Dental advice

[Janice & Johnny]

Hi!

Johnny was diagnosed with DB in May 2010 and went off the juice at the end of August. In late November, we found his numbers had creeped up really high and he returned to getting Lantus twice a day. The vet did bloodwork and said everything was normal. They also did a urine culture that was fine.

Some people in LL have suggested that he might need a dental (he's never add one). But, the vet wants him to be 'regulated' before doing the procedure. I'm wondering if this is the standard advice you've heard? I want to keep Johnny safe, but if it's something with his teeth or gums that is causing the return to insulin and higher numbers, can he really be regulated? If so, I feel like we're in a between-a-rock-and-a-hard-place scenario.

I'm wondering what you all think and if you have any experience to share. Any other ideas of what made him need insulin again so soon?

Thanks!
Janice

 

[BJM]

We just had a discussion on feline dental health here

Can you take a look in his mouth? Gently lift up the lip on each side and inspect the teeth and gums. You may see caked on tartar, or red irritation along the gum line. If that is all you see, it may be okay to begin doing the dental home care. If you do begin home dental care, and Johny seems to have pain during this, stop. He needs a vet if his mouth is painful like that.

If you see a tooth which appears to be broken off or receding into the gum line (which can be resorption), those can be very painful, so don't touch those - they definitely need veterinary attention under anesthesia and possibly pain meds if that needs to be post-poned. A painful mouth can interfere with eating, which will make it difficult to manage glucose control.

 

[Blue]

Tell your vet that you want the dental done. For a dentist to say he wants the diabetic patient regulated first is nonsense to me. If the teeth are bad and causing the diabetic upheaval, then fix the teeth!

I had never taken Shadoe for any dental and when her dose was up around 14u, I took her in for a dental. She had 4 iffy teeth and then once Xrayed, it was found that one upper right canine had to go and the others could be OK and just watched for the time being.
After the cleaning and that one tooth pulled, her dose dropped to something like 3u.

Teeth make a difference in BG if there is some bad stuff happening.

So tell your vet to set up the appt for the dental and maybe that's all Johnny needs to get back to the falls.

When the appt is set, there are plenty of people here that can give you tips on dentals.
Here's what I have handy, but others will have more current info if available.
Dental Info
Dental Discussion, including Dr. Lisa link

 

[Ronnie & Luna]

But, the vet wants him to be 'regulated' before doing the procedure

hey Janice, looks like we are both in the same boat...I was told the same thing this past week by our vet.
and no, it makes no sense to me either. I was also told to switch to a Hills dental kibble in the meantime, by the vet tech ohmygod_smile ...hmmm, No.
I've saved your thread in my folder of dental threads by the way. We plan to do ours in February.

 

[Pria & Splodge]

I was also told no dental until regulated. I demanded a dental, but sadly Squidgy was really poorly the day before it was due. I am now booking him in again for early next week!

 

[Blue]

I think I would like the vets to say EXACTLY what they mean by 'regulated'. Put it in black and white because this word regulated gets thrown around alot and I am betting that everyone has a different idea of its meaning.

It's like saying I want your cat to have good numbers. Well, what is good! If you were getting numbers in the 500s, but now are getting consistent low 300s, is that good? If you are getting numbers that are bouncy, but the highest is never over 250 is that good or bad?

If the teeth are bad, you are not going to have much luck with good numbers.

 

[Larry and Kitties]

Typically the vets want BG to be controlled to some degree since there is always a risk with the anesthesia associated with the dental and "uncontrolled" diabetes increased the risk. For example, it the cats is borderline DKA because of the uncontrolled diabetes a dental is sue not in order.

 

[Kathy&Powder]

I am no expert but if FD is all that is wrong then imho it would be best to do it. My cat was dx in Aug had lost half his body weight is 14+ and had his dental done in Oct. Of course it was a risk but anesthesia is always a risk. It is a well known fact that gum disease puts diabetics at risk for some other serious issues. Even healthy cats (& humans)with gum disease can get heart disease. My vet who doesn't support me with Lantus put him on abs for the inflammation first and after. I do think it has helped and it certainly didn't hurt. His vet used propofol not gas. It is short acting and he only had to use enough to keep him under long enough to do it and his full body x-rays. I know its scary but it could really lower his BG. Here is a link another member in LL posted for me it is full of really info and questions to find out. http://www.cathospitalofchicago.com/lib ... vices.html Good luck.

 

[Hillary & Maui (GA)]

Consider going to a board certified dentist. Make sure whatever dentist you use, does xrays - my regular vet does not do xrays and without them, how do you know what is really going on. When you see the dentist, they take xrays right - well it's the same for your animal.

Also, in case your cat has to stay overnight, find out if they have 24 hour care.

All my cats had dentals done this year and each has special needs. I took them to a board certified dentist with 24/7 care. Granted Maui is in remission and not on insulin, so she was easy for them to treat. My Sydney is quite fragile and in early stages of kidney failure and is on an asthma inhaler. I explained this and they kept her overnight before the dental, to give her IV fluids to protect the kidneys. After the dental, the dentist gave her more fluids, again as a precaution. She came out of it just fine.

Since this place now offers to take the animal the night before, I label and brought their food and treats with them and instructions. Telling them not to feed anything other than what I brought. I also brought Sydney's aerokat and inhalers (labeled) and with instructions for use. They called a couple times to make sure they understood those instructions and how to treat.

I would recommend doing the same with your insulin. Even asking them to get BG readings while in their care.

I hope this helps and at a minimum, take your cat to the specialist for a consult/exam to determine if a dental is even necessary. My guess is, it probably is.