Any ideas on what is going on with Mogee's tooth?

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Adam Flowers

Adam Flowers

Member Since 2017
Mogee's numbers have been a bit higher than normal lately and I was starting to wonder if it was related to his teeth.

I looked them over really well tonight and this is what I found. The picture below shows a tooth with redness around it. I tried to touch it and it seems loose, almost as if it could fall out. The gum around it seems really irritated as well and raw.

I am obviously going to make an appointment first thing when my vet opens tomorrow but for the sake of me possibly getting any rest and not worrying all night, does this look familiar to anyone? What should I be concerned about?

The last time his teeth were looked over by my vet she said they looked good. That was about 6 months ago. He was already missing the bottom middle when this happened.
 

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Adam Flowers said:
Mogee's numbers have been a bit higher than normal lately and I was starting to wonder if it was related to his teeth.

I looked them over really well tonight and this is what I found. The picture below shows a tooth with redness around it. I tried to touch it and it seems loose, almost as if it could fall out. The gum around it seems really irritated as well and raw.

I am obviously going to make an appointment first thing when my vet opens tomorrow but for the sake of me possibly getting any rest and not worrying all night, does this look familiar to anyone? What should I be concerned about?

The last time his teeth were looked over by my vet she said they looked good. That was about 6 months ago. He was already missing the bottom middle when this happened.
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Yes Mogee's numbers could be driven up by an infected tooth. (Just about any infection can drive BG #s up) And certainly that is a compromised tooth as evidenced by the redness of the gum and looseness of the tooth. Many times cats teeth will decay below the gum line so just a quick look the decay isn't seen. Generally during cleaning they get a bit below the gum line and with the cat out they can do closer inspection. Sketch had several teeth that were decayed below the gum line that needed extracting. But outside of slight redness on the gum the tooth looked fine...the vet noted even with being out for a cleaning Sketch would react to contact on one tooth.
You are doing the right thing getting Mogee's in asap to at least address the pictured tooth....they may get him started on some antibiotics to knock the infection down then schedule the cleaning and extraction.
Hope you can get Mogee's appt early and get him on the way to minty fresh breath and pearly whites.
 
Tooth resorption is not uncommon in cats. (They used to call it feline odontoclastic resorptive lesion (FORL).) So, it could be that. It is painful and would very likely cause an increase in BG. I would suggest x-rays. If there is an issue that you can see with a tooth there may be more issues under the gum line that you cannot see. Willow was diagnosed with FORLs back probably 9 years ago or so. She had several teeth removed back then and had to have several more removed in August of 2017. In August of this year, she had to have both top canines removed, and one of them was bad. All you could see on the outside was a tiny - and I mean tiny - red spot on her gums (in this case, it wasn't at the gum line but higher). The Dental Specialist said it was really, really bad. It had abscessed and gone up into her nasal passage. In the x-rays from the year before, that tooth was fine. So, these things can sometimes come on and progress rapidly.

Let us know how things go.
 
I say a dental is required.
The red inflammation of the gum is around an incisor tooth. Worse yet it looks like the adjacent canine tooth has thinning (reabsorption) at the gumline and that canine may have to be extracted.
 
I agree, this looks like feline resorptive lesion. My other kitty, Oliver, had a tooth that looked similar (my vet caught it in his wellness exam). After a full dental exam, it ended up he needed all of his teeth except the tiny front teeth removed. I think he feels a lot better and it hasn't slowed him down a bit. Good catch finding this and I hope Mogee is feeling much better very soon :)
 
Hey everyone, thank you for your input and advice! Mogee and I always appreciate it!

Mogee saw the vet this past Friday morning and he has some gingivitis going on. The tooth in question was pulled and he was put on an antibiotic, ZydaClin.

He is having some pretty bad diarrhea from it, and I called today and they said to stop giving it for a day, and reduced the dose, as he could be having a reaction to it. Many had suggested a probiotic and I plan on picking one up after work today.

As many of you mentioned and so did the vet, Mogee does need a dental. He is scheduled to have it done a week from tomorrow, Tuesday the 23rd.

