Dear Dr. John,
Our 12-year-old Spaniel X is in good health according to our vet. Our vet does feel that his teeth need to be addressed. He has a fair amount of tartar and, as you might imagine, his breath is pretty offensive. His gums are very red which we were told suggests that he has gingivitis. To assess whether our dog would be a safe risk for anesthesia to have his teeth cleaned, our vet did a blood panel. What was found was an elevation of something called ALT at a level of 140. Apparently, this has something to do with his liver function and it might influence his tolerance for general anesthesia. Would you proceed with a dental cleaning given the findings? What can be done for the gingivitis since the cleaning probably won’t get rid of that? N.M.
Dear N.M.,
What does your veterinarian think? ALT is a liver specific enzyme and I have written recent columns about risks associated with various elevations in certain blood values. Depending on the lab values that one uses to be considered normal, ALT at the upper end of normal is between 120 and 130 in dogs. As with many blood parameters, levels often go up with older age. Since your dog is now 12, I do not consider a value of 140 to be excessively high but I would limit the use of any drugs that might compromise the liver, namely the use of NSAIDs.
One must always weigh out the risks and benefits and I would think that given how he is now, I would likely proceed. One could consider using supplements that promote liver health as well and probably recheck the liver values a few months after the anesthetic procedure. The dental cleaning will be somewhat helpful in cleaning off some of the bacteria associated with the tartar and plaque, which can cause some of the gingivitis. After the procedure, I am sure that your veterinarian will suggest regular brushing of the teeth and the gums (gingiva) to improve the oral health. Hopefully, the cleaning will improve his breath, his oral and thereby overall health, and start to get rid of the gingivitis.
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.
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