Poppy, the little 11-year-old Cavalier King Charles spaniel is absolutely adored by her human family and everyone who has the pleasure of meeting her! Her warm personality and big puppy dog eyes are irresistible. Poppy’s family have always taken the best care of their little fluffy family member in every way they can; getting out for her daily walks, being careful not to feed her too many treats (despite how cute she is!), and staying on top of her vaccination, worming and health checks at her local veterinary clinic.
With COVID, the rush back to work, and just life in general, however, along with many pets, Poppy missed a couple of years of her health checks. Poppy’s owner, Adele, knew that a lot can change in our dogs as they get older. So she booked her to restart her vaccinations and have a general health check to help identify any hidden niggles Poppy might have.
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At the vet clinic
After a quick greeting from the friendly receptionist, Poppy and Adele had their consultation with their vet. The vet commented on what a good body condition score Poppy had. And how important this is to help control conditions such as arthritis as dogs get older. The vet assessed that Poppy was fit for her vaccinations on that day. And they explained that to ensure she had the best immunity cover possible, she could have one vaccination today and a top-up vaccination in a couple of weeks. The vet also had a couple of other things to discuss with Poppy’s owner.
A heart murmur
Poppy had a slight heart murmur on the left side of her chest when the vet listened (also called auscultating) to Poppy’s heart with a stethoscope. The vet explained that this wasn’t anything that Poppy’s owner had done wrong to cause this. Heart murmurs are very common in small dogs as they get older. The best thing to do would be to have some further investigation, using an ultrasound of Poppy’s heart.
The vet explained that Cavalier King Charles Spaniels have a gene that makes them more likely to develop a heart disease called Mitral Valve Disease (MVD). This means that instead of the valves in the heart forming a nice tight seal when the heart pumps, the valves (the gates in the heart) are shorter and thicker than they should be. Therefore this can cause some leaking of blood back into the heart when it should be pumped out to the rest of the body. The vet explained that this condition cannot be cured, but it can be managed. And the progress of the disease can be slowed down with medication. This allows most pets with MVD to continue to live happy lives for many years.
The vet also advised that Poppy has quite a bit of dental disease including some rotten and wobbly teeth. She would benefit from getting a dental procedure to fix this.
A plan for Poppy
This was quite a bit for Poppy’s owner to take in. She was upset that Poppy might have something wrong with her heart and that her teeth might be sore; even though she had been eating normally at home. The vet explained that the vast majority of dogs with very painful teeth will still eat normally. This is because it is a survival instinct. The vet came up with a suggested plan for Poppy. Adele felt reassured that Poppy was in the best hands possible to get the veterinary care she needed. Poppy’s owner was also glad that the vet had brought up about getting Poppy’s teeth taken care of; her children had been complaining about Poppy having “a really smelly breath!” for several months now.
The vet explained that the best course of action would be to get Poppy booked in for an ultrasound of her heart the following week. This ultrasound would help stage Poppy’s heart disease. And identify whether she needed to start on any medications to control the progression of the heart disease. They could then discuss getting Poppy in for a dental procedure to get her smelly breath and sore teeth taken care of. In the meantime, the vet recommended softening Poppy’s food with some warm water, so it was easier for her to eat.
What about the costs?
Poppy’s owner raised concerns about the cost of medical care, especially if Poppy might need ongoing medication for her heart. The veterinary team got her booked in the next day to chat with one of the clinic’s Customer Care Advisors; who explained that Poppy was recorded as being insured. Poppy’s owner confirmed that she still had an active insurance policy for Poppy and when they checked the insurance policy details, Poppy’s insurance covered diagnostics (such as ultrasound and x-rays), dental procedures, and lifelong medication.
