Dental Need - Reluctant To "Put Under"

[TheBowHuntress]

My cat needs dental work and he is somewhat newly diagnosed (11/22/12). My vet does not want to "put him under" to perform the dental work, just yet, until he is regulated.

I found the 9/2011 records of Gobbles' dental surgery (rotten tooth) and the vet found/bioposed an ORAL EOSINOPHILIC GRANULOMA on his tongue; she removed it and had it biopsied; it was benign. She explained to me what it was and that it can come back. Since this dental work, he hasn't had any cleanings, etc. Is there a reason for good dental health in (esp.) diabetic cats? His teeth do look like they need a good cleaning... I know that sometimes dental problems are the root of the cause of diabetes, esp. if there is an infection.

During Gobbles' last vet visit (new vet as I had moved away from the vet that did the dental surgery) the vet did peer into his mouth to see if his granuloma came back, didn't see any, but did say sometimes it is extremely hard to find one if it is way at the back of the tongue.

I'd like to know if it is better to (risk) anesthesia for the dental work, or to wait to Gobbles' diabetes regulates and then do the dental work?

Further, Gobbles' hair is thinning and has been since before DX. My vet has run a lot of tests to determine why, and nothing in the bloodwork shows a reason. My vet said that a skin biopsy might be the next step to possibly determine re: hair loss, but he will not put him under for that, though could give him a local as it is painful. He also said it is expensive and that the skin biopsy will stress him out.

Does anyone have thoughts, comments, suggestions, etc. with regard to this post? Much appreciated!

 

[Ry & Scooter]

See that's the thing, regulating might be hard if his teeth are bugging him. Pain, infection, inflammation, etc. can all skew BG. You may find that he is much easier to regulate AFTER his mouth is clean and pain-free.

 

[TheBowHuntress]

But my vet won't put him under because he say's Gobby is a new diabetic and not regulated thus far. He won't even put him under for a skin biopsy (which I'm sure takes less time than a dental).

 

[Sienne and Gabby (GA)]

Dental issues may make it extremely difficult to get a cat regulated. As Ry noted, this is cyclic: the vet doesn't want to anesthetize Gobbles because he's not regulated but because he needs dental work, it's going to make it hard for him to become regulated. Gabby had dental work early in the process of her FD. She wasn't regulated. The other aspect of this is that anesthesia acts to lower BG levels. Most vets tell you to not give insulin the morning of a procedure since numbers can drop into low ranges.

My best advice is to look for a veterinary dentist in your area and arrange for a consultation.

Here's all the info you'll likely need if you are contemplating a dental procedure whether with your vet or a specialist. There's info on how to compare services.

 

[Wendy&Tiggy(GA)]

I have had dentals done on both my diabetic boys when not regulated. My vet said that it could result in them needing less insulin as an infection can cause cortisol to be released and raise their BG.

I think you have a lot of ammo here. Reasons Gobby needs a dental.

1. to clear infection to better control his BG
2. to check better in the mouth for that granuloma and remove it if there
3. to do a skin biopsy (might as well do it at the same time!)

He works for you remember? I think some vets forget that sometimes.

 

[Larry and Kitties]

Being a diabetic, especially an unregulated one, increases the risk of complications from anesthesia.
You can talk to denistry specialist and see if they will do the dental..

 

[Just-As-Appy]

I would also want to ensure that the person handling the anaesthetic is specially trained. I had a board certified anaesthetist handle the procedure for my diabetic cat - worth the extra $$ in my opinion. If your vet is reluctant to do it, I'd be reluctant to have him do it.

 

[Shelly/Boots]

My regulated diabetic cat became unregulated because of a mouth infection. I went to a dental specialist.
My cat is two months away from 17 yrs. old. She is doing great. The specialist will take way less time than a reg. vet
because teeth is all they do. The specialist should be experienced in how to regulate the
anesthesia for an older cat as well.

 

[Sandy and Black Kitty]

Hi there

In BKs case, the state of his teeth and gums made all the difference in the world. It took 2 dentals, 5 months apart.
BK was the last cat I thought would make it to the falls. Have a look at his ss to see the effect it had on his BGs and insulin needs.

The first was 12/08/2008 - 8 extractions. At that time he needed 13u Lantus bid. By Feb 2009 he was down to 3u bid and pink seemed to be a thing of the past.
Then the numbers started creeping up. Pink came back on the scene as did red.
On 05/29/2009 back to the dental specialism he went, this time all that was needed was a cleaning.
And the rest is history.

Prior to his dental, on 10/23/2008, he had a lump on his neck (benign) removed and while he was under for that (a very light anesthesia, because his vet was totally freaked out by his crazy BGs). While he was under she got a good look into his mouth and removed what was left of a rotten tooth. She recommended a dental specialist as his mouth was beyond what she was comfortable handling.

Most vets are reluctant to place a diabetic cat on insulin under. There is a risk anytime there is anesthesia. Like Sienne said, look for a veterinary dentist in your area and arrange for a consultation. A good veterinary dental specialist makes all the difference.

Also, there is no way to know whats going on in a cats mouth, beneath the gum-line (where all the trouble could be) unless the cat is under.
No way. Period.

After those 2 initial dentals, his regular vet was able to take it from there. He has had a dental pretty much each year since, the last one was this past June.
And that really was the last dental - he is now toothless (although still able to shred paper towels)

This has been our experience. ECID as we say.