Other than that the vet believes he looks great.

Obviously, I am worried about the dental. My vet did mention that I should take his food away at midnight the night before. Mogee is scheduled to be there at 730 AM.

The one main thing that worries me is that the vet recommended giving him half his normal dose that morning but not feeding him. I should NOT give him any insulin if he doesn't get food, right? Please let me know. Other than that, anything else I should be ready for when it comes to his dental?

Thanks guys!
 

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Are they doing x-rays? They are so important, and 'regular vets' do not always do them as part of a dental cleaning. So, I would suggest making sure they are doing them.

I recall being instructed to and giving Mia half her dose the morning of her dental procedure.
 
FurBabiesMama said:
Are they doing x-rays? They are so important, and 'regular vets' do not always do them as part of a dental cleaning. So, I would suggest making sure they are doing them.

I recall being instructed to and giving Mia half her dose the morning of her dental procedure.
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This is what I was worried about as well. I was told the same thing in this group already about the Xrays, about how important they are.

So here is the catch..

Mogee's current vet does not have the capabilities of doing them.

Which means, I have to find an office where I am (Lincoln, Nebraska) that can do them, which I have been calling all day, before his cleaning the 23rd. Or I have to cancel it. And the last thing I want to do is prolong the cleaning.

His vet tried to reassure me that he didn't need them and I wouldn't know any better if it wasn't for all of you wonderful people. But it obviously makes sense, you cannot tell what is really going on under without them.

So I'm stuck unless anyone has any ideas?

What else should I MAKE SURE they do? I know I am having them do the pre OP bloodwork and they are using injection anesthesia...

And I should give the half dose of insulin in the AM even without food?
 
I have talked to a few places over my lunch break that do the xrays. It just stinks as I have to have his teeth cleaned AT the place that does the xrays, as they do them once he is sedated.

It's hard for me to drop him off somewhere we've never been, with people that I don't really know. Wish there was a way to get the xrays done and then the cleaning at my vet.

Always something. But you know I will do anything I have to do for Mogee. Thanks for the help.
 
Here is an old thread that you may want to read through: http://www.felinediabetes.com/FDMB/threads/teeth-cleaning-and-diabetic-cat.186827/#post-2074387 There are links within to articles with info on this topic.

I gave Mia 1/2 of her dose as the Dental Specialist told me to before her dental procedure.

Besides the x-rays and type of anesthesia, monitoring is the other important thing. Find out what monitoring will be done during the procedure. (One of the things they should be monitoring is his glucose. If he goes too low, they can intervene.)
 
There's no point in having clean teeth if they still hurt. So I understand the importance of the xrays

Just hate switching to another office.
 
Adam Flowers said:
I have talked to a few places over my lunch break that do the xrays. It just stinks as I have to have his teeth cleaned AT the place that does the xrays, as they do them once he is sedated.

It's hard for me to drop him off somewhere we've never been, with people that I don't really know. Wish there was a way to get the xrays done and then the cleaning at my vet.
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Here is my personal unfiltered opinion on this... I would not let a place that does not even have the capabilities to do dental x-rays do any dental work on my cats. What else do they not have or not do up to a high standard? If possible, go to a specialist. They normally have better training, experience, equipment and methods.
 
I just checked the AVDC directory (https://www.avdc-dms.org/dms/list/diplomates-map.cfm) and there are no board-certified dentists there. Sorry. I would say that if a place does the x-rays, they are a better bet than a place that does not, so maybe that will just have to be a big indicator for you. Once you get satisfactory answers on the other items, you will know you are in a good place.

I wish you and Mogee the best!
 
FurBabiesMama said:
Here is my personal unfiltered opinion on this... I would not let a place that does not even have the capabilities to do dental x-rays do any dental work on my cats. What else do they not have or not do up to a high standard? If possible, go to a specialist. They normally have better training, experience, equipment and methods.
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I can agree with you on the xrays.

You, out of most, should know how hard it has been for me to find a vet that knows what they're doing. I was shocked when they said they didn't do the xrays, honestly. Everything else has been great.

