn here on GreyTalk. THANK YOU! 

[kudzu]

The lump under her chin hasn’t changed. That tooth is now a little loose. It will have to go but will see at next recheck. 
 

We had more of a discussion about anesthesia procedures with LP dogs. Tbhounds, he actually said basically what you did. I laughed when he said “chewing”.
 

I’ve not decided about canine dentist. The ride to & fro, even with anxiety meds, might be asking a lot of her. It’s odd that we can hook up the trailer, load her in the van & it the road without much stress but drive around without the trailer & we have issues. Of course, if I tow the trailer to the dentist…  Can imagine the phone call, “Hello. My dog needs a dental with extractions. How big is your parking lot?”

[cleptogrey]

my late vet was really a renegade now that i think about it. our scottie had loose molars, due to years of predisone for his addison's disease. he gave him a mild sedative and just removed 3~ the dog had minimal bleeding since they were so loose and it was just a matter of not letting him frolic since he was so stoned. are you sure your regular vet can't handle the extraction?