The Customer Care Advisor helped Poppy’s owner to fill in a pre-authorization form for her heart ultrasound and dental procedure, while Poppy’s owner breathed a big sigh of relief! While not all insurance policies cover dental work, Poppy’s owner vaguely recalled ticking the box, even though it had increased the premium…
Investigative tests
Poppy had her heart ultrasound a couple of days later. The scan revealed that Poppy had only mild heart disease which currently did not need medication to manage. The vet recommended that Poppy have a repeat ultrasound in 6 months’ time to check for any changes. The vet advised that they would be happy for Poppy to go ahead with getting a dental procedure done. They gave Poppy’s owner an estimate for the cost of dental treatment.
Extra precautions
Even though Poppy’s heart disease was currently mild, Poppy’s owner was still understandably worried about her undergoing general anaesthesia for her dental procedure. Poppy’s vet explained that although all general anaesthesia carries some risk, Poppy would be monitored at all times throughout the procedure by the clinic’s Registered Veterinary Nurse (RVN). And local anaesthesia blocks (numbing injections) could be used for extraction of teeth; helping reduce the amount of general anaesthesia drugs Poppy would need. The vet also discussed how beneficial dental procedures are, especially for dogs with heart disease. This is because the same bacteria that is present under the gums in dental disease can also travel in the bloodstream and cause endocarditis. (An infection in the heart that can be dangerous on its own, but even more dangerous if there is pre-existing heart disease such as MVD).
To help make the procedure even safer, Poppy’s vet advised that they would like to carry out a blood test to check Poppy’s kidney and liver function before the procedure. The vet explained that this would help ensure that the anaesthesia drugs that Poppy was given could be properly broken down by her body and then excreted in her urine by her kidneys. Poppy’s owner was happy with this plan and got Poppy booked in for her blood test.
When Poppy’s blood test came back to show that she had normal kidney and liver function, Poppy’s owner was delighted! Poppy was booked in for her dental procedure the next day.
Poppy’s dental procedure
It was an anxious wait for Poppy’s owner after she dropped Poppy off at the hospital that morning for her dental procedure. The vet had advised that it was really difficult to say exactly how much dental work Poppy might need until they were able to assess her full mouth under general anaesthesia and take x-rays of her teeth to check which teeth needed to be extracted. Poppy’s owner kept her phone on loud mode for the entire morning; the vet had explained that they would give her a phone call during the procedure to advise of how many extractions Poppy would need, and an updated estimate of costs. Poppy’s owner was also reassured when the vet explained that if there were any concerns at all with Poppy’s anaesthesia, they would bring her straight around to recovery.
When the phone call came, the vet advised that Poppy had three broken teeth which were extremely painful. And she would need fourteen teeth out in total! The vet discussed that Poppy’s anaesthesia was going smoothly so far; the Registered Veterinary Nurse was happy with how she was responding to the drugs. Poppy’s owner consented to the vet and RVN to go ahead with the procedure.
Time to go home
When Poppy’s owner came to collect her from the vet clinic that evening, she was shocked at what good form Poppy was in! She bounded out to greet her family. The RVN discussed the treatment plan for Poppy for the next week. Poppy had some pain relief medication to go home with. The RVN explained how to give this to Poppy each day. The RVN explained that it would be best to continue to soften Poppy’s food for the next ten days. This was because Poppy had some stitches in her gums from where her rotten, sore teeth had been extracted. And the surgery sites needed to heal before she could move to regular dry food. The RVN also booked Poppy in for a post-dental check in two days’ time and then a week’s time to make sure everything was healing nicely and there were no complications.
Poppy’s recovery
In happy news, Poppy recovered really well from her procedure! A couple of weeks after her dental procedure, Poppy’s family noticed that she started playing with toys that she had ignored for years. And she even started to play tug of war again with her rope toy. Poppy now gets her teeth brushed every day to help keep on top of her dental hygiene. And she is booked in for a follow-up heart ultrasound in six months’ time to keep an eye on her heart disease. Poppy’s family are really delighted with the outcome. They are also really delighted that they could claim back Poppy’s treatment through her insurance policy!
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