I plan on cancelling the scheduled dental with his current vet based on the xrays alone. Cost isn't an issue. Finding someone who will do the checklist everyone states is.

Time is the issue. Thanks for the help. I'll keep you updated
 
Adam Flowers said:
I can agree with you on the xrays.

You, out of most, should know how hard it has been for me to find a vet that knows what they're doing. I was shocked when they said they didn't do the xrays, honestly. Everything else has been great.

I plan on cancelling the scheduled dental with his current vet based on the xrays alone. Cost isn't an issue. Finding someone who will do the checklist everyone states is.

Time is the issue. Thanks for the help. I'll keep you updated
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Hey Adam, on another related note make sure with the diarrhea that Mogee is staying hydrated! You might check on reducing the dose possibly and of course a probiotic. Now I don't know if it holds true for cats but there are studies in humans that a standard bacterial based probiotic is not very effective against the diarreha issue caused by antibiotics because the antibiotic still kills the bacteria from the probiotic. The more effective yeast based (since not bacterial based the antibiotic doesn't kill it off) probiotic for humans is Saccharomyces boulardii. I haven't found if its safe for cats or if any pet probiotics contain it. You might inquire with your vet.
As to the half dose question, when Sketch had his dental work they did have me take away food at midnight and half dose his insulin...they also monitored him before, during and after the procedure. They suggested to save a few dollars and since they use the same meter that if I wanted to bring my test strips in they wouldn't have to charge me. you might check and see if thats a possibility for you (saved like 25.00)
Hope Mogee is feeling better at least with the one infected tooth gone...have his BG numbers come back down?
 
Adam Flowers said:
And I should give the half dose of insulin in the AM even without food?
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Most of the latest information I see on doing dentals in diabetics recommend a small meal in the morning with half dose of insulin and have the dental scheduled for as early as possible. They should be sure to check his glucose before, during and after and you should take food with you so they can offer it to him afterwards if he'll eat.

Have some meat-only baby foods at home in case his mouth is sore for a few days.

Make sure they give you something for pain like buprenorphine.
 
Jeff D / Sketch said:
Hey Adam, on another related note make sure with the diarrhea that Mogee is staying hydrated! You might check on reducing the dose possibly and of course a probiotic. Now I don't know if it holds true for cats but there are studies in humans that a standard bacterial based probiotic is not very effective against the diarreha issue caused by antibiotics because the antibiotic still kills the bacteria from the probiotic. The more effective yeast based (since not bacterial based the antibiotic doesn't kill it off) probiotic for humans is Saccharomyces boulardii. I haven't found if its safe for cats or if any pet probiotics contain it. You might inquire with your vet.
As to the half dose question, when Sketch had his dental work they did have me take away food at midnight and half dose his insulin...they also monitored him before, during and after the procedure. They suggested to save a few dollars and since they use the same meter that if I wanted to bring my test strips in they wouldn't have to charge me. you might check and see if thats a possibility for you (saved like 25.00)
Hope Mogee is feeling better at least with the one infected tooth gone...have his BG numbers come back down?
Click to expand...

When I called about the diarrhea, they said to take him off the prescription for a day and then try again with half the amount they had originally prescribed. Not sure how that works or if that is good advice? His stool is still loose but nowhere near almost water like it was Sunday night and yesterday morning. He seems to be drinking normal.

As for his numbers, they still are high 100s to lower 200s ar nadir, which I know many would love to see, but he was down near 100 at nadir regularly a couple months ago.

After posting yesterday, there are many things I still need to get etched out by my vet. There was a lot brought up by you guys that I really didn't think about when I scheduled the cleaning. I definitely want to make sure they are monitoring him throughout.

I plan on calling them tomorrow, as planned, with an update on Mogee and his stools. I will ask them all the questions regarding stuff that has been mentioned to me.

Really, I'm extremely overwhelmed. Not nearly as bad as when he was diagnosed but close. Just worried something will go wrong. Next Tuesday is going to be a hard day for us.
 
UPDATE:

I worked with Mogee's current vet and found an office here where we live that is going to do his dental. I chose to have it done at this place, as I always listen to you guys (as I feel Mogee would not be here today still, if it weren't for all of you) because they do xrays! :)

I meet with them this coming Saturday morning for the dental consultation. I spoke with then twice now on the phone and this is what I have gathered thus far:

(PLEASE TELL ME WHAT ELSE I NEED TO ASK ABOUT, AND IF YOU SEE ANY MAJOR "NO-NO'S")

* Take away food at midnight the night before
* Give half his normal dose of insulin at his normal AM time
* Do NOT feed
* Anesthesia they use is Propofol (injection) - never marked during procedure
* Isoflorene will also be used to maintain anesthesia
* Will be hooked up to monitor during procedure
* Xrays will be done
* Will have catheter and IV (they said due to age?)

As mentioned, our consultation is Saturday. I have already touched base with them about me wanting him tested during to make sure he doesn't go low. @Chris & China I also asked about the buprenorphine as you mentioned. They did say that they will contact me after the dental to let me know how it goes and around what time I can pick up.

Do you guys have any other good questions I should ask or any other advice?

I am sure with him not eating in the AM that he is going to be starving by the time he is done. Should I ask about bringing his food along?

And what about if pick up time gets too close to his PM injection? What if he is still out of it by that time? Or uninterested in food? This is my first experience with a dental. Do they usually come to pretty fast or does it take a while for the anesthesia to wear off? I'm pretty sure when Mogee was fixed, it took him all day to be really alert.

Thanks again everyone and please let me know what else to expect or ask!
 
Anytime my girls have had dental procedures, I have been told not to feed them until that evening, so there was no need for me to take food. And they both ate well that evening. (I'm sure due to being really, really hungry!) I was told to give Mia 1/2 of her dose both in the AM before the procedure and in the PM of that day. I have always taken them in first thing, 8/8:30am, and they were the first procedure for the day. I just checked old texts I have from when I took Willow last year, and the doctor's assistant sent me a note at 9:45 letting me know they were cleaning her teeth, and she was doing well under sedation. I got another text at 11:39am with a photo of her awake and wrapped in a warm blanket. She had ended up having extractions, too, so it was more than just a cleaning. I was able to pick her up about 2:30/2:45pm which has been the case every time I have taken one of them in. They were definitely drugged up when they came home. I was given an anti-inflammatory (Onsior, I believe) and pain medicine (bupe) to give for a few days after. (If an antibiotic was necessary/given, I was given Cerenia in case there ended up being an nausea from it).

Sorry, but I do not remember the names of the anesthesia drugs used, but I know there were two, and the doctor explained that they had the ability to reverse them right away if there were issues (by giving another drug, I think). They use monitor equipment and have a person visually monitoring throughout. For Mia, they kept a check on her glucose levels and had dextrose available if needed (she never went too low, so it was never needed). They also put them on an IV to give fluids. My girls are stressed by going to the vet, especially Mia, she is completely terrified. So, the vet gives them something to help them stay calm (I think maybe gabapentin) right away and takes them to a quiet area to wait until the procedure. I really appreciate that because it makes me feel a tiny bit less horrible about leaving my babies there. The vet also has his assistant call me during the procedure if they find anything they need to do like extractions (which has always been the case), and he even gets on the phone briefly to make sure I know what's up and what he recommends and he gets my ok to proceed. Ummmmm… that's everything that comes to mind right now. Oh, just thought of one thing... if you don't know, I just want to forewarn you that they will have to shave part of one of his legs for the monitor during sedation.

It is hard to leave your baby there, and it is hard to see them look so pitiful when they first come home, but it is worth it. It will be okay. My experiences have always involved extraction, but maybe you will get by with just a cleaning.
 
Propofol is used via IV for induction, that is to initially anesthetize the cate so that the endotracheal tube can be inserted down the throat. That tube is used to administer the gas anesthesia (isoflurane in this case) and oxygen mixture. Propofol only lasts minutes so no reason to reverse it. Isoflurane has a very short (<5 minutes) half life and there is no reversing drug. Isoflurane (or the similar Sevoflurane) are used by almost all vets (and people too)
